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\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
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\\n\\nNote: Edited in October 2021
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\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
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\n\nBiomedical Engineering, ISSN 2631-5343
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\n\nDentistry (Coming Soon)
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\n\nNote: Edited in October 2021
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Arabia"}}},{id:"149745",title:"Dr.",name:"Hoda",middleName:null,surname:"Kattan",fullName:"Hoda Kattan",slug:"hoda-kattan",email:"hoda@kfshrc.edu.sa",position:null,institution:{name:"King Faisal Specialist Hospital & Research Centre",institutionURL:null,country:{name:"Saudi Arabia"}}},{id:"149746",title:"Dr.",name:"Abdullah",middleName:null,surname:"Aldowaish",fullName:"Abdullah Aldowaish",slug:"abdullah-aldowaish",email:"dowaish@kfshrc.edu.sa",position:null,institution:{name:"King Faisal Specialist Hospital & Research Centre",institutionURL:null,country:{name:"Saudi Arabia"}}}]},book:{id:"2663",title:"Child Abuse and Neglect",subtitle:"A Multidimensional Approach",fullTitle:"Child Abuse and Neglect - A Multidimensional Approach",slug:"child-abuse-and-neglect-a-multidimensional-approach",publishedDate:"July 11th 2012",bookSignature:"Alexander Muela",coverURL:"https://cdn.intechopen.com/books/images_new/2663.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"138437",title:"Dr.",name:"Alexander",middleName:null,surname:"Muela Aparicio",slug:"alexander-muela-aparicio",fullName:"Alexander Muela Aparicio"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"11493",leadTitle:null,title:"Solar Radiation - Enabling Technologies, Recent Innovations, and Advancements for Energy Transition",subtitle:null,reviewType:"peer-reviewed",abstract:"\r\n\tSolar radiation is the radiant energy that originates from the sun in the form of electromagnetic radiation at various wavelengths. Almost all renewable energy comes from the sun, either directly or indirectly. A very vast amount of solar energy (173,000 terawatts) reaches the atmosphere and surface of the earth, which is more than 10,000 times greater than the total energy use in the world. To harness and convert a tiny part of such amount of energy into various forms (e.g., electricity and heat), we need much more innovation and progress in the current technologies as well as cost-efficient and smarter approaches for energy system integration in the built environment. The energy transition is a pathway toward the transformation of the global energy sector from fossil-based to zero-carbon. To achieve this, the world needs to reduce energy-related CO2 emissions to limit climate change. The decarbonization of the energy sector requires urgent action on a global scale to reduce carbon emissions and mitigate the effects of climate change. Renewable energy and energy efficiency can potentially play a major role (up to 90%) in the required carbon reductions. The energy transition will be powered by enabling technologies such as Artificial Intelligence (AI), Internet of Things (IoT), Digital Twin (DT), 3D Printing, Autonomous technology, Robotics, Unmanned Aerial Vehicle (UAV), Big Data Analytics, Blockchain, etc. This will aim to develop promising solutions and lead the world to meet the sustainable development goals (SDGs) as well as make energy cleaner, accessible, and more efficient.
\r\n\r\n\tThis book will aim to provide detailed information about recent innovations and advancements in the relevant enabling technologies for an energy transition which will be beneficial for a broad range of readership, including undergraduate and postgraduate students, young or experienced researchers, and engineers.
\r\n\tThis book will address the various modern, technical, and practical aspects of smart technology for capturing solar radiation and converting it into different forms of energy, as well as enabling it for renewables integration in energy generation and transformation, built environment, transportation, buildings, and agriculture.
\r\n\tThe book will cover the most recent developments, innovations and applications concerning the following topics:
\r\n\t• Solar radiation – Smart and enabling technologies for measurement, modelling, and forecasting
\r\n\tHigh-resolution measurement sensor and instrument technology (Pyranometers, Albedometers, Pyrheliometers, UV Radiometers, Sun Trackers, Spectroradiometer, Pyrgeometers, etc.), Artificial intelligence techniques for modelling and forecasting of solar radiation, Solar Irradiance forecast with satellite data, Solar potential analysis, Short-term forecasting of photovoltaic power and solar irradiance prediction with sky imagers.
\r\n\t• Renewable energy integration – Smart solutions for integration of RE in distributed generation, energy storage, and demand-side management.
\r\n\tIntegrated Photovoltaics: Smart technology for vehicle-integrated PV, Building Integrated PV, Agrivoltaics, Road-Integrated PV, Floating PV, Product-integrated PV.
\r\n\tRenewable Energy Applications in Built Environment and mobility: Solar cars, solar-powered electric charging stations, passive solar systems, solar heating, and cooling systems, building-integrated vegetation, multifunctional solar systems, solar pumps, solar lighting, solar shading, Natural lighting, Solar dryer, Greenhouse.
For more than four decades, Cathode Ray Tube (CRT) Displays have been the dominant display technology providing very attractive performance. Brightness, contrast ratio, high image quality, speed and resolution were the main high standard specifications that CRTs were satisfied.
\n\t\t\tThe last two decades, there was a tremendous growth in small portable applications which required the necessary adjustment of the display technology to them. The large depth of the CRTs was the main disadvantage for preventing them to be used in these kinds of applications. Flat Panel Displays seem to be the most attractive solution to this problem. Displays engineers searched for many years in order to find the suitable flat panel display technologies that could replace CRT displays. The first successfully established flat panel technology was the plasma displays, which demonstrated to be of larger size and higher image quality compared to the CRT technology. However, the problem with the integration of plasma displays in small portable applications still exists. Finally, the inroad of the thin-film transistors liquid crystal displays (TFT-LCD), in late 1990’s, was a milestone in the displays industry and technology.
\n\t\t\tThe successful development of the TFT-LCDs was achieved not accidentally. It was the sequence of the liquid crystal cell technology development, in combination with the development of semiconductors technologies for large-area microelectronics on glass, like thin-film transistors. Although, both technologies were very-well known before the 90’s, an extended research for establishing compatible fabrication processes for the materials and the manufacturing equipment has led to the TFT-LCDs realization.
\n\t\t\tTFT-LCDs were rapidly grown and dominated the displays industry, especially in small portable applications. The implementation of the TFT-LCD panel peripheral driving components with low-power CMOS blocks and, therefore, the compatibility with battery operation was the main reason for the ascendance of the TFT-LCD technology in small portable applications. Today, the TFT-LCD market has been expanded. They can be used in an extremely wide range of our everyday life products, like mobile phone applications, ATMs, PDAs, navigation systems, notebook PCs and home applications, such as wide screen TVs.
\n\t\t\tAt the beginning, when LCDs were used in calculators, watches and small sized displays, direct and passive matrix addressing were the applicable addressing methods. As the size, resolution and information content of the displays were increased, the number of the pixels array was, also, increased leading the existing addressing methods to become non-applicable. A solution to this problem was proposed by Lencher (Lechner et al., 1971) and by Marlone (Marlowe & Nester, 1972). A switch TFT was added at each pixel of the display matrix and in this way the pixels were controlled independently with the use of the external driving voltages. The first external voltage controls whether the switch TFT will be turned “ON” or “OFF” and the second voltage is the necessary, to the liquid crystal, bias voltage which is stored to a capacitor. The storage capacitor is placed in parallel to the liquid crystal and ensures that the necessary liquid crystal voltage remains constant during the frame time. This addressing method is called Active Matrix and the displays that used this method are called Active Matrix Liquid Crystal Displays (AMLCDs).
\n\t\t\tIn this chapter, the fundamentals of an AMLCD will be presented. The fundamentals include the operation description, the driving methods and circuitry and finally the analog circuits design by using polycrystalline silicon TFTs. At the beginning of the chapter, a short presentation of the thin-film transistors technology, including structures and operations modes, will be given. More attention will be given to the analog circuit design due to the difficulties that arise by implementing TFTs in circuits. Moreover, design techniques for overcoming these difficulties will be described in more details.
\n\t\tIn the past twenty years, the development of Thin-Film Transistors (TFTs) has become the spearhead of the electronic flat panel displays industry. However, the generation of TFTs is originated many years before, back to the earliest days of semiconductors physics. The TFTs principals and their potential utilities were settled nearly seventy years ago, but the remarkable development of the bipolar transistors and their technological cousin, the metal oxide semiconductor field-effective transistors (MOSFETs), has overshadowed the TFTs concept.
\n\t\t\t\tThe first attempt for implementing a TFT device is traced back to the 40’s and it was a thin-film field effect device used a germanium film (Bardeen & Brattain, 1948). The history and the structure of the TFTs, as it is known today, began with the work of Weimer (P. K. Weimer, 1962) at RCA Labs. in 1962. Polycrystalline cadmium sulphide (CdS) was the material that used for the thin-film and silicon monoxide was the insulator. Source and drain contacts were placed on the opposite side of the gate. This structure is called “staggered” and it is shown in fig. 1. Glass was used as the insulating substrate, forming in this way a three-terminal device. On the theoretical part, the analysis of the device characteristics was realized by Borkan and Weimer (Borkan and Weimer, 1963), based on Shockley’s JFET analysis.
\n\t\t\t\tIn the 70’s, two very important events changed dramatically the prospects for TFTs. The first was the implementation of a thin-film semiconductor instead of crystalline bulk silicon material, like Cadmium Selenide (CdSe) (Broody et al., 1973). The impact of this implementation was the reduction of the fabrication cost and the decrease of the transistor size. The second landmark was the Active Matrix addressing method proposed by (Lechner et al., 1971) and the fact that the switch device needed in each pixel of the matrix can be materialized with the use of a TFT device.
\n\t\t\t\tSchematic diagram of Weimer’s staggered CdS TFT structure.
The period from 1979 to 1981 was revolutionary for the TFT technology. In 1979, a new material was introduced for the implementation of the thin-film. (LeComber et. al., 1979) proposed a TFT using amorphous hydrogenated silicon (a-Si:H) as the active layer material. Amorphous hydrogenated silicon was preferred over the pure amorphous silicon due to the fact that it can be doped with both donors and acceptors forming n-type and p-type TFT devices. Thin-film, formed with a-Si:H, have no grain boundaries and it was the most cost-effective technology. However, the main disadvantage of this technology was the low mobility of the carriers and the instability of the device electrical characteristics.
