Case-control studies on the relationship between adverse pregnancy outcome and periodontal disease
\r\n\tThis book intends to provide the reader with a comprehensive overview of the current state-of-the-art novel imaging techniques by focusing on the most important evidence-based developments in this area.
",isbn:null,printIsbn:null,pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"d9159ce31733bf78cc2a79b18c225994",bookSignature:"Dr. Gabriel Cismaru",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11867.jpg",keywords:"Hypertrophic Cardiomyopathy, Dilated Cardiomyopathy, Restrictive Cardiomyopathy, Transesophageal Echocardiography, Intracardiac Echocardiography, 3-Dimensional Echocardiography, Adult Congenital Heart Disease, Tetralogy of Fallot, Transposition of the Great Vessels, Coronary Artery Disease, Risk Stratification, Revascularization",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 21st 2022",dateEndSecondStepPublish:"May 19th 2022",dateEndThirdStepPublish:"July 18th 2022",dateEndFourthStepPublish:"October 6th 2022",dateEndFifthStepPublish:"December 5th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Cismaru Gabriel is an Assistant Professor at the University of Medicine and Pharmacy Cluj-Napoca, certified in Cardiology. After completing his certification in cardiology, Dr. Cismaru began his electrophysiology fellowship at the Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu. He has authored or co-authored peer-reviewed articles and book chapters in the field of cardiac pacing, defibrillation, electrophysiological study, and catheter ablation.",coeditorOneBiosketch:"Raluca Tomoaia is an MD, Ph.D. in novel techniques in Echocardiography at the University of Medicine and Pharmacy in Cluj-Napoca, Romania., assistant professor, and a researcher in echocardiography and cardiovascular imaging.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"191888",title:"Dr.",name:"Gabriel",middleName:null,surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru",profilePictureURL:"https://mts.intechopen.com/storage/users/191888/images/system/191888.png",biography:"Dr. Cismaru Gabriel is an assistant professor at the Cluj-Napoca University of Medicine and Pharmacy, Romania, where he has been qualified in cardiology since 2011. He obtained his Ph.D. in medicine with a research thesis on electrophysiology and pro-arrhythmic drugs in 2016. Dr. Cismaru began his electrophysiology fellowship at the Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu, France, after finishing his cardiology certification with stages in Clermont-Ferrand and Dinan, France. He began working at the Rehabilitation Hospital\\'s Electrophysiology Laboratory in Cluj-Napoca in 2011. He is an experienced operator who can implant pacemakers, CRTs, and ICDs, as well as perform catheter ablation of supraventricular and ventricular arrhythmias such as ventricular tachycardia and ventricular fibrillation. He has been qualified in pediatric cardiology since 2022, and he regularly performs device implantation and catheter ablation in children. 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Preterm (PTB) delivery and low birth weight (LBW) are considered to be the most relevant biological determinants of newborn infant survival in both developed and developing countries. The oral changes that can occur in pregnancy have been a focus of interest for many years. Physiological changes that occur in pregnant women can adversely affect oral health. Elevations in estrogen and progesterone enhance the inflammatory response and consequently alter the gingival tissue (Mascarenhas et al., 2003). During pregnancy, the incidences of gingivitis and periodontitis are increased, and many pregnant women suffer from bleeding and spongy gums.
Periodontal disease, a persistent bacterial infection, leads to a chronic and systemic challenge with bacterial substances and host-derived inflammatory mediators that are capable of initiating and promoting systemic diseases (Williams et al., 2000; Gibbs, 2001). The mechanisms underlying this destructive process involve both direct tissue damage resulting from bacterial products and indirect damage through bacterial induction of the host inflammatory and immune responses. Even though controversy exists regarding the role of oral health as an independent contributor to abnormal pregnancy outcomes, the recognition and understanding of the importance of oral health has led to significant research into the role of maternal oral health in pregnancy outcomes (Sanz et al., 2013). Adequate oral hygiene habits are mandatory to control the development of periopathogenic oral biofilms, which have been reported to be associated with poor obstetric outcomes (Lieff et al., 2004; Han, 2011).
