Studies on architects’ attitudes towards the use of EWPs for construction.
\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"Milestone",originalUrl:"/media/original/124"}},components:[{type:"htmlEditorComponent",content:'
Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"},{slug:"intechopen-identified-as-one-of-the-most-significant-contributor-to-oa-book-growth-in-doab-20210809",title:"IntechOpen Identified as One of the Most Significant Contributors to OA Book Growth in DOAB"}]},book:{item:{type:"book",id:"9867",leadTitle:null,fullTitle:"Composite Materials",title:"Composite Materials",subtitle:null,reviewType:"peer-reviewed",abstract:"This book presents information about composite materials, which have a variety of applications in engineering and aeronautics, transportation, construction, sports, and recreational activities, and so on. The first section evaluates the thermal and mechanical properties of thermoplastic and thermoset polymers reinforced with particles and fibers. The second section discusses new 2D composites such as thin films for their conductivity and shielding properties. In discussing the different materials, Composite Materials include information on the design of the materials, their structure, and their preparation methods.",isbn:"978-1-83962-740-8",printIsbn:"978-1-78984-787-1",pdfIsbn:"978-1-83962-741-5",doi:"10.5772/intechopen.87676",price:119,priceEur:129,priceUsd:155,slug:"composite-materials",numberOfPages:186,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"30cffe429a772008121d9ec81db6224a",bookSignature:"Mohammad Asaduzzaman Chowdhury, José Luis Rivera Armenta, Mohammed Muzibur Rahman, Abdullah Asiri and Inamuddin",publishedDate:"March 17th 2021",coverURL:"https://cdn.intechopen.com/books/images_new/9867.jpg",numberOfDownloads:3992,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:1,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:1,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 16th 2019",dateEndSecondStepPublish:"March 10th 2020",dateEndThirdStepPublish:"May 9th 2020",dateEndFourthStepPublish:"July 28th 2020",dateEndFifthStepPublish:"September 26th 2020",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"185329",title:"Prof.",name:"Mohammad Asaduzzaman",middleName:null,surname:"Chowdhury",slug:"mohammad-asaduzzaman-chowdhury",fullName:"Mohammad Asaduzzaman Chowdhury",profilePictureURL:"https://mts.intechopen.com/storage/users/185329/images/system/185329.jpg",biography:"Mohammad Asaduzzaman Chowdhury is a professor of Mechanical Engineering at Dhaka University of Engineering and Technology (DUET), Gazipur, Bangladesh. His research interests are Engineering Tribology, Surface Engineering, Automation and Robotics, Coating Technology, Polymer and Composite Materials, Characterization of Materials. He is working as an Editorial Board Member of large number of International Reputed Journals. Currently, he is working as an editor, reviewer of many ISI and Scopus Indexed International Journals and books. He has also published many research and review papers in refereed International Journals and Conference Proceedings. He is working as a consultant, advisor and expert member of many government and autonomous organizations. His teaching & research experience about 21 years. He is involved himself with different cultural and social activities. He has engaged himself to write the articles, stories, lyrics and poems in different newspapers and relevant media.",institutionString:"Dhaka University of Engineering and Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"Dhaka University of Engineering & Technology",institutionURL:null,country:{name:"Bangladesh"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"107855",title:"Dr.",name:"Jose Luis",middleName:null,surname:"Rivera Armenta",slug:"jose-luis-rivera-armenta",fullName:"Jose Luis Rivera Armenta",profilePictureURL:"https://mts.intechopen.com/storage/users/107855/images/system/107855.png",biography:"José Luis Rivera-Armenta has a BSc in Chemical Engineering, an MSc in Petroleum Technology and Petrochemicals, and a Ph.D. in Chemical Engineering, all from the Technological Institute of Madero City (ITCM), Mexico. Since 2003, he has been a full-time professor in postgraduate programs at ITCM and head of the thermal analysis, injection, and extrusion laboratory. He has been responsible for several research projects sponsored by Consejo Nacional de Ciencia y Tecnología (CONACYT) and the National Technological Institute of Mexico (TecNM). He has advised ten Ph.D., seventeen master’s degrees, and five bachelor’s degree theses. He has published fifty-five scientific articles, five book chapters, and has edited three books and one special issue journal.",institutionString:"National Technological Institute of Mexico",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"National Technological Institute of Mexico",institutionURL:null,country:{name:"Mexico"}}},coeditorTwo:{id:"24438",title:"Prof.",name:"Mohammed Muzibur",middleName:null,surname:"Rahman",slug:"mohammed-muzibur-rahman",fullName:"Mohammed Muzibur Rahman",profilePictureURL:"https://mts.intechopen.com/storage/users/24438/images/system/24438.jpg",biography:"Prof. Mohammed Muzibur Rahman received his BSc and MSc from Shahjalal University of Science & Technology, Sylhet, Bangladesh, in 1999 and 2001, respectively. He received his Ph.D. from Chonbuk National University, South Korea, in 2007. He worked as a postdoctoral fellow and assistant professor in pioneering research centers and universities located in South Korea, Japan, and Saudi Arabia. Presently, he is an associate professor at the Center of Excellence for Advanced Materials Research (CEAMR) and Chemistry Department, King Abdulaziz University, Jeddah, Saudi Arabia. He has published more than 245 international and domestic conferences and several book chapters. He has also edited ten books. His research interests include photocatalysis, semiconductors, nanoparticles, carbon nanotubes, nanotechnology, electrocatalysis, sensors, ionic liquids, surface chemistry, electrochemistry, and nanomaterials.",institutionString:"King Abdulaziz University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"8",totalChapterViews:"0",totalEditedBooks:"11",institution:{name:"King Abdulaziz University",institutionURL:null,country:{name:"Saudi Arabia"}}},coeditorThree:{id:"198266",title:"Dr.",name:"Abdullah Mohammed",middleName:"Ahmed",surname:"Asiri",slug:"abdullah-mohammed-asiri",fullName:"Abdullah Mohammed Asiri",profilePictureURL:"https://mts.intechopen.com/storage/users/198266/images/system/198266.png",biography:"Prof. Abdullah Mohammed Ahmed Asiri is a professor and chairman of the Chemistry Department, King Abdulaziz University, Jeddah, Saudi Arabia. He is also the director of the university’s Center of Excellence for Advanced Materials Research (CEAMR). He obtained a Ph.D. in tribochromic compounds and their applications from the University of Wales College, Cardiff, UK, in 1995. He is the director of the Education Affair Unit–Deanship of Community Services. Dr. Asiri is a member of the advisory committee for advancing materials, National Technology Plan, King Abdul Aziz City of Science and Technology, Riyadh, Saudi Arabia. He is an editorial board member of the Journal of Saudi Chemical Society, Journal of King Abdul Aziz University, Pigment and Resin Technology Journal, Organic Chemistry Insights, Libertas Academica, and Recent Patents on Materials Science. Dr. Asiri holds membership in several national and international societies and professional bodies.",institutionString:"King Abdulaziz University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"King Abdulaziz University",institutionURL:null,country:{name:"Saudi Arabia"}}},coeditorFour:{id:"289905",title:"Dr.",name:null,middleName:null,surname:"Inamuddin",slug:"inamuddin",fullName:"Inamuddin",profilePictureURL:"https://mts.intechopen.com/storage/users/289905/images/system/289905.jpeg",biography:"Dr. Inamuddin is currently an assistant professor in the Chemistry Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia. He has extensive research experience in multidisciplinary fields of analytical chemistry, materials chemistry, and electrochemistry, and, more specifically, renewable energy and the environment. He has published 127 research articles in international journals of repute and eighteen chapters in books published by renowned international publishers. He has also edited thirty-nine books. Dr. Inamuddin is a member of various journal editorial boards and is an associate editor for journals such as Environmental Chemistry Letter, Applied Water Science, Euro-Mediterranean Journal for Environmental Integration, and Springer-Nature. He is also an editor for the Eurasian Journal of Analytical Chemistry.",institutionString:"King Abdulaziz University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"King Abdulaziz University",institutionURL:null,country:{name:"Saudi Arabia"}}},coeditorFive:null,topics:[{id:"156",title:"Composite Materials",slug:"materials-science-composite-materials"}],chapters:[{id:"72738",title:"The Role of Novel Composite of 2D Materials and Their Characterization, Properties, and Potential Applications in Different Fields",doi:"10.5772/intechopen.92707",slug:"the-role-of-novel-composite-of-2d-materials-and-their-characterization-properties-and-potential-appl",totalDownloads:516,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Thin layers or coating of transition metal dichalcogenides (TMDs) is a new class of two-dimensional (2D) inorganic materials with unique physical and chemical properties. This book chapter covers the recent research of thin film of 2D materials using various novel technologies to synthesize and grow monolayer 2D materials on different substrates in different fields based on the knowledge available in the literature. Thin film on substrate can be enhanced with the favorable properties. Therefore, selection of methods can play a key role in characterizing the coating. The novel coating processes on composite materials and their characterization, properties, and process and potential applications also have been discussed. The 2D materials that have been investigated created a thin film through different methods and were used to serve different biomedical purposes such as modifying drug release, improving energy efficiency and storing energy, catalysts, and so an.",signatures:"Zahra Sayyar and Zahra Jamshidi",downloadPdfUrl:"/chapter/pdf-download/72738",previewPdfUrl:"/chapter/pdf-preview/72738",authors:[{id:"314656",title:"Dr.",name:"Zahra",surname:"Sayyar",slug:"zahra-sayyar",fullName:"Zahra Sayyar"},{id:"317659",title:"Mrs.",name:"Zahra",surname:"Jamshidi",slug:"zahra-jamshidi",fullName:"Zahra Jamshidi"}],corrections:null},{id:"73084",title:"Thermal and Mechanical Properties of Polypropylene Polymer Nanocomposites Infused with Sonochemically Coated SiC/SiO2 Nanoparticles",doi:"10.5772/intechopen.93498",slug:"thermal-and-mechanical-properties-of-polypropylene-polymer-nanocomposites-infused-with-sonochemicall",totalDownloads:458,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter describes the coating of silicon carbide nanoparticles on different types of silicon dioxide that varied in size and shape using sonochemical method. These composite particles were further infused into polypropylene polymer to increase its thermal and mechanical properties for various applications. A two-step process was used to fabricate SiC/SiO2/polypropylene nanocomposites. In the first