Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
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We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
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Throughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\n
We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
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\r\n\tThis book is about the various diseases that could result due to exposure to different kinds of occupational settings. Usually, it is difficult to link certain diseases to specific occupations due to a longer latency period. However, compelling shreds of evidence are required to establish the strong relationship between the diseases and the occupations that may actually lead to the occurrence of those diseases.
\r\n
\r\n\tThis book aims to bring out the work-related causative factors associated with diseases such as bronchopulmonary diseases that may be due to exposures to different substances such as hard metal dust, the dust of cotton, flax, hemp, sisal, or sugarcane; diseases due to exposures to asphyxiants such as carbon monoxide, hydrogen sulfide, hydrogen cyanide, and their derivatives; diseases caused by exposures to different types of radiations such as ionizing radiation, ultraviolet radiation, infrared radiation, and even visible light radiation; diseases caused due to the exposure to a range of pesticides in agricultural farmlands; musculoskeletal and cardiovascular diseases. An upcoming topic on psychosocial illnesses can also be considered under occupational diseases if it can be linked with statistical evidence to specific occupations.
",isbn:null,printIsbn:"979-953-307-X-X",pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"de0ea2d70ff0bd6218d95ada9e2a9a09",bookSignature:"Dr. Kavitha Palaniappan",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11230.jpg",keywords:"Hard-Metal Dust, the Dust of Cotton, Carbon Monoxide, Hydrogen Sulfide, Ionizing Radiation, Ultraviolet Radiation, Organophosphates, Malathion, Carpal Tunnel Syndrome, Back Pain, Arrhythmias, Cardiomyopathy",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 1st 2021",dateEndSecondStepPublish:"December 21st 2021",dateEndThirdStepPublish:"February 19th 2022",dateEndFourthStepPublish:"May 10th 2022",dateEndFifthStepPublish:"July 9th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"8 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:"Associate Professor Dr. Palaniappan is the academic director at the Newcastle Australia Institute of Higher Education (Singapore). She is an active researcher in the field of occupational health and industrial safety. Also, she is a graduate member of the Institution of Occupational Safety and Health (IOSH).",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"311189",title:"Dr.",name:"Kavitha",middleName:null,surname:"Palaniappan",slug:"kavitha-palaniappan",fullName:"Kavitha Palaniappan",profilePictureURL:"https://mts.intechopen.com/storage/users/311189/images/system/311189.jpg",biography:"Associate Professor Dr. Kavitha Palaniappan is the academic director at Newcastle Australia Institute of Higher Education (Singapore), a wholly-owned entity of the University of Newcastle, Australia. She teaches the program of Bachelor of Environmental and Occupational Health and Safety (BEnvOHS). Apart from teaching, Dr. Palaniappan is also actively involved in multi-disciplinary research, including the prevalence of psychosocial illnesses and their impacts on society, economy and country. She also researches alternative therapies to enhance sleep, yoga and its health benefits, the toxicity of nanomaterials, exposure measurements and hygiene requirements for nano-titanium dioxide, exposure to nano-silver in mattresses and beddings and their health effects, associations between seasonal patterns, climate variables, and dengue risks in Singapore. 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1. Introduction
Despite the emphasis on arteriovenous fistula creation in patients requiring renal replacement therapy, catheter-based hemodialysis remains a valuable access option that allows for immediate initiation. They continue to serve as an important option for chronic kidney disease (CKD) patients who are: (a) awaiting a permanent AV access creation or maturation, (b) in need of acute hemodialysis, (c) have exhausted traditional access routes, and (d) those suffering from graft infection or extravasation episodes [1].
Catheter-related sheath (CRS) formation, previously referred to as the “fibrin sheath” is a well documented physiologic reaction occurring between the catheter, vein wall, and blood elements. The incidence of central venous CRS formation is reported to occur in 42%-100% of central venous catheters [2-5]. The sheaths can be asymptomatic or result in a number of complications including withdrawal occlusion, medication extravasation, thrombosis, infection and in rare cases pulmonary embolism. Repeat catheter removal and replacement, or loss of an access route is not infrequently the end result of catheter related sheath formation. It is important for those clinicians caring for CKD patients to be aware of the clinical and imaging manifestations of CRS and understand the interventions that can be used to mitigate them.
The goals of this chapter are to review the existing literature on CRS in animals and humans, to provide a current, coherent explanation of the composition of the CRS and how they form, and describe the clinical manifestations and treatment options that are available
2. A brief history of central venous catheters and catheter-related sheaths formation
The first catheterization of a central vein was performed in 1733 by an English clergyman named Stephen Hales who fixed a glass tube to the left jugular vein of a mare to measure venous pressure [6,7]. It wasn’t until the late 1920’s that Werner Forssmann performed the first documented central venous catheterization in a human when he passed “a well oiled 4F ureteric catheter” through his left antecubital fossa and into this heart. Remarkably, Forssmann then climbed several flights of stairs to the x-ray department to visualize his catheter placement [8,9]. Decades passed and it was not until the 1970’s that the central venous catheter became widely available [10].
One of the earliest descriptions of CRS covering a central venous catheter described a “fibrin sleeve” published in the French literature in 1964 by Motin [11]. A number of subsequent studies referred to the central venous catheter related sheaths as a fibrin sleeve and fibrin sheath [2,3,5]. More recently, the work of Xiang et al. more accurately described the CRS as cellular-collagen tissue covered by an endothelial layer. Fibrin was described a component of an early physiologic response to the catheter that consists of pericatheter thrombus, but the CRS itself is not composed of fibrin [12]. Subsequent papers by these authors and others reinforced the concept of CRSs representing a spectrum of thrombosis and thrombus organization [13-16].
3. Clinical implications
The most common manifestation of CRS is catheter dysfunction. This interrupts the patient’s medical therapy, may require intervention ranging from thrombolytic infusion to catheter removal or exchange, and may have long lasting implications such as loss of specific venous access locations. Extravasation of fluids or intravenous medication is a less common but certainly significant complication that can result in tissue loss and necrosis. Thrombus that forms on the CRS or the CRS itself can on rare occasion become dislodged and embolize to the pulmonary circulation. Finally, there have been reports that the presence of the sheath is a risk factor for catheter-related bacteremia and infection.
When dysfunction is present, the patient is commonly referred for radiographic evaluation of the catheter. A radiograph or fluoroscopy of the chest is performed to document catheter tip position. Contrast injection of a normal, functioning catheter should show contrast exiting the end-holes and filling a substantial portion of the vein lumen distal to the catheter tip. When a sheath is present, contrast will track in a retrograde fashion along the catheter. The contrast will then “spill” out into the vein lumen via gaps or fissures in the sheath.
Figure 1.
Catheter injection under fluoroscopy. The existing catheter has been pulled back approximately 10 cm and then injected. Contrast fills a well developed sheath considerably narrower than the expected diameter of the superior vena cava. A guide wire has been advanced through the other catheter lumen and is positioned in the inferior vena cava in preparation for exchange.
4. Histopathology of catheter related sheaths
By the middle of the 20th century, central venous catheters were being placed with subclavian and jugular approaches and used for intravenous infusion [6]. The presence of a tissue-like covering was reported after catheters had been indwelling for relatively short periods of time. An early description of this coating appeared in the French literature in 1964 [11]. Since that time, the covering has been referred to as a fibrin sleeve [2,3], a sleeve thrombus [4], a sleeve [12], and—the most recognized phrase—a fibrin sheath [5]. The reported frequency of this observation ranges from 42% to 100% [2-5]. Although there are a number of articles in the literature that are concerned with the clinical aspects of CRS; a minority of these focus on the sheaths’ histopathologic features and microscopic development.
An often-referenced article [2] describes the findings at autopsy in 55 patients with subclavian vein catheters. In that study, sheaths were identified in all specimens, even as soon as 24 hours after catheter insertion. Microscopic evaluation was reported to reveal a predominately fibrin makeup, “with no evidence of endothelialization or organization.” The sleeve was observed, in many cases, to be adherent to the adjacent vein wall.
Figure 2.
a)Gross photograph of a well developed, circumferential catheter-related sheath (CRS) that formed in a swine vena cava after only seven days indwelling time. b)Catheter-related sheath from a human autopsy specimen. The sheath is well developed and there is a prominent pedicle-like attachment to the vein wall. c)Ultrasound (US) image of a catheter-related sheath (CRS). Transverse US image from the base of a patient’s neck prior to insertion of a tunneled hemodialysis catheter. There is a rounded structure attached to the anterior jugular vein wall representing residual CRS. A previous tunneled catheter had recently been removed secondary to infection.
Well into the 1990s, descriptions of a catheter-related sheath consisting of “fibrin and thrombocytes” [17] or a “layer of investing fibrin and proteinaceous material” [18], could still be found in the literature.
Later, two reports offered a more detailed microscopic and histologic description. In 1996, a study [19] was performed in which small-caliber silicone catheters were inserted in 15 rats. The catheters were placed via a jugular approach, and the animals were sacrificed at 3, 7, and 60 days. Catheter-related thrombus, with points of attachment to the vein wall, was observed in the earliest group. The thrombus underwent changes typical of organization at the 7-and 60-day observation points and evolved into what was described as a “dense fibrous connective tissue containing numerous spindle-shaped fibroblasts” [19].
In a second, larger study [12], again performed in a rat model, catheters were placed via the jugular vein in 123 animals. Histologic changes were studied at catheter indwelling times that ranged from 1 day to 6 months. A true pericatheter thrombus was identified in all animals within the first 3 days after catheter insertion. A transformation occurred from pericatheter thrombus to a more cellular structure composed of collagen with smooth muscle and endothelial cells; this latter structure appeared 1–4 weeks after catheter placement.
Three kinds of catheter-associated thrombus have been described [14]. The first variety is a mesh-like thrombus that bridges the vein wall and catheter. This is thought to evolve into the mixed cellular and collagen catheter-related sleeve described by these authors in an earlier report [12]. A second, nonorganized form of thrombus has been termed “sleeve-related thrombus” and is found on the distal aspects of the indwelling catheter itself. This variety has no attachment to the vein wall and is histologically and physically separate. Last, mural thrombus is found on the vein wall adjacent to the distal intravascular aspect of the catheter. This thrombus undergoes organization and is thought to become incorporated into the vein wall. It is uncertain why a thrombus at a particular location develops into a cellular bridge instead of incorporating into a vein wall, although catheter motion may influence this process [20].
In a large animal model (swine), Forauer et al [16] examined CRS formation at 7, 14, 30, and 45 days after catheter insertion. This confirmed the cellular nature of the sheath including endothelial and smooth muscle cells; see Figure 3. These cell populations were not randomly present; the smooth muscle cells assumed a typical orientation to the vessel lumen with the long axis of the cell oriented with the circumference of the vessel. The smooth muscle cells were also involved in neovascularity of the sheath, forming small lumens lined with endothelial cells. The endothelial cells formed a monolayer covering the external portion (vascular lumen aspect) of the sheath that was indistinguishable from adjacent vein wall intima.