The chapter will cover the following aspects on oral health and adverse pregnancy outcomes including a systematic analysis of the studies linking preterm delivery, low birth weight, preeclampsia and periodontal disease.
Association between periodontitis and pregnancy.
Pre term birth, low birth weight and periodontal disease.
Preeclampsia and periodontal disease.
Biological mechanism linking periodontal disease to adverse pregnancy outcome.
Evidence based literature analysis.
Observational and systematic studies.
Intervention studies on the impact of periodontal therapy
Other expected oral outcomes due to pregnancy
Early childhood caries.
Gingival enlargement.
Several studies have revealed the role and influence of periodontitis on adverse pregnancy outcomes. During pregnancy, the changes in hormone levels promote an inflammatory response that increases the risk of developing gingivitis and periodontitis. Even with good plaque control, 50%-70% of all women will develop gingivitis during their pregnancy, commonly referred to as pregnancy gingivitis, due to the variations in hormone levels. Pregnancy gingivitis generally manifests during the second and eighth months of pregnancy and is considered a consequence of the observed increased levels of the hormones progesterone and estrogen, which can effect small blood vessels of the gingiva, making it more permeable (Jensen et al., 1981; Barak et al., 2003).
Research suggests that the presence of maternal periodontitis has been associated with adverse pregnancy outcomes such as preterm birth (Offenbacher et al., 1996; Jeffcoat et al., 2001; Offenbacher et al., 2001), preeclampsia (Boggess et al., 2003), gestational diabetes (Xiong et al., 2006), delivery of a small-for-gestational-age infant, and fetal loss (Moore et al., 2004; Boggess et al., 2006). These increased risks suggest that periodontitis may be an independent risk factor for adverse pregnancy outcomes.
Preterm (PTB) delivery is defined as delivery before 37 weeks of gestation. The international definition of low birth weight (LBW), adopted by the 29th World Health assembly in 1976, is a birth weight of less than 2,500 grams (WHO, 1984). The primary cause of LBW is PTB delivery or premature rupture of membranes. Preterm infants who are born with a low birth weight are termed preterm low birth weight (PLBW). PTB and LBW are considered to be the most relevant biological determinants of newborn infants survival, both in developed and in developing countries. Preterm birth is a major cause of infant mortality and morbidity and poses considerable medical and economic burdens on society (Alves and Ribeiro, 2006). The rate of preterm birth appears to be increasing worldwide, and efforts to prevent or reduce its prevalence have been largely unsuccessful. The importance of PTB and LBW deliveries comes from their capacity to predict the increased risk of mortality among infants born with this condition. Preterm births account for 75% of perinatal mortality and more than half of long-term morbidity (Goldenberg et al., 2008). Moreover, one of the targets of the World Health Organization is to reduce the number of births in which the child weighs less than 2,500 g because this is a known predictor of childhood morbidity and mortality (Cruz et al., 2005).
The primary factors causing LBW infant deliveries are high or low maternal age (>34 yrs or <17 yrs.), smoking, alcohol or drug use during pregnancy, inadequate prenatal care, race, maternal demographic characteristics, hypertension, psychological characteristics, adverse behaviors, multiple pregnancies, nutritional status, diabetes, genitourinary tract infections, uterine contractions and cervical length, and biological and genetic markers (Verkerk et al., 1993; Copper et al., 1996; Nordstrom and Cnattingius, 1996; Romero et al., 2002; Marakoglu et al., 2008).