\n\t\t\t\tIn 1980, Lueder (Lueder, 1980) introduced a new approach in the TFT fabrication process. Photolithography was used instead of shadow masks that were being used since then. Their devices were optimized for liquid crystal displays applications, since the photolithography process made source-drain contacts that were self-aligned to the gate, causing the gate-source parasitic capacitance to be reduced. The compensation of the parasitic effects has improved the performance of the TFT-LCDs in the terms of the response time and the image quality.
\n\t\t\t\tIn 1981, Depp (Depp et. al., 1981) from IBM proposed a polycrystalline silicon active layer. The use of chemical vapour-deposited polycrystalline silicon has improved the characteristics of the TFTs devices since the mobility has shown a significant increase. However, the chemical vapour-deposition was a high temperature process making the glass substrate in-appropriate. This was the reason for the replacement of the glass substrate with a high temperature substrate such as quartz.
\n\t\t\t\tIn the forcoming years until now, the research of the TFT technology was focused on the improvement of the TFT devices characteristics and their fabrication process. Amorphous and polycrystalline silicon TFTs were the two main technologies that were used in the flat panel display industry. Recently, new TFTs technologies have been proposed, like nano-crystalline silicon (Pappas et. al, 2007.b), metamorphous silicon and organic TFTs (Lin et. al, 1997). These technologies have been emerged due to the constantly increasing performance of the flat panel displays which requires improved TFTs technologies. Furthermore, the introduction of new flat panel displays, like Organic Light Emitting Diode (OLED) displays, and the flexible substrate displays have created the need for new TFT technologies, compatible with the new types of flat panel displays.
\n\t\t\tPolycrystalline and amorphous silicon are the two most commonly used types of thin-film transistors in the display industry. Fig. 2 shows four basic structures of a-Si:H TFTs according to the positions of the electrodes, insulator and the active layer. Staggered structures have already being described, whereas coplanar TFTs have all electrodes on the same side of the active layer. For better control of the active layer, the inverted structures of the above have been proposed. The inverted structures are also called bottom-gated structures.
\n\t\t\t\tAmorphous silicon TFT technology can provide only n-channel devices because their electronic properties do not allow high-quality p-channel devices, since the ON-current is significant low. This is caused due to the low mobility (less than unity) of the holes along the active layer. The amorphous silicon TFTs market includes notebooks, desktop monitors and home LCDs televisions. The main advantage of the a-Si:H technology is the easy fabrication process with limited number of process steps making this technology cost efficient.
\n\t\t\t\tBasic a-Si:H TFT structures.
On the other hand, polycrystalline silicon (poly-Si) technology can provide both n-type and p-type devices. Depending on the fabrication process, poly-Si TFT can be divided into high-temperature TFTs with fabrication processes similar to the ordinary silicon MOSFET devices and the low-temperature TFTs where the deposited amorphous silicon film is turned into polycrystalline silicon either with excimer laser annealing (ELA) or with solid state phase crystallization combined with ELA process. The basic top-gated poly-Si TFT structure is shown in fig. 3.
\n\t\t\t\tPoly-Si top-gated TFT structure.
The main advantage of the poly-Si TFTs technology is the high carrier mobility (more than 100 cm2 / Vs), meaning that poly-Si TFTs can provide high driving current. The high driving current has led to the implementation of the peripheral driving circuits of an AMLCD with poly-Si TFTs, causing the reduction of the total fabrication cost and the realization of Systems on Glass (SoG).
\n\t\t\tThe operation of both poly-Si and a-Si TFTs is similar to the ordinary silicon MOSFETs operation. Typical transfer characteristics of n-type and p-type poly-Si and n-type a-Si TFTs, with gate dimensions W / L = 100 μm / 10 μm, are shown in fig. 4. As it can be seen from fig. 4, poly-Si TFTs have higher ON-current due to the higher carrier mobility. The TFTs operation can be divided into three working modes: cut-off, linear and saturation modes. The drain current of an n-type TFT can be presented with the following expressions for each mode of operation:
\n\t\t\t\tCut-off mode: IDS = 0, when Vgs< Vthn\n\t\t\t\t\t
\n\t\t\t\t\tLinear mode: IDS = μCoxW [VeffVds – Vds\n\t\t\t\t\t\t2/2]/L, when 0 < Vds< Veff\n\t\t\t\t\t
\n\t\t\t\t\tSaturation mode: IDS = [μCoxWVeff\n\t\t\t\t\t\t2]/2L, when Veff< Vds\n\t\t\t\t\t
\n\t\t\t\twhere IDS is the drain current, μ is the effective surface mobility of the carriers, COX is the gate oxide capacitance per unit area, W is the effective gate mask width, L is the effective gate mask length, Vds is the drain-to-source voltage and Veff is the effective gate voltage, equal to the different between the gate to source voltage Vgs and the transistor threshold voltage Vthn, Veff = Vgs - Vthn.
\n\t\t\t\tTransfer characteristics of polysilicon and amorphous TFTs.
The expressions of the drain current for each working mode indicate the important role that the threshold voltage and mobility play in the TFTs operation. However, measurements in fabricated TFTs have shown that threshold voltage and mobility variations exist from device to device, even if the devices are implemented on the same wafer and with the same fabrication process.
\n\t\t\t\tFor the poly-Si TFT technology, the threshold voltage and mobility variations are caused due the random distribution of the grain boundaries along the channel (Jagar et. al., 2003). The grain boundaries are produced when the amorphous silicon is turned into polycrystalline during the fabrication process and they can modeled as discontinues for the carriers along the active layer. For small sized display, the threshold voltage variation is about ± 300 mV (Zhang et. al., 2000), while for large substrate area it can be up to ± 1 V (Lee et. al., 1999).
\n\t\t\t\tAmorphous silicon TFT technology exhibits good uniformity in the electrical characteristics of the TFT devices over a large area even if some of the characteristics are rather poor, like the mobility. However, protracted bias stress will cause threshold voltage shift due to the inherent instability of the amorphous material (Powell et. al., 1989). The threshold voltage shift can be modeled by the equation (Den Boer, 2005)
\n\t\t\t\twhere ΔVthn is the threshold voltage shift in the case of an n-type TFT and β and τ are constants that depend on the temperature and the quality of the active layer-insulator interface. Threshold voltage shift can be more than 3 V (Arokia et.al., 2005) and even if it is temporal in nature, it can be considered to have the same impact on the circuits design as the threshold voltage variations of the poly-Si TFTs.
\n\t\t\t\tAnother second order effect that produces instabilities in the TFTs operation is the impact ionization of the carriers which is known as “kink effect” (Valdinoci et. Al., 1997)). Kink effect appears when the device is operating in the saturation mode and for high values of the drain voltage. The result of the kink effect is an abrupt increase of the drain current caused by the impact ionization of the carriers near the drain electrode due to the high electric field. Kink effect can not be controlled, causing difficulties in the analog circuits design especially when high supply voltages are required. Among the variations that produce instabilities in the TFTs operation, the threshold voltage variations have the highest impact in the analog circuits design (Vaidya et. al., 2008) and compensation methods will be described in a next paragraph.
\n\t\t\tThere are three different addressing methods in the display technology, direct, passive matrix and active matrix. The addressing method that will be used in a LCD design is a very important choice, because the peripheral driving circuits of the pixel array depend on it. The addressing method can be selected by taking into account the specifications of the information content, the fabrication cost, the available TFT technology, the response time, the area and the power consumption, with the first three parameters being the most important.
\n\t\t\tThe first used addressing method was the direct method. According to this method, its segment is directly connected and controlled individually by the peripheral electronics. The segments are arranged in such way so that they can produce the desired icon. The most common arrangement is the 7-segments, shown in fig. 5, used in simple alphanumerical displays, such as calculators and watches. In this method, no multiplexing is available and this is the reason for only being used in low information content applications. In the direct method, the smallest controllable component for the image production is called segment instead of pixel, which will be used in the two other addressing methods.
\n\t\t\t\tSegment arrangement with direct addressing method.
As the displays and the information content were getting larger, the need for more picture elements was arisen. The solution to this problem was the modification of the segments arrangement into a pixels matrix with M rows and N columns. In this method, each pixel can not be controlled individually and a multiplexing addressing approach has to be realized. The new multiplexed addressing method was the passive matrix (PM). The configuration of the passive matrix addressing method is shown in fig. 6.
\n\t\t\t\tThe passive matrix is a one-line-at-a-time driving method. During the programming time, a pulse from the row peripheral driver activates all the pixels of the programming line and at the same time the data voltage is delivered to the storage capacitor and the liquid crystal through the peripheral column driver. Passive matrix is the addressing method with the minimum number of interconnections. For example, for an M rows and N columns array, the direct method needs MxN interconnections while the passive matrix method needs M+N interconnections. Furthermore, passive matrix is the simplest and the most cost-efficient method. However, the disadvantages of the passive matrix method are the low multiplexing capability and the crosstalk effect between the pixels. Crosstalk effect is caused because all the row-pixels are electrically related and a small dc voltage can be added to the pixel liquid crystal voltage from its neighbour pixels. The results of the crosstalk are the poor contrast ratio and the small active region of operation for the displays.
\n\t\t\t\tConfiguration of the passive matrix addressing method.
The Active Matrix (AM) addressing method overcomes the multiplexing limitation of the PM method and the crosstalk effect. This can be achieved by incorporating a nonlinear control element, like a switch, in the cross point of the row and column lines (in series connection) of each pixel. The use of a switch will provide a 100 % duty ratio for the pixel by using the charge stored at the pixel during the row addressing time. Figure 7 illustrates the configuration of an AMLCD. The switch is controlled by two pulse signals which are produced by external driving circuits, the row and column drivers. As in most of the matrix addressed displays with line-at-a-time programming, the rows are scanned by a select gate pulse. The gate pulse of the selected row will turn “ON” the switch TFT of each pixel and simultaneously, the storage capacitor will be charged with the data voltage provided from the column driver. After the row time, the switch TFT will turn “OFF” as soon as the negative edge of the row pulse is delivered and the pixel will be isolated from all its neighbour pixels until the next frame time. In this way, the crosstalk effect and the multiplexing limitation are eliminated.