The development of the catheter-related sheath is postulated to begin with thrombus that develops after trauma associated with the catheter insertion procedure [3,21]. Local trauma occurs at the venotomy site. Factors contributing to thrombus formation include disturbance of normal flow through the venous segment and stasis that occurs between the catheter and the vein wall. Other locations of trauma occur at foci of friction of the catheter against the vein wall or catheter tip impact against the vein wall and in segments where catheters lie in acute angles within the course of the vein [20,21]. In addition, acute or chronic (organized) thrombus has been confirmed in catheter stripping specimens [13].
Figure 3.
Low-power (x50) micrograph demonstrating smooth muscle cells in the catheter-related sheath. Immunohistochemistry (anti-smooth muscle stain, 1:50) highlights positive staining smooth muscle cells, seen as brown, in both the vein wall and throughout the sheath (solid arrow). A circular arrangement of smooth muscle cells is present in the sheath (open arrow), representing neovascularization within the sheath.
The role of catheter-tip trauma and associated thrombus formation has been examined, also in a swine model [20]. Silicone catheters with or without a 0.018-inch wire stabilizing loop at the distal indwelling tip were inserted, and their tips were positioned in the distal aspect of the superior vena cava. In the group in which catheter tips were stabilized by the wire loop, there was only a mild increase in vein wall thickness without vein wall thrombus. In the control group (without the stabilizing loop), mural thrombus formed at the site of local vein wall trauma caused by catheter tip motion. This thrombus subsequently underwent organization and resulted in vein wall thickening and intimal hyperplasia. The organization of intravascular thrombus involves an infiltration by smooth muscle cells and the development of a vascularized connective tissue that includes collagen, smooth muscle cells, and endothelial cells [22,23]. Inflammatory cells are also known to be involved in venous thrombosis [24].
The process of catheter-related sheath formation is a dynamic and ongoing response of the components of the vein wall to the catheter and associated thrombus. The sequence of the steps of sheath formation is similar among animals and humans. Inflammatory, endothelial, and smooth muscle cells are involved in this response, and these are all biologically active cell types. Findings support the hypothesis that a pathologic process occurs when thrombus organizes adjacent to a synthetic scaffold—a catheter. This process differs from intravascular thrombus formation because the presence of the catheter within the vessel lumen allows the process to continue with only limited focal vein wall contact.
The role of medical comorbidities, such as diabetes mellitus and hypercholesterolemia, in the formation of CRS has not been well evaluated. A small randomized study evaluating the occurrence of late malfunction in tunneled hemodialysis catheters did note a trend toward late catheter malfunction (either thrombosis or CRS formation) in patients with diabetes, but this did not reach statistical significance (p=0.054) [25]. Several series focusing on peripherally inserted central catheters and non-tunneled internal jugular central venous catheters have shown no clear relationship between diabetes or hypercholesterolemia on thrombotic complications [26-28]. The specific role of hypercholesterolemia in CRS formation has not been addressed.
5. Clinical manifestations of the CRS
While this process can remain clinically silent, there are many clinically important sequelae to sheath formation. These include withdrawal occlusion, total occlusion of the catheter [29], vein thrombosis [4,17,30,31], infusate extravasation [30], pulmonary embolus at catheter removal [2,4], and predisposition to infection [32-34]. Vessel thrombosis can also result in loss of the venous access route- a sobering prospect for a patient requiring long-term renal replacement therapy.
The first indication that a CRS is present is often the ability to flush or inject, but the inability to aspirate from a catheter, termed withdrawal occlusion. This occurs when a CRS encases the tip of a catheter and effectively forms a one-way valve [35]. Additionally, defects or rents in the CRS may allow infusion while not providing sufficient area to aspirate; see Figure 1. This persistent withdrawal occlusion results in chronic catheter dysfunction and poor flow rates. It can also result in the serious complication of medication extravasation [36]. Medication extravasation can result in significant morbidity with administration of chemotherapeutic agents. The infusate injected into the catheter exits the end-hole, tracks retrograde between catheter and the sheath and can follow this path back to the venotomy and into the soft tissues; see Figure 4. The patient may experience pain, inflammation, and tissue necrosis.
The thrombotic complications of pericatheter thrombus formation resulting in a catheter related sheath can lead to stenosis or frank occlusion of the veins anywhere along the indwelling path of the catheter. Intraluminal and mural thrombosis may also contribute to catheter dysfunction and complete venous thrombosis. The catheter dysfunction secondary to intraluminal thrombosis may also present with persistent withdrawal occlusion secondary to a “ball–valve” effect within the catheter lumen [37], and may likely manifest resistance to antegrade flushing as well. Mural thrombi may partially or completely block a vein and are often asymptomatic, but may present with arm, neck, head or jaw pain, numbness of the ipsilateral extremity, erythema, phlebitis or venous distension [37]. In the extreme, the patient may display symptoms of superior vena cava syndrome.
Figure 4.
Catheter-related sheath causing soft tissue extravasation. a)Early and b) late images from a contrast injection of a right sided chest port. No contrast is observed exiting the distal end-hole of the post catheter. The contrast tracks retrograde along the catheter and exits in the soft tissues of the neck at the level of the venotomy.
CRS and pericatheter thrombus has also been implicated as a risk factor for infection. Mehall et al. established that CRS significantly enhanced catheter related infection and bacteremia. It was postulated that the sheath provides a surface for bacterial attachment and source of septic emboli [34].
Cases of CRS being dislodged into pulmonary vasculature have been described [4,38]. However, this complication appears to be rare or clinically insignificant given the relatively small volume embolic burden and the bridging of cellular tissue with the vein wall.
6. Clinical interventions and management
6.1. Thrombolytic therapy
An initial, conservative approach to patency restoration is the use of thrombolytic agents. Thrombolytic therapy for treatment of hemodialysis catheter malfunction due to thrombosis or CRS has been used for decades. Two basic protocols have been employed: indwelling (“lock”) catheter treatments and infusion therapies. Indwelling or “lock” treatments involve administration of a volume of thrombolytic agent which only fills the catheter lumen for a variable amount of time. Infusion treatments involve the infusion of variable doses of thrombolytic through the hemodialysis catheter over several hours.
Multiple different thrombolytic medications have been used with the two methods above in varying doses over the years. Urokinase was the agent of choice for both protocols until its withdrawal from the North American market in 1999. It was reintroduction to the market in 2002. To date, it is the only thrombolytic agent to be directly compared with percutaneous catheter related sheath stripping (PCRSS) in a prospective randomized trial. In 2000, Gray et al found no significant difference in primary patency between urokinase infusion and PCRSS [39]. Low dose (5000 to 9000 units) indwelling treatments have had mixed results in the literature with successful return of catheter function ranging from 14% to 95% [40]. More recently, positive results with high dose urokinase (25,000 to 100000 IU) indwelling treatments have been reported by Donati et al with recanalization rates up to 100% [41].
Since urokinase was withdrawn from the market in North America, several other thrombolytic agents have been evaluated. Multiple published reports and a clinical trial have shown alteplase to be effective and safe [42-45]. There is evidence that alteplase yields similar or better results compared to UK [46-48]. Although less studied, reteplase has also been shown to be safe and effective but no direct comparison has been made to the more commonly used thrombolytic agents [49,50]. Tenecteplase has also been shown in Phase III trials to be safe and effective in the treatment of dysfunctional catheters [51,52]. Newer thrombolytic agents such as recombinant-urokinase, afimeprase, and anistreplase are currently under investigation [53].
Because the composition of the CRS has a significantly cellular component, the efficacy of thrombolytics must be attributed to interaction with the associated thrombotic elements that are present.
6.2. Percutaneous CRS stripping and other mechanical interventions
Mechanical interventions have also been employed as a treatment for CRSs which result in occlusion or decreased blood flow rates. Such interventions include catheter exchange and PCRSS with balloon disruption. Although sheath stripping is used less frequently in favor of catheter exchange at many institutions, an understanding of the technique is important.
Treatment of occluded central venous catheters by some method of mechanical disruption has been described in the literature as early as 1983 using a straight guide wire advanced through the catheter lumen via a Y-valve under simultaneous constant suction with 100% success [54].
In 1995, Knelson et al [55] described two techniques (a wire only and separate snare technique) for PCRSS. Eleven of the patents had either a J-tipped wire or tip-deflecting wire advanced through the catheter until the curved tip just excited the catheter end, after which it was rotated several times until contrast injection under fluoroscopy demonstrated patency. Alternatively, a snare technique was employed via right femoral vein access. Here, a nitinol loop snare was advanced 5cm over the catheter with the aid of a 6-F guiding catheter, closed and retracted under moderate tension stripping off the sheath surrounding the catheter. Nineteen of the twenty treatments were successful with a mean duration of satisfactory function following intervention of 150 days.
Subsequent retrospective studies have reported high technical success rates [56-59], but with less promising durable clinical results with 45% and 28% primary patency at 3 and 6 months respectively [58]. A study specifically evaluating HD catheter flow rates post stripping yielded more disappointing results: the average flow rate fell below host the institution’s standard by the fifth hemodialysis session [56]. Suhocki found primary and secondary mean patency at 3 and 4.5 months respectively [59]. Johnstone found at 6 months primary and secondary patency rates of 40% and 60%, respectively [60]. In 1999, Brady et al [61] prospectively found median post-stripping patency of 89 days(i.e., 3 months).
In 2007, Reddy et al [62] described a new “internal” snare approach as opposed to the “external” approach from a femoral vein. Here, a nitinol wire was bent in its mid portion 180 degrees resulting in a loop. The loop was then advanced through the proximal lumen until and then was tightened down on the distal portion of the catheter snaring it. The looped nitinol wire was also advanced though the distal lumen. Multiple passes were made in each lumen often resulting in clot/sheath removal. Disruption of the CRS was attributed to two mechanisms of action: the stripping action of the snare over the distal lumen and the deformation/expansion of the catheter as the snare is advanced. Nine internal snare procedures were performed in seven patients who had failed pharmacologic lysis with 100% technical success. With the internal snare procedure, there was a 100% patency at 8 weeks and a mean patency of 108.5 days without complication.
In 2002, Angle et al [63] published a five year retrospective analysis of 115 patients with 340 tunneled hemodialysis catheter fluoroscopic evaluations of which underwent one of five interventions: conservative management (aspiration/flushing), tip-deflecting guide wire manipulation, catheter exchange, PCRSS with a snare via femoral approach, and thrombolytic infusion. Failure rates at 30 days using the five management strategies above ranged from 24% to 62%. PCRSS had the lowest 30 day failure rate of all the methods evaluated.
There have been two prospective trials comparing the effectiveness of different techniques on the dysfunctional dialysis catheter. In 2000, Merport et al [64] performed a randomized prospective clinical trial comparing the effectiveness of over-the-wire catheter exchange versus PCRSS over 37 encounters in 30 patients with malfunctioning hemodialysis catheters which demonstrated 1-month patencies of 93% and 31% respectively. Estimated costs were lower in the catheter exchange group.