Microbiological studies suggest that intrauterine infection might account for 25–40% of preterm births. Microorganisms can gain access to the amniotic cavity by (1) ascending from the vagina and the cervix; (2) hematogenous dissemination through the placenta; (3) accidental introduction during invasive procedures; and (4) retrograde spreading through the fallopian tubes (Goldenberg et al., 2000). It has been suggested that spontaneous preterm labor is commonly associated with bacterial vaginosis, a vaginal condition characterized by the prevalence of anaerobes (Gibbs, 2001). This has been shown to elicit an inflammatory burden that results in placental damage and distress and, hence, fetal growth restriction. In addition, the cascade of disordered cytokine response can lead to the stimulation of prostaglandin synthesis and the release of matrix metalloproteinases (MMPs), which account for the uterine contractions and membrane rupture, respectively, and lead to the induction of labor (Romero et al., 1992; Winkler et al., 1998). This suggests that distant sites of infection (oral cavity) or sepsis may target the placental membranes. The maternal susceptibility to oral infections during pregnancy increases the sensitivity of the gingiva to the pathogenic bacteria found in dental biofilms (Barak et al., 2003). Studies have reported the presence of higher levels of
In 1996, researchers first reported a relationship between maternal periodontal disease and the delivery of a preterm infant. The 1996 study by Offenbacher and colleagues suggested that maternal periodontal disease could lead to a seven-fold increased risk of delivering a PLBW infant. Since then, researchers have investigated these possible associations for over a decade. It is important to understand the underlying biologic mechanisms for the relationship between periodontal disease and adverse pregnancy outcomes such as preterm birth to provide a rationale for therapeutic interventions and exploration of other methods that may be used as adjuncts to the standard treatment. These authors concluded that approximately 18% of PLBW cases might be attributable to periodontal disease (Offenbacher et al., 1996).
Preeclampsia is a complication recognized by gestational hypertension and proteinuria. It is one of the most significant health problems during pregnancy and affects 8% to 10% of all pregnancies (Roberts et al., 2003). Intravascular inflammation and endothelial cell dysfunction with altered placental vascular development is believed to be central to the pathogenesis of preeclampsia. To prevent fetal morbidity due to preeclampsia, preterm delivery is induced (Boggess et al., 2006). Maternal clinical periodontal disease at delivery has been associated with an increased risk for the development of preeclampsia (Canakci et al., 2007).
Boggess et al. (2003) were the first investigators to report an association between maternal clinical periodontal infection and the development of preeclampsia. In this longitudinal study, they found a two-fold increased risk for preeclampsia among women with periodontal disease during pregnancy compared with controls. A few other studies also reported an association between preeclampsia and periodontal disease (Table). Canakci et al. (2007) reported that women with preeclampsia were three times more likely to have periodontal infections than healthy women and that periodontal disease also affects the severity of preeclampsia. Barak and colleagues (2007) also found that women with preeclampsia experienced more severe periodontitis than healthy controls. They found a significant elevation in the gingival crevicular fluid levels of PGE-2, interleukin (IL)-1 P, and tumor necrosis factor alpha (TNF-a). In their study, Contreras et al. (2006) found more severe periodontal infections in pregnant women with preeclampsia with the presence of
Two potential mechanisms have been put forward to explain the underlying link between oral health and adverse pregnancy outcomes (Han, 2011). First, periodontal disease causes systemic abnormal immunological changes, leading to pregnancy complications. The elevated systemic inflammation leads to elevated C-reactive protein (CRP) levels, which increase the risk for preeclampsia. Translocation of oral bacteria into the placenta has been demonstrated in animal models of both chronic and acute infections (Lin et al., 2003b; Han et al., 2004).
Possible biological mechanism linking periodontal disease and pregnancy complications.
The biological mechanisms proposed to explain the link between maternal periodontitis and PLBW involve the translocation of either inflammatory mediators such as IL-1 β, TNFα and PGE2 or periodontal bacteria and their products from the periodontal tissues to the fetal-placental unit via the systemic circulation, thereby triggering preterm labor (Hillier et al., 1988). Increased levels of interleukin-1 beta (IL-1
Cytokines such as IL-1, IL-6, and TNF-α are all potent inducers of both prostaglandin synthesis and labor, and the levels of these cytokines have been found to be elevated in the amniotic fluid of patients with amniotic fluid infections in preterm labor (Romero et al., 2006). The intra-amniotic levels of PGE2 and TNF-α rise steadily throughout pregnancy until a critical threshold is reached to induce labor, cervical dilation, and delivery (Offenbacher et al., 1996). Lipo poly sacchrides (LPS), one of the microbial components, can activate macrophages and other cells to synthesize and secrete a wide array of molecules, including the cytokines IL-16, TNF-α, and IL-6, PGE2 and matrix metalloproteinases (Darveau et al., 1997).