step, SiC nanoparticles were coated onto four different types of SiO2 nanoparticles. The coated nanoparticles were then characterized using a high resolution transmission electron microscope (TEM), X-ray diffraction (XRD) determined the morphology and crystalline structure, and X-ray photoelectron spectroscopy (XPS). These results showed that the nanoparticles were crystalline, spherical in shape, and were uniformly coated. In the second step, nanocomposite samples were extruded using a Wayne Yellow Label Top single screw extruder. The as prepared nanocomposite samples were then characterized for their thermal and mechanical properties. These properties show increase in their flexural strength and thermal degradation. These results show increase in mechanical properties. The importance of this work lies in the simple sonochemical synthesis of SiC/SiO2 hybrid nanomaterials and their filler applications in polypropylene polymer nanocomposites which are widely used for various application including automotive and electronic industries.",signatures:"Vijaya Rangari and James Davis",downloadPdfUrl:"/chapter/pdf-download/73084",previewPdfUrl:"/chapter/pdf-preview/73084",authors:[{id:"318463",title:"Dr.",name:"Vijay",surname:"Rangari",slug:"vijay-rangari",fullName:"Vijay Rangari"},{id:"324127",title:"MSc.",name:"James",surname:"Davis",slug:"james-davis",fullName:"James Davis"}],corrections:null},{id:"71600",title:"Advanced Polypropylene and Composites with Polypropylene with Applications in Modern Medicine",doi:"10.5772/intechopen.91783",slug:"advanced-polypropylene-and-composites-with-polypropylene-with-applications-in-modern-medicine",totalDownloads:623,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Synthetic polypropylene (PP) is used extensively in many fields of medicine. On the one hand, it is utilized in the manufacture of medical equipment: syringes, storage, transport, electric cables, etc. On the other hand, synthetic, nonabsorbable isotactic PP (iPP) is often used to perform meshes for hernia and pelvic organ repair operations, as well as in urinary incontinence. Products that release in time from meshes are depending on the conditions in which they are utilized, can produce undesirable reactions for the human body. For this reason, nonabsorbable synthetic PP was replaced in surgical sutures and meshes with bio polypropylene (bio PP). The chapter analyzes the specific characteristics of these polymers as well as their degradation due to the influence of different factors: humidity, perspiration, temperature, and presence of bacteria. Obtaining new composite materials with PP as matrix and metal powders as fillers is considered as a possibility of their use in vital problems such as cancer detection and treatment. These allow the emergence of new strategies in the design of biosensors that use nanocomposite materials with different fillers and polymeric films. The chapter analyzes the characteristics of new composite materials with PP matrix and metallic powders of iron (Fe).",signatures:"Doina Elena Gavrila, Victor Stoian, Alina Caramitu and Sorina Mitrea",downloadPdfUrl:"/chapter/pdf-download/71600",previewPdfUrl:"/chapter/pdf-preview/71600",authors:[{id:"313022",title:"Dr.",name:"Doina Elena",surname:"Gavrila",slug:"doina-elena-gavrila",fullName:"Doina Elena Gavrila"},{id:"313027",title:"Dr.",name:"Victor",surname:"Stoian",slug:"victor-stoian",fullName:"Victor Stoian"},{id:"316823",title:"Dr.",name:"Alina",surname:"Caramitu",slug:"alina-caramitu",fullName:"Alina Caramitu"},{id:"316825",title:"Dr.",name:"Sorina",surname:"Mitrea",slug:"sorina-mitrea",fullName:"Sorina Mitrea"}],corrections:null},{id:"73268",title:"Synthesis and Characterization of PANI and Block Copolymer PANI-b-PEO Catalyzed by Maghnite (AlgerianMMT): Electrical and Electronic Domain",doi:"10.5772/intechopen.93342",slug:"synthesis-and-characterization-of-pani-and-block-copolymer-pani-b-peo-catalyzed-by-maghnite-algerian",totalDownloads:383,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Polyaniline (PANI) and its block copolymer (PANI-PEO2000) has been prepared under effect of Maghnite-H+ (Algerian MMT) in different weight percentage (wt %) by cationic polymerization method. The structure of PANI and PANI-PEO2000 is predicted by the FT-IR and 1HNMR spectra. The thermal stability of homopolymer and block copolymer is confirmed by difference scanning calorimetry and analysis thermogravimetry. So after this results we can suggest that our heterogeneous catalyst called maghnite (Algerian MMT) can modified the morphology and the physical chemical properties of polyaniline (PANI) and its homolog block polyaniline-b-poly ethylene oxide (PANI-b-PEO2000) in the mild conditions under microwave irradiation.",signatures:"Abdelkader Rahmouni, Fatima Zohra Zeggai, Mohammed Belbachir, Bachari Khaldoun and Redouane Chebout",downloadPdfUrl:"/chapter/pdf-download/73268",previewPdfUrl:"/chapter/pdf-preview/73268",authors:[{id:"254801",title:"Dr.",name:"Rahmouni",surname:"Abdelkader",slug:"rahmouni-abdelkader",fullName:"Rahmouni Abdelkader"},{id:"260927",title:"Prof.",name:"Mohammed",surname:"Belbachir",slug:"mohammed-belbachir",fullName:"Mohammed Belbachir"},{id:"321194",title:"Dr.",name:"Fatima Zohra",surname:"Zeggai",slug:"fatima-zohra-zeggai",fullName:"Fatima Zohra Zeggai"},{id:"321195",title:"Dr.",name:"Bachari",surname:"Khaldoun",slug:"bachari-khaldoun",fullName:"Bachari Khaldoun"},{id:"321196",title:"Dr.",name:"Redouane",surname:"Chebout",slug:"redouane-chebout",fullName:"Redouane Chebout"}],corrections:null},{id:"70301",title:"The Effect of Temperature on the Mechanical Performance of Steel and Carbon Fiber Reinforced Polymer (CFRP) Tensegrity System",doi:"10.5772/intechopen.90010",slug:"the-effect-of-temperature-on-the-mechanical-performance-of-steel-and-carbon-fiber-reinforced-polymer",totalDownloads:470,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This paper compares the behavioral pattern of steel and carbon fiber reinforced polymer tensegrity system in a suspen-dome that has a span of 4-m span and a 0.4-m, using the finite element method software – namely ANSYS – to undertake the analysis at various temperature regimes. These comparisons were undertaken in order to validate the performance of carbon fiber reinforced polymer cables. Under cold and hot temperatures, the elastic modulus usually reduces as a result of changes in molecular structure. Previous analysis has shown that carbon fiber reinforced polymer cables are able to resist cold and hot temperatures more than steel cables do as the integrity of steel system begins to deform at high temperatures. However, with their low thermal expansion and esthetic properties, carbon fiber reinforced polymer cables can provide structural stability for a tensegrity system in a suspen dome in regions with high temperature conditions.",signatures:"IfeOlorun Olofin and Ronggui Liu",downloadPdfUrl:"/chapter/pdf-download/70301",previewPdfUrl:"/chapter/pdf-preview/70301",authors:[{id:"310693",title:"Dr.",name:"IfeOlorun",surname:"Olofin",slug:"ifeolorun-olofin",fullName:"IfeOlorun Olofin"},{id:"310695",title:"Prof.",name:"Ronggui",surname:"Liu",slug:"ronggui-liu",fullName:"Ronggui Liu"}],corrections:null},{id:"70798",title:"Thick-Section Epoxy Composites",doi:"10.5772/intechopen.90834",slug:"thick-section-epoxy-composites",totalDownloads:306,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Thick-section composites (TSC) are extensively demanded in many fields, such as aerospace, wind energy, and oil and gas industries. However, the manufacturing process of thick-section thermoset composites (TSSC) encounters significant complexities, such as variations of nonuniform resin flow, exothermal reaction and curing, and dimensional stability through the thickness direction. These process-related nonuniformities are expected to result in through-thickness gradients of mechanical properties and curing-induced deformations, leading to undesirable residual stresses and damage. This chapter introduces the application of TSC and issues related to its manufacturing processes. Methods of TSC are examined and analyzed. Fundamental characteristics of curing kinetics, thermal transfer, and residual stress in TSC will be explained. Research of detailed experiments will be referred for readers for further studies.",signatures:"Yanan Hou, Liguo Li and Joseph H. Koo",downloadPdfUrl:"/chapter/pdf-download/70798",previewPdfUrl:"/chapter/pdf-preview/70798",authors:[{id:"228959",title:"Prof.",name:"Joseph",surname:"Koo",slug:"joseph-koo",fullName:"Joseph Koo"},{id:"230298",title:"Ms.",name:"Yanan",surname:"Hou",slug:"yanan-hou",fullName:"Yanan Hou"},{id:"310289",title:"Mr.",name:"Liguo",surname:"Li",slug:"liguo-li",fullName:"Liguo Li"}],corrections:null},{id:"72569",title:"Study of Composite Structures Based on a Porous Silicon Matrix and Nanoparticles Ag/Zno Used as Non-Invasive Highly Sensitive Biosensor Devices",doi:"10.5772/intechopen.92850",slug:"study-of-composite-structures-based-on-a-porous-silicon-matrix-and-nanoparticles-ag-zno-used-as-non-",totalDownloads:321,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In this work composite structures based on a porous silicon were obtained and studied. Porous matrices were formed by electrochemical etching in aqueous solutions of hydrofluoric acid. Based on the obtained substrates, por-silicon (Si)/silver (Ag) and por-Si/zinc oxide (ZnO) composite structures were formed. These composites were functionalized by various methods (electro (E)-, thermo (T)-, electrothermal exposure) as a result of which the structures were modified. When studying the samples by scanning electron microscopy (SEM), it was concluded that silver nanoparticles actively diffused into the pores under these technological modes of functionalization. The por-Si/Ag and por-Si/ZnO composite structures were also studied using the following methods: infrared (IR) spectroscopy and Raman ultrasoft X-ray emission spectroscopy. Also, the photoluminescent characteristics of the samples were studied. Based on the obtained results, it was concluded that functionalization methods actively change the phase composition of structures and the optical properties of composites.",signatures:"Veniamin Koshevoi, Anton Belorus, Ilya Pleshanov, Anton Timchenko, Roman Denisenko, Daniyar Sherimov and Ekaterina Vodkailo",downloadPdfUrl:"/chapter/pdf-download/72569",previewPdfUrl:"/chapter/pdf-preview/72569",authors:[{id:"318404",title:"Ph.D. Student",name:"Veniamin",surname:"Koshevoi",slug:"veniamin-koshevoi",fullName:"Veniamin Koshevoi"},{id:"320281",title:"Mr.",name:"Anton",surname:"Belorus",slug:"anton-belorus",fullName:"Anton Belorus"},{id:"321164",title:"Mr.",name:"Ilya",surname:"Pleshanov",slug:"ilya-pleshanov",fullName:"Ilya Pleshanov"},{id:"321165",title:"Ph.D. Student",name:"Anton",surname:"Timchenko",slug:"anton-timchenko",fullName:"Anton Timchenko"},{id:"321166",title:"Mr.",name:"Roman",surname:"Denisenko",slug:"roman-denisenko",fullName:"Roman Denisenko"},{id:"321169",title:"Ms.",name:"Ekaterina",surname:"Vodkailo",slug:"ekaterina-vodkailo",fullName:"Ekaterina Vodkailo"},{id:"321170",title:"Mr.",name:"Daniyar",surname:"Sherimov",slug:"daniyar-sherimov",fullName:"Daniyar Sherimov"}],corrections:null},{id:"72860",title:"Investigation of Shielding Effectiveness of M-Type Ba-Co-Ti Hexagonal Ferrite and Composite Materials in Microwave X-Band Systems",doi:"10.5772/intechopen.91204",slug:"investigation-of-shielding-effectiveness-of-m-type-ba-co-ti-hexagonal-ferrite-and-composite-material",totalDownloads:590,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Ferrites