\n\t\t\tThe design of the displays electronics modules is an essential task due to the fact that the design defines the image quality of the display. The functionality of the electronics involves the acquisition of the incoming video signal, the signal processing and finally, the representation of the signal image on the pixels matrix. Therefore, the main objection of the electronics modules is the accurate supply of the data signal to each pixel with the right timing.
\n\t\t\tConfiguration of the active matrix addressing method.
Two of the most important parameters in the AMLCD design are the definition of the addressing method and the size of the pixels matrix. These two parameters will determine the peripheral driving electronics modules and the timing and programming issues. Furthermore, the types of displays format are separated based on the size of the pixels matrix, proving the significance of this parameter. The various displays format with their timing specifications are shown in Table 1.
\n\t\t\t\tThe resolution of the display is referred to the number of the active pixels in each dimension, horizontal (rows) and vertical (columns). The first given number is the number of the columns and the second is the rows number. Higher resolution results in better image quality of the display. However, higher resolution for a standard matrix size requires additional hardware for its implementation; higher resolution is achieved by decreasing the size of the pixels. Furthermore, the ratio of the column number to the row number will determine the aspect ratio of the display.
\n\t\t\t\tVideo Format | \n\t\t\t\t\t\t\tResolution | \n\t\t\t\t\t\t\tH-Sync. @60Hz | \n\t\t\t\t\t\t\tSystem Clock | \n\t\t\t\t\t\t\tPanel Size | \n\t\t\t\t\t\t
VGA | \n\t\t\t\t\t\t\t640x480 | \n\t\t\t\t\t\t\t31 μs | \n\t\t\t\t\t\t\t28 MHz | \n\t\t\t\t\t\t\t≤ 10.4“ | \n\t\t\t\t\t\t
SVGA | \n\t\t\t\t\t\t\t800x600 | \n\t\t\t\t\t\t\t26 μs | \n\t\t\t\t\t\t\t40 MHz | \n\t\t\t\t\t\t\t10.4“, 12.1“ | \n\t\t\t\t\t\t
XGA | \n\t\t\t\t\t\t\t1024x768 | \n\t\t\t\t\t\t\t20 μs | \n\t\t\t\t\t\t\t65 MHz | \n\t\t\t\t\t\t\t12.1“, 13.3“, 14 | \n\t\t\t\t\t\t
QVGA | \n\t\t\t\t\t\t\t1280x960 | \n\t\t\t\t\t\t\t16 μs | \n\t\t\t\t\t\t\t104 MHz | \n\t\t\t\t\t\t\t13.3“, 14.1“ | \n\t\t\t\t\t\t
SXGA | \n\t\t\t\t\t\t\t1280x1024 | \n\t\t\t\t\t\t\t15 μs | \n\t\t\t\t\t\t\t108 MHz | \n\t\t\t\t\t\t\t14.1“, 15“ | \n\t\t\t\t\t\t
SXGA+ | \n\t\t\t\t\t\t\t1400x1050 | \n\t\t\t\t\t\t\t15 μs | \n\t\t\t\t\t\t\t124 MHz | \n\t\t\t\t\t\t\t17“, 18.1“ | \n\t\t\t\t\t\t
HDTV | \n\t\t\t\t\t\t\t1920x1080 | \n\t\t\t\t\t\t\t14 μs | \n\t\t\t\t\t\t\t144 MHz | \n\t\t\t\t\t\t\t≥ 24“ | \n\t\t\t\t\t\t
UXGA | \n\t\t\t\t\t\t\t1600x1200 | \n\t\t\t\t\t\t\t13 μs | \n\t\t\t\t\t\t\t184 MHz | \n\t\t\t\t\t\t\t20.1“, 23“ | \n\t\t\t\t\t\t
QXGA | \n\t\t\t\t\t\t\t2048x1536 | \n\t\t\t\t\t\t\t10 μs | \n\t\t\t\t\t\t\t195 MHz | \n\t\t\t\t\t\t\t≥ 30“ | \n\t\t\t\t\t\t
QSXGA | \n\t\t\t\t\t\t\t2560X2048 | \n\t\t\t\t\t\t\t8 μs | \n\t\t\t\t\t\t\t256 MHz | \n\t\t\t\t\t\t\t≥ 32“ | \n\t\t\t\t\t\t
QUXGA | \n\t\t\t\t\t\t\t3200X2400 | \n\t\t\t\t\t\t\t6 μs | \n\t\t\t\t\t\t\t400 MHz | \n\t\t\t\t\t\t\t≥ 36“ | \n\t\t\t\t\t\t
Displays format (VGA: Video Graphic Array, S : Super, X : Extended, Q : Quarter, U : Ultra, HDTV : High Definition Television).
For example, in the case of a VGA display the aspect ratio is 4:3 while in HDTV is 16:9.
\n\t\t\t\tAnother important specification is the refresh rate of the display. Refresh rate is the number of times that an image is refreshed per second. A very usual mistake is the confusion between the refresh and frame rate. The refresh rate is the repeated illumination of identical frames, while the frame rate measures how often a display image can change into another. The refresh rate is calculated by dividing the horizontal scan rate by the number of horizontal pixels and muliplying the result by 0.95. The refresh rate is measured in hertz and a typical bandwidth is starting from 60 Hz for small displays and it can be up to 100 Hz for high motion displays. The refresh rate depends upon the monitor resolution and its maximum horizontal scan rate, as higher resolution necessitates more scan lines per second. Increased refresh rates reduce flickering and thereby reduce eye strain for a viewer. Because of this, it is advisable to purchase monitors that have a refresh rate between 75 and 85 Hz.
\n\t\t\t\tFor the timing (clock) issues, the horizontal synchronization (H-sync) period of each display format (i.e. the programming time of all the pixels of a row for a given refresh rate of 60 Hz) are shown in Table 1. The H-sync period is given by the following expression.
\n\t\t\t\tThe system clock frequency is, also, depending strongly on the matrix size since it is given by the expression.
\n\t\t\t\t\n\t\t\t\t\tFigure 8 shows a block diagram of AMLCD electronics modules. An AMLCD consists of the pixels matrix, the peripheral column and row driving modules, the backlight, a timing – control unit and a booster module for producing DC voltages higher than the power supply voltage.
\n\t\t\t\tThe pixels array and the row / column drivers are implemented using TFT technology meaning that they are fabricated on the glass substrate. The control and power supply generation blocks are separated, mounted on a PC board and connected to the row and column drivers on the one side and the host controller on the other. The control block may include level shifter, timing and analog functions generators. The objective of the control unit is to generate timing and data signals for biasing the row and column drivers, by taking as input digital signals which contain all the video, synchronization and timing information from the host system, which is a graphics controller chip.
\n\t\t\t\tBlock diagram of an AMLCD architecture.
The architecture and design of the module electronics have a significant impact not only on the image quality of the display but also on the display system fabrication cost and power consumption. Figure 9 shows the contribution to the power consumption and the fabrication cost of each electronic module of a typical 10.4-in. backlit TFT-LCD. The typical power consumption of this display is 3 W at 150 cd/m2 brightness.
\n\t\t\t\tSummarizing, an AMLCD designated for portable applications is expected to satisfy the specifications that are presented below:
\n\t\t\t\tHigh Pixels Matrix (above QVGA)
High Resolution (160 dots/inch)
High Contrast Ratio (≥ 100 : 1)
Full Color (8 bit/color)
Full Motion Video (80 frames per second)
Adequate Brightness (15-100 fl,)
Wide Viewing Angle (≥ ± 45 in horizontal and vertical directions)
Light Weight
Small Volume (small depth)
Low Power Consumption / High Luminous Efficiency
Low Cost
a) Fabrication cost contribution of each component. (b) Power consumption contribution of each electronic module.
Liquid Crystal Pixels are transmission type pixels with a backlight, meaning that they are not emitting their own light. While there are many types of liquid crystal materials such as smectics, nematics and cholesterics, twisted nematic (TN) display mode is the most advanced and popular. A TN pixel cell consists of two glass substrates coated on their inner surfaces with transparent electrodes and separated by several millimeters from each other. A nematic liquid crystal material fills the space between the two substrates and two polarizers are attached on both sides of the pixel with their polarization axis crossed. The polarizer is a three-layer composite film with a stretched iodine doped polyvinyl alcohol (PVA) polarizing film in the center and two outer films for protecting the PVA film from the ambient. Since the two substrates, each having alignment layer, are oriented with their alignments perpendicular to each other, liquid molecule is twisted initially. In the voltage-off state, the polarizers are oriented perpendicular and the incoming light from a back light source, whose polarity is twisted by the liquid crystal, is transmitted through the output polarizer. When a voltage is applied to the electrodes, the director of the molecules tends to orient themselves parallel to the applied field, since liquid crystal materials have positive dielectric anisotropy. In this situation, the polarization of the light transmitted through liquid crystal is crossed to the output polarizer resulting in the cut off of the light and thus creating a black state for the display pixel. This operation is called normally white mode, while normally black mode can be achieved by changing the polarizers to a parallel orientation. Figure 10 shows the configuration a TN pixel cell in a normally white mode.
\n\t\t\t\tThe transmission (luminance) versus the applied voltage characteristic is shown in Fig. 11. The shown characteristic is for normal viewing angle and indicates that grayscale levels can be achieved by varying the voltage across the LCD. Unfortunately, the transmission – voltage curve is viewing angle dependent, leading to grayscale errors and color shift in a display when it is viewed from significant angles to the display normal.
\n\t\t\t\tPrinciple of operation of a TN pixels cell in a normally white mode.
Transmission versus applied voltage characteristic for normal viewing angle.
The equivalent circuit with the parasitic elements of a pixel cell and a typical TFT-LCD pixel layout are shown in fig. 12. The pixel consists of a switch TFT device, with the gate electrode connected to the row driver lines and the source electrode connected to the column driver lines. Furthermore, a storage capacitor is connected in parallel to the LC pixel capacitance.
\n\t\t\t\ta) Equivalent circuit with the parasitic elements of a pixel and (b) typical pixel layout design.