The second hypothesis suggests that oral bacteria directly colonize the placenta, causing a localized inflammatory response that results in prematurity and other adverse outcomes. The ratio of anaerobic gram-negative bacterial species to aerobic species increases in dental plaques during the second trimester of pregnancy (Kornman and Loesche, 1980), which may lead to increased cytokine production. If these bacteria escape into the general circulation and cross the placental barrier, they could augment the physiologic levels of PGE2 and TNF-α in the amniotic fluid and induce premature labor. Animal studies have shown that chronic maternal exposure to the periodontal pathogen
The increasing number of case control studies investigating a link between periodontal disease and various adverse pregnancy outcomes in humans has produced conflicting findings (Table 1, 2, 3). Several studies suggest a significant association between maternal periodontal disease and pregnancy complications, including premature delivery, low birth weight and preeclampsia. Periodontal disease and progression during pregnancy appear to confer risk for preterm delivery, and the strength of the association increases at earlier gestational deliveries. However, not all studies supported this contention. Differences in the ethnicity and levels of periodontal disease in patients have been proposed as possible reasons for the conflicting findings reported in these studies. Periodontal disease is twice as prevalent among African-Americans, and this might possibly explain the observed increased risk in preterm delivery and fetal growth restriction among African-Americans (Madianos et al., 2001).Adverse pregnancy outcome and periodontal disease share a number of common risk factors, including age, ethnicity, socioeconomic status and smoking. The majority of studies investigating this association have used a dichotomous definition based on the number of teeth or sites with predefined levels of probing depth and attachment loss. Other studies have employed a range of continuous variables to reflect periodontal status, including probing depth, attachment loss and bleeding on probing. Several studies focused on the clinical measures of periodontal disease, which may not adequately reflect the infectious/ inflammatory burden present in pregnant women. The effect of periodontal disease on adverse pregnancy outcome suggests that periodontal infection as a risk factor but the evidence is insufficient to establish a cause and effect relationship.
Several studies have examined the effects of periodontal treatment on preterm birth and low birth weight outcomes with conflicting findings (Table.4). Studies showed that periodontal therapy provided to women with periodontitis or gingivitis during pregnancy reduced the incidence of preterm low birth weight compared to those whose treatment was delayed until after birth (Lopez et al., 2002; Jeffcoat et al., 2003; Lopez et al., 2005).
Another study reported that significantly reduced rates of preterm births and low birth weight infants were observed for pregnant women who received plaque control instructions and scaling and root planing (Tarannum and Faizuddin, 2007). A three-year retrospective examination of a large insurance company database suggested that receiving preventive dental treatment is associated with a lower incidence of adverse birth outcomes compared with instances in which no dental services are delivered (Albert et al., 2011). However, a large multi-center study that included over 800 patients reported that periodontal treatment had no effect on pregnancy outcomes, recording the occurrence of preterm birth as 12% in the treatment group and 12.8% in the control group (Michalowicz et al., 2006).
Notably, the incidence of adverse birth outcomes from the various studies was lower among women who received some dental care and more so among those who received post-delivery periodontal care or those who received prophylactic treatment compared with those who received no dental care. The beneficial effect of dental care during the gestation period among these health-conscious and care-seeking women might also represent a coincidence. Good oral hygiene practices, however, can minimize gingival disease during pregnancy (Gibbs, 2001). Therefore, it has been recommended that all women should have a dental examination and appropriate dental hygiene care at least once during their pregnancy (Lieff et al., 2004). The American Academy of Periodontology recommends that women considering pregnancy or who are pregnant undergo a periodontal examination and receive the appropriate preventive and/or therapeutic services, if indicated.