are a wide class of materials that are still a very rich field of scientific interest and under the scope of recent research. The polycrystalline Co2+-Ti4+ substituted Ba hexagonal ferrite has been synthesized by the standard ceramic method. The vector network analyzer has been incorporated to measure different microwave parameters at X-band (8.2–12.4 GHz) frequencies. The microwave shielding effectiveness is evaluated by S-parameters for near field and AC conductivity as well as skin depth for far field. The doping of Co2+ and Ti4+ ions causes absorption in composite x = 0.5 to exhibit good shielding effectiveness and it exhibits large 20-dB bandwidth of 4.70 GHz in the near field and 3.60 GHz for far field respectively. The AC conductivity increases with frequency in composites x = 0.1, 0.3, and 0.5 and skin depth decreases with frequency in all composites. The shielding effectiveness, AC conductivity, and skin depth are correlated to each other.",signatures:"Charanjeet Singh, S. Bindra Narang and Ihab A. Abdel-Latif",downloadPdfUrl:"/chapter/pdf-download/72860",previewPdfUrl:"/chapter/pdf-preview/72860",authors:[{id:"188441",title:"Prof.",name:"Sukhleen Bindra",surname:"Narang",slug:"sukhleen-bindra-narang",fullName:"Sukhleen Bindra Narang"},{id:"248894",title:"Dr.",name:"Ihab",surname:"Abdel-Latif",slug:"ihab-abdel-latif",fullName:"Ihab Abdel-Latif"},{id:"312065",title:"Dr.",name:"Charanjeet",surname:"Singh",slug:"charanjeet-singh",fullName:"Charanjeet Singh"}],corrections:null},{id:"73205",title:"A New Boundary Element Formulation for Modeling and Optimization of Three-Temperature Nonlinear Generalized Magneto-Thermoelastic Problems of FGA Composite Microstructures",doi:"10.5772/intechopen.93515",slug:"a-new-boundary-element-formulation-for-modeling-and-optimization-of-three-temperature-nonlinear-gene",totalDownloads:326,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The main purpose of this chapter is to propose a new boundary element formulation for the modeling and optimization of three-temperature nonlinear generalized magneto-thermoelastic functionally graded anisotropic (FGA) composite microstructures’ problems, which is the gap of this study. Numerical results show that anisotropy and the functionally graded material have great influences on the nonlinear displacement sensitivities and nonlinear thermal stress sensitivities of composite microstructure optimization problem. Since, there are no available data for comparison, except for the problems with one-temperature heat conduction model, we considered the special case of our general study based on replacing three-temperature radiative heat conductions with one-temperature heat conduction. In the considered special case, numerical results demonstrate the validity and accuracy of the proposed technique. In order to solve the optimization problem, the method of moving asymptotes (MMA) based on the bi-evolutionary structural optimization method (BESO) has been implemented. A new class of composite microstructures problems with holes or inclusions was studied. The two-phase magneto-thermoelastic composite microstructure which is studied in this chapter consists of two different FGA materials. 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Discovery of stem cells by James Till and Ernest McCulloch in 1961, stands as one of the most remarkable medical-research achievements of the 20th century. This discovery provided a foundation for further breakthroughs in the field of stem cells. Sir Martin J. Evans along with Mario R. Capecchi, and Oliver Smithies were jointly awarded a Nobel Prize in 2007 for their contribution in introducing specific gene modifications in mice by the use of embryonic stem cells. Later in 2012, John B. Gurdon and Shinya Yamanaka were also jointly awarded a Nobel Prize for discovering that mature cells can be reprogrammed to become pluripotent cells. [1]
Ramon y Cajal in 1926 stated “Once the development was ended, the founts of growth and regeneration of the axons and dendrites dried up irrevocably. In the adult centers, the nerve paths are something fixed, ended, and immutable. Everything may die, nothing may be regenerated. It is for the science of the future to change, if possible, this harsh decree.” [2]. It was a long-standing belief that cells of the central nervous system once damaged cannot be regenerated. The medical science of stem cells has finally made restoration of CNS possible which has changed the old concept of medicine. Not too long ago, this therapy was hamstrung by various controversies, ethical and moral issues. But, tremendous progress of research in this field has finally led to its translation from laboratory to innovative cellular therapies.
A variety of cells including embryonic stem cells, adult stem cells, umbilical cord blood cells and induced pluripotent stem cells have been explored as a therapeutic alternative for treating a broad spectrum of neurologic disorders including stroke, Alzheimer’s, Parkinson’s, spinal cord injury, cerebral palsy etc. amongst others. It is essential to select suitable cells depending on the nature and status of neurological dysfunctions to achieve optimal therapeutic efficacy. Along with the selection of cells, the route of administration also plays an important role to maximize the clinical therapeutic effect of the cell therapy. Numerous preclinical studies have been carried out to study the safety of intrathecal, intravenous and direct cerebral implantation. A plethora of published literature is also available to provide evidence of stem cells initiating functional restoration of CNS. The postulated mechanisms of action involved are neuromodulation, neuroprotection, axon sprouting, neural circuit reconstruction, neurogenesis, neuroregeneration, neurorepair, and neuroreplacement.
In view of the fact that stem cell therapy has a promising therapeutic potential in the treatment of neurological disorders, it is important for all the professionals in the medical field to understand the concepts of this upcoming therapeutic strategy.
In this chapter, we have focused on stem cell therapy for Cerebral Palsy (CP) which is a heterogeneous group of neurological disorders mainly observed in infants. It results due to a static brain lesion at the time of pregnancy or early life. The survival of CP children has increased due to advanced modern medicine which has led to their growing population. CP involves impairment of movement, muscle function, and cognitive functioning and the effects range from mild to severe. [3] Chronic motor disability along with intellectual disability, epilepsy, behavioral disorders, and sensory and perceptual disturbances are few of the complications seen in these patients. No biological intervention has been effective for CP and the standard approach is limited to supportive management strategies which do not address the core issue of neural tissue damage. Currently, stem cell based strategies have garnered attention due to their ability of neuroregeneration and neuroprotection in CP.
We have discussed the clinical aspects of stem cell therapy in cerebral palsy supported by various human case studies and clinical trials. We have also enumerated our experience and results wherein our subjects were administered autologous bone marrow mononuclear cells. In our study it was found to be safe, feasible and efficacious and may be used as a combinatorial strategy with the currently available standard treatments.
Here, we try to summarize the current vast knowledge available for stem cell therapy in cerebral palsy.
Stem cells are defined as “cells that have the ability to renew them continuously and possess pluripotent or multipotent ability to differentiate into many cell types.” [4]These cells exhibit a unique property of “plasticity” where in cells isolated from one tissue convert to cells of different tissues by crossing lineage barriers and adopting the expression profile and phenotype of cells that are unique to other tissues. [5]
Stem cells are categorized based on their potential to differentiate into other types of cells.
Totipotent cells: These cells have the ability to differentiate into all possible cell types of the human body including extra embryonic and placental cells.
Pluripotent cells: These cells have ability to differentiate into any of the three germ layers viz. endoderm, mesoderm and ectoderm.
Multipotent cells: These cells have the ability to differentiate into specialized cells.
Oligopotent cells: These cells have the ability to differentiate into a few cell types.
Unipotent cells: These cells have the ability to produce cells only of their own type, but are capable of self-renewal to be classified as a stem cell.
Stem cells are broadly classified based on their source, as follows:
Amount of stem cells found in the cord blood is 10% less than that obtained from the bone marrow. [14] There are some reports of associated Herpes virus and JC virus infection by allogeneic UCBCs transplantation [15,16]
Bone marrow is a proficient source of autologous cells with distinct regenerative properties, which can be quickly harvested and are thus applicable for both chronic and acute diseases. Cells isolated from the bone marrow not only differentiate into blood cells but also into neural tissues. [20] The mononuclear cell fraction derived from the bone marrow is a heterogeneous population containing differentially matured B-cells, T-cells and monocytes, as well as rare progenitor cells such as hematopoietic stem cells (HSC), mesenchymal stromal cells (MSC), endothelial progenitor cells (EPC) and very small embryonic-like cells (VSEL). The hematopoietic stem cells (HSCs) are the blood cells which give rise to the myeloid and lymphoid lineages. HSCs also have a potential to transdifferentiate into various nonhematopoietic cell lineages especially neural lineage. [21] [Figure1] Bone marrow mesenchymal stem cells (BMMSCs) give rise to mesodermal lineage cells such as osteoblasts, chondrocytes, adipocytes, and muscle cells along with neuroectodermal cells. [22] BMMSCs express a unique surface molecule profile, including expression of CD13, CD29, CD44, CD49e, CD73, CD90, CD105, CD146, CD166, CD271, STRO-1, Octamer-4 (Oct4), and stage-specific embryonic antigen-4 (SSEA4). It is generally believed that BMMSCs are negative for hematopoietic cell markers such as CD14, CD34, c-kit, SCA1. [23]
It has been observed that use of cell mixture is more efficacious than individual sub fractionated cells of the bone marrow. They promote angiogenesis, mediate vascular repair, and express several cytoprotective growth factors and cytokines. These cells are also safe and due to its easy availability they are most preferred for cellular therapy. These cells are used for the treatment of various neurological disorders such as cerebral palsy, stroke, Parkinson’s, Spinal cord injury, etc. along with diabetes, orthopedic conditions, cancers and wound healing. [24,25]
In brain injury, stem cells induce neuroprotection and neural repair by inflammatory suppression, causing tissue reconstruction of completely or partially damaged cells and prevent cell death. [26] On administration, these cells migrate to the injured tissue and initiate host repair and recovery through direct and indirect cell-cell signaling. [27]The safety of use of bone marrow derived cells has been well established as they have an autologous origin and do not result in tumor formation.