In 2000, Gray et al [39] performed a randomized prospective clinical trial comparing the effectiveness of PCRSS with a femoral snare approach versus 250,000 U urokinase infusion over 4-hours. Forty-five day primary patency rates for PCRSS and urokinase infusion were 35% & 48% respectively and were not statistically significant (p=.2).
6.3. Other alternatives
Hemodialysis catheter exchange with or without CRS balloon disruption with has been well described with comparable or improved outcomes compared to PCRSS [64-68]. This procedure is performed by placing guide wires through the existing catheter into the superior or inferior vena cava, freeing the retention cuff from the surrounding tissues using blunt dissection, and removal of the catheter. Disruption of the CRS can be accomplished by advancing a modest diameter (6-8 mm) angioplasty balloon catheter and performing inflations along the previous course of the catheter; see Figure 5. A new catheter is then advanced over the guide wires and through the existing subcutaneous tunnel. When performed using strict sterile technique, there is no increased risk for infection. This strategy has the advantage of preserving the existing venous access site. The less invasive nature of this procedure is responsible for its current widespread application.
Figure 5.
Balloon disruption of a catheter-related sheath (CRS). a) Inflation of an over the wire angioplasty balloon to disrupt the sheath.b) Post balloon disruption contrast injection. The full lumen of the superior vena cava is now opacified.
Endoluminal brushing of occluded hemodialysis catheters during thrombolysis has been reported with success [69]. This technique targets only the inner lumen of the catheter, not the external CRS.
6.4. Catheter material, coatings and shape
A multitude of tunneled hemodialysis catheters have been marketed over the years with differences in catheter material, tip shape, number of side holes and surface coatings with the hope of reducing complications. While the effects on infection rates and thrombosis of these different catheter types have been studied, rigorous examination of different catheter types on CRS formation is less well understood.
Catheter material has traditionally been variants of either silicone or polyurethane. More recently carbothane has been introduced allowing for greater catheter wall strength and resistance to certain chemicals. In vivo studies of catheter material with regard to thrombogenicity and platelet adhesion have had mixed results showing both no difference between polyurethane and silicone [70] and lower thrombogenicity with polyurethane [71]. Unfortunately, these studies did not evaluate the relationship between thrombogenicity and CRS formation.
A variety of antibiotic and antithrombotic catheter-bound coatings have been developed to prevent infection and thrombosis. As expected, studies have shown that heparin-coated central venous catheters can reduce central venous catheter thrombotic complications [72,73]. A retrospective study published in 2009 evaluated the differences in primary patency between heparin-coated and uncoated hemodialysis catheters. Primary patency at 30 and 90 days demonstrated a slight trend favoring the heparin-coated catheters, but the results did not reach statistical significance (p=0.08) [74].
Variations in catheter tip shape, number of lumen and number of side holes continue to evolve with promises of decreased recirculation, rates of thrombosis and improved flow rates. A randomized prospective evaluation of three catheter configurations- paired catheters, split tip catheters, and stepped lumen catheters was published in 2001. Despite different design and arrangement of side holes or lumens, all three catheters had similar survival times and flow rates [75]. In 2008, Kakkos et al attributed differences in tip shape to the significant improvement in 90 day primary assisted patency of the Tal Palindrome Ruby (Covidien; Mansfield, MA, USA)) catheter compared to the HemoSplit (Bard Access Systems; Salt Lake City, UT, USA) tunneled catheter, 94% versus 71%, respectively [76]. This difference persisted at 180 days.
6.5. Future directions
Considerable effort in current interventional cardiovascular research is focused on drug-eluting coatings for stents [77]. These coatings consist of cytostatic or cytotoxic agents that target cell populations involved in stent related restenosis. The characterization of the cellular basis of catheter-related sheath formation may initiate further developments in the area of catheter technologies [78] that could include the development of materials with or without coatings that prevent, retard, or eliminate the sheath.
7. Summary
Catheter-based hemodialysis remains an important option for many chronic kidney disease (CKD) patients. In addition to catheter-related infections, CRS formation is responsible for a significant proportion of catheter dysfunction. It is a dynamic and on-going response of the vein wall to the catheter and the associated thrombus. It involves biologically active cell types and there are many similarities with the process of thrombus organization. There have been numerous methods developed to restore catheter function; thus far, none have provided consistent long term, durable results.
\n',keywords:null,chapterPDFUrl:"https://cdn.intechopen.com/pdfs/43069.pdf",chapterXML:"https://mts.intechopen.com/source/xml/43069.xml",downloadPdfUrl:"/chapter/pdf-download/43069",previewPdfUrl:"/chapter/pdf-preview/43069",totalDownloads:3318,totalViews:857,totalCrossrefCites:4,totalDimensionsCites:8,totalAltmetricsMentions:3,introChapter:null,impactScore:6,impactScorePercentile:95,impactScoreQuartile:4,hasAltmetrics:1,dateSubmitted:"May 1st 2012",dateReviewed:"August 31st 2012",datePrePublished:null,datePublished:"February 27th 2013",dateFinished:"February 15th 2013",readingETA:"0",abstract:null,reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/43069",risUrl:"/chapter/ris/43069",book:{id:"3267",slug:"hemodialysis"},signatures:"Robert Percarpio, Elizabeth T. Chorney and Andrew R. Forauer",authors:[{id:"157540",title:"Dr.",name:"Andrew",middleName:null,surname:"Forauer",fullName:"Andrew Forauer",slug:"andrew-forauer",email:"andrew.r.forauer@hitchcock.org",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Dartmouth College",institutionURL:null,country:{name:"United States of America"}}},{id:"157543",title:"Dr.",name:"Robert",middleName:null,surname:"Percarpio",fullName:"Robert Percarpio",slug:"robert-percarpio",email:"robert.b.percarpio@hitchcock.org",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Dartmouth College",institutionURL:null,country:{name:"United States of America"}}},{id:"166202",title:"Dr.",name:"Elizabeth",middleName:null,surname:"Chorney",fullName:"Elizabeth Chorney",slug:"elizabeth-chorney",email:"echorney@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Dartmouth College",institutionURL:null,country:{name:"United States of America"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. A brief history of central venous catheters and catheter-related sheaths formation",level:"1"},{id:"sec_3",title:"3. Clinical implications",level:"1"},{id:"sec_4",title:"4. Histopathology of catheter related sheaths",level:"1"},{id:"sec_5",title:"5. Clinical manifestations of the CRS ",level:"1"},{id:"sec_6",title:"6. Clinical interventions and management",level:"1"},{id:"sec_6_2",title:"6.1. Thrombolytic therapy",level:"2"},{id:"sec_7_2",title:"6.2. Percutaneous CRS stripping and other mechanical interventions",level:"2"},{id:"sec_8_2",title:"6.3. Other alternatives",level:"2"},{id:"sec_9_2",title:"6.4. Catheter material, coatings and shape",level:"2"},{id:"sec_10_2",title:"6.5. Future directions",level:"2"},{id:"sec_12",title:"7. Summary ",level:"1"},{id:"sec_13",title:"Nomenclature",level:"1"}],chapterReferences:[{id:"B1",body:'The National Kidney Foundation. 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Catheter Patency and Function after Catheter Sheath Disruption: A Pilot Study. Clin J Am Soc Nephrol 2007;2(6) 1201-6.'},{id:"B69",body:'Farmer CKT et al. Endoluminal brushing of blocked permanent indwelling haemodialysis catheters saves money. Nephrol Dial Transplant 1997;12(9) 2040.'},{id:"B70",body:'Linder LE et al. Material thrombogenicity in central venous catheterization: A comparison between soft, antebrachial catheters of silicone elastomer and polyurethane. J Parenter Enteral Nutr 1984;3 399-406.'},{id:"B71",body:'Soloman DD et al. An in vivo method for the evaluation of catheter thrombogenicity. J Biomed Mater Res 1987;21(1) 43-57.'},{id:"B72",body:'Krafte-Jacobs B et al. Catheter-related thrombosis in critically ill children: Comparison of catheters with and without heparin bonding. J Pediatr 1995;126 50-4.'},{id:"B73",body:'Pierce CM, Wade A, Mok Q. Heparin-bonded central venous lines reducethrombotic and infective complications in critically ill children. Intensive Care Med 2000;26 967-72.'},{id:"B74",body:'Clark TWI et al. Comparicon of heparin-coated and conventional split-tip hemodialysis catheters. Cardiovasc Intervent Radiol 2009;32 703-6.'},{id:"B75",body:'Richard HM et al. A randomized, prospective evaluation of the Tesio, Ash Split, and Opti-flow hemodialysis catheters. Cardiovasc Intervent Radiol 2001;12 431-5.'},{id:"B76",body:'Kakkos SK et al. Effectiveness of a new tunneled catheter in preventing catheter malfunction: a comparative study. J Vasc Intervent Radiol 2008;19 1018-26.'},{id:"B77",body:'Duda SH et al. Sirolimus-eluting stents for the treatment of obstructing superficial femoral artery disease: six-month results. Circulation 2002;106(12) 1505–9.'},{id:"B78",body:'Baumann M et al. Prolonged catheter survival in intermittent hemodialysis using a less thrombogenic micropatterned polymer modification. ASAIO J 2003;49(6) 708–12. '}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Robert Percarpio",address:null,affiliation:'
Dartmouth-Hitchcock Medical Center, Department of Radiology, Lebanon, NH, USA
'},{corresp:null,contributorFullName:"Elizabeth T. Chorney",address:null,affiliation:'
Department of Radiology, Mount Sinai Medical Center, New York, NY, USA
'},{corresp:"yes",contributorFullName:"Andrew R. Forauer",address:"Andrew.R.Forauer@Hitchcock.org",affiliation:'
Dartmouth-Hitchcock Medical Center, Department of Radiology, Lebanon, NH, USA
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1. Introduction
Replace the entirety of this text with the introduction to your chapter. The introduction section should provide a context for your manuscript and should be numbered as first heading. When preparing the introduction, please bear in mind that some readers will not be experts in your field of research.
Cultural heritage is situated in both natural and semi-natural environments, as well as in highly urban environments, where various activities can accelerate the transformation of the area and have a negative impact on the quality and use of the cultural heritage. Therefore, spatial development policy is crucial in protecting, managing and increasing the value of such areas, primarily through the adoption and implementation of appropriate planning solutions and measures. In addition, the interaction between different sectoral policies and the coordination of their territorial impacts is important.
These generally accepted positions point to the key role of spatial and urban planning in the sustainable development and protection of cultural heritage. With these starting points, the authors use spatial plans as the research subject in this paper, analyzing the methodology of their development and content. The hypothetical assumptions of this research are that the method of planning in an area of cultural heritage differs depending on the type and level of the spatial plan. Furthermore, it is possible to identify aspects of protection and sustainable development in the plans, with the protection of cultural assets clearly dominating in planning practice. Finally, the hypothetical assumptions are concluded with the authors’ views that the protection and the development of cultural heritage are not integrated with landscape planning, and that the aspect of implementation is insufficiently addressed in plans.