The association between maternal periodontitis with adverse pregnancy outcomes such as low birthweight, pre-term birth and pre-eclampsia has been investigated for the past 20 years. Several systematic reviews and meta-analysis has been conducted on various aspect of the association (Table 5). However, the strength of the observed associations based on clinical parameters is modest and seems to vary according to the population studied, the method used to assess periodontal diseases (Ide and Papapanou, 2013)
Khader and Ta’ani (2005) conducted a meta-analysis of periodontal disease in relation to the risk of preterm birth/low birth weight (PTB/LBW) based on two case-control studies and three prospective cohort studies. The sample sizes in the studies ranged from 80 to 1,313 women, with an age range between 12 and 40 years old. The odds ratio in these studies ranged from 3.5 to 7.5. Pregnant women with periodontal disease had an overall adjusted odds ratio of preterm birth that was 4.28 times higher than the odds ratio for healthy subjects (95% CI: 2.62 to 6.99;
Based on the meta-analysis, Xiong et al. (2006) concluded that periodontal disease might be associated with an increased risk of adverse pregnancy outcomes. They analyzed 44 studies (26 case-control studies, 13 cohort studies, and five controlled trials). The authors observed that the findings from observational studies yielded inconsistent conclusions on the relationship between periodontal disease and various pregnancy outcomes. Of the 39 observational studies, 25 studies (16 case-control and nine cohort) suggested that periodontal disease was associated with an increased risk of adverse pregnancy outcomes. Several studies demonstrated a direct relationship between the intensity of the periodontal disease and the risk of adverse pregnancy outcomes.
Vergnes and Sixou (2007) too echoed the same association when they reviewed 17 observational studies (11 case/controls, four cohorts, and two cross-sectionals) resulting in preterm low birth weight with an OR = 2.83 (95% CI: 1.95-4.10, P < 0.0001) and low birth weight with OR = 4.03 (95% CI: 2.05-7.93, P < 0.0001)
Though most of the studies have focused on the pregnancy outcome and periodontitis, very few studies have addressed the effect of periodontal treatment on adverse pregnancy outcome. One such review (Michalowicz et al., 2013) analyzed the same and resulted in a lone study on 303 Brazilian women 18 to 35 years of age with a gestational age ≤20 weeks. Randomization was stratified on smoking. All women, regardless of their periodontal status, received comprehensive non-surgical treatment (test group: oral hygiene instruction, scaling and root planing, and at least monthly follow-up visits) or supragingival scaling and oral hygiene instruction (control group).Despite statistically significant and substantial improvements in clinical periodontal measures with treatment (e.g. bleeding on probing (BOP) was reduced from 50% to 11%), there were no significant differences between test and control groups in preterm birth rates at <37 weeks (11.7 versus 9.1%, respectively, p = 0.57) or at <35 weeks (5.5% versus 5.8%, p = 0.99), or in fractions of infants weighing <2500 g (5.6% versus 4.1%,p = 0.59).
In a meta-analysis of the seven randomized trials, Polyzos and colleagues (2009) summarized that overall treatment of periodontal problems substantially reduced the rate of preterm delivery. They evaluated seven randomized controlled trials (n=2,663). There was a statistically significant reduction in incidence of preterm birth (OR 0.55, 95% CI 0.35 to 0.86, p<0.05) and low birth weight (OR 0.48, 95% CI 0.23 to 1.00, p<0.05) in women who received periodontal treatment compared to those who did not. The review findings suggested that treatment of periodontal disease during pregnancy reduced the rate of preterm birth and may reduce the incidence of low birth weight in infants.
Early childhood caries
Polyzos et al (2010) examined whether treatment of periodontal disease with scaling and root planing during pregnancy is associated with a reduction in the preterm birth rate in randomized controlled trials. Of the 11 trials (with 6558 women), five trials were considered to be of high methodological quality (low risk of bias), whereas the rest were low quality (high or unclear risk of bias). It is noteworthy to see that the results among low and high quality trials were consistently diverse; low quality trials supported a beneficial effect of treatment, and high quality trials provided clear evidence that no such effect exists (odds ratio 1.15, 95% confidence interval 0.95 to 1.40; P=0.15).
Early childhood caries (ECC) is an infectious disease that can present as soon as an infant’s teeth erupt. ECC can progress rapidly and may have a lasting detrimental impact on the health and well-being of the child. Mothers with poor oral health and high levels of cariogenic oral bacteria are at greater risk for infecting their children with bacteria and increasing the risk of their children developing caries at an early age (Ramos-Gomez et al., 2002).