Bone marrow stem cells
The appropriate route of cell administration is essential prerequisite for the success of cellular therapy. For the treatment of cerebral palsy, cells are injected via various routes such as intrathecal, intravenous and intracerebral.
This procedure needs to be done under aseptic condition to avoid any sort of infections. In case of cerebral palsy, it is considered to be the safe, feasible and efficacious route of administration. In cerebral palsy, studies have shown that this route of administration results in positive functional outcomes. [37]
To understand the mechanism of action of stem cells in the treatment of cerebral palsy, it is important to understand the empirical neuropathophysiology. In spite of the vast and varied etiology; underlying cellular mechanisms, that cause the morbidity or mortality associated with cerebral palsy, are tissue damage caused by hypoxia and ischemia. The clinical manifestations of this cellular damage, depends on a range of factors including the time of insult, the severity of insult and cause of the insult. Brain tissue is heterogeneous and responds differently to hypoxia and ischemia. Therefore, a certain type of brain tissue is implicated to cause cerebral palsy. Recent preclinical, immunohistochemical and imaging evidence suggests periventricular white matter injury (PWMI), particularly damage to oligodendrocytes (OLs) as a primary cause of cerebral palsy [40,41,42]. PWMI is a spectrum ranging from cystic focal necrotic lesions, periventricular leuckomalacia (PVL) to specific cortical scarring in the deep regions of sulci, Ulegyria to diffuse myelination disturbances. Oligodendrocyte progenitors are abundantly present in the subventricular and periventricualr zones, therefore damage to these cells is seen as PVL in neuroimaging investigations. The extent of the damage to the white matter and its consequences are dependent on the developmental stage at which the damage occurred, brain vascularization and the type of tissue[43].
Phases of Oligodendrocyte development
Vascularization of the brain begins as early as 28th day of gestation with the formation of carotid arteries, followed by the large arteries, their branches, communicating arteries, long penetrating arteries and ends with the formation of short penetrating arteries in the post term period. Damage at pre term leads to focal cystic necrosis in the vascular end zones of the long penetrating arteries causing PVL, damage at term leads to tissue injury at the border zones of the long and short penetrating arteries giving rise to Ulegyria and damage at post term leads to diffuse myelination disturbances caused at the vascular end zones of short penetrating arteries [44]. Subsequently most vulnerable cells, precursors of Oligodendrocytes (OLs), undergo necrosis through apoptosis. This leads to myelination disturbances. Oligodendrocytes evolve through an established lineage of OL progenitors to pre OLs to immature OLs to mature OLs. [Figure 2] Hypoxic ischemia as observed in cerebral palsy leads to death of pre OLs and subsequent deficiency of mature OLs and myelination. Other cell types and mechanisms that contribute to pathophysiology of CP are axonal damage and microglial activation [45]. Following this primary insult to the nervous tissue, activation of glial cells leads to secretion of various chemical mediators of tissue necrosis in the neural microenvironment, leading to secondary white matter injury. These mediators are Reactive oxygen and nitrogen species, glutamates, adenosine and inflammatory cytokines like Tumor necrosis factor alpha (TNF-α), interferon gamma (INF-γ), Interleukin -1 beta (IL-1β) and superoxide radicals [46].
Cellular therapy regulates all of the above cellular mechanisms. Neuroplasticity of the brain is maximal during childhood. Hence, stem cell intervention is more successful in these children as the integration of new cells in the brain to carry out the repair process is more effective [47]. Stem cell possess the capacity to home onto the injured sites of brain, as guided by chemo attractant pathway [48]. The effects of cellular therapy are twofold, enhancing the brain tissue repair caused by various paracrine mechanisms and regeneration of neural tissue. Stem cells help in modifying the microglial response by exhibiting immunomodulatory, neurotrophic properties and enhance axonal sprouting. Various neurotrophic factors secreted by the stem cells are connective tissue growth factor, fibroblast growth factor 2 and 7 that are responsible for cell proliferation, interleukins responsible for cytoprotection [49,50,51]. Stem cell therapy restores lost myelin by replacing dead cells with new oligodendrocytes and their progenitors. Indirectly, it may also support their survival by introducing other cell types able to restore missing enzymes to an otherwise deficient environment [47]. Stem cell therapy also has an anti-inflammatory effect on the neural microenvironment as they reduce the levels of TNF-α,IL-1β, IL-1α, IL-6 and increased levels of IL-10 [52]; therefore, enhancing the endogenous brain repair. Stem cells also secret various growth factors like vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), brain fibroblast growth factor (bFGF). These growth factors initiate neoangiogenesis and induce secretion of hormones like erythropoietin. The cascade events triggered due to these lead to formation of new vessels as well increased bold flow. Improved blood circulation of the brain thus helps retrieving the lost tissue functions [50].
Several preclinical experiments on animal models of cerebral palsy have been carried out to demonstrate the potential of cell transplantation to minimize damage and promote recovery. However, limited clinical trials have been initiated to study the effect cell therapy in humans.
Human umbilical cord blood cells (hUCBCs) have been explored to a great extent in cerebral palsy. hUCBCs have been administered in rat models of neonatal hypoxia/ ischemia. They protect the mature neurons in the neocortex from injury, bring about near-normalization of brain damage in the subventricular zone (SVZ) leading to significant improvement in behavioral functions. The long lasting effect of these cells is due to the paracrine effects of hUCBCs which stimulate recovery in the injured brain and protect against further brain damage. [53] On transplantation, hUCBCs have shown to ameliorate neurological and motor deficits in CP model by reducing the levels of pro-inflammatory cytokines (Interleukin-1α (IL-1α), Interleukin-1β (IL-1β), and Tumor necrosis factor α (TNFα) ) [54,55]
They also alleviate spastic paresis in neonatal rat models resulting in normal walking [56] Studies have also shown that these cells promote neural stem cell proliferation via Sonic hedgehog (Shh) signaling pathway improving the brain damage. [57] Human umbilical cord blood (hUCB) cells have also shown to reduce sensorimotor deficits after hypoxic ischemic brain injury in neonatal rats. The dimensions of cortical maps and receptive fields, which are significantly altered after injury, are largely restored. Additionally, the lesion induced hyper-excitability is no longer observed in treated animals compared to control animals. The results demonstrate that hUCB cells reinstall the way central neurons process information by normalizing inhibitory and excitatory processes. [58] it is also observed that these cells exhibit a neuroprotective effect in the striatum, and decrease the number of activated microglial cells in the cerebral cortex of treated animals, further resulting in better functional recovery. [59] Tanaka et al, observed that CD133+ cells derived from hUCBCs reduce the cortical damage and also promote axonal growth in neonatal rat organ co-cultures exposed to hypoxia. [60]
Various preclinical studies have shown that transplantation of stem cells in the CP models lead to survival, homing and differentiation of these cells into neurons, oligodendrocytes, astrocytes etc.
Park et al reported clonal neural stem cells (NSCs) when transplanted into brains of postnatal hypoxic-ischemic (HI) injury mice, home preferentially to and integrate extensively within the ischemic areas. They differentiate into neurons and oligodendrocytes, the cell types damaged due to HI. [61] A chinese study, wherein neural stem cells derived from human fetal brain (hNSCs) were transplanted into cerebral ventricle of HI injury neonatal rat, too demonstrated the survival, migration and differentiation capacity of these cells in rat brain. [62] Similarly, Zheng et al showed that Multipotent astrocytic stem cells (MASCs) from mice transplanted into a rat model of hypoxia-ischemia (HI) survive, migrate and differentiate into neurons and astrocytes. [63] In their study, Titomanlio et al implanted neurosphere-derived precursors in neonatal mouse model of cerebral palsy induced by excitotoxicity. They observed that cells migrated to the lesion site, remained undifferentiated at day 10, and differentiated into oligodendrocyte and neurons at day 42. Although grafted cells finally die there few weeks later, this procedure triggered a reduction in lesion size and an improvement in memory performance compared with untreated animals. [64] Chen et al, transplanted magnetically labeled mesenchymal stem cells in a model of perinatal brain injury. They found that these cells migrate to lesion sites and proliferate. They are neuroprotective and indirectly contribute to brain repair. [65]
Yasuhara et al, investigated the efficacy of intrahippocampal transplantation of bone marrow derived multipotent progenitor cells (MPCs) in HI injury. They found that transplanted MPCs ameliorated motor deficits associated with HI injury. [66] Webber et al in their study highlighted the protective effects of oligodendrocyte precursor cell transplantation in neonatal inflammation-induced rat model of periventricular leukomalacia. [67]
All the above preclinical studies have been carried out in animal models of acute hypoxic injury, hence showing significant results. But, similar results are difficult to replicate in human cases since the intervention always, cannot be carried out immediately post injury. Thus, more studies should be carried out in chronic injury models. Based on this observation, it can also be concluded that earlier the intervention, better is the outcome.
Below are few of the published studies carried out in human cases of cerebral palsy.
Luan et al carried out a study on 45 patients diagnosed with severe CP. They underwent transplantation of neural progenitor cell (NPC) derived from aborted fetal tissue. After 1 year, the developmental level in gross motor, fine motor, and cognition of the treatment group was significantly higher compared to the control group. These results suggested that NPC transplantation is a safe and effective therapeutic method for treating children with severe CP. [68]
Chen et al, injected neural stem cell-like (NSC-like) cells derived from autologous marrow mesenchymal stem cells in 30 cases of cerebral palsy. On follow up, they observed an increase in the GMFM scores and language quotients compared to the control group. No adverse events were recorded indicating that NSC-like cells are safe and effective for the treatment of motor deficits related to cerebral palsy. [69] Mink et al carried out a double blind, randomized, controlled trial in which they administered allogeneic umbilical cord blood cells potentiated with recombinant human erythropoietin (rhEPO) in CP patients. They observed improvement in motor and cognitive dysfunction in children with CP, accompanied by structural and metabolic changes in the brain. [70]
Papadopoulos et al administered autologous umbilical cord blood cells in 2 children diagnosed with spastic diplegic CP. They found that this therapy was safe, feasible and led to functional improvements in children which was seen by the change in GMFCS. [71]
Li et al, transplanted autologous bone marrow mesenchymal cells in an 11 year old CP case with visual impairment. On six month follow up, he could walk better and his vision had improved significantly. These findings were supported by the electrophysiological examinations. [72]
Jensen et al recently published a study wherein a 2 ½ year old boy received autologous umbilical cord blood mononuclear cells intravenously. At 2-months follow-up the boy\'s motor control improved, spastic paresis was largely reduced, and eyesight was recovered, as did the EEG. He smiled when played with, was able to sit and to speak simple words. At 40 months, independent eating, walking in gait trainer, crawling, and moving from prone position to free sitting were possible, and there was significantly improved receptive and expressive speech competence (four-word sentences, 200 words). This suggested that autologous cord blood transplantation could be a treatment alternative for cerebral palsy. [73]
Wang et al reported a case of a 5-year old girl with CP who underwent umbilical cord mesenchymal stem cells (MSCs) transplantation. She was treated with multiple times of intravenous and intrathecal administration of MSCs derived from her young sister and was followed up for 28 months. The gross motor dysfunction was improved. Immunity was enhanced, physical strength improved along with speech and comprehension. [74]
Purandare et al, reported a case of cerebral palsy who was administered with autologous bone marrow mononuclear cells. On follow up, they recorded a significant improvement in motor, sensory, cognitive, and speech. Bowel and bladder control was also achieved. On the GMFCS-E&R level, the patient was promoted from grade III to I. Hence, concluding that intrathecal infusion of autologous BMMNCs is feasible, effective, and safe in CP patients. [75]
In our previously published cases of cerebral palsy, one was with comorbid intellectual disability [76] while the other one was without any comorbidity. [77] These cases were administered with autologous bone marrow mononuclear cells intrathecally. Six months after the treatment, both cases showed significant functional outcomes which was supported by improvement in PET CT scan.