The aperture part is the light transparent part and it is designated for the placement of the liquid crystal while the TFT, voltage lines and storage capacitor areas are non-light transparent. The ratio between the transparent portion of a pixel and its surrounding electronics is called aperture ratio or fill factor. Furthermore, in the shown layout design, the storage capacitor is connected to an adjacent row line resulting in the maximization of the aperture ration but the load capacitance of the row lines is, also, increased. The counter electrode of the LC pixel capacitor is the common ITO electrode on the opposite substrate (Den Boer, 2005). For large displays, this configuration is difficult to be used due to the large RC delay time of the row lines. In order to overcome this problem, a common storage bus can be placed in the aperture area which reduces the load capacitance of the row lines, but also reduces the aperture ration of the pixel.
\n\t\t\t\tThe crosstalk effect is caused due to the column-line video-signal coupling during one frame and a DC component is being added to the AC data voltage. The DC component can not be entirely eliminated for all gray across the entire pixels matrix, resulting to slight difference in the pixel transmittance between the odd and even frames. A solution to this problem is the polarity inversion method. Apart from elimination of the DC component, the influence of the flicker on the display image quality is also eliminated with the use of a polarity inversion method. Four different polarity inversion methods have been widely used. Figure 13 shows the configuration of the four polarity inversion methods. The type of the polarity inversion method has an impact on the power consumption of the display. In the frame inversion method, all the pixels are driven to + Vp polarity in one frame period and then all of them are driven to – Vp polarity during the next frame period. This method is the most power-efficient method. However, this method is sensitive to the flicker and to vertical and horizontal crosstalk, meaning that this method can not be used in high image quality displays.
\n\t\t\t\tIn the line and column inversion methods, the polarity of the pixels is alternated in the adjacent rows and columns, respectively. The line inversion method is compatible to the Vcom modulation (Den Boer, 2005) while column inversion method is not compatible. Furthermore, the line inversion method consumes more power than the column inversion method because the capacitance of all row busses is charged and discharged every row time. Finally, the column inversion method has better results to the compensation of the flicker.
\n\t\t\t\tIn the pixel inversion method, the polarity of each pixel is inverted from the polarity of its neighbouring pixels, by a combination of simultaneous row and column inversions. This produces the highest quality images by total elimination of the flicker and crosstalk effect. This method is not compatible with the Vcom modulation and thus it requires high voltage column drivers leading to high power consumption.
\n\t\t\t\tTypical AMLCD polarity inversion methods.
A full color LCD display can be generated by incorporating red, green and blue color filters at the pixels. In order to produce the desirable color tone, the pixel is divided into three sub-pixels each one having red, green and blue color filter, respectively. The three sub-pixels have the same dimensions and the proper combination of each color tone; by applying the right voltages to the liquid crystals, the desired pixel emissive colour will be produced. The width of each sub-pixel is three times smaller than the sub-pixel length and when the three sub-pixels are very closely placed in parallel, a square full color pixel is produced. Figure 14 shows a full colour square pixel.
\n\t\t\t\tTypical full color square pixel.
The pixels matrix on glass substrates is directly connected to the row and column drivers, implemented for integrated circuits. Figure 15 shows the basic architecture of a row driver. The operation of the row driver is based on the generation of the gate pulse, controlling the line of pixels to be programmed by turning “ON” or “OFF” the switch TFT device of each pixel. This is the reason for often being referred as gate driver. The generated, from the row driver, pulse has to satisfy the following specification: the selected gate pulse must be higher than the most positive column voltage by at least one TFT threshold voltage. The non-selected gate pulse must be lower than the lowest column voltage by at least one TFT threshold voltage. The above specifications ensure that the selected pixel stays “turned-on” during the programming period and “turned-off” during the emission period to hold the pixel charge. The duration of the gate pulses is about 10 – 50 μs, depending on the display resolution as described in the systems clock frequency.
\n\t\t\t\tA row driver consists of a bi-directional shift register, level shifter, an enable system and an output buffer block. At the beginning, the input start (IS) bit selects a row at a time. If multiple cascaded chips architecture is available, the IS bit can be transferred to the second row driver and play the role of the start bit. This is the reason why IS’s bit pin acts as both input and output pin. The DIR input controls the direction of the shift register, enabling the row driver to be mounted either at the left or at the right side of the display area. The enable system allows the output pulse to be turned to the non-selected edge before the end of the line time. The operation of this system is very important especially for large displays with high RC delay time of the lines, in order to avoid cross-talk effects by turning “OFF” the switch TFT devices for a few microseconds just before the data voltage is delivered to the pixels. Level shifters raise the voltages to the desirable output logical levels and the output buffers reduce the output impedance of the row driver so that the row lines can be driven by the output signals.
\n\t\t\t\tColumn driver is more complex than the row driver. The operation of the column driver is to convert the input video signal into an output analog data signals for one row. The levels of the data signals represent the gray (or color) tone and all data signals are applied to the source of the switch TFT of all row’s pixels simultaneously.
\n\t\t\t\tBasic architecture of a row driver.
The transmission – applied voltage curve (fig. 11) of the liquid crystal indicates that the liquid crystal requires about 5 V for its proper illumination. Considering the need of an AC drive signal, the required voltage swing across the LC material is about 10 V. In order to achieve a 10 V swing, the columns driver uses a 12 V power supply. The basic architecture of a column driver is shown in fig. 16.
\n\t\t\t\tA column driver consists of a bi-directional shift register which can be implemented with multiple chip architecture, like the row driver, in order to ensure either top or bottom mounting of the viewing area. The digital data signals for the red, green and blue channels are the input signals of the latch and the following, level shifter raises the signals to the proper voltage levels. The D/A converter is used for transforming the digital signal into analog gray scale levels. The reference input voltage Vg-cor is used for the gamma correction, while the POL signal controls the polarity inversion method that will be used. Finally, the output buffer has the same functionality as the output buffers of the row driver.
\n\t\t\tThe main disadvantage of the TFTs technologies is the instability of the device electrical characteristics, like threshold voltage and carriers mobility, which have been described in a previous paragraph. These instabilities provoke the repeated implementation of the circuit blocks with constant specifications and identical performance, even if the blocks are placed on the same wafer. In digital blocks, the impact of the parameters variations is negligible due to the fact that TFTs are switching elements. On the other hand, in analog blocks, the effects of the parameters variations are a major problem that the designers have to overcome since the existing, in the literature, analog blocks can not be used.
\n\t\t\tBasic architecture of a column driver.
Furthermore, measurements have shown that the threshold voltage variation has stronger impact on the analog circuit performance than the mobility variation (Vaidya et. al., 2008), indicating that the new analog topologies have to be designed in such way so that threshold voltage compensation is achieved. In this paragraph, following the example of two compensation methods applied on an analog buffer design, complete description of the analog circuits design procedure with threshold voltage compensation is presented.
\n\t\t\tAs it has already been mentioned, the analog buffer is the output stage of both row and column drivers and provides the necessary voltage to the row and column lines. The most commonly used topology for the analog buffer implementation is the common drain or source follower amplifier. The simple source follower type analog buffer is shown in fig. 17 (a). Although theoretically, the dc level of the output voltage is not the same as the dc level of the input signal, ideally the small-signal voltage gain is close to unity. In practical applications, the source follower exhibits an offset voltage from the input value, in which the offset voltage is mainly determined from the transistor threshold voltage since the final output voltage is equal to VGS – Vth. For two source followers implemented with poly-Si TFTs, the output voltages will be different for the same applied input voltage due to the poly-Si TFTs threshold voltage variation. Furthermore, if these two source followers are used in the column driver architecture, a non-well controllable data voltage will be applied to the pixels resulting in the non-uniformity of the pixels brightness and gray scale. Therefore, source follower topologies with immunity in the threshold voltage variations have to be designed, in order to produce high quality image displays.
\n\t\t\t\ta) Typical source follower topology, (b) Source Follower topology with threshold voltage compensation.
Many compensation methods have been proposed including voltage mode or current mode threshold voltage compensation. All of them are based on increasing the input voltage by one threshold voltage by using an additional bias circuit topology, connected at the gate of the driving transistor. Figure 17 (b) shows the source follower topology with threshold voltage variations cancellation technique used in the column /row driver block.
\n\t\t\t\tFor generation of an output voltage independent of the threshold voltage, a number of circuits have been proposed (Chun & Mok, 2004), (Tai et. al., 2005), (Chung et. al., 2001). The main similarity of the proposed circuits is the use of switches and additional control signals for sensing the threshold voltage of the driving transistor and the storage in a capacitor connected to the gate of the driving transistor. Therefore, the buffer operation has to be divided into compensation phase and data input phase. The disadvantage of these methods is that additional control signals are required in the configuration of the switches, which have to be generated from the row and column driver. Thus, changes in the architecture have to be made and circuit blocks have to be introduced, avoiding the storage capacitor which results in reduction of the buffer maximum frequency of operation. Recently, novel topologies of bias circuits have been proposed without requiring the use of either switches or storage capacitor, since the gate voltage is generated by either a static or a dynamic circuit. Each case is examined in the following paragraphs.
\n\t\t\t\n\t\t\t\t\tFigure 18 shows the topology of a static source follower with their timing diagram (Pappas et. al., 2007.a). The static source follower consists of five n-type poly-Si TFTs and only one bias voltage, which is proportional to the input data voltage, is required. For the theoretical analysis of the circuit, all TFTs have to operate in saturation mode. Furthermore, for poly-Si TFT devices which are very closely located on the same wafer and fabricated under the same conditions, their threshold voltage variation can be considered to be negligible compared to the threshold voltage variation over the whole panel. This assumption is generally accepted and it has been verified through measurements on fabricated circuits (Lin and Tsai, 2007), (Jung et. al., 2007). The gate voltage is produced from the combination of M1 and M2 and M4 is the driving TFT. The operation of the static buffer can be divided onto two phases.
\n\t\t\t\tStatic source follower topology with its timing diagram.
During the first phase, the enable signal is at low voltage level causing the load capacitance to be discharged. At the same time, the data and bias voltages are applied to the buffer and node A is charged. The same current flows through transistors M1 and M2, while M2 has four time larger gate width than M1 (W2 = 4W1 → k1 = 4k2). Under these conditions, the node A voltage is calculated by the expression
\n\t\t\t\tThe bias voltage is selected to be equal to 3Vdata. Therefore, VGS1 = Vbias – VA = 3Vdata – VA and VGS2 = Vdata. Applying these to eq. 5, we obtain
\n\t\t\t\tTherefore, node A is charged to the proper voltage.