Cariogenic bacteria can be transmitted from mother to child by behaviors that directly pass saliva such as sharing a spoon when tasting baby food, cleaning a dropped pacifier by mouth or wiping the baby’s mouth with saliva (Berkowitz, 2003). Reducing the transmission of cariogenic bacteria can be accomplished by reducing the maternal reservoir, avoiding vectors, and increasing the child’s resistance to colonization (Li et al., 2003). Studies have demonstrated the effectiveness of a primary prevention program initiated during pregnancy to significantly improve the oral health of mothers and their children (Gunay et al., 1998; Soderling et al., 2001). Hence, comprehensive dental care for pregnant women is imperative to safeguard their oral and general health, as well as to reduce their children’s caries risk (Brambilla et al., 1998; Boggess and Edelstein, 2006).
Hormonal changes during pregnancy have been associated with varying types of gingival enlargement. These changes can potentiate the effects of local irritants on gingival connective tissue. Localized gingival overgrowth (pregnancy gingival tumor) is found in 0.2‑0.5% of pregnant females. It occurs as a benign, rapidly growing lesion, usually in the 1st trimester of pregnancy and extending up to 3rd trimester. A pregnancy gingival tumor is a smooth or lobulated exophytic lesion with a pedunculated or sessile base (Srivastava et al., 2013) (Figure 3.). Several theories and speculations have been suggested to explain its occurrence during pregnancy, and meticulous maintenance of oral hygiene during pregnancy is important in reducing its incidence and the severity of gingival inflammation. Hormonal factors might play a role in aggravating gingivitis and gingival overgrowth (Oettinger-Barak et al., 2006; Andrikopoulou et al., 2013)
Pregnancy gingival overgrowth
Birth weight is considered to be an important determinant of the chances that an infant survives, grows, and matures. Maternal risk factors include age, height, weight, socio-economic status, ethnicity, smoking, alcohol use, nutritional status, and stress (Copper et al., 1996; Davenport et al., 2002). A review of the available literature has shown an association between periodontal disease and early pregnancy loss, preterm birth, low birth weight and preeclampsia (Jeffcoat et al., 2001; Gomes-Filho et al., 2007; Vergnes and Sixou, 2007; Xiong et al., 2007). However, the results regarding the treatment of oral disease during pregnancy are conflicting; some studies suggest a reduction in the rate of preterm births and dental caries (Brambilla et al., 1998; Jeffcoat et al., 2003; Lopez et al., 2005), whereas others show no impact (Michalowicz et al., 2006; Offenbacher et al., 2009; Macones et al., 2010).
The hypothesis that infection elsewhere in the body may influence PLBW has led to an increased awareness of the potential role of chronic bacterial infections. Periodontal disease is associated with a chronic Gram-negative infection of the periodontal tissues that results in a long-term local elevation of pro-inflammatory prostaglandins and cytokines and an increase in systemic levels of some of these inflammatory mediators (Page and Kornman, 1997). The evidence suggests that periodontitis can have a significant effect on systemic health. Periodontal disease is associated with many adverse pregnancy outcomes such as preterm delivery (Xiong et al., 2006), preeclampsia (Canakci et al., 2004), abortion and stillbirth (Moore et al., 2004), low birth weight (LBW) infants (Jarjoura et al., 2005) and preterm LBW infants (Xiong et al., 2006).
The strength of the association between periodontal disease and PTLB ranges from a two-fold to a seven-fold increase in risk. Although there are several data suggesting a relationship between maternal periodontal infection and preterm birth, several studies have failed to demonstrate such an association (Davenport et al., 2002; Holbrook et al., 2004; Moore et al., 2004; Buduneli et al., 2005; Rajapakse et al., 2005). Some of the factors that might have affected these observations are the lack of a consistent clinical definition and the failure to control for potential confounders (Holbrook et al., 2004; Moore et al., 2004; Buduneli et al., 2005). Another potential reason for the disparate findings among studies is the differences in the populations studied.