Currently, there are five clinical trials on stem cell therapy for cerebral palsy registered in clinicaltrials.gov. [http://clinicaltrials.gov/]
2 studies are from India studying the safety and efficacy of bone marrow MNCs in cerebral palsy in children below 15 years. One of the studies is a combination of phase 1 and phase 2 while the other is a combination of phase 2 and phase 3.
2 studies are from Iran, one evaluating the side effects of bone marrow derived CD133 cells transplantation in cerebral palsy patients and the other studying the safety of multiple intrathecal injections of bone marrow derived CD133 cells.
A study from USA is based on evaluating the safety and effectiveness of a single, autologous, cord blood stem cell infusion for the treatment of cerebral palsy in children. It is a randomized, controlled, blind, crossover study
Sharma et al, carried out a study on 71 children, wherein they administered 20 cases of cerebral palsy with autologous bone marrow mononuclear cells, intrathecally. [78] These cases included dystonic and spastic CP. Symptoms commonly observed in them were delayed milestones, spasticity, motor impairment, ambulation deficits, cognitive impairment, swallowing and speech problems etc.
Autologous bone marrow MNCs were selected as they are easily obtainable, safe and do not involve any ethical issues. As discussed earlier, intrathecal route of administration is a minimally invasive, safe and an effective procedure as compared to other routes. Studies have also proved that a mixture of cells exhibits more benefits as compared to a single sub fraction of cells. [79] Hence, we chose to carry out intrathecal autologous BMMNC transplantation.
The patients were administered Granulocyte Colony Stimulating Factor (GCSF), 48 hours and 24 hours before the harvest and transplantation of BMMNC. On the day of the transplantation, bone marrow was aspirated under general anesthesia in the operation theatre with aseptic precautions. Approximately, 100 ml of bone marrow (varying between 80 ml and 100 ml, based on the age and body weight) was aspirated from the region of anterior superior iliac spine using the bone marrow aspiration needle and collected in the heparinized tubes.
The aspirate was then transferred to the laboratory where the mononuclear cells were separated by the density gradient method. CD34+ counting was done by Fluorescence activated cell sorting (FACS). The MNCs were checked for viability (Average viability count was found to be 97%).
The separated autologous BMMNCs were immediately injected on the same day, intrathecally using an 18G Touhy needle and epidural catheter at the level between fourth and fifth lumbar vertebrae. The average numbers of cells injected were 8.19 x 107. Simultaneously 20mg/kg body weight methyl prednisolone in 500 ml Ringer Lactate was given intravenously to enhance survival of the injected cells. Patient was monitored for any adverse events.
On mean follow up of 15 months ± 1 month post stem cell administration, improvement was observed in 85% cases. [Figure 3] Significant improvement was observed in spasticity, neck holding, drooling of saliva, muscle strength in upper and lower limbs, sitting and standing balance, gross and fine motor activities, speech, swallowing, ambulation, and cognition. There was also a reduction in dystonic movements. No major adverse events were recorded. Some minor side effects such as headache, nausea and vomiting were experienced by few children who were self-limiting (resolved within a week) and treated with medications. The improvements in these patients sustained even after the follow up period of the study. None of them showed any deterioration on the GMFCS [78]
We are also currently conducting a clinical study to assess the efficacy of autologous BMMNC in 64 patients with CP. These patients are being treated with a combination of cell therapy and rehabilitation. The unpublished data analysis have shown preliminary results as improvement in oromotor skills, speech, neck holding, sitting, standing and walking balance and significant reduction in muscular tone and dystonic movements. These changes were observed in all types of cerebral palsy over 6 months with varied follow up periods. [Figure 4,5,6]
Graph demonstrating overall improvements in CP patients after stem cell therapy.
Percentage improvement noted in patients of diplegic cerebral palsy was as follows. Oromotor skills (75%), speech (64%), neck holding (100%),Sitting balance (67%), standing balance(67%), walking balance (67%), ambulation (30%), leg movements (54%), overhead movements (38%), distal hand movements (69%), upper limb spasticity (38%), Lower limb spasticity (38%), trunk muscle tone (36%), trunk dissociation (30%)
Percentage improvement noted in patients of quadriplegic cerebral palsy was as follows. Oromotor skills (58%), speech (40%), neck holding (94%),Sitting balance (48%), standing balance(27%), walking balance (21%), ambulation (13%), involuntary movements (25%), upper limb spasticity (51%), Lower limb spasticity (50%), trunk muscle tone (36%)
Percentage improvement noted in patients with other types of cerebral palsy was as follows. Oromotor skills (55%), speech (55%), neck holding (40%),Sitting balance (45%), standing balance(50%), walking balance (27%), involuntary movements (9%), upper limb spasticity (22%), lower limb spasticity (14%), dystonia of upper limbs (50%), dystonia of lower limbs (100%), dystonia of the trunk (50%)
Graph demonstrating improvements in Diplegic CP patients after stem cell therapy
Graph demonstrating improvements in Quadriplegic CP patients after stem cell therapy
Graph demonstrating improvements in other types of CP patients after stem cell therapy
Various clinical outcome measures have been devised to measure changes in sensory, motor, cognitive, perceptual and Behaviour functions in CP. [80] It is however important to understand the underlying mechanisms behind these changes.
MRI scans not only help reveal the underlying pathology of CP, but it also correlates with the clinical findings. [81] It has been observed that, clinical trials using MRI as a primary outcome measure failed to fully identify the effects of the therapy on clinical measures. [82] MRI shows the structural malformations and grey and white matter lesions, these are only suggestive of underlying tissue mechanisms; but MRI is not sensitive to measure the changes at cellular level. Principle mechanisms underlying the benefits of cellular therapy are the changes brought about in the microenvironment of cells reducing cell necrosis, ischemia and hypoxia. These changes therefore cannot be measured on a plane MRI and hence it is not a sensitive tool to monitor the effects of stem cell therapy. Functional neuroimaging on the other hand may be an appropriate option to monitor the finer changes at cellular level.
The basic principle underlying the functional neuroimaging of the brain is that the cerebral blood flow and metabolism is associated with neuronal activity. [83] Stem cell therapy aims to modulate neuronal tissue function in the patients of cerebral palsy, through various paracrine mechanisms. Measurement of the tissue function is therefore a preferred outcome measure to monitor the effects of cellular therapy.
Positron Emission Tomography – Computed Tomography (PET – CT) is one of the techniques of functional neuroimaging that measures the metabolism of the nervous tissue in terms of Fleuro-deoxy glucose (FDG) uptake. FDG is a radioactive glucose analogue that undergoes glycolysis in the same manner as that of glucose. Once it has been metabolized to FDG – 6 – Phosphate it cannot be further metabolized and is trapped inside the cell due to the impermeability of the cell membrane for this molecule. With increased glycolysis higher concentration of FDG-6-phosphate is observed. Photons emitted by this radioactive isotope are then measured to identify concentration of FDG in the nervous tissue [84]. This is expressed as a ratio of the actual uptake and the calculated presumed uptake of FDG, standard uptake value [85]. Because of its ability to measure the finer changes in tissue metabolism, FDG PET-CT holds a great potential as a monitoring tool. [86,87]
PET-CT scan is performed following a standard protocol. Various guidelines are available for appropriate standardization, image acquisition and interpretation during PET-CT scanning. Dosage of the radioactive dye is calculated based on the age and weight of the patient. Calculated units are then administered systemically 30 minutes before scanning. [88].
FDG, chemically expressed as 18F-FDG is radionuclide and therefore special safety concerns with its use need to be address. The primary safety concern is exposure to radiation. Incidence of developing any side effect is negligible with the use of 18F-FDG PET-CT. The half-life of 18F-FDG is 109.8 minutes and is excreted via urine. The tissue metabolism of 18F-FDG is the same in adult and children and the dose administered in children is “as low as reasonably achievable”. Various adjustments with regards to scanning technology and measurement period are made to enhance the quality of the image with the administered dose [89]. PET-CT is sensitive to measure the cellular changes and it is a standardized imaging modality which makes it a good monitoring tool to assess the effects of cellular therapy.
In our previous case studies involving cerebral palsy patients treated with autologous bone marrow derived mononuclear cells (BMMNCs), the clinical outcome was correlated with changes in the PET scan. In one case of a 20 year old CP patient with co morbid intellectual disability, a repeat PET-CT scan showed significant increase in the FDG uptake in various affected areas of the brain, which correlated with the clinical improvement in social behavior, balance and motor control. However the MRI remained unchanged (76).
In another case of a 2 year old child with cerebral palsy, we observed similar correlation of clinical improvement with the PET-CT changes in metabolism. (77) Six months following cellular therapy she developed good neck control along with improvement in balance and speech. These clinical changes were synonymous with the increased FDG uptake in the bilateral mesial temporal structures, right basal ganglia, frontal, parietal, temporal and occipital lobes.