\n\t\t\t\tDuring the second phase of operation, the enable signal (E) is turned to high voltage level. In this situation, the driving transistor is connected as a source follower amplifier causing the load capacitor to be charged up to Vdata. The theoretical analysis demonstrates that the static source follower exhibits high immunity to threshold voltage variations, since the output voltage is independent on the threshold voltage. The only change that has to be made in the column or row driver architecture is the addition of a circuit block, which will produce the bias voltage and the additional control signal (Enable). This circuit block can be a simple multiplier, because the bias voltage is proportional to the data voltage. The necessary change in the row/column driver architecture is shown in fig. 19.
\n\t\t\t\tRow/Column driver architecture with the use of the static source follower.
The advantage of the static source follower is the absence of switches and storage capacitor, leading to less real silicon area and higher maximum frequency of operation. However, the static source follower requires higher supply voltage, since all poly-Si TFTs have to operate in saturation mode and a high bias voltage is used. High power supply results in higher power consumption.
\n\t\t\t\n\t\t\t\t\tFigure 20 shows the dynamic source follower topology and its timing diagram (Pappas et. al., 2008). The dynamic source follower consists of five n-type poly-Si TFTs, a 2-to-1 multiplexer and two additional control signals. For the theoretical analysis of the buffer, the same assumption for the threshold voltage variation of closely placed devices is considered and all transistors have to operate in saturation mode. The control signal “Reset” can be used as the multiplexer select signal and as a reset signal for the buffer at the same time.
\n\t\t\t\tDynamic source follower topology with its timing diagram.
The operation of the dynamic source can be divided into three phases. During the first phase, the reset signal is at high voltage level causing the load capacitor to be discharged. At the same time, with the reset signal at high voltage level, the high voltage Vdd is selected from the multiplexer causing node B to be charged up to Vdd – VTH due to the diode-connected transistor M1. During the second phase, the reset signal is turned to low voltage level and the data voltage is selected from the multiplexer causing node A to be charged up to the data voltage. Transistor M1 will turn “OFF” and node B will be discharged through M2 until the voltage at node B is equal to: VB = Vdata + VTH, due to the diode-connected transistor M2 and the value of the node A voltage. When the voltage at node B obtain its proper value, the enable signal is turned to high voltage level and the driving transistor M4 is connected as a source follower amplifier causing the load capacitor to be charged up to Vdata. When the load capacitor is completely charged, all signal will turn into their low voltage levels and the buffer will operate in idle mode.
\n\t\t\t\tThe theoretical analysis demonstrates that the dynamic threshold voltage variation has no impact on the dynamic source follower functionality, without using switches and storage capacitor for sensing the threshold voltage. Furthermore, the dynamic source follower requires lower power supply compared to the static one, leading to lower power consumption. However, the dynamic source follower requires two additional control signals and a 2-to-1 multiplexer, indicating that changes have to be made in the row/column architecture. The row/column architecture with the use of the dynamic source follower is shown in fig. 21.
\n\t\t\t\tRow / Column driver architecture with the use of the dynamic source follower.
The verification of the analog circuit functionality can be made through circuit simulations by using simulation programs, like Spice or CADENCE. A poly-Si TFT model is needed for the simulations and the most commonly used is the RPI poly-Si model developed by Renseelaer Polytechnic Institute (Shur et. al., 1997). In order to obtain realistic simulations, the TFT parameters must be extracted from fabricated devices (Pappas et. al., 2007). The parameters extraction can be realized by using, special designed for TFT technologies, CAD tools, like Silvaco ATLAS. For the design of circuits, one of the most significant parameter is the supply voltage. The supply voltage has to be high enough so all transistors will operate in saturation mode and low enough in order to decrease the power consumption. Another trade-off is the dimensions of the transistors. The transistor dimensions have to be large enough to produce drain current able to charge the load capacitors and small enough to reduce the real silicon area of the circuits. Finally, statistical analysis for the threshold voltage variation in fabricated devices has to be made, enabling the modelling of the threshold voltage variations in Monte Carlo analysis (Pappas et. al., 2006). The results of the Monte Carlo analysis can demonstrate the impact of the threshold voltage variation on the functionality and performance of the circuits.
\n\t\t\tActive Matrix Liquid Crystal Displays, implemented with amorphous or polycrystalline silicon thin-film transistors, is the most attractive solution for the display industry. However, as the specifications become more and more demanding, the AMLCDs design and the TFTs device characteristics have to be improved. The AMLCDs electronics modules define the image quality of the display and the power consumption and, therefore, their architecture and design have a great impact on the AMLCD performance. The definition of these aspects and the detailed description of their functionality presented in this chapter can provide a helpful handbook for every designer.
\n\t\tThere is increasing focus on platelet functions in people living with HIV/AIDS. This is because of the high incidence of cardiovascular events in these individuals that is 10 times higher than general population [1] independent of traditional risk factors such as age, hyperlipidemia, and ethnic/racial differences. Acquired platelet dysfunctions are often observed in association with HIV/AIDS. Of the available tests for platelet functions [2, 3], none fully captures the complexity involved in this population group.
The results of the functional assays are modified by the viral count, CD4/CD8 ratio, and immunological response and whether or not on antiretroviral treatment. The effects of combined antiretroviral therapy (cART) on platelet functions are complex. Despite achieving viral suppression, these drugs have been demonstrated to have independent effects on platelet functions.
Complete blood count and microscopic examination of formed elements are often the first investigations in suspected hemostatic disorders in clinical situations. Platelet count and morphological changes have impact on bleeding or thrombosis.
Globally, the prevalence of HIV-associated thrombocytopenia is 4–40% [4] though there are geographical, racial as well as ethnic differences from the same locality [5] and stage of disease. Indeed, thrombocytopenia has been considered as a marker of disease progression and improvement [6]. Whereas platelet counts improve with initiation of combined antiretroviral therapy (cART) viral suppression [7], beneficial effect does not apply to zidovudin (AZT) [8].
Despite thrombocytopenia, very low rates of clinical hemorrhage have been reported, estimated at only 3.2% among HIV thrombocytopenic patients [9] even with platelet count as low as 50 × 109/L [10] casting doubt on the clinical relevance of the laboratory results. As a result of lack of clear correlation between HIV-associated thrombocytopenia and clinical significance, some authors have questioned benefit of treatments purely directed toward improvement of platelet count [11].
The prevalence of HIV-associated thrombocytosis, defined as platelet count of more than 400× 109/L [12], is low but depends on the population studied and concurrent medications. Reported prevalence of thrombocytosis in pediatric group who were also HIV-positive cART naive was found at 6% [13], though could be higher at 14% (more than thrombocytopenia at 7% in same cohort) for children on co-trimoxazole prophylaxis [14]. Whether these findings were independent or dependent on co-administered drugs remains undetermined.
Thrombocytosis is an emerging toxic complication accounting for 9% on stable cART depending on the regimen [7] up from 5.8% in treatment-naïve individuals [7]. It remains undetermined the relationship between HIV-associated thrombocytosis and accelerated thrombosis.
Despite the thrombocytopenia being associated with HIV, peripheral blood film smears of platelets are either unremarkable or hypogranular, which are of different sizes appearing as fragments [15].
Ultrastructure of platelets from HIV individuals, apart from showing normal features of hyperactivated aggregates having membrane pseudopodia/filopodia formation, in addition have shriveled aggregates with irregular and torn membrane surfaces, membrane blebbing and shedding of vesicles [16, 17]. The most distinctive features are alteration of granular structure though data are limited.
Most studies on platelet aggregation in HIV have used single or fewer than the recommended panel of agonists with conflicting results [18]. Application of escalating agonist concentrations has uncovered dose-response patterns [19]. In this study, while epinephrine demonstrated greater potency indicating hyperresponsiveness, responses with collagen, TRAP, and ADP showed lesser maximum aggregation indicating lesser efficacy and hyporesponsiveness. The agonist dose-response curve is, however, modified by cART viral suppression, especially abacavir-containing regimens [20] depending on agonist [21]. It must be remembered that although cART is a commonly mentioned modifier, the effects of fever associated with HIV are neither reported nor analyzed in these studies. Hyperthermic conditions such as fever are associated with reduced platelet aggregation [22].
A study comparing whole blood platelet aggregation using MEA found hyporeactivity in both HIV-treated and untreated individuals [23], similar to findings by impedance aggregometry [24]. It is worth noting that co-infection with HBV (6 vs. 4%) and HCV (0 vs. 2%) and low CRP levels [23] could have obscured the overall response. Co-infection with other viruses modulates platelet responses in HIV [25].
Few studies have been performed using thromboelastography (TEG) in HIV individuals. Of the few studies done, MA amplitude was low despite higher normal fibrinogen levels in both cART-treated [21] and untreated HIV subjects [23]. These study results of hypocoagulability are not in keeping with other tests, probably reflecting lack of sensitivity of TEG as a platelet function assay.
Activated platelets are characterized by surface expression of activation-specific molecules such as P-selectin or CD62P, active GPIIbIIIa (PAC-1), phosphatidyleserine (PS) externalization; platelet-leukocyte aggregates (PLA); platelet microparticle formation (PMP), in addition to granule secretion such as platelet factor 4(PF4), β-thromboglobulin, and intracellular calcium flux [26].
A number of studies have documented platelet hyperactivity in HIV characterized by increased plasma membrane surface expression of CD62P, PAC-1, PS, CD63, [27], but paradoxically decreased GPIbα [28]. The levels positively correlate with viral loads but not CD4 count [29].
Although activation markers are higher in HIV sero-positive individuals who are cART naïve compared to healthy controls [30], with cART treatment levels decrease but do not normalize to pre-treatment levels [20, 31]. The persistent levels are related to inflammatory markers in virally suppressed individuals [32].
There is evidence of altered signal transduction affecting protein synthesis, degranulation, and activation functioning in HIV platelets. Experimental data show that HIV platelets had upregulation of ABCC4 (ATP-binding cassette subfamily 4), increase in cAMP, decrease in vasodilator-stimulated phosphoprotein (VASP), which correlated with increased membrane expression of CD62P and integrin αIIbβ3 (GPIIbIIIa) [33]. It must be noted that VASP is only sensitive to PY12 inhibitors, and not much data are available from HIV patients.