One of the basic principles of sustainable spatial development is the principle of increasing cultural heritage stock as a development factor [1, 2], which includes increasing the value of cultural heritage. This is one of the most significant contributions to economic development and the strengthening of regional identity, achieved by means of increasing the attractiveness of sites for investors, tourists and the public. Spatial development policy should contribute to the integrated management of cultural heritage, based on the idea of the development process of protection and conservation, while respecting the needs of modern society. Many countries in Europe have monuments that follow the traces of different schools of art and artistic movements, which requires the development of a common approach in conservation, restoration and use, initiating programs of “great cultural routes”. In many countries, there are types of cultural heritage that, due to historical changes, events and changes in borders, do not belong to only one but to a larger number of nations, language communities and religious groups, some of which no longer live in those regions. Spatial development policy must preserve and respect the memories of each nationality, language community and religious group, which have created a specific type of cultural heritage.
International documents adopted in the last decade [3] which refer to the protection, planning and management of cultural heritage emphasize a contextual approach that considers the expansion of the object of protection, from individual monuments to wider spatial units. They underline the need for integrating conservation, management and planning strategies for historic urban areas with development and planning documents. In addition, the concept of protecting areas of cultural heritage and their surroundings is closely connected to the issues of planning and protecting landscapes, with special significance given to the integration of landscape development into spatial planning and other sectoral policies, as well as the implementation of integrated policies aimed at the protection, management and planning of areas of cultural heritage.
Based on the above, it seems that the current procedures for protection and planning with regard to cultural heritage can and must be improved, particularly concerning the development aspects of protection, implementation, coordination with other sectoral policies and others. The analysis of previous experiences and the possibility of improving the process of spatial planning in the field of cultural heritage are the main goals of this paper.
2. Literature review
Consulting the most recent scientific literature, i.e., papers published in the last five years, the authors consider that the greatest preoccupation is on themes related to planning within protected natural areas, while studies covering the relationship between planning actions and restrictions related to the protection of cultural and historical heritage are scarce. On the other hand, it is clear that this topic is by no means exhausted and requires further analysis, especially from the aspect of developing sustainable tourism and strategies for actively protecting and promoting valuable monuments.
Some studies concentrate on the topic of the cultural landscape as the broadest concept: “Cultural landscapes are poorly inventoried and evaluated in protected natural areas. But there is a novel procedure to assess cultural landscape features and their cultural values in the major protected areas. After identifying a set of culturally modified land cover types and habitat types the GIS-based survey, with a set of 12 cultural attributes (involving cultural heritage values, traditional land uses and aesthetic quality) indicators were scored to assess these “cultural values” in each site. Gradient maps were produced to express an initial nation-wide site ranking profile. Heatmaps help link instead of solely rank culturally valuable sites that are in proximity to each other, showcasing site clusters of outstanding value. These analyses help define the level of “culturalness” of each site based on human-modified landscape and habitat types and provide a baseline review of cultural values in protected natural areas. This screening-level survey identifies the protected areas that may require special attention for managing cultural elements-of-diversity” [4].
Other authors focus on the use of modern GIS technologies for displaying locations and their overlapping areas of interest and restrictions, as well as for tracking the number of visits: “New technologies are used in mapping not only of heritage locations but also about visitation and expressed interest” [5]. Massiveness certainly brings profit, but it reduces the quality of the experience, so it is necessary to change the concept and approach: “Visitor management planning is a new concept, tool and strategy of sustainable tourism and ecotourism. The importance of this concept is in the new approach to tourism in natural and heritage protected areas of the country, which means implementing a completely different philosophy of tourism” [6].
It is the number of visits that has become a key factor for some locations, because the excessive crowds resulting from the huge interest of tourists, so-called “overtourism”, causes negative effects, and instead of contributing to the presentation and sustainability of valuable monuments, it leads to its degradation [7]. The authors cite a number of examples and offer recommendations for overcoming such situations. One of the causes of excessive tourism can be cruising destinations, if the distribution of visitors is not properly dosed. On the other hand, tours on the Danube Corridor can be seen as having great potential as an opportunity, which has contributed to the strategic planning of 9 new locations for passenger ports, in addition to the existing 5, primarily in the immediate vicinity of cultural and historical sites: “In the Podunavlje area in Serbia, significant attractions are located in vibrant urban centers such as Belgrade and Novi Sad, with seven fortresses from north to east downstream, including Bač, Petrovaradin, Beograd, Smederevo, Ram, Golubac, and Kladovo (Fetislam). There are also 21 archeological sites, the most significant of which are the Vinča and Lepenski Vir sites from prehistoric times, along with the city of Viminacium, Emperor Trajan’s road, bridge and stone board with inscriptions from the Roman period. Apart from these landmarks, two national parks (Fruška Gora and Ðerdap), several other parks, special nature reserves, nature monuments, and areas with significant characteristics are situated in the surrounding areas and are protected areas” [8].
Participation of the public and stakeholders in the planning process itself, and the harmonization of the needs of contemporary life and development of tourism with the limitations arising from protection regimes are also significant issues: “Most studies on community participation in tourism planning only advocate the importance of the concept and/or identify barriers without articulating the required actions or strategies to actually promote community participation. Six strategies emerged as major prerequisites to achieve full and active community participation in tourism planning associated with protected areas are: public awareness and education; capacity building; creation of linkages; use of appropriate participation methods; involvement of appropriate local community organisations and decentralisation and coordination of relevant management organisations” [9]. Proper implementation of the participation procedure and transparency of the planning process are the guarantee of quality implementations of plans in the future [10, 11, 12, 13, 14]. The general conclusion is that some global topics, as well as practical experience, can be used with certain adjustments to the situation and systemic frameworks in the Republic of Serbia.
3. System of sustainable development and protection of cultural heritage in the Republic of Serbia
The basic framework for the protection and sustainable development of cultural heritage in the Republic of Serbia is determined by the Law on Cultural Property [15] and the Law on Planning and Construction [16]. In accordance with the Law on Cultural Property, cultural heritage is made up of objects and creations of material and spiritual culture of general interest, which are under appropriate protection. They are divided into movable and immovable cultural heritage. Depending on the physical, artistic, cultural and historical characteristics, immovable cultural heritage is: cultural monuments (buildings/architectural objects or units), whole cultural and historical spatial units (part of an urban or rural settlement in which there are multiple cultural assets), archeological sites and landmarks (space related to an event or person of significance in history).
According to their significance, they can be: uncategorized cultural heritage, cultural heritage of great importance and cultural heritage of exceptional importance. Cultural heritage of exceptional importance has one of the following characteristics: special significance for the social, historical and cultural development of the people; it testifies to crucial historical events and personalities; it presents unique examples of the creativity of its time; it has a great influence on the development of society, culture, technology and science; or it has exceptional artistic and esthetic value. Cultural heritage of great importance has one of the following characteristics: it is significant for a certain area or period; it testifies to the phenomena or conditions of social, cultural and historical development; it testifies to significant events and prominent figures in history.
When an architectural object is declared as immovable cultural heritage, its protected environment is determined, which has the same protection status as the object itself.
These elements indicate the dominant aspect of protecting cultural heritage. However, the issue of their sustainable development (presentation, use), spatial aspects and integration with other activities and functions in space are determined by the Law on Planning and Construction. As basic principles in the arrangement and use of space, the law defines the protection and sustainable use of immovable cultural heritage, and the preservation of customs and traditions, as well as the specifics of the landscape.
The system of planning documents consists of the spatial plan of the Republic of Serbia, regional spatial plans and spatial plans for special purpose areas adopted at the national or regional level, as well as the spatial plans of local self-government units and urban plans adopted at the local level. Each of the listed plans in the hierarchy must be harmonized with the higher order plan (wider area).
The spatial plan of the Republic of Serbia is the basic planning document for spatial development, which has a strategic development function, and contains measures for the protection, arrangement and improvement of cultural heritage (scale of graphic attachments 1: 300,000). Regional spatial plans are prepared for larger spatial units of an administrative character and are focused on regional development goals and projects (scale of graphic attachments 1: 50,000). Spatial plans for special purpose areas are prepared for areas of national interest that require a special regime of organization, arrangement, use and protection of space, and especially for areas of cultural and historical units and environmental value. Their specificity is that they can contain all the detailed elements of urban plans (different sizes, up to 1: 1,000) and that they are directly implemented by applying the rules of arrangement and construction, with the possibility of resolving property relations if necessary.
Bearing in mind the basic elements of this system, the authors conducted research on a case study of three spatial plans which in terms of their methodology and content make up the planning system of protection and sustainable development of cultural heritage in Serbia.
Further, the paper presents only some of the key elements that indicate the aspect of protecting immovable cultural heritage and its surroundings in plans, while the analysis included the entire spatial plans and the documentation on which their development was based.
4. Analysis of the sustainable development and protection of the cultural heritage in spatial plans
4.1 Spatial plan of the Republic of Serbia from 2021 to 2035
The Spatial Plan of the Republic of Serbia from 2021 to 2035 [17] concerns the entire territory of Serbia, which covers 88,488 km2. As one of the important aspects of spatial development, it deals with cultural heritage. According to the available information of the Institute for the Protection of Cultural Monuments from 2020 [18], it consists of a total of 2592 immovable cultural assets of various types and significance (Table 1, Figure 1).
Importante Cultural assets
Exceptional importante
Great importante
Untategorized tultural assets
Total
Cultural monument
155
512
1566
2233
Spatial cultural/historieal unit
11
28
47
86
Arclieological site
18
25
151
194
Landmark
16
17
46
79
Total
200
582
1810
2592
Table 1.
Immovable cultural assets in Serbia by type and category in 2020.
Figure 1.
Thematic map of the protection of immovable cultural heritage in the spatial plan of the Republic of Serbia from 2021 to 2035. Source: Spatial plan of the republic of Serbia from 2021 to 2035 – Draft, Ministry of Construction, transport and infrastructure, April 2021.
In addition to these, there are 12 sites (or 6 entries) under UNESCO protection in Serbia: Stari Ras medieval complex of monuments and Sopoćani Monastery, 4 medieval monasteries of the Serbian Orthodox Church in Kosovo and Metohija (Visoki Dečani, Patriarchate of Peć, Bogorodica Ljeviška, Gračanica), the remains of the Felix Romuliana Palace (Gamzigrad) and three sites of medieval tombstones known as the Stećak tombstones. In addition, 11 more sites have been suggested for entry: 1 monastery, 3 national parks and 1 nature reserve, 1 archeological site, 1 historical location, 1 settlement, 1 fortress, 1 rare natural phenomenon, and one cultural belt (the Danubian Limes).
The general aim of spatial development in the field of the protection, arrangement and use of cultural heritage is the affirmation of cultural heritage as a valuable resource for sustainable development and as a factor of national and regional, urban and rural identity. Some of its specific objectives are the development of an integrative and territorial approach to the protection, arrangement and sustainable use of cultural heritage as well as the introduction of a typological approach, and the characterization of space at the level of areas, settlements and smaller units.