Functional MRI is also one of the emerging techniques to study the functional outcome of the intervention. The technique of fMRI is based on Blood oxygenation level dependent (BOLD) contrast between rest and activated states of human brain. (90) Activation of neuronal tissue leads to increased metabolism and increased oxygen demands that have a twofold effect of greater oxygen extraction and increased cerebral blood flow; both of which result in higher BOLD signals than that of resting tissue. In ischemic tissues the blood flow–metabolism couple is impaired. Stem cells enhance angiogenesis, increasing the cerebral blood flow. Hence, fMRI may be effectively used to monitor the therapeutic outcome of stem cell therapy and should be studied further. (91)
For a long time, rehabilitation has been the standard approach for cerebral palsy. The goal of rehabilitation in cerebral palsy is to develop coordination, build strength, improve balance, maintain flexibility, optimize physical functions, manage spasticity and maximize independence. Rehabilitation is multidisciplinary. Various therapeutic regimens aim to enhance particular clinical, functional and psychosocial consequences of CP. Physiotherapy, makes use physical modalities to muscle spasticity, increase flexibility, balance and co-ordination, build strength and enhance function. Physiotherapists also prescribe different assistive devices to gain higher functionality. Multiple medical and surgical regimens are also instituted to deal with these physical impairments. Botox injections are most commonly used to reduce spasticity of the muscles, but the effects are short lived. A variety of surgical techniques are utilized to correct deformities.
Occupational therapy is focused at therapeutic regimens to improve cognitive abilities of the child and increase participation in activities of daily and social living. Children with CP most often present with poor oromotor control and speech disorders, speech therapy aims at correcting these impairments. Psychiatric and psychological intervention is aimed at patient and caregiver wellbeing. It helps to improve the quality of life by addressing co-morbid psychological disturbances and cognitive impairments.
All of the rehabilitative modalities face the fundamental limitation of inability to repair the damage to the nervous tissue. Some studies have defined minor improvements in motor and social skills. Wright and Nicholson and Sommerfeld et al have demonstrated that physical therapy alone does not show a consistent benefit in cerebral palsy. [92]
However, rehabilitation in combination with stem cell therapy may augment its benefits. Exercise helps in enhancing the cell proliferation and neurogenesis. [93] Increased mobilization of hematopoietic stem cells and erythropoieticprogrnitor cells (EPCs) to peripheral blood is observed post exercise. It also increases angiogenesis and oxygen supply to the brain thereby improving the cognitive function. [94,95,96]. Regular exercise induces suppression of pro-inflammatory cytokines and up regulation of anti-inflammatory cytokines in various tissues of the body including brain. [97,98,99] One of the key mechanisms for homing of bone marrow mononuclear stem cells is the chemokine stromal derived factor -1 / CXCR4+ receptor pathway, exercise has also been found to up regulate expression of CXCR4+ receptors is ischemic tissue ensuring enhanced homing of stem cells. In addition, mobilization of stem cells, enhanced homing, improved angiogenesis exercise also exerts immunomodulatory effects. [97] Benefits of regular exercise resonate with the cellular mechanisms of stem cell therapy and therefore it augments the therapeutic potential of stem cell therapy. Exercise and rehabilitation has a synergistic effect for the benefits of cell transplantation. [100]
Stem cell therapy for cerebral palsy still remains in its infant stage. Although cellular therapy for cerebral palsy has moved from the preclinical studies to bedside therapy; evidence remains inconclusive regarding multitude of variables. These variables are pertaining to cerebral palsy and cellular therapy.
Cerebral palsy is a heterogeneous group of disorders. This inherently reduces the generalizability of the findings. Pre-clinical models of effects of cellular therapy in cerebral palsy are far from the ideal state and show benefits only in acute injury. Majority of the human application of stem cells in cerebral palsy is for individuals who already have established pathology, hence at a chronic stage. Animal models of chronic injury are therefore required to study the efficacy and mechanism of action of stem cells. The individuals suffering from cerebral palsy are from various age groups, and present with varied kinds and severities of clinical manifestations; there is only a limited evidence about which of these groups will benefit the most from cellular therapy.
Only preliminary evidence using basic research methodologies is available for the effects of cellular therapy in humans. Various factors limit the methodological robustness of the current trials. There are limited controlled trials in humans with cerebral palsy. We require more double blind, randomized, multicenter controlled clinical trials to prove the safety and feasibility of stem cells. The evidence available is heterogeneous in methodology, patient population, outcome measures and cellular therapy provided. Stem cells provide their beneficial effects through numerous mechanisms; it is difficult to underpin the exact mechanism of action of stem cells. Types, sources and numbers of cells administered, frequency of transplantation, time of transplantation are concerns which require attention imperatively. It is important to not only conduct more trials but also to standardize research protocols to allow comparison. Comparative studies will help in establishing the most effective cell based therapy for cerebral palsy.
Apart from these issues, development and validation of outcome measures to obtain evidence of the efficacy of intervention is very important. Different scales, monitoring tools need to be standardized. Modalities should be developed to study the effect of cell transplantation at a cellular level. Outcomes that can successfully assess these cellular changes are measuring the serum, plasma and cerebrospinal fluid biomarkers, which are invasive. Less invasive modalities would be functional imaging techniques. PET-CT scan has been used as an outcome to assess the effects of cellular therapy however it is required to further explore its various components in depth. fMRI also provides insights regarding the changes at cellular level however there is no evidence of its use in monitoring the changes post cellular therapy. It is therefore necessary to explore how functional imaging can provide us a better understanding of the cellular mechanisms.
Stem cell therapy has been extensively studied but still needs to be standardized before it becomes a definitive treatment modality. Autologous BMMNCs are safe and feasible option but their effectiveness needs more clinical trials. Other types of stem cells need to establish safety and efficacy. Though not a cure, stem cell therapy has emerged as a novel therapeutic option to improve the quality of life.
By its very nature, one cubic meter of wood stores almost a ton of CO2, so wood reduces the carbon footprint of the construction industry while evaluating the entire life cycle from raw material to production, use, and recycling, and timber buildings play an important role in supporting to the sustainable bioeconomy [1, 2].
Studies indicate that increasing the use of EWPs in the construction sector has environmental benefits, as wood is a renewable and lightweight material [3, 4], where utilization of EWPs instead of conventional building materials e.g. concrete or steel, the total fossil fuel footprint of building construction can be diminished to a considerable extent through environmental-friendly-material replacement [5, 6]. Also, based on some estimates, substituting concrete with wood could lessen the energy used by construction processes by 40%, while greenhouse gas emissions could be reduced by 35% [7, 8]. Extensive use of EWPs may have helped make the transition towards more carbon-free production of building materials [9, 10].
A construction project involves a large number of participants with various roles, goals, and concerns [11] as in the case of high-rise timber buildings e.g. Mjøstårnet (Norway, 2019) (Figure 1), HoHo (Austria, 2020) (Figure 2). Besides, the building material selection process includes many parameters, e.g. cost, structural performance, environmental friendliness, fire performance, availability, and speed of construction [12, 13]. Moreover, the material selection procedure is a complex non-linear process involving various actors such as contractors, structural designers, developers, and architects [14, 15, 16].
Mjøstårnet (Norway, 2019) (Source: Wikipedia).
HoHo (Austria, 2020) (Source: Wikipedia).
Among these parties involved, architects play a critical role in material selection [17, 18], their perceptions influence their choice of material in the structural frame [13, 15, 19, 20]. Perhaps more importantly, architects’ perceptions could lead to an increase in the use of EWP for construction [19, 21].
In the literature, many studies have been carried out on the ecological, technological, economic, and social aspects of engineered wood products and various technical solutions in buildings [22]; while there is a relatively limited number of studies concentrating on the EWPs for construction from the stakeholders’ perspective (e.g. [11, 16, 20, 21, 22, 23, 24, 25]).
This chapter presented a comprehensive overview of the perceptions, attitudes, and interests of architects in the use of EWPs together with their perceived benefits and barriers for construction. This study gathered, mapped out, and systematized scattered and multifaceted knowledge on architects’ attitudes towards EWPs employment in buildings, and chronologically presented them in an accessible and manageable discourse. Notably, the chapter also revealed how this perception has changed over time.
An increasing emphasis on the climate impact of building materials in the construction sector should therefore increase the likelihood that future EWPs will be favored to a greater extent. In this sense, attempts to increase the awareness of architects about EWPs will have a positive effect, e.g. regarding the economic aspects. In this study, wood or timber refers to engineered timber products such as cross-laminated timber, laminated veneer lumber, glue-laminated timber/glulam.
In the literature, several studies from different countries such as Australia, America, Sweden are concentrating on wood as a structural material in the buildings from architects’ perspective through questionnaires and/or interviews (e.g. [13, 20, 23, 24, 26, 27]).
Among the studies, Truskett undertook surveys and interviews with architects in Victoria (Australia) to explore factors influencing the specification of wood products [28]. The findings showed that while the vast majority (90%) of those surveyed ‘always or mostly’ used structural timber for residential purposes, only 20% frequently used structural timber for non-residential applications. According to the architects, timber as a structural and finishing material has strong aesthetic appeal, but the factors such as maintenance and durability, professional networks, industry practice, information, and environmental issues hamper its general use.
Kozak and Cohen focused on the construction material selection of architects (n = 594 out of 3,986) and structural engineers (n = 384 out of 1,822) for non-residential buildings through an online survey in the United States and Canada [26]. The results showed that steel and concrete continue to be the most common material in non-residential applications, whereas wood governs the construction market for elderly housing and is also frequently employed in religious buildings, restaurants, and commercial/residential combinations. It was also pointed out that as the building height increases, the use of wood decreases. However, the attitudes of architects were encouraging towards the use of timber-frame if they had previously specified it.
In 2004, Wagner and Hansen scrutinized material preferences among architects and engineers in America and Chile by a cross-cultural comparison to establish a procedure for choosing a customer group of a company and then classifying its demands and needs [27]. They stated that American architects did not give much weight to issues concerning cost and ecological properties of the building material when deciding on wood construction, whereas other considerations e.g. dimensional stability were thought to have more potential for development when compared with competing materials like steel. Similarly, surveyed architects from Chile were not interested in the environmental features of the wood. Besides this, both sample groups of architects had a positive attitude towards the aesthetical properties of wood, and they perceived uniform quality as an essential asset. It was also noticed that fire-related issues received less concern among the architects than the relevant literature suggests [26].
O’Connor et al. studied architects’ and engineers’ perceptions regarding the use of wood in the North American non-residential construction sector through an extensive mail survey applied to a series of specifier’s focus groups [15]. This research identified several perceived challenges for wood utilization in construction: building code concerning fire safety; cost-competitiveness with steel especially in terms of complicated structures or structures with a longer span; design performance related to strength, durability, stiffness, and lack of established practices. They also proposed short- and long-term recommendations for addressing these obstacles.
The research of Bayne and Taylor also examined the barriers to the use of wood in Australian non-residential buildings to understand the reasons behind the common use of non-wood products e.g., concrete and steel [29]. They aimed to identify the reasons for the lack of confidence in specifying wood as a structural material in these buildings. As a result of interviews with 34 architects, engineers, building designers, and project managers, a range of strengths and weaknesses regarding the structural application of wood to non-residential use were underlined. Findings suggested that aesthetics, easy construction, and adaptability of design and fire performance were evaluated as advantages, while cost and speed of erection were taken as the most common obstacles by the specifiers. It was also concluded that the use of wood was found more suitable and promising by the architects for smaller building types such as housing for the elderly, schools, public buildings, and churches.