People living with HIV have increased secretion of alpha granule contents such as RANTES, sP-selectin, and sCD40L [34], despite viral suppression [33]. The persistence of these chemokines, especially anomalous secretion of RANTES, despite cART treatment [28] remains unexplained to date.
HIV platelets have low basal dense granule content and diminished secretion response as evidenced by low mepacrine uptake and release [33]. Although platelet mepacrine uptake and release have been considered among dense granule assays, it is not as specific as serotonin and lummiaggregometry for ATP [35, 36]. Despite this knowledge, the measurements of platelet serotonin and ATP remain largely undescribed in people living with HIV.
Although HIV-associated platelets display increased baseline expression of surface activation markers compared to healthy controls [32], there is evidence of refractoriness to further agonist stimulation. This behavior has been referred to as “platelet exhaustion” in many publications [25, 28, 32, 37, 38].
Platelet “exhaustion” as a concept was postulated in references to previous observations, before HIV era, where activated platelets continued to circulate [39, 40] and were shown to be activated [41] but with decreased aggregation [42, 43]. They were considered refractory to further agonist stimulation [44] owing to acquired storage pool granule depletion [45, 46].
In HIV, stimulation with increased agonist concentration leads to lesser response at each corresponding dose [21]. Specifically, decreased thrombin dose-response curve for granule content and secretions for P-selectin, PFA/CXCL4,TXA and RANTES in HIV platelets less than healthy controls [32]. The decreased P-selectin and PAC-1 secretory responses correspond to impaired c-AMP, ABCC4 and VASP signal transduction mechanisms [33]. Furthermore, HIV platelets display decreased mepacrine uptake and release [33], and wheat germ agglutinin staining (WGA) [32] indicating reduction of dense and alpha granule contents respectively.
Despite many studies mentioning “platelet exhaustion” in HIV, however the results in support are neither consistent for all agonists nor confirmed by other tests. In patients who are cART naïve, stimulation with AA, ADP or collagen, the dose-response curves for CD62P are higher than the uninfected controls [30]. None of the LTA aggregation tests have been accompanied by corresponding Lummiaggregometry test which could have better characterized platelet ATP dense granule secretion [47, 48]. Platelet lumiaggregometry testing remains largely un-described in HIV. Furthermore, the studies are on people who are already infected by HIV, but platelet responses prior to HIV infection remains unknown.
From the foregoing, evidence in support for “platelet exhaustion” in HIV is suggestive but inconclusive. Although decreased dose-response to thrombin has been described, however response to epinephrine was enhanced in some studies. The maintained response to epinephrine casts doubt on granule exhaustion, since true storage pool disorder do not respond to epinephrine [49] or variable [50]. Indeed HIV platelets maintain both alpha and dense granule secretions to collagen and ADP agonists stimulation [51]. Perhaps a better term to use could be “anergy,” refractory or “tired” platelets.
HIV platelets have enhanced adherence to fibrinogen-coated surfaces [32, 33]. However, testing by this method is technically difficult and not available in clinical situations.
Although platelet PFA-100/200 testing is always recorded as aggregation in most studies, in actual fact it is marker of adhesion [2, 52]. The few tests of PFA-100 in HIV compared those on cART treatment with untreated [31], or in addition to [53] all of which showed shorter closure time in treatment-naïve individuals. The short closure times were neither normalized with aspirin nor with cART. The results are strongly indicative of influence of vWF as a third dimension in platelet function testing [54, 55].
People living with HIV (PLWHIV) despite having very low platelet counts do not have issues of bleeding [56, 57, 58]. Instead, HIV-associated thrombotic complications [59] are an emerging issue of concern [60]. Although congenital thrombotic thrombocytopenic purpura (TTP) is very rare, acquired TTP is on the increase and associated with HIV estimated to be 15–40 times than the HIV negative in the general population [61]. It has been reported that HIV is responsible for 80% of TTP cases [62].
TTP is characterized by reduced or absent ADAMTS-13 and elevated vWF antigen as well as activity [63] especially the Unusually Ultralarge vWF multimers [64]. Elevated vWF Ag and high-molecular-weight vWF multimers [65] with reduced ADAMTS-13 have been detected in acute and chronic HIV [66, 67] and those with confirmed thrombosis [68]. Unusually, ultralarge vWF multimers that have increased adhesion to platelet GPIbα-V-IX receptors [69] compensates for hemostasis in the presence of the low platelet count in HIV.
It has been demonstrated that blood from HIV individuals have abundant circulating platelet microparticles [70], and this is despite viral suppression [71, 72]. The levels were associated with increased cellular ROS, caspases, eNOS [72], and mitochondrial membrane depolarization [73] indicative of apoptosis [74] . Further, co-existence of platelet microparticles with increased LPS and platelet P-selectin and TF [29] are strong indicators that they are products of platelet activation.
Recently, in mice, HIV particles were shown to be endocytosed by platelets by binding to TLR-7&9 leading to increased secretion of alpha (PFA-4) and dense granules (serotonin), and membrane expression of P-selectin [75]. Additionally, HIV interacts directly with platelets CLEC-2 and DC-SIGN receptors [76]
HIV preferentially infects CD4-T lymphocytes present in the gut leading to reduction in number and function [79]. The consequence is loss of gut epithelial immune protection and disruption of gut epithelial barrier allowing luminal indigenous intestinal bacteria to translocate out of the mucosa and into circulation [80]. Once in circulation, bacterial products such as lipopolysaccharides (LPS) interact with platelet toll-like receptors 4 (TLR4) [81]. The microbial products induce signal transduction mechanisms that eventually lead to facilitating platelet membrane receptor expression [82, 83]. The phenomenon of gut microbial translocation has been used to explain enhanced platelet reactivity despite therapy with antiplatelets such as ticagrelor in myocardial infarction [84]. However, some studies have disputed the role of LPS in platelet activation instead of reporting attenuation of receptor expression and aggregation in the presence of agonists [85] contradicting earlier findings. The paradoxical result may be due to the absence or presence of other factors such as soluble CD14 that prime TLR4 sensing of LPS [86], extent of TLR expression [87] or the different LPS isoforms [88], and experimental conditions [89] as well as clinical condition [89].
HIV infection is associated with elaboration of cytokines from inflammatory cells, and these have been shown to induce platelet activation [90, 91] The platelet activation is not limited to interleukins only, since tumor necrosis factor in blood leads to dose- and time-dependent increase in platelet expression of GPIIbIIIa, PS, and mitochondrial dysfunction [92]. The role of TNF-α in platelet activation and apoptosis are well supported by empirical evidence [93].
Platelets express FcRIIA (CD32a) or simply FcR receptor that recognizes the constant region of IgG in immune complexes [94]. The consequence of platelet-immune complex binding leads to platelet activation [95], aggregation and release of contents from alpha and dense granules [94], and microparticle formation [96]. The platelet activation from immune complexes is dependent on membrane GP IIbIIIa [97]. However, the immune complex-induced platelet aggregation is dependent on dose and charge [98].
Cross-reactive antibodies between HIV epitopes and platelet receptors have been described [99, 100].
When neutrophils encounter viruses such as HIV, they respond by releasing reactive oxygen species and net-like structures called neutrophil extracellular traps [101, 102]. The NETs, composed of DNA, histones, myeloperoxidase, citrinulated histones, and elastases, are the potent inducers of platelet aggregation and activation [103, 104, 105].
There is often cross-talk between platelets and leukocytes associated with bidirectional priming and activation of each other [106, 107]. These two cells interact through platelets such as P-selecti-PSGL-1, GPIb-vWF-CD18, integrin IIaIIIb-fibrinogen-MAC-1 neutrophil linkages that lead to the formation of platelet-leukocyte aggregates (PLA) [108] linked by P-selectin-PSGL. These PLA conjugates have been found in HIV patients involving T-cells associated with CD42b and CD62P [109]. Elevated PLA together with other immune markers is positively correlated with increased platelet CD36, CD62P, and platelet aggregation but inversely with CD4 count [110].
There is evidence of endothelial damage [111] and increased vWF levels in HIV patients [66, 67, 68, 112, 113]. Apart from the high vWF Ag levels, of significant is the persistently high functionally active Ultralarge vWF multimers (ULvWFM) in HIV individuals [65] that causes adhesion even at low platelet counts [114]. Correspondingly, as HIV disease progresses, platelet expression of the integrin GPIbα decreases paradoxically unlike the other surface receptors indicating consumption [28].
There are similarities in markers of platelet activation and apoptosis [115]. In both processes, there is phosphatidyleserine (PS) exposure on the membrane [116] and microparticles [117]. However, specific features of platelet apoptosis include mitochondrial membrane leakage characterized by changes in membrane depolarization (Δψm) and increase in cytosolic caspases 3&8, [118, 119]. Indeed, features of platelet apoptosis and activation have been demonstrated in HIV patients [25, 32, 38]. It should be noted that the few studies demonstrating occurrence of full spectra of apoptosis in HIV individuals were confounded by cART viral suppression [32] and dengue co-infection [25] and therefore, whether results were specific to HIV in itself largely remains undetermined.
Some of the consequences of platelet apoptosis include thrombocytopenia [120, 121]. This is because, apart from the fact that apoptotic platelet eventually disintegrates [74], the surface exposure of PS acts as “eat me” signal for engulfment by the macrophages thus removing the altered cells from circulation shortening survival [122, 123, 124].
Despite the success attained by cART in viral suppression and recovery of platelet counts [125, 126], their effects on platelet function remain variable. In general, platelet surface markers such as CD62P, PAC-1 and CD40L, soluble sCD62P, sCD40L as well as platelet-secreted chemokines such as RANTES persist despite cART viral suppression [27] with some variations between the individual drugs and study designs.