This spatial plan treats cultural heritage as an inseparable part of the living environment (natural and created), seeing it in correlation with its immediate environment and the way it fits into the functions that meet the needs of modern users. The following are recommended: applying the concept of protection in urban planning, introducing contextual analysis and valorizing building stock, and the spatial audits of individual locations. In order to preserve the identity of urban and rural settlements in Serbia, it is necessary to protect, present and affirm the material remains and influences of various civilizations that inhabited the Balkan Peninsula (Roman, Byzantine, Ottoman and modern European civilizations, including the socialist period).
Bearing in mind that this is a national planning document that is indirectly implemented through other spatial plans, this plan defines a set of guidelines for the lower levels of planning.
Guidelines for cultural monuments - chronological and topographic gaps should be a priority in the valorization and revalorization of cultural monuments which, perhaps more than other immovable cultural heritage, provide a cross-section of complex civilizational trends in the area. Their preservation, study, restoration and popularization will be performed in a coordinated and integrated manner through the process of spatial and sectoral planning (in tourism, the protection of cultural monuments, etc.).
Guidelines for spatial cultural/historical units - when determining spatial cultural/historical units and their treatment in planning documents, it is necessary to respect the criteria of scientific assessments with regard to the artistic, cultural, historical and other values of the immovable cultural heritage that belong to the unit. Alongside the protection, arrangement and sustainable use of cultural heritage, it is necessary to include categories in accordance with international recommendations and standards [19, 20], such as: historic buildings and ensembles; urban and rural settlements/historic towns and villages; agricultural, industrial and technological properties; military properties; cultural landscapes, parks and gardens; cultural routes; burial monuments and sites; modern heritage, etc.
Within the current planning procedures, it is necessary to valorize the wider environment of cultural heritage in order to determine the space that is relevant for experiencing and presenting it. In that sense, it is necessary to protect the appearance, scenery, spatial configuration of the entire area, landscape and units that belong to the protection zones. Cultural heritage can be spatially connected by defining cultural areas and cultural routes at the international, national, regional and local levels.
Guidelines for archeological sites - indicate an approach to site protection which must be adapted to the site’s specific characteristics. For sites in areas that are not developed, there is an option of implementing protection by preparing a planning document. No construction or buried infrastructure can be planned in these areas. Preventive archeological research is also recommended as part of the planning process in response to proposed development solutions that could jeopardize archeological resources. Preventive archeological research should also be carried out in order to identify and record elements of archeological heritage that would be abandoned and/or destroyed as a result of development, especially when it comes to the construction of dams, roads, railways and other similar structures.
Guidelines for landmarks - it is necessary to conduct a revalorization of both already identified landmarks and landmarks whose memorial and historical value is dominant. As traces of historical events, all immovable cultural heritage of this kind should be treated equally.
The concept of the protection, arrangement and sustainable use of landscapes can be added to the mentioned elements in the planned treatment of immovable cultural heritage. One of the key elements in this is the protection and sustainable use of natural resources, natural and cultural assets, and their connection in space (local, regional, national ecological and cultural networks).
Depending on the degree and type of modification, the dominant processes that control a given space, and the character of human influence on the landscape, the territory of Serbia is classified into natural and cultural landscapes.
Cultural landscapes are divided into rural and urban landscapes, depending on the character of the modification of the landscape structure, the predominant manner of land use, the network, the type of settlement and the population density. Rural landscapes, in a structural sense, show natural characteristics that are close to the landscape. They have a lower population density and extensive land use, and rural settlements are an organic part of the natural environment. Urban landscapes are completely modified natural or rural landscape that are formed and function in relation to the needs of the urban way of life. They are zones of urban development (metropolitan areas, agglomerations, urban centers of the development axis).
Cultural landscapes may belong to the following categories: (1) designed cultural landscapes; (2) organic and relict cultural landscapes; and (3) associative cultural landscapes that possess esthetic, symbolic and spiritual value for the human community.
The spatial plan further defines guidelines for achieving the target quality of rural and urban areas. In rural areas, sustainable development is based on recognizing, protecting and improving their specific character, existing value and landscape capacities. In the development of spatial and urban plans, it is necessary to ensure: the preservation of the landscape pattern based on the specific composition and configuration, land use, the ratio of built and open space, regulation of construction and landscaping in accordance with tradition; an appropriate purpose of space and protection of the local identity; the integral protection of cultural and natural heritage and their adequate presentation for tourism, taking protection regimes into account; the affirmation and creation of the architectural identity of a settlement, based on the preservation and revitalization of traditional architecture, as well as on new construction that increases attractiveness; the formation of an ethno settlement as a museum of rural vernacular architecture, which is typical for the character of the landscape and its use for tourist purposes; prescribing morphological, ecological and landscape-shaping rules of arrangement and rules of construction.
The development of urban landscapes is based on the fact that these will continue to be the landscapes with the greatest dynamic of change. In the development of spatial and urban plans, it is necessary to provide: regulated construction and spatial planning in accordance with the target quality and character of the landscape, the specifics of the development of the urban landscape as a whole and development of individual settlements; directed expansion of urban settlements and planned construction in accordance with the demands of preserving cultural and natural heritage, the rational use of urban construction land and giving priority to urban renewal, recycling and construction within the already existing urban matrix; the preservation of open spaces and elements of nature in urban centers, the activation of abandoned and devastated spaces and the formation of a network of public spaces that connect natural and cultural assets.
4.2 Regional spatial plan of the Kolubara and Mačva administrative districts
The Regional Spatial Plan of the Kolubara and Mačva Administrative Districts [21] covers an area of 5,746 km2, i.e. an area of 14 local government units. One of its basic aims is to define the protection, preservation and presentation of cultural assets, in order for them to be included in the tourist offer and to establish a regional and local cultural identity.
In the area of the spatial plan a total of 219 immovable cultural assets are protected, of which 7 are of exceptional importance, 20 of great importance and 192 are uncategorized (of which there are 190 cultural monuments, 6 spatial cultural/historical units, 16 archeological sites and 7 landmarks).
Its main aim is elaborated through a number of specific objectives, such as: establishing integrative protection and cultural property management; undertaking urgent action to conserve, restore and revitalize the most valuable and most endangered heritage; determining and arranging the protected environment surrounding the immovable cultural heritage; integrating the protection and presentation of cultural assets in the development of the tourist offer of an area (transit and touring of cultural routes).
The basic planning commitment is the adequate protection of cultural heritage, which includes taking general measures. For archeological sites - categorizing the most valuable sites; more efficiently protecting cave archeological sites within the integral protection of natural areas of river canyons; infrastructural equipping and arranging the space covered by archeological sites; establishing archeological parks for individual sites; and determining the zones of archeological sites of regional significance.
For cultural monuments - complete technical protection, along with the renovation of individual buildings; preserving the basic properties and constructive, stylistic and typological characteristics, especially of buildings of sacral and technical architecture; presenting cultural monuments without disturbing their cultural and historical properties; recording and valorizing immovable cultural heritage, with priority given to valorizing vernacular buildings, commercial buildings, technical culture buildings and newer urban architecture; recording, valorizing and determining cultural monuments dedicated to the liberation wars of the Republic of Serbia, primarily during World War I; bringing sacral cultural monuments to an exclusively sacral purpose and liturgical needs; etc.
For spatial cultural/historical units - revalorizing and determining the categorization of individual units, as well as re-examining the validity of the boundaries of the wider protection zone for the old bazaar (City of Valjevo); implementing measures for the technical protection of a whole village (Bebića Luka), remediating and reconstructing buildings of vernacular architecture, with the introduction of modern construction and architectural elements that do not violate the integrity and authenticity of the buildings or the whole unit; defining the degree of reconstructive and remedial interventions and conservation conditions for the technical protection and presentation of buildings within individual cultural and historical units; defining restricted traffic zones and pedestrian zones in urban areas; etc.
For landmarks - intensive and systematic research and documenting of landmarks, memorials, cemeteries and tombstones; identifying commercial users; stimulating the construction of a complex within the area of a landmark to which endangered objects of vernacular architecture would be transferred; removing unplanned objects in the wider protection zone of the landmark; etc.
In addition, the basic planning commitment is to adequately present and affirm the immovable cultural assets as generators of tourism and overall development. The plan singles out particular heritage and areas that should enjoy special treatment, regardless of their current status of protection. This refers to the characteristic objects and traditions that are part of the architectural heritage - vernacular architecture (design elements, building materials, method of use), traditions and the intangible associations connected with them.
A special role in the integration of a comprehensive tourist offer is played by the possibility of forming “cultural routes” which will present immovable and intangible cultural heritage, and make connections with other types of tourist offers. Two cultural trails of international importance are planned, one through the towns of Sabac and Loznica and the other which partly follows the course of the Drina River. In addition, the plan identifies potential cultural routes of national, interregional, regional and local significance, such as the routes insurgents took during the First and Second Serbian Uprising, routes of battles and victims during the First World War, rural life through time, old mining routes and more.
This plan does not define more detailed measures, rules of arrangement or construction in the vicinity of cultural heritage, neither does it define any significant elements regarding the implementation of these solutions.
4.3 Spatial plan for the special purpose area of the landscape of outstanding features: Ovčar-Kablar Gorge
This spatial plan [22] covers a total area of 97.5 km2, i.e., the Ovčar-Kablar Gorge landscape of outstanding features (protected natural heritage) and the Ovčar-Kablar Monasteries (22.8 km2 of protected area, 74.7 km2 of unprotected area).
Unlike the previously analyzed plans, which were prepared for administratively determined areas and in which the protection and development of cultural heritage is only one of many aspects, the following are the specific focus of this spatial plan:
The Ovčar-Kablar Gorge landscape of outstanding features, protected as a natural asset, with a level III protection regime on an area of about 1,700 ha and a level II protection regime on about 550 ha within six separate spatial units;
The buildings and surroundings of the cultural monuments of great importance (monasteries) and other cultural/historical heritage within the unit of the Ovčar-Kablar Monasteries (future spatial cultural/historical units);
Spaces with the purpose of: (1) tourism, recreation and sports, especially paragliding on Ovčar Mountain; (2) integral presentations of the most attractive areas, especially the Zagrađe meander zone of the West Morava River, which is considered to be a center of cultural, natural and tourist potential.
In the area of the spatial plan, in the Ovčar-Kablar Gorge, there are 11 shrines (nine active monasteries), which is why it is often called the Serbian Mount Athos. Four monasteries have the status of established cultural monuments, which are categorized as immovable cultural heritage of great importance.
It is envisaged that the sustainable development of the special purpose areas will be based on the protection, improvement and use of natural and cultural heritage, the development of tourism, sports and recreation and the functional integration of the protected area and the wider environment.
This ensures the permanent and integrated protection of the buildings and surroundings of cultural monuments and other cultural and historical heritage, as well as their traffic and infrastructural arrangement and equipment, the creation of other spatial conditions for their presentation to the public, and the development of religious tourism.