In 2008, Roos et al. presented perceptions of 23 Swedish architects and structural engineers about the material selection process, which also included a comparison of wood with other materials, the effects of main stakeholders, and the relation of wood construction with professional roles and knowledge [30]. Both architects and engineers were interested in using wood but perceived it as complicated. This study as a prospect highlighted the issues such as clear demonstration of business-sound wood compared with concrete and steel; functional information flows from the construction industry to wood sector; expression of smart solutions enabling flexibility and appropriate span lengths from an architectural standpoint; putting emphasis on aesthetic and visual aspects of timber-frame, and importance of providing more information about environmental benefits of wood by suppliers.
Bysheim and Nyrud investigated Norwegian architects’ perceptions regarding the use of wood as a structural material in urban construction via a questionnaire to measure attitudes towards the physical, mechanical, and fire-related properties of wood [31]. They found that many architects show a tendency to use structural timber, but few are planning to do so. They were also positive; fire and aesthetically related properties, costs of using structural timber compared to substitutes, and the energy-related properties of the material, the physical and mechanical properties of timber-frame. They felt qualified to specify timber-frame in buildings but did not perceive the choice of using structural timber as being entirely up to them. The architects had positive attitudes towards timber-frame in residential buildings but were negative towards use in other building types. Additionally, they were positive to utilize in buildings up to 3-story. The architects had little experience with timber-frame in other building types other than residential ones. Most of the respondents strongly agreed that other architects would have a positive tendency to them employing timber-frame, whereas contractors and real estate developers were perceived as negative towards the use of timber-frame.
Robichaud et al. explored the challenges to the use of wood in the North American non-residential construction sector [32]. This study aimed to examine the possible role of communication in this emerging market among architects through a survey (n = 165 out of 5,000). The results showed that generally, the architects assessed wood to be a ‘sincere’ but ‘unexciting’ structural material. When compared to concrete and steel, wood was perceived as the most environmentally friendly material. However, wood was rated with the lowest score in terms of durability, fire-resistant, structural performance, and contribution to the high building value. In the recommendation part of the study, the issue of better communication on the part of wood producers and product information was highlighted.
The research of Roos et al. analyzed architects’ and structural engineers’ attitudes and perceived factors that hinder or facilitate the specification of wood construction in Sweden [20]. The main finding of this research was that the material preference of architects and structural engineers is affected by attitudes concerning the properties of wood and beliefs about the control and ease of building in wood. Wood was generally perceived as a suitable building material. Issues about decay, instability, and sound transmission were assessed as negative aspects, while the features of strength, environmental friendliness, simple handling, and suitability for use along with industrial methods were taken as advantages of wood. Besides this, developers and contractors were perceived as the most influential parties by both Swedish architects and structural engineers in the material selection process.
The result suggests that if the following measures are taken into consideration, perceived obstacles could be lessened: (i) developing clearer business concepts for timber-based transparent and affordable construction approaches that decrease the uncertainty, (ii) creating prefabrication methods for wood to reduce the risk factor in the construction, (iii) developing education and training in building design and construction in wood, (iv) providing information about the environmental performance of wood as a building material, (v) improving the ‘professional status’ of wood via interesting design, (vi) supporting architects and engineers in pursuing wood construction and developing a dialogue among all the related professions.
Hemström et al. assessed Swedish architects’ perceptions, attitudes, and interest towards steel-, concrete-, and timber-frames in multi-story buildings through a web-based questionnaire (n = 412 out of 3,600) [11]. The results indicated that concrete was found the most favorable frame material for multi-story construction mainly because of its performance of engineering-based issues e.g., stability and fire safety that was considered critical for the selection of frame material. The general attitude towards, and interest in, timber-frame utilization was positive and related to its perceived environmental features. Differing from findings in North America [15], this study showed that costs and time to construct a building are not perceived as major barriers to the use of wood among architects in Sweden. Contradictory to the perception of wood being a less suitable multi-story frame material than concrete and steel, the interest in the use of wood frames was large. Contrary to Norwegian findings [16], the overall attitude towards the use of wood frames in residential buildings presented here was not different from the attitude towards the wood in non-residential buildings. Besides this, the results showed that contractors, structural engineers, and building commissioners have a great influence on the choice of frame material.
In 2014, Xia investigated the reasons as perceived obstacles for comparatively limited use of the timber-frame in multi-story non-residential buildings (compared to low-rise housing) among industry professionals - also including architects - in Australia by a questionnaire survey (n = 74 out of 176) [13]. The results indicated five main groups of identified obstacles: (1) lack of support in official regulations, (2) lack of interest in the industry, (3) lack of experience in professionals, (4) perception of drawbacks, and inadequate knowledge about merits of timber-frame utilization. This study also made several recommendations concerning more supportive legislation by the governmental side to stimulate the use of wood in multi-story building construction, industry training to raise the awareness and knowledge of the technological improvements regarding EWPs, the attitudes of developers and investors as the most influential decision-makers towards increasing the awareness of timber-frame advantages.
Viluma and Bratuškins conducted research among architects and other stakeholders in Latvia to find out the main barriers to using wood for buildings through 38 interviews and questionnaires [33]. There were 73 answers from 85 registered persons of which 36 were architects, 25 were students and lecturers, as well as representatives from timber production and media. In this study, the main motivating factors and seven main barriers to the selection of wood constructions were identified. Research results showed that architects’ attitude towards timber-frame, in general, is positive, but they thought that due to the Latvian Fire Safety Regulation, it is not easy to find solutions for wood construction. Additionally, the architects emphasized the
Conroy et al. investigated familiarity, use, and perceptions of EWPs among the AIA-certified architects across Washington, Oregon, and California through an online questionnaire (n = 533 out of 3,469) [18]. The results indicated that durability, fire resistance, and strength were assessed as weaknesses of engineered wood products, unlike other studies such as [16, 29] that found architects saw wood fire performance as a strength. The architects from Washington and Oregon projected the use of wood in the construction industry to develop more in the next five years compared to steel and concrete. To boost the use of wood as a construction material for the structure and building enclosure in non-residential buildings, it was recommended that the forest products industry enhances its internet presence, developing interdisciplinary communication strategies.
As one of the most recent studies, Kuzman et al. attempted to better understand the specification process of EWPs and to provide an updated overview of the perceived identity of these materials among architects in Slovenia, Austria, France, Sweden, Croatia, and Bosnia, and Herzegovina [34]. The results indicated that generally, participating architects have a positive attitude towards wood utilization in all countries. Thermally modified wood was perceived as positive, whereas the architects were unfamiliar with more recently introduced wood modification methods e.g., acetylation, furfurylation (which are not well known). Their findings suggested that the opportunities for wood to gain a greater market share will grow.
Markström et al. probed Swedish architects’ perception of the use of EWPs in buildings and the parameters which positively influence the preference of these products via a survey questionnaire [24]. Findings highlighted that in general, and as per the more recent study by [34], the perception of EWPs is positive among Swedish architects, and most of them think that their use will increase in the future. They also added that other decision-makers with greater influence over the material selection, such as contractors, developers choose other materials. A lack of knowledge, as well as uncertainties about the quality over time, were other common reasons for not preferring EWPs. The results also indicated that environmental concerns and aesthetic appearance are the main reasons to select these materials for the architects involved in building projects. It was stated that knowledge, familiarity, and architects’ attitude play a role in increasing the use of EWPs.
Therefore, it can be said that perceived positive aspects of EWPs have markedly changed from earlier studies in 1997. By that year, in one of the studies by [28] entitled
[24] | architects in Sweden |
|
|
[18] | architects in the US West Coast |
|
|
[33] | stakeholders (including architects) in Latvia |
| |
[13] | industry professionals (including architects) in Australia |
| |
[11] | architects in Sweden |
| |
[20] | architects and structural engineers in Sweden |
|
|
[32] | architects in North America |
|
|
[31] | architects in Norway |
| |
[30] | architects and building engineers in Sweden |
|
|
[29] | architects, engineers, building designers, and project managers in Australia |
|
|
[27] | architects and engineers in the US and Chile |
| |
[26] | architects and structural engineers in the US and Canada |
|
|
Studies on architects’ attitudes towards the use of EWPs for construction.
In terms of the major benefits and barriers to using EWPS for construction, similar findings were identified in different studies such as [11, 24, 32]. Architects mostly had a positive attitude towards aesthetic quality (e.g. [24, 31]) and environmental performance (e.g. [18, 26]) of EWPs.
Also, in Bayne and Taylor’s study on the barriers to the use of EWPs, it was found that the use of timber is more suitable for smaller buildings such as housing development [29]. Similarly, Bysheim and Nyrud found that architects took a positive attitude towards the use of timber as frame material in three-story houses [31].
Some other studies among architects such as [11, 18, 24, 32] highlighted
In studies conducted among architects in the USA [18, 32] and those in Sweden [30],
As many studies (e.g. [13, 33]) reported,
Besides, according to the participants in the study by Xia et al.,
Overall, architects’ perceptions of EWPs’ engineering performance can deter them from employing EWPs for construction. Such a change can be driven by an increase in examples of promising timber building applications. e.g. high-rise buildings (over 8-story), and so the general attitude of architects towards EWPs will be more positive in terms of engineering-based features such as sound insulation, fire safety, durability, and structural performance.
Future scenarios for wooden buildings could improve if there is a new trend towards greater importance of environmental factors in the choice of structural material facilitated by policies, which can make a difference in the demands of customers and the tendencies of contractors.
Moreover, architects can play an important role as prime marketers in increasing EWPs for construction, but it seems that more initiatives are required to enhance their familiarity since the lack of experience and level of knowledge may prevent architects from proposing timber in their projects.
The aim of this chapter was to understand the architects’ perceptions, attitudes, and interests in the use of EWPs for construction. In doing so, this research attempted to identify perceived major benefits and barriers to EWPs utilization.
Overall, architects mostly had a positive attitude towards the use of EWPs. Among EWPs’ positive aspects, aesthetic quality, environmental performance, energy efficiency, and speed of erection were the highlights. Durability, fire resistance, and strength were assessed as the most critical barriers to the common use of EWPs. These were followed by a lack of cost competitiveness, knowledge gaps or lack of expertise, and lack of developer interest.