Platelet signal transduction and secretory effects are enhanced by HIV, but these effects are accentuated by cART. This was demonstrated by Pastori et al.’s [78] study in which levels of sCD40L, platelet sNOX-dp, and 8-iso-PGF2-α were elevated, the effects of PIs greater than NNRTI. The mechanism appears to be induction of oxidative stress, ROS, and arachidonic pathways that synergistically augment AA platelet activation. cART causes mitochondrial toxicities [127]
Abacavir is unique among cART [51] since it is a guanosine analogue and induces platelet activation
Despite other studies reporting levels of platelets MP remaining unchanged [29] or increased [71] after initiating antiretrovirals, one study found MP TF levels decreased with cART treatment [133]. The difference could be attributed to monocyte phenotypes [134] and level of activation and attendant TF expression with cART [135]. This is because platelets undergo decryption [136] and transfer TF to monocytes using microparticles as vehicles [137, 138].
The effects of cART on platelets are complicated by other factors such as TNF-α, a known platelet activator and apoptosis inducer. Although TNF levels are often elevated in HIV infection, levels persist despite cART [139] even if used over 24-month period [34]. Whereas cART treatment decreases circulating bacterial LPS levels in HIV patients, platelet reactivity is increased instead [23] suggesting intrinsic effects of the drugs independent of bacterial translocation.
People living with HIV/AIDS are at increased risk of cardiovascular events [140, 141], especially coronary heart disease [142, 143] and ischemic stroke [144, 145], than the general population. The increased risk is due to HIV infection alone and accentuated by cART [146, 147].
Although there is evidence of enhanced platelet activation in association with HIV [27], studies of antiplatelet therapy in these patients have yielded inconsistent results, perhaps owing to drug interactions [148]. It should be noted that the studies so far done were on patients concurrently taking cART.
In a study of HIV-1 infected patients who had been on 6-month cART, it was found that 325 mg of oral aspirin-attenuated platelet aggregation to agonists, activation markers [37]. In the same study, although levels of urinary thromboxane were decreased in both HIV-positive cART untreated and treated, it was least responsive to aspirin. Furthermore, despite aspirin administration, suppression of platelet hyperactivity did not decline to baseline levels indicating the contributory effects of cART. Apart from the small sample size and short duration of therapy, other limitations of this pilot study are that it evaluated only one antiplatelet drug, and it did not perform subgroup analysis among the different cART drugs (NNRTI, PI, Raltegravir, and abacavir) as well as the racial and ethnic differences.
Although aspirin and R406 (thromboxane analogue) but not ticagrelor inhibits platelet engulfment, they do not inhibit CD62P expression or PMA complex formation [149]. Other studies have confirmed the suboptimal effects of aspirin on platelets agonist (collagen and epinephrine)-induced aggregation, surface expression of CD62P, CD40L, and PAC-1 from individuals with HIV taking ABC [53]. This study identified subjects taking abacavir-containing cART as poor responders. While cART is currently standard of care in the treatment of HIV, there are no data on effects of antiplatelets in PLWH before adoption of practice.
Clopidogrel reduces thrombogenicity and platelet hyperreactivity better than aspirin in PLWH on cART [21]. The question whether dual antiplatelet therapy compared to single agent may have a better reduction in platelet hyperreactivity in HIV concurrently taking cART was evaluated in the EVERE2ST-HIV [18]. This study evaluated the extent of platelet inhibition patients with acute coronary patients on dual antiplatelet therapy undergoing PCI utilizing various platelet function assays [18]. The findings were that P2Y12 inhibitors (clopidogrel, prasugrel, and ticagralor) and aspirin were all associated with residual platelet reactivity on light transmission aggregometry (LTA), VerifyNow, and VASP assays. Furthermore, HIV infection was an independent risk factor for the high on antiplatelet reactivity that was increased by combined antiretroviral therapy (cART). Of the cART, protease inhibitors had greater effects than the NNRTIs. The residual platelet reactivity in PLWHIV despite viral suppression and dual antiplatelet therapy can probably be accounted by the active immune mechanisms and drug interactions [148].
Overall, few studies have evaluated the effects of antiplatelets in persons living with HIV. The available studies suffer from small sample sizes and have not been performed in populations not taking cART. Furthermore, the different classes of antiplatelets have not been evaluated. Of the studies done so far, the results do demonstrate neither efficacy nor improved outcomes with either aspirin or clopidogrel.
Infection with HIV is associated with reduced platelet count; extent of thrombocytopenia inversely correlates with viral load and disease progression. Despite thrombocytopenia, cardiovascular events are on the increase. There is associated platelet hyperactivity, as evidenced by increased surface expression of CD62P, CD40L, platelet microparticles, and platelet leukocyte aggregates. There is enhanced secretion of chemokines such as RANTES. Combined antiretroviral drugs independently and synergistically with HIV enhance platelet hyperactivity that persists despite viral suppression. Data on the effects of antiplatelets in this population can at best be described as clinical equipoise.
Autor’s ORCID identifier: 0000-0001-6466-172X.
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Hypertension-induced structural remodeling is associated with an increased risk of life-threatening arrhythmias and heart failure in both humans and experimental animals. Recent studies suggest that abnormal distribution and/or downregulation of Cx43 accompanied with altered protein kinase C (PKC)ε signaling in spontaneously hypertensive rats were linked with increased propensity to ventricular fibrillation compared to normotensive rats. By contrast, the long-term treatment of hypertensive rats with cardioprotective compounds such as melatonin, omega-3 fatty acids, or red palm oil resulted in protection from lethal arrhythmia. Their antiarrhythmic effect was attributed to the attenuation of abnormal Cx43 topology and modulation of Cx43 mRNA as well as protein expression and its functional phosphorylated forms. The latter might be attributed to upregulation of PKCε. It appears that maladaptive consequences of hypertension resulting in abnormal myocardial distribution of Cx43 and its downregulation can contribute to arrhythmogenesis and occurrence of malignant arrhythmias. On the other hand, the attenuation of myocardial Cx43 abnormalities by treatment with melatonin, omega-3 fatty acids, or red palm oil confers arrhythmia protection in rodent model of essential hypertension. Findings uncover novel mechanisms of cardioprotective effects of melatonin, omega-3 fatty acids, and red palm oil. Well-designed clinical trials are needed to explore antiarrhythmic potential of these compounds in human essential hypertension.",book:{id:"5216",slug:"update-on-essential-hypertension",title:"Update on Essential Hypertension",fullTitle:"Update on Essential Hypertension"},signatures:"Tamara Egan Benova, Barbara Szeiffova Bacova, Csilla Viczenczova,\nMiroslav Barancik and Narcis Tribulova",authors:[{id:"181938",title:"D.Sc.",name:"Narcisa",middleName:null,surname:"Tribulova",slug:"narcisa-tribulova",fullName:"Narcisa Tribulova"},{id:"185905",title:"Dr.",name:"Tamara",middleName:null,surname:"Egan Benova",slug:"tamara-egan-benova",fullName:"Tamara Egan Benova"},{id:"185907",title:"Dr.",name:"Barbara",middleName:null,surname:"Szeiffova Bacova",slug:"barbara-szeiffova-bacova",fullName:"Barbara Szeiffova Bacova"},{id:"185908",title:"Dr.",name:"Csilla",middleName:null,surname:"Viczenczova",slug:"csilla-viczenczova",fullName:"Csilla Viczenczova"}]},{id:"48384",doi:"10.5772/60418",title:"A Review on Amiodarone as an Antiarrhythmic Drug",slug:"a-review-on-amiodarone-as-an-antiarrhythmic-drug",totalDownloads:2769,totalCrossrefCites:4,totalDimensionsCites:5,abstract:"Antiarrhythmic drugs are used to suppress abnormal heart rhythms by different mechanisms. Amiodarone as an iodinated benzofuran derivative is a potent antiarrhythmic drug that is being used for the treatment of a wide variety of cardiac arrhythmias. Amiodarone has been reported to cause frequent and potentially serious toxicity. It was estimated that the prevalence of side effects was 15 % in the first year and increased to 50% with long-term therapy. Thyroid, lung, liver, ophthalmologic and neurologic systems can be affected by Amiodarone. Most of the adverse effects of the drug are related to its dosage and duration of administration. Therefore the effectiveness of Amiodarone in long-term treatment of patients with heart arrhythmia is limited because of the development of its adverse side effects.",book:{id:"4584",slug:"abnormal-heart-rhythms",title:"Abnormal Heart Rhythms",fullTitle:"Abnormal Heart Rhythms"},signatures:"Fereshteh Mehraein",authors:[{id:"173324",title:"Associate Prof.",name:"Fereshteh",middleName:null,surname:"Mehraein",slug:"fereshteh-mehraein",fullName:"Fereshteh Mehraein"}]},{id:"41776",doi:"10.5772/52512",title:"Principles of External Defibrillators",slug:"principles-of-external-defibrillators",totalDownloads:3710,totalCrossrefCites:2,totalDimensionsCites:5,abstract:null,book:{id:"3289",slug:"cardiac-defibrillation",title:"Cardiac Defibrillation",fullTitle:"Cardiac Defibrillation"},signatures:"Hugo Delgado, Jorge Toquero, Cristina Mitroi, Victor Castro and Ignacio Fernández Lozano",authors:[{id:"38793",title:"Dr.",name:"Jorge",middleName:null,surname:"Toquero",slug:"jorge-toquero",fullName:"Jorge Toquero"}]}],mostDownloadedChaptersLast30Days:[{id:"41776",title:"Principles of External Defibrillators",slug:"principles-of-external-defibrillators",totalDownloads:3705,totalCrossrefCites:2,totalDimensionsCites:4,abstract:null,book:{id:"3289",slug:"cardiac-defibrillation",title:"Cardiac Defibrillation",fullTitle:"Cardiac Defibrillation"},signatures:"Hugo Delgado, Jorge Toquero, Cristina Mitroi, Victor Castro and Ignacio Fernández Lozano",authors:[{id:"38793",title:"Dr.",name:"Jorge",middleName:null,surname:"Toquero",slug:"jorge-toquero",fullName:"Jorge Toquero"}]},{id:"46160",title:"Basic Mechanisms of Cardiac Arrhythmias",slug:"basic-mechanisms-of-cardiac-arrhythmias",totalDownloads:4459,totalCrossrefCites:1,totalDimensionsCites:1,abstract:null,book:{id:"3815",slug:"cardiac-arrhythmias-mechanisms-pathophysiology-and-treatment",title:"Cardiac Arrhythmias",fullTitle:"Cardiac Arrhythmias - Mechanisms, Pathophysiology, and Treatment"},signatures:"Andrey Moskalenko",authors:[{id:"63235",title:"Dr.",name:"Andrey",middleName:"V.",surname:"Moskalenko",slug:"andrey-moskalenko",fullName:"Andrey Moskalenko"}]},{id:"48384",title:"A Review on Amiodarone as an Antiarrhythmic Drug",slug:"a-review-on-amiodarone-as-an-antiarrhythmic-drug",totalDownloads:2764,totalCrossrefCites:4,totalDimensionsCites:5,abstract:"Antiarrhythmic drugs are used to suppress