The spatial plan analytically determines the space for declaring the future spatial, cultural and historical unit of Ovčar-Kablar Monasteries as immovable cultural heritage. It establishes measures of protection within three regimes that are spatially identified as: level I protection regime (strict protection) – courtyard of the cultural monument, with a total area of about 1.12 ha; level II protection regime (ambiental protection) – the courtyard and surroundings of the other monasteries, with a total area about 66.66 ha; level III protection regime (general protection) - the remainder of the Ovčar-Kablar Monasteries unit, with an area of about 2,211.22 ha.
The main measures in the level I protection regime are: banning the construction of facilities, except for the reconstruction, extension and maintenance of monastic housing and auxiliary facilities, technical protection, restoration and maintenance of church buildings, and the reconstruction and maintenance of energy and communal infrastructure; prohibiting other works, except for the appropriate landscape and horticultural arrangement, and protection from the harmful effects of water and landslides; controlled visits to church festivals and cultural events.
The main measures of the level II protection regime are: banning the construction of facilities, except for monastic farm facilities; the reconstruction and maintenance of traffic, energy and communal infrastructure; maintaining weekend facilities; the prohibition of works, except for agriculture, forestry, landscaping and protection from the harmful effects of water and landslides; conducting archeological, natural and other research; arranging and maintaining hiking and other walking trails; banning activities, except for church festivals, cultural events, controlled tourist visitor movement, hiking and cycling, limited and controlled motor vehicle traffic, etc.
The main measures of the level III protection regime are largely in line with the measures established for the level III protection regime for natural heritage, which include: banning the construction of facilities that may cause damage or destroy the material contents of the cultural heritage or may have adverse effects on the landscape features; banning the opening of quarries and the exploitation of mineral resources other than thermal waters and banning or restricting the use of other natural resources.
Archeological sites and buildings of vernacular architecture are an important segment of cultural heritage, and their properties, chronology and significance can be judged with certainty only on the basis of systematic archeological research or the appropriate research of their architecture and construction, as well as their cultural and historical features. For these reasons, detailed and systematic research of the overall cultural heritage of the protected area is recommended.
The cultural and religious tourism zone is formed by all of the monastery complexes with level I and II protection regimes, including the access roads, and the hiking, and bicycle paths that connect them. In the cultural and religious tourism zone, the reconstruction and equipping of the existing parking lots and construction of new ones on the access roads is planned, as well as equipping the local, forest and field roads with signs. For monasteries along the river, providing access from the water area should be considered, which can be done by setting up a pier for adequate vessels.
In the area of the monastery, which is covered by a detailed planning elaboration (Figure 2), the basic purpose of the space is religious buildings and complexes. This primary purpose also includes the detailed purposes of the courtyard and the monastery farm. Within the detailed purpose of the courtyard, there are temples, bell towers and monastery residences - residential buildings with accompanying auxiliary buildings. The detailed purpose of the monastery farm covers economic and agricultural buildings and areas of the monastery. The immediate surroundings of the monastery largely consist of monastery forests, in which no construction is allowed.
Figure 2.
Map of the detailed planning of the Blagoveštenje monastery. Source: Regulation on determining the spatial plan for the special purpose area of Ovčar-Kablar Gorge landscape of exceptional features (official gazette, No. 46/19).
Having these protection regimes in mind, the plan gives more detailed rules of arrangement and construction, which mostly refer to roads and infrastructure systems, while all further rules relating to cultural monuments are determined through conditions set by the competent protection institute.
5. Discussion on the implementation of sustainable development and protection for the cultural heritage in spatial plans
In order to consider the issues of implementing the sustainable development and protection of cultural assets in the spatial plans analyzed, the authors use and build on previous research on the implementation model for spatial plans [11, 12, 23], as follows:
The theoretical definition that the model of implementation of a spatial plan is a simplified representation of a set of related planning decisions on actions in the future, which reflects logical, functional and time coherent planning action, depending on the type and methods of planning;
The model of implementation has its own elements, which are determined by a set of planning actions in the broadest possible sense, starting from general decisions, through relatively firm target propositions, to very definite statements in terms of content, time and space. The elements of the model go beyond the plan itself as a document (phase of the planning process), and in addition to the mentioned planning elements, they also include “postplanning elements” defined by the plan (carried out later) and all the necessary elements of monitoring;
Depending on the type and method of planning, several types of spatial plan implementation models have been singled out, and the implementation model of spatial protection has been analyzed and applied in practice for the purpose of spatial protection.
According to the authors, the research presented in this paper has a special significance, because it refers to the issues of sustainable development and protection of cultural property that have not been subject to such analyses so far. Previous analyses of the implementation model have included protected areas of natural resources and water sources, but not protected areas of cultural heritage.
Furthermore, in their analysis, the authors thematically separate and analyze three aspects (Table 2), namely: (1) the protection of cultural heritage and its environment in a narrower sense (P); (2) the development of cultural heritage, i.e. primarily those elements related to the rules of their arrangement, presentation and inclusion in tourist activities (D); and (3) integrating the protection and development of cultural assets into landscape planning and protection (L).
Spatial Plans
I Planning elements
II Post-planning elements
III Monitoring eL
Strategic framework
General goals
Specific goals
Planning solutions
Dynamic framework
Measures and instruments
Participants (subjects)
Monitoring system
Evaluation (indicators)
Institutional and organzational aspects
Priority planning solutions (4 years)
Medium-term and long-term stages
Planning-programming
Organizational
Normative-legal
Financial
1.
Spatial Plan of the Republic of Serbia from 2021 to 2035
P D L
P D L
P D L
P D L
P D
P D L
P D L
P L
P L
P
P
P
2.
Regional Spatial Plan of the Kolubara and Mačva Administrative Districts
P D
P D
PD
P D
P D
P D
P
P D
P D
3.
Spatial Plan for the Special Purpose Area “Ovčarsko-kablarska klisura”
P D L
P D L
P D
P D
P D
P D
P D L
P D
P
P
P – protection, D – development, L – landscape.
Table 2.
Elements of the implementation model for the protection and development of landscapes in the spatial plans analyzed.
The Spatial Plan of the Republic of Serbia has applied the largest number of elements of the implementation model, those relating both to protection and to developing cultural heritage and landscape planning (a total of 27 elements). The specificity this plan is the large number of recognized elements relating to landscapes from all three plans, as well as the definition of the monitoring elements that are missing in other plans. Therefore, it can be concluded that a general approach has been applied in this plan, which is justified having in mind that it belongs to the national level of planning.
In The Regional Spatial Plan for the area of Kolubara and Mačva administrative districts, the fewest elements of the implementation model were applied (a total of 17 elements). The specificity of this plan is that it does not integrate the protection and development of cultural heritage in the planning and protection of landscapes, that is, there is a complete lack of any elements related to the theme of landscapes. Elements of the protection and development of cultural heritage are equally applied in this plan. Since this type of plan is focused on the goals and projects of regional development, i.e. the regional approach to planning, further elaboration on all missing elements is possible and necessary through the local level of planning.
In The Spatial Plan for the Special Purpose Area of the Landscape of Outstanding Features Ovčar-Kablar Gorge, a combination of the implementation elements of all three aspects (a total of 21 elements) was applied. However, the fewest elements are related to the integration of cultural heritage in landscape planning and protection, and they refer only to the general strategic framework, general goals, and planning and program measures for implementation, indicating that these were not sufficiently considered. Elements that relate to the protection and development of cultural goods are relatively evenly distributed. This kind of approach to planning can be characterized as special (as indicated by the name and subject of the plan) and is determined by the need to protect and plan the development of both the protected natural area and the future protected area of cultural monuments.
After analyzing all three plans, the basic conclusion is that general planning elements (strategic framework, goals, planning solutions) are dominant, that there are fewer post-planning elements (dynamics, implementation measures), and that there is a marked lack of elements related to the implementation of monitoring. Further analysis in this direction is not necessary, as it would be largely focused on the legislative framework, procedures and assessment of the quality of the plans, which is not the subject of this paper.
In the opinion of the authors, the most important conclusion concerns the relationship between aspects of protecting cultural heritage, its sustainable development and its integration into planning and protecting landscapes. Out of all these elements recognized in the plans, most concern the protection of cultural heritage, of which there are 31, followed by the elements of development (rules of arrangement, presentation and tourism), of which there are 23, but only 11 elements concerning the integration of cultural heritage in landscape planning and protection. This points towards the basic conclusion of the research, that protecting cultural assets and their environment in the narrower sense dominates the planning practice of Serbia, which is in itself justified and necessary. However, this does not sufficiently consider and plan for the sustainable development of cultural heritage, because there is insufficient elaboration of elements that would indicate the rules of construction and spatial planning in their environment, along with their unification and further planning development integrated with tourism (cultural routes, tourist areas, etc.). This is even more pronounced when considering the aspect of integrating the protection and development of cultural heritage into the planning and protection of landscapes, which is not developed in the practice of planning in Serbia. Indeed, it is considered only in a general and declarative manner, and only in individual cases.
6. Conclusions
Alongside the starting point that spatial (and urban) planning is of key importance for the sustainable development and protection of cultural heritage, this paper aimed to, based on the analysis of previous experiences, point out the need and possibilities for further improving the spatial planning process.
The fact is that in the current practice, cultural heritage is not clearly articulated as a development resource, and the connection and harmonization of policies for protection, arrangement and use of cultural heritage has not been achieved, especially in the case of the cultural landscapes and areas mentioned here. The Law on Cultural Property is not sufficiently harmonized with international recommendations, and does not recognize categories of the cultural landscape. The plans mainly include data on the number and category of cultural assets, as well as measures for their protection, obtained from the competent protection services.
The case study of three spatial plans confirmed the basic hypothetical assumptions of the research, that the methods used to plan areas of cultural heritage differ depending on the type and level of the spatial plan. The plans identify aspects of protection and the sustainable development of cultural heritage, and also in part their integration with landscape planning, but with obvious important shortcomings.
A key conclusion was reached based on this analysis, namely that there is no dominant and developed concept of protecting cultural heritage that has evolved into a system of comprehensive and adequate planning for its sustainable development. Therefore, in the coming period, it is necessary to improve planning methods and techniques in order to fully consider the sustainable development of cultural heritage in spatial plans. The first step in this can be the detailed planning and definition of all of the necessary rules for the arrangement and construction of space (urbanistic rules) in the vicinity of cultural heritage (protected or wider), the application of which would enable the construction of traffic and infrastructure systems, tourist facilities and infrastructure, and even those elements which reinforce the very aspect of protection from new activities in the environment. This would enable adequate presentation of cultural heritage, and the spatial connection and definition of cultural areas and cultural routes at the international, national, regional and local levels.
Such spatial planning would be a really key instrument in the implementation of European policies, which emphasize a contextual approach and expansion with regard to the subject of protection, from individual monuments to wider spatial units, as well as the need to integrate conservation and protection strategies with development and planning documents, and others.