Several common risk factors are responsible for PLBW, such as age, socioeconomic status, and smoking, along with periodontal diseases. Because the inflammatory mediators that occur in periodontal diseases also play an important part in the initiation of labor, it is possible that a biological mechanism links the two conditions. Furthermore, intervention studies, animal studies, and more detailed mechanistic examinations are needed to directly correlate periodontal diseases to PLBW babies and eliminate the confounding effects of various other risk factors.
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
Jacob and Nath (2014), India | \n\t\t\t170/170 | \n\t\t\tLBW | \n\t\t\tBOP,PD, CAL | \n\t\t\tPeriodontitis represents a strong, independent, and clinically significant risk factor for LBW | \n\t\t\tSignificant | \n\t\t
Bulut et al. (2014), Turkey | \n\t\t\t50/50 | \n\t\t\tPTB | \n\t\t\tPPD, CAL | \n\t\t\tThe findings indicated that maternal periodontitis was not a possible risk factor for pre-term delivery | \n\t\t\tSignificant | \n\t\t
Santa Cruz et al.(2013), Spain | \n\t\t\t54/116 | \n\t\t\tPTB | \n\t\t\tMicrobiological tests | \n\t\t\tClinical periodontal condition was not associated with adverse pregnancy outcomes in a Spanish Caucasian population with medium-high educational level | \n\t\t\tNon-significant | \n\t\t
Kumar et al.(2013), India | \n\t\t\t61/132 | \n\t\t\tLBW | \n\t\t\tPeriodontal examination | \n\t\t\tMaternal periodontitis is associated with an increased preterm delivery and low birthweight infants. | \n\t\t\tSignificant | \n\t\t
Cruz et al (2009) Brazil | \n\t\t\t164/388 | \n\t\t\tLBW | \n\t\t\tPI,BOP, PD, CAL | \n\t\t\tThe findings suggest an association between periodontal disease and low birth weight among mothers with low education levels | \n\t\t\tSignificant | \n\t\t
Vettore et al. (2008) Brazil | \n\t\t\t150/66 | \n\t\t\tPTB / LBW | \n\t\t\tPI, CI, BOP, PD, CAL | \n\t\t\tPD was significantly higher in non-preterm low birth weight controls than in subjects in the preterm low birthweight. | \n\t\t\tNon- significant | \n\t\t
Santo-Pereira (2007) Brazil | \n\t\t\t124 | \n\t\t\tPTB | \n\t\t\tPeriodontitis was classified based on CAL | \n\t\t\tPeriodontal disease more prevalent in women with preterm vs. term labor | \n\t\t\tSignificant | \n\t\t
Bassani et al.(2007), Brazil | \n\t\t\t304/611 | \n\t\t\tLBW | \n\t\t\tPD, CAL | \n\t\t\tSimilar rate of periodontal disease among cases and controls | \n\t\t\tNon-significant | \n\t\t
Gomes-Filho et al. (2006), Brazil | \n\t\t\t44/177 | \n\t\t\tPLBW | \n\t\t\tPI, PD, BOP, CAL | \n\t\t\tNo statistically significant difference in the periodontal clinical parameters between the groups | \n\t\t\tNon-significant | \n\t\t
Wood et al. (2006), Canada | \n\t\t\t50/101 | \n\t\t\tPTB | \n\t\t\tOral hygiene index simplified, PD, CAL, BOP | \n\t\t\tThere was no difference in the proportion of sites with significant attachment loss. | \n\t\t\tNon-significant | \n\t\t
Skuldbol et al. (2006), Denmark | \n\t\t\t21/33 | \n\t\t\tPTB | \n\t\t\tPI, PD, BOP, Bitewing radiographs | \n\t\t\tNo association between periodontal disease and preterm birth was found | \n\t\t\tNon-significant | \n\t\t