abnormal heart rhythms by different mechanisms. Amiodarone as an iodinated benzofuran derivative is a potent antiarrhythmic drug that is being used for the treatment of a wide variety of cardiac arrhythmias. Amiodarone has been reported to cause frequent and potentially serious toxicity. It was estimated that the prevalence of side effects was 15 % in the first year and increased to 50% with long-term therapy. Thyroid, lung, liver, ophthalmologic and neurologic systems can be affected by Amiodarone. Most of the adverse effects of the drug are related to its dosage and duration of administration. Therefore the effectiveness of Amiodarone in long-term treatment of patients with heart arrhythmia is limited because of the development of its adverse side effects.",book:{id:"4584",slug:"abnormal-heart-rhythms",title:"Abnormal Heart Rhythms",fullTitle:"Abnormal Heart Rhythms"},signatures:"Fereshteh Mehraein",authors:[{id:"173324",title:"Associate Prof.",name:"Fereshteh",middleName:null,surname:"Mehraein",slug:"fereshteh-mehraein",fullName:"Fereshteh Mehraein"}]},{id:"61466",title:"Idiopathic Ventricular Arrhythmias",slug:"idiopathic-ventricular-arrhythmias",totalDownloads:1526,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Idiopathic ventricular arrhythmias (VAs) occur with a mechanism that is unrelated to myocardial scar. Idiopathic VAs most commonly occur in patients without structural heart disease, but can occur in those with structural heart disease. Idiopathic VAs present as a sustained or a non-sustained ventricular tachycardia or premature ventricular contractions. Imaging examinations such as echocardiography, nuclear tests, and cardiac magnetic resonance imaging are helpful for excluding any association of an idiopathic VA occurrence with myocardial scar. For the past two decades, the sites of idiopathic VA origins, commonly endocardial but sometimes epicardial, have been increasingly recognized. Idiopathic VAs usually originate from specific anatomical structures and exhibit characteristic electrocardiograms based on their anatomical background. Idiopathic VAs are basically benign, but they require medical treatment or catheter ablation when idiopathic VAs are symptomatic, frequent, or cause tachycardia-induced cardiomyopathy. This book chapter describes the up-to-date information on the prevalence of idiopathic VA origins relevant to the anatomy, diagnosis, and treatment of idiopathic VAs.",book:{id:"6536",slug:"cardiac-arrhythmias",title:"Cardiac Arrhythmias",fullTitle:"Cardiac Arrhythmias"},signatures:"Takumi Yamada",authors:[{id:"68148",title:"Prof.",name:"Takumi",middleName:null,surname:"Yamada",slug:"takumi-yamada",fullName:"Takumi Yamada"}]},{id:"59994",title:"Atrial Flutter: Diagnosis and Management strategies",slug:"atrial-flutter-diagnosis-and-management-strategies",totalDownloads:1496,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Atrial flutter (AFL) is a regular, macro reentrant arrhythmia traditionally defined as a supraventricular tachycardia with an atrial rate of 240–320 beats per minute (bpm). Pathophysiology of atrial flutter and atrial fibrillation (AF) is closely related to the similar risk of stroke and they coexist clinically. Atrial flutter is classified to cavotricuspid isthmus (CTI) dependent (or typical) and non-isthmus dependent (atypical). Isthmus is a distinct structure in the right atrium (RA) through which atrial flutter passes and makes a good target for ablation therapy. Ablation is the primary therapy in atrial flutter, particularly in CTI dependent group, with regard to its safety profile and high success rate of approximately 90%. Three-dimensional electroanatomic mapping is progressively being used to ablate atypical forms of atrial flutter.",book:{id:"6536",slug:"cardiac-arrhythmias",title:"Cardiac Arrhythmias",fullTitle:"Cardiac Arrhythmias"},signatures:"Hamid Reza Bonakdar",authors:[{id:"227955",title:"Dr.",name:"Hamid Reza",middleName:null,surname:"Bonakdar",slug:"hamid-reza-bonakdar",fullName:"Hamid Reza Bonakdar"}]}],onlineFirstChaptersFilter:{topicId:"986",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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",coverUrl:"https://cdn.intechopen.com/series/covers/22.jpg",latestPublicationDate:"July 28th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:1,editor:{id:"356540",title:"Prof.",name:"Taufiq",middleName:null,surname:"Choudhry",slug:"taufiq-choudhry",fullName:"Taufiq Choudhry",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000036X2hvQAC/Profile_Picture_2022-03-14T08:58:03.jpg",biography:"Prof. Choudhry holds a BSc degree in Economics from the University of Iowa, as well as a Masters and Ph.D. in Applied Economics from Clemson University, USA. In January 2006, he became a Professor of Finance at the University of Southampton Business School. He was previously a Professor of Finance at the University of Bradford Management School. He has over 80 articles published in international finance and economics journals. His research interests and specialties include financial econometrics, financial economics, international economics and finance, housing markets, financial markets, among others.",institutionString:null,institution:{name:"University of Southampton",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:3,paginationItems:[{id:"86",title:"Business and Management",coverUrl:"https://cdn.intechopen.com/series_topics/covers/86.jpg",isOpenForSubmission:!0,editor:{id:"128342",title:"Prof.",name:"Vito",middleName:null,surname:"Bobek",slug:"vito-bobek",fullName:"Vito Bobek",profilePictureURL:"https://mts.intechopen.com/storage/users/128342/images/system/128342.jpg",biography:"Dr. Vito Bobek works as an international management professor at the University of Applied Sciences FH Joanneum, Graz, Austria. He has published more than 400 works in his academic career and visited twenty-two universities worldwide as a visiting professor. Dr. Bobek is a member of the editorial boards of six international journals and a member of the Strategic Council of the Minister of Foreign Affairs of the Republic of Slovenia. He has a long history in academia, consulting, and entrepreneurship. His own consulting firm, Palemid, has managed twenty significant projects, such as Cooperation Program Interreg V-A (Slovenia-Austria) and Capacity Building for the Serbian Chamber of Enforcement Agents. He has also participated in many international projects in Italy, Germany, Great Britain, the United States, Spain, Turkey, France, Romania, Croatia, Montenegro, Malaysia, and China. 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At the Ministry of Justice of Slovenia, she is a member of examination boards for court expert candidates and judicial appraisers in the following areas: economy/finance, valuation of companies, banking, and forensic investigation of economic operations/accounting. At the leading business newspaper Finance in Slovenia (Swedish ownership), she is the editor and head of the area for business, finance, tax-related articles, and educational programs.",institutionString:null,institution:{name:"University of Primorska",institutionURL:null,country:{name:"Slovenia"}}},editorThree:null},{id:"87",title:"Economics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/87.jpg",isOpenForSubmission:!0,editor:{id:"327730",title:"Prof.",name:"Jaime",middleName:null,surname:"Ortiz",slug:"jaime-ortiz",fullName:"Jaime Ortiz",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002zaOKZQA2/Profile_Picture_1642145584421",biography:"Dr. Jaime Ortiz holds degrees from Chile, the Netherlands, and the United States. He has held tenured faculty, distinguished professorship, and executive leadership appointments in several universities around the world. 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She specializes in the subject of brands, brand equity, and brand management in production, service, and trade enterprises. She combines this subject with marketing and marketing management in both theoretical and practical aspects. Prof. Hanna Górska-Warsewicz also analyzes brands in the context of trademarks, legal regulations and the protection of intangible. She is an author or co-author of over 200 publications in this field, including 8 books. 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The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. 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She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. Gonzalez-Sanchez",slug:"juan-a.-gonzalez-sanchez",fullName:"Juan A. Gonzalez-Sanchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico System",country:{name:"United States of America"}}},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}},{id:"338856",title:"Mrs.",name:"Nur Alvira",middleName:null,surname:"Pascawati",slug:"nur-alvira-pascawati",fullName:"Nur Alvira Pascawati",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universitas Respati Yogyakarta",country:{name:"Indonesia"}}}]}},subseries:{item:{id:"94",type:"subseries",title:"Climate Change and Environmental Sustainability",keywords:"Environmental Protection, Socio-economic Development, Resource Exploitation, Environmental Degradation, Climate Change, Degraded Ecosystems, Biodiversity Loss",scope:"\r\n\tSustainable development focuses on linking economic development with environmental protection and social development to ensure future prosperity for people and the planet. To tackle global challenges of development and environment, the United Nations General Assembly in 2015 adopted the 17 Sustainable Development Goals. SDGs emphasize that environmental sustainability should be strongly linked to socio-economic development, which should be decoupled from escalating resource use and environmental degradation for the purpose of reducing environmental stress, enhancing human welfare, and improving regional equity. Moreover, sustainable development seeks a balance between human development and decrease in ecological/environmental marginal benefits. Under the increasing stress of climate change, many environmental problems have emerged causing severe impacts at both global and local scales, driving ecosystem service reduction and biodiversity loss. Humanity’s relationship with resource exploitation and environment protection is a major global concern, as new threats to human and environmental security emerge in the Anthropocene. Currently, the world is facing significant challenges in environmental sustainability to protect global environments and to restore degraded ecosystems, while maintaining human development with regional equality. Thus, environmental sustainability with healthy natural ecosystems is critical to maintaining human prosperity in our warming planet.
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After that, he was a postdoc research fellow at the University of British Columbia in Canada to do research on large-scale stream experimental manipulation and watershed ecological survey in temperate rainforests of BC. He was a faculty member at the University of Hong Kong to run ecological research projects on aquatic insects, fishes, and newts in Tropical Asian streams. He also conducted research in streams, rivers, and caves in Texas, USA, to study the ecology of macroinvertebrates, big-claw river shrimp, fish, turtles, and bats. 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