In addition to the above, it can be further concluded that the lack of integration between protection policy and the development of cultural heritage in the planning and protection of landscapes is even more pronounced. It is interesting to note that the analysis indicated that this type of integration is only found in the Spatial Plan of the Republic of Serbia, i.e., at the national level of planning. The planning and protection of landscapes are not considered in other spatial plans. This further raises issues and needs for improvement, not only with regard to planning, but also legal regulations that should make integrated aspects of protection and development of cultural assets mandatory in landscape planning.
Based on the examples analyzed here, one gets the impression that in practice only the integration of the protection and development of cultural heritage with the protection of natural heritage has been truly achieved, that is, the integration of different aspects of protection.
Finally, all the above findings presented by the authors in this paper need to be further researched and scientifically shaped. The shortcoming of this research could be its small scientific sample of three spatial plans. With an increase in the number of spatial plans analyzed, i.e. the number of cultural assets and the area where they are located, it is certain that the research results would be more precise and significant. Indeed, that is the imperative of the planner in the period ahead.
Finally, in the opinion of the authors, this analysis of models and elements of implementing plans also highlights those general shortcomings in the plans that need to be eliminated and solved by improving planning methodology. This relates not only to the issue of the protection and sustainable development of cultural heritage, but also to numerous other aspects and subjects of planning (the economy, traffic, settlement networks, regional development, rural development, etc.). It especially refers to the concretization of planning solutions, determination of priorities, measures and instruments of implementation, and in particular elements for monitoring the implementation of spatial plans. The more precisely defined the implementation framework of spatial plans, the greater their role in integrating the protection and sustainable development of cultural heritage with other aspects of development.
Conflict of interest
There is no conflict of interest.
\n',keywords:"Cultural heritage, spatial plan, protection, sustainable development, landscape, implementation",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/78130.pdf",chapterXML:"https://mts.intechopen.com/source/xml/78130.xml",downloadPdfUrl:"/chapter/pdf-download/78130",previewPdfUrl:"/chapter/pdf-preview/78130",totalDownloads:145,totalViews:0,totalCrossrefCites:0,dateSubmitted:"May 31st 2021",dateReviewed:"June 24th 2021",datePrePublished:"August 17th 2021",datePublished:null,dateFinished:"August 17th 2021",readingETA:"0",abstract:"The starting point in this paper is the position that spatial and urban planning has a key role in sustainable development and the protection of cultural heritage. The planning method used in areas of cultural heritage differs depending on the type and level of the spatial plan. It is possible to identify aspects of protection and sustainable development in plans, with the protection of cultural heritage dominating in practice. Research was carried out on a case study of three spatial plans at different levels, which both in terms of their methodology and content make up the planning system for the protection and sustainable development of cultural heritage in Serbia. The comparative analysis of the plans includes three aspects: protection, the sustainable development of cultural heritage, and the integration of cultural heritage into the planning and protection of landscapes. The implementation models of the spatial plans were considered. The main conclusion of the paper is that the concept of protecting cultural heritage has not evolved into a system of comprehensive and adequate planning for its sustainable development, nor is it sufficiently integrated with the planning and protection of landscapes. The paper provides guidelines for improving both the methodology of spatial planning and the concept of the sustainable development and protection of cultural heritage in spatial plans.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/78130",risUrl:"/chapter/ris/78130",signatures:"Nebojša Stefanović and Nataša Danilović Hristić",book:{id:"10660",type:"book",title:"Heritage - New Paradigm",subtitle:null,fullTitle:"Heritage - New Paradigm",slug:null,publishedDate:null,bookSignature:"Prof. Daniela Turcanu-Carutiu",coverURL:"https://cdn.intechopen.com/books/images_new/10660.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-83969-621-3",printIsbn:"978-1-83969-620-6",pdfIsbn:"978-1-83969-622-0",isAvailableForWebshopOrdering:!0,editors:[{id:"176482",title:"Prof.",name:"Daniela",middleName:null,surname:"Turcanu-Carutiu",slug:"daniela-turcanu-carutiu",fullName:"Daniela Turcanu-Carutiu"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Literature review",level:"1"},{id:"sec_3",title:"3. System of sustainable development and protection of cultural heritage in the Republic of Serbia",level:"1"},{id:"sec_4",title:"4. Analysis of the sustainable development and protection of the cultural heritage in spatial plans",level:"1"},{id:"sec_4_2",title:"4.1 Spatial plan of the Republic of Serbia from 2021 to 2035",level:"2"},{id:"sec_5_2",title:"4.2 Regional spatial plan of the Kolubara and Mačva administrative districts",level:"2"},{id:"sec_6_2",title:"4.3 Spatial plan for the special purpose area of the landscape of outstanding features: Ovčar-Kablar Gorge",level:"2"},{id:"sec_8",title:"5. Discussion on the implementation of sustainable development and protection for the cultural heritage in spatial plans",level:"1"},{id:"sec_9",title:"6. Conclusions",level:"1"},{id:"sec_13",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'European Spatial Development Perspective ESDP (Towards Balanced and Sustainable Development of the Territory of the European Union), Agreed at the Informal Council of Ministers responsible for Spatial Planning, Potsdam, may 1999. – Published by the European Commission'},{id:"B2",body:'Guiding Principles for Sustainable Spatial Development of the European Continent", 12th Session of the European Conference of Ministers responsible for Regional Planning (CEMAT), September 2000, Hanover'},{id:"B3",body:'Territorial Agenda of the European Union 2020, 2011'},{id:"B4",body:'Vlami, V., Kokkoris, I. P., Zogaris, S., Cartalis, C., Kehayias, G., Dimopoulos, P. Cultural landscapes and attributes of “culturalness” in protected areas: An exploratory assessment in Greece. Science of The Total Environment, Volume 595, 2017: 229-243, ISSN 0048-9697, DOI: 10.1016/j.scitotenv.2017.03.211'},{id:"B5",body:'Levin, N., Lechner A. M., Brown, G. An evaluation of crowdsourced information for assessing the visitation and perceived importance of protected areas. Applied Geography 79 (2017): 115-126 DOI: 10.1016/j.apgeog.2016.12.009'},{id:"B6",body:'Bartula, M., Radun, M. Visitor management planning as a tool for sustainable tourism in protected areas in Serbia. Tourism in function of development of the Republic of Serbia, Tourism and Rural Development (TISC 2020) – Thematic proceedings I: 77-93'},{id:"B7",body:'Hristov, M., Danilović Hristić, N., Stefanović, N. Impact of Overtourism on Urban Life. Spatium International Review, No …, 2021: …'},{id:"B8",body:'Danilović Hristić, N.; Stefanović, N.; Milijić, S. (2020) Danube River Cruises as a Strategy for Representing Historical Heritage and Developing Cultural Tourism in Serbia. Sustainability, Special Issue "Cultural and Creative Tourism Developments: Past, Present and Future" 12, 10297: 1-19 DOI: 10.3390/su12241029, ISSN 2071-1050'},{id:"B9",body:'Bello, F. G., Lovelock, B., Carr, N. Enhancing community participation in tourism planning associated with protected areas in developing countries: Lessons from Malawi. Tourism and Hospitality Research 2018, Vol. 18(3): 309-320 DOI: 10.1177/1467358416647763'},{id:"B10",body:'Danilović Hristić, N., Stefanović N. The Role of Public Insight in Urban Planning Process: Increasing Efficiency and Effectiveness. Spatium International Review, 30, 2013: 33-39, ISSN 14 50-569X'},{id:"B11",body:'Stefanović, N., Danilović Hristić, N., Milijić, S. (2015) Implementation Model of Planning Rules in Spatial Plans. Spatium International Review, 33, ISSN 14 50-569X, No. 33, 2015: 62-68 DOI: 10.2298/SPAT1533062S'},{id:"B12",body:'Stefanović N., Danilović Hristić, N., Krunić, N. (2017) Comparative analysis of elements and models of implementation in local-level spatial plans in Serbia. Spatium International Review, No 37: 58-67. DOI:10.2298/SPAT1737058S'},{id:"B13",body:'Stefanović N., Danilović Hristić, N., Srnić D. (2018) A Methodological Framework for the Integrated Planning of the Protection and Development of the Natural Resource Areas in Serbia - Case Study of the Spatial Plans for the Special Purpose Area for the Protected Natural Areas. Spatium International Review, No 40: 25-32. DOI: 10.2298/SPAT18400255'},{id:"B14",body:'Graovac, A., Danilović Hristić, N., Stefanović N. Technical and Logical Methods for Improving the Process of Urban Planning in Serbia, SPATIUM International Review, No 38, 2017: 27-34. DOI: 10.2298/SPAT1738027G'},{id:"B15",body:'Law on Cultural Heritage, Official Gazette of the Republic of Serbia No. 71/94, 52/11-and other laws, 99/11-and other laws, 6/20-and other laws. Original in Serbian [Zakon o kulturnim dobrima, "Službeni glasnik Republike Srbije" br. 71/94, 52/11dr. zakon 99/11dr. zakon, 6/20dr. zakon.]'},{id:"B16",body:'Law on Planning and Construction, Official Gazette of the Republic of Serbia No. 72/09, 81/09-amendment, 64/10-US, 24/11, 121/12, 42/13-US, 50/13-US, 98/13-US, 132/14, 83/18, 31/19, 37/19-and other laws, 9/20. Original in Serbian [Zakon o planiranju i izgradnji, "Službeni glasnik Republike Srbije" br. 72/09, 81/09-ispravka, 64/10-US, 24/11, 121/12, 42/13-US, 50/13-US, 98/13-US, 132/14, 83/18, 31/19, 37/19-dr. zakon 9/20.]'},{id:"B17",body:'Spatial Plan of the Republic of Serbia from 2021. to 2035. – Draft, Ministry of civil engineering, traffic and infrastructure, April 2021, Belgrade. Original in Serbian [Prostorni plan Republike Srbije od 2021. do 2035. godine – Nacrta, Ministarstvo građevinarstva, saobraćaja i infrastrukture, april 2021, Beograd]'},{id:"B18",body:'Conditions of the Republic Institute for Cultural Heritage Protection, 2020'},{id:"B19",body:'Recommendation on the Historic Urban Landscape, UNESCO, 2011'},{id:"B20",body:'The World Heritage List: Filling the Gaps-an Action Plan for the Future, An Analysis by ICOMOS, 2004'},{id:"B21",body:'Regional Spatial Plan of the Kolubara and Mačva Administrative Districts, Official Gazette of the Republic of Serbia No. 12/14. Original in Serbian [Regionalni prostorni plan za područje Kolubarskog i Mačvanskog upravnog okruga, "Službeni glasnik Republike Srbije" br. 12/14]'},{id:"B22",body:'Spatial Plan for the Special Purpose Area of the Landscape of Outstanding Features "Ovčarsko-kablarska klisura", Official Gazette of the Republic of Serbia No. 46/19. Original in Serbian [Prostorni plan područja posebne namene predela izuzetnih odlika „Ovčarsko-kablarska klisura“, "Službeni glasnik Republike Srbije" br. 46/19]'},{id:"B23",body:'Stefanović, N., Josimović, B., Danilović Hristić, N. (2018) Models of Implementation of Spatial Plans – Theoretical Approach and Case Studies for Spatial Plans for the Special Purpose Area, In: Ergen, Y. (Ed.) An Overview of Urban and Regional Planning, IntechOpen, London, Chapter 4, pp. 59-81, ISBN 978-1-78984-835-9, Print ISBN: 978-1-78984-834-2, DOI: 10.5772/intechopen.78242'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Nebojša Stefanović",address:null,affiliation:'
Institute of Architecture and Urban and Spatial Planning of Serbia, Belgrade, Serbia
Institute of Architecture and Urban and Spatial Planning of Serbia, Belgrade, Serbia
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IntechOpen’s Academic Editors and Authors have received funding for their work through many well-known funders, including: the European Commission, Bill and Melinda Gates Foundation, Wellcome Trust, Chinese Academy of Sciences, Natural Science Foundation of China (NSFC), CGIAR Consortium of International Agricultural Research Centers, National Institute of Health (NIH), National Science Foundation (NSF), National Aeronautics and Space Administration (NASA), National Institute of Standards and Technology (NIST), German Research Foundation (DFG), Research Councils United Kingdom (RCUK), Oswaldo Cruz Foundation, Austrian Science Fund (FWF), Foundation for Science and Technology (FCT), Australian Research Council (ARC).