In this sense, the following recommendations may help to overcome identified barriers by improving overall attitudes towards EWPs for construction:
(1) providing architecture students with more education and inspiration at university, more information about wood-based products, better design aids, and more design examples (2) supporting architects in timber construction by creating a sharing environment with members of these professions (3) developing more active participation in EWP-based problem solving and better interdisciplinary communication strategies among timber suppliers, the timber construction industry and the architectural community (4) developing business-oriented approaches for timber compared to traditional materials e.g. concrete in construction (5) developing effective timber prefabrication methods to reduce the risk factor in construction (6) Enhance the collaboration of different stakeholders such as government, client, designer, contractor, and supplier by issuing more supportive regulations and guidelines to increase the use of EWPs for construction.
It is believed that this chapter will help to deepen the understanding of various considerations shaping the decision-making process in the use of EWPs for construction.
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\n\nA Conflict of Interest is a situation in which a person's professional judgment may be influenced by a range of factors, including financial gain, material interest, or some other personal or professional interest. For IntechOpen as a publisher, it is essential that all possible Conflicts of Interest are avoided. Each contributor, whether an Author, Editor, or Reviewer, who suspects they may have a Conflict of Interest, is obliged to declare that concern in order to make the publisher and the readership aware of any potential influence on the work being undertaken.
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\n\nIntechOpen requires:
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\n\nAll Authors are obliged to declare every existing or potential Conflict of Interest, including financial or personal factors, as well as any relationship which could influence their scientific work. Authors must declare Conflicts of Interest at the time of manuscript submission, although they may exceptionally do so at any point during manuscript review. For jointly prepared manuscripts, the corresponding Author is obliged to declare potential Conflicts of Interest of any other Authors who have contributed to the manuscript.
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Considering this, this chapter presents the types of Brazilian propolis as the types available nowadays, their chemical compositions, as well as, some of their important biological properties enabling employing them as important health food, such as antimicrobial, antioxidant, and immunomodulation action. Various “in vivo” and clinical trial studies, conducted in different regions, on the safety and dosage of propolis, technologies used to obtain propolis extract, and several innovative presentations of this promising bee product are also presented in this chapter. Finally, this chapter aims to present the regulatory affairs, potential market for propolis around the world, and perspectives for a near future.",book:{id:"5505",slug:"superfood-and-functional-food-an-overview-of-their-processing-and-utilization",title:"Superfood and Functional Food",fullTitle:"Superfood and Functional Food - An Overview of Their Processing and Utilization"},signatures:"Andresa A. Berretta, Caroline Arruda, Felipe Galeti Miguel, Nathalia\nBaptista, Andresa Piacezzi Nascimento, Franciane Marquele-\nOliveira, Juliana Issa Hori, Hernane da Silva Barud, Bianca Damaso,\nCésar Ramos, Raul Ferreira and Jairo Kenupp Bastos",authors:[{id:"74602",title:"Dr.",name:"Jairo Kenupp",middleName:null,surname:"Bastos",slug:"jairo-kenupp-bastos",fullName:"Jairo Kenupp Bastos"},{id:"191621",title:"Dr.",name:"Andresa",middleName:"Aparecida",surname:"Aparecida Berretta",slug:"andresa-aparecida-berretta",fullName:"Andresa Aparecida Berretta"},{id:"192234",title:"Dr.",name:"Franciane",middleName:null,surname:"Marquele-Oliveira",slug:"franciane-marquele-oliveira",fullName:"Franciane Marquele-Oliveira"},{id:"192235",title:"Mrs.",name:"Nathalia",middleName:null,surname:"Baptista",slug:"nathalia-baptista",fullName:"Nathalia Baptista"},{id:"192236",title:"Dr.",name:"Juliana",middleName:null,surname:"Hori",slug:"juliana-hori",fullName:"Juliana Hori"},{id:"192237",title:"Ms.",name:"Caroline",middleName:null,surname:"Arruda",slug:"caroline-arruda",fullName:"Caroline Arruda"},{id:"192238",title:"Mr.",name:"Carlos",middleName:null,surname:"Redher",slug:"carlos-redher",fullName:"Carlos Redher"},{id:"192327",title:"Dr.",name:"Andresa",middleName:"Piacezzi",surname:"Nascimento",slug:"andresa-nascimento",fullName:"Andresa Nascimento"},{id:"192328",title:"Mr.",name:"Raul",middleName:null,surname:"Ferreira",slug:"raul-ferreira",fullName:"Raul Ferreira"},{id:"196526",title:"Dr.",name:"Bianca",middleName:null,surname:"Damaso",slug:"bianca-damaso",fullName:"Bianca Damaso"}]},{id:"41625",doi:"10.5772/53169",title:"Oxidation and Antioxidants in Fish and Meat from Farm to Fork",slug:"oxidation-and-antioxidants-in-fish-and-meat-from-farm-to-fork",totalDownloads:6750,totalCrossrefCites:9,totalDimensionsCites:26,abstract:null,book:{id:"3424",slug:"food-industry",title:"Food Industry",fullTitle:"Food Industry"},signatures:"Sabine Sampels",authors:[{id:"161434",title:"Ph.D.",name:"Sabine",middleName:null,surname:"Sampels",slug:"sabine-sampels",fullName:"Sabine Sampels"}]}],mostDownloadedChaptersLast30Days:[{id:"41652",title:"Quality Management: Important Aspects for the Food Industry",slug:"quality-management-important-aspects-for-the-food-industry",totalDownloads:9482,totalCrossrefCites:0,totalDimensionsCites:10,abstract:null,book:{id:"3424",slug:"food-industry",title:"Food Industry",fullTitle:"Food Industry"},signatures:"Caroline Liboreiro Paiva",authors:[{id:"95816",title:"Ms.",name:"Caroline",middleName:"Liboreiro",surname:"Paiva",slug:"caroline-paiva",fullName:"Caroline Paiva"}]},{id:"65652",title:"Current Standing and Future Challenges of Dairying in Pakistan: A Status Update",slug:"current-standing-and-future-challenges-of-dairying-in-pakistan-a-status-update",totalDownloads:2301,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"Pakistan is considered among the leading raw milk producing countries. Unlike the production systems in the developed countries, milk production systems in Pakistan represent smallholding with subsistence- or market-oriented-level farming followed by peri-urban or commercial-level farming. Historically, dairy sector has been owned and managed by the private sector. During the past two decades, new initiatives have been taken because of the active involvement of corporate private sector. These efforts have resulted in improvements like enlargement of herds and import of high-quality milk germ plasm, the productivity per animal, milk collection, processing and marketing, the supply of dairy inputs (machinery, equipment, feeds, semen, and elite dairy animals), and farmers knowledge, and skills on modern management practices. Conclusively, the dairy sector is performing at some sustainable level to meet the food requirements of the growing population and helping save a handful of foreign exchange. Yet, challenges like local replacements of high genetic potential dairy animals, health hazards of β-casein proteins, antibiotics and aflatoxins, and uneconomical operational costs facing the dairy industry in the near future need to be addressed. The main objective of this chapter is to identify the current trends in dairy industry of Pakistan and describe those factors, which can influence the sustainability and profitability of dairying in the near future.",book:{id:"6911",slug:"milk-production-processing-and-marketing",title:"Milk Production, Processing and Marketing",fullTitle:"Milk Production, Processing and Marketing"},signatures:"Muhammad Naeem Tahir, Roshan Riaz, Muhammad Bilal and Hafiz Muhammad Nouman",authors:[{id:"270832",title:"Dr.",name:"Muhammad Naeem",middleName:null,surname:"Tahir",slug:"muhammad-naeem-tahir",fullName:"Muhammad Naeem Tahir"},{id:"281816",title:"Dr.",name:"Roshan",middleName:null,surname:"Riaz",slug:"roshan-riaz",fullName:"Roshan Riaz"},{id:"298338",title:"Dr.",name:"Muhammad",middleName:null,surname:"Bilal",slug:"muhammad-bilal",fullName:"Muhammad Bilal"},{id:"298339",title:"Dr.",name:"Hafiz Muhammad",middleName:null,surname:"Nouman",slug:"hafiz-muhammad-nouman",fullName:"Hafiz Muhammad Nouman"}]},{id:"41694",title:"Seaweeds for Food and Industrial Applications",slug:"seaweeds-for-food-and-industrial-applications",totalDownloads:8232,totalCrossrefCites:30,totalDimensionsCites:96,abstract:null,book:{id:"3424",slug:"food-industry",title:"Food Industry",fullTitle:"Food Industry"},signatures:"Berna Kılınç, Semra Cirik, Gamze Turan, Hatice Tekogul and Edis Koru",authors:[{id:"88972",title:"Dr.",name:"Edis",middleName:null,surname:"Koru",slug:"edis-koru",fullName:"Edis Koru"},{id:"161688",title:"Dr.",name:"Berna",middleName:null,surname:"Kılınç",slug:"berna-kilinc",fullName:"Berna Kılınç"}]},{id:"67669",title:"Probiotic Characteristics and Health Benefits of the Yogurt Bacterium Lactobacillus delbrueckii sp. bulgaricus",slug:"probiotic-characteristics-and-health-benefits-of-the-yogurt-bacterium-em-lactobacillus-delbrueckii-e",totalDownloads:805,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Yogurt is a good source of several micronutrients and has played an important role in human nutrition. Consumption of yogurt has been shown to promote health benefits due to the presence of live bacteria. A number of human studies have demonstrated that yogurt contains viable bacteria, and especially L. bulgaricus, improve the health of the host and thus qualifies as a bona fide probiotic in its own right. In this chapter, we review the literature covering attributes of the yogurt bacterium L. bulgaricus that confirm its probiotic bacterial characteristics.",book:{id:"8174",slug:"current-issues-and-challenges-in-the-dairy-industry",title:"Current Issues and Challenges in the Dairy Industry",fullTitle:"Current Issues and Challenges in the Dairy Industry"},signatures:"Ayowole Oyeniran, Rabin Gyawali, Sulaiman O. Aljaloud, Albert Krastanov and Salam A. 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Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:null,institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda",middleName:"R.",surname:"Gharieb",fullName:"Reda Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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Valarmathi",profilePictureURL:"https://mts.intechopen.com/storage/users/69697/images/system/69697.jpg",institutionString:"Religen Inc. | A Life Science Company, United States of America",institution:null},{id:"205081",title:"Dr.",name:"Marco",middleName:"Vinícius",surname:"Chaud",fullName:"Marco Chaud",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDGeQAO/Profile_Picture_1622624307737",institutionString:null,institution:{name:"Universidade de Sorocaba",institutionURL:null,country:{name:"Brazil"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"profile.detail",path:"/profiles/117372",hash:"",query:{},params:{id:"117372"},fullPath:"/profiles/117372",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()