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Open Access publication costs can often be designated directly in the grants or in specific budgets allocated for that purpose. Many of the most important funding organisations encourage, and even request, that the projects they fund are made available at no cost to the wider public. IntechOpen strives to maintain excellent relationships with these funders and ensures compliance with mandates.
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In order to help Authors identify appropriate funding agencies and institutions, we have created a list, based on extensive research on various OA resources (including ROARMAP and SHERPA/JULIET) of organizations that have funds available. Before consulting our list we encourage you to petition your own institution or organization for Open Access funds or check the specifications of your grant with your funder to ascertain if publication costs are included. Where you are in receipt of a grant you should clarify:
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If you are associated with any of the institutions in our list below, you can apply to receive OA publication funds by following the instructions provided in the links. Please consult the Open Access policies or grant Terms and Conditions of any institution with which you are linked to explore ways to cover your publication costs (also accessible by clicking on the link in their title).
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Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. 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He has (co)authored more than 150 publications in indexed journals, international conferences and book chapters, 1 book (in Greek), 3 edited books, and 5 journal special issues. His publications have more than 2100 citations with h-index 27 (GoogleScholar). His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. 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In the last five years, he has published more than 60 papers in international journals indexed in the JCR (around 70% of them belonging to first quartile journals) and he has edited some Springer books “Supervised Descriptive Pattern Mining” (2018), “Multiple Instance Learning - Foundations and Algorithms” (2016), and “Pattern Mining with Evolutionary Algorithms” (2016). He has also been involved in more than 20 research projects supported by the Spanish and Andalusian governments and the European Union. He currently belongs to the editorial board of PeerJ Computer Science, Information Fusion and Engineering Applications of Artificial Intelligence journals, being also associate editor of Applied Computational Intelligence and Soft Computing and IEEE Transactions on Cybernetics. Finally, he is editor-in-chief of Progress in Artificial Intelligence. 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He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. 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He was elected a Yangtze River Scholars Distinguished Professor in 2013, a member of the International Statistical Institute (ISI) in 2016, a member of the board of the International Chinese Statistical Association (ICSA) in 2018, and a fellow of the Institute of Mathematical Statistics (IMS) in 2021. He received the ICSA Outstanding Service Award in 2018 and the National Science Foundation for Distinguished Young Scholars of China in 2012. He serves as a member of the editorial board of Statistics and Its Interface and Journal of Systems Science and Complexity. He is also a field editor for Communications in Mathematics and Statistics. His research interests include biostatistics, empirical likelihood, missing data analysis, variable selection, high-dimensional data analysis, Bayesian statistics, and data science. 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He is an IEEE Senior Member and a member of several other research organizations worldwide. His main research interests are computer vision, intelligent systems, robotics, and image and video processing. He has participated in or coordinated several research projects and received more than thirty-five awards. He has 161 publications to his credit, including books, book chapters, journal articles, and conference papers. He has vast experience as a reviewer of several journals and conferences. As a professor, Dr. Neves has supervised several Ph.D. and master’s students and was involved in more than twenty-five different courses.",institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"11317",title:"Dr.",name:"Francisco",middleName:null,surname:"Javier Gallegos-Funes",slug:"francisco-javier-gallegos-funes",fullName:"Francisco Javier Gallegos-Funes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/11317/images/system/11317.png",biography:"Francisco J. Gallegos-Funes received his Ph.D. in Communications and Electronics from the Instituto Politécnico Nacional de México (National Polytechnic Institute of Mexico) in 2003. He is currently an associate professor in the Escuela Superior de Ingeniería Mecánica y Eléctrica (Mechanical and Electrical Engineering Higher School) at the same institute. His areas of scientific interest are signal and image processing, filtering, steganography, segmentation, pattern recognition, biomedical signal processing, sensors, and real-time applications.",institutionString:"Instituto Politécnico Nacional",institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"428449",title:"Dr.",name:"Ronaldo",middleName:null,surname:"Ferreira",slug:"ronaldo-ferreira",fullName:"Ronaldo Ferreira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428449/images/21449_n.png",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. 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He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:null,institution:null},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"417317",title:"Mrs.",name:"Chiedza",middleName:null,surname:"Elvina Mashiri",slug:"chiedza-elvina-mashiri",fullName:"Chiedza Elvina Mashiri",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"352140",title:"Dr.",name:"Edina",middleName:null,surname:"Chandiwana",slug:"edina-chandiwana",fullName:"Edina Chandiwana",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"342259",title:"B.Sc.",name:"Leonard",middleName:null,surname:"Mushunje",slug:"leonard-mushunje",fullName:"Leonard Mushunje",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"347042",title:"Mr.",name:"Maxwell",middleName:null,surname:"Mashasha",slug:"maxwell-mashasha",fullName:"Maxwell Mashasha",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"2941",title:"Dr.",name:"Alberto J.",middleName:"Jorge",surname:"Rosales-Silva",slug:"alberto-j.-rosales-silva",fullName:"Alberto J. Rosales-Silva",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"437913",title:"Dr.",name:"Guillermo",middleName:null,surname:"Urriolagoitia-Sosa",slug:"guillermo-urriolagoitia-sosa",fullName:"Guillermo Urriolagoitia-Sosa",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"435126",title:"Prof.",name:"Joaquim",middleName:null,surname:"José de Castro Ferreira",slug:"joaquim-jose-de-castro-ferreira",fullName:"Joaquim José de Castro Ferreira",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"437899",title:"MSc.",name:"Miguel Angel",middleName:null,surname:"Ángel Castillo-Martínez",slug:"miguel-angel-angel-castillo-martinez",fullName:"Miguel Angel Ángel Castillo-Martínez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"289955",title:"Dr.",name:"Raja",middleName:null,surname:"Kishor Duggirala",slug:"raja-kishor-duggirala",fullName:"Raja Kishor Duggirala",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Jawaharlal Nehru Technological University, Hyderabad",country:{name:"India"}}}]}},subseries:{item:{id:"23",type:"subseries",title:"Computational Neuroscience",keywords:"Single-Neuron Modeling, Sensory Processing, Motor Control, Memory and Synaptic Pasticity, Attention, Identification, Categorization, Discrimination, Learning, Development, Axonal Patterning and Guidance, Neural Architecture, Behaviours and Dynamics of Networks, Cognition and the Neuroscientific Basis of Consciousness",scope:"Computational neuroscience focuses on biologically realistic abstractions and models validated and solved through computational simulations to understand principles for the development, structure, physiology, and ability of the nervous system. This topic is dedicated to biologically plausible descriptions and computational models - at various abstraction levels - of neurons and neural systems. This includes, but is not limited to: single-neuron modeling, sensory processing, motor control, memory, and synaptic plasticity, attention, identification, categorization, discrimination, learning, development, axonal patterning, guidance, neural architecture, behaviors, and dynamics of networks, cognition and the neuroscientific basis of consciousness. Particularly interesting are models of various types of more compound functions and abilities, various and more general fundamental principles (e.g., regarding architecture, organization, learning, development, etc.) found at various spatial and temporal levels.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",hasOnlineFirst:!1,hasPublishedBooks:!0,annualVolume:11419,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null,series:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403"},editorialBoard:[{id:"13818",title:"Dr.",name:"Asim",middleName:null,surname:"Bhatti",slug:"asim-bhatti",fullName:"Asim Bhatti",profilePictureURL:"https://mts.intechopen.com/storage/users/13818/images/system/13818.jpg",institutionString:null,institution:{name:"Deakin University",institutionURL:null,country:{name:"Australia"}}},{id:"151889",title:"Dr.",name:"Joao Luis Garcia",middleName:null,surname:"Rosa",slug:"joao-luis-garcia-rosa",fullName:"Joao Luis Garcia Rosa",profilePictureURL:"https://mts.intechopen.com/storage/users/151889/images/4861_n.jpg",institutionString:null,institution:{name:"University of Sao Paulo",institutionURL:null,country:{name:"Brazil"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",institutionURL:null,country:{name:"Turkey"}}}]},onlineFirstChapters:{paginationCount:6,paginationItems:[{id:"83073",title:"Dental and Orofacial Trauma Impacts on Oral-Health-Related—Quality of Life in Children: Low- and Middle-Income Countries",doi:"10.5772/intechopen.105845",signatures:"Yolanda Malele-Kolisa, Nazia Khan, Mpho P. 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\r\n\tThe era of antibiotics led us to the illusion that the problem of bacterial infection is over. However, bacterial flexibility and adaptation mechanisms allow them to survive and grow in extreme conditions. The best example is the formation of a sophisticated society of bacteria defined as a biofilm. Understanding the mechanism of bacterial biofilm formation has changed our perception of the development of bacterial infection but successfully eradicating biofilm remains a challenge. Considering the above, it is not surprising that bacteria remain a major public health threat despite the development of many groups of antibiotics. Additionally, increasing prevalence of acquired antibiotic resistance forces us to realize that we are far from controlling the development of bacterial infections. On the other hand, many infections are endogenous and result from an unbalanced relationship between the host and the microorganism. The increasing use of immunosuppressants, such as chemotherapy or organ transplantation, increases the incidence of patients highly susceptible to bacterial infections in the population.
\r\n
\r\n\tThis topic will focus on the current challenges and advantages in the diagnosis and treatment of bacterial infections. We will discuss the host-microbiota relationship, the treatment of chronic infections due to biofilm formation, and the development of new diagnostic tools to rapidly distinguish between colonization and probable infection.
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