Radnai et al. (2006), Hungary | \n\t\t\t77/84 | \n\t\t\tPTB | \n\t\t\tPI, CI, BOP, PD | \n\t\t\tA significant association was found between PB and initial chronic localized periodontitis | \n\t\t\tSignificant | \n\t\t
Bosnjak et al.(2006) , Croatia | \n\t\t\t17/64 | \n\t\t\tPTB | \n\t\t\tCAL, PD, Papillary bleeding index | \n\t\t\tPeriodontal disease was a significant independent risk factor for PTB. | \n\t\t\tSignificant | \n\t\t
Alves and Ribeiro (2006), Brazil | \n\t\t\t19/40 | \n\t\t\tPLBW | \n\t\t\tThe periodontal screening and recording | \n\t\t\tThere was a higher rate of periodontal disease in cases (84.21%-16/19) as compared with controls (37.5% -15/40). | \n\t\t\tSignificant | \n\t\t
Moore et al. (2005) UK | \n\t\t\t61/93 (154) | \n\t\t\tPTB | \n\t\t\tPI, PD, CAL, BOP | \n\t\t\tNo association between periodontal disease and pregnancy outcome | \n\t\t\tNon-significant | \n\t\t
Noack et al. (2005), Germany | \n\t\t\t59/42 | \n\t\t\tPLBW | \n\t\t\tPI, BOP, PD, CAL | \n\t\t\tPeriodontitis was not a detectable risk factor for preterm low birth weight. | \n\t\t\tNon-significant | \n\t\t
Buduneli et al. (2005) Turkey | \n\t\t\t53/128 (181) | \n\t\t\tPTB/LBW | \n\t\t\tBOP, PD, PI | \n\t\t\tNo difference in periodontal disease between cases and controls | \n\t\t\tNon-significant | \n\t\t
Jarjoura et al. (2005) USA | \n\t\t\t83/120 (203) | \n\t\t\tPTB/LBW | \n\t\t\tPI, BOP, PD, CAL | \n\t\t\tPeriodontal disease associated with PTB/LBW | \n\t\t\tSignificant | \n\t\t
Moliterno et al.(2005), Brazil | \n\t\t\t76/75 | \n\t\t\tPLBW | \n\t\t\tPD, CAL | \n\t\t\tSignificant associations with low birth weight babies was periodontitis | \n\t\t\tSignificant | \n\t\t
Moore et al.(2004), UK | \n\t\t\t48/82 | \n\t\t\tPTB | \n\t\t\tPI, PD, CAL, BOP | \n\t\t\tNo statistically significant difference in the carriage of the IL-1P + 3953 allelic variant between cases and controls | \n\t\t\tNon-significant | \n\t\t
Goepfert et al. (2004) USA | \n\t\t\t95/44 | \n\t\t\tPTB | \n\t\t\tCAL | \n\t\t\tMultivariable analyses supported the association between severe periodontal disease and spontaneous preterm birth. | \n\t\t\tSignificant | \n\t\t
Mokeem et al.(2004) Saudi Arabia | \n\t\t\t30/60 | \n\t\t\tPLBW | \n\t\t\tPD, BOP, CI, CPITN, | \n\t\t\tThere is a correlation between periodontal disease and PLBW | \n\t\t\tSignificant | \n\t\t
Radnai et al | \n\t\t\t41/44 | \n\t\t\tPTB /LBW | \n\t\t\tPD,BOP ,CI | \n\t\t\tPeriodontitis can be regarded as an important risk factor for PTB | \n\t\t\tSignificant | \n\t\t
Davenport et al. (2002) UK | \n\t\t\t236/507(743) | \n\t\t\tPLBW | \n\t\t\tPD, BOP, CPITN | \n\t\t\tNo evidence for an association between periodontal disease and PLBW. | \n\t\t\tNon-significant | \n\t\t
Louro et al. (2001)Brazil | \n\t\t\t13/13 | \n\t\t\tLBW | \n\t\t\tExtension and severity index | \n\t\t\tPeriodontal disease may be a risk factor for LBW | \n\t\t\tSignificant | \n\t\t
Dasanayake et al. (2001) USA | \n\t\t\t17/63 | \n\t\t\tLBW | \n\t\t\t\n\t\t\t\t | \n\t\t\tWomen with higher levels of P.g. IgG had higher odds of giving birth to LBW infants | \n\t\t\tSignificant | \n\t\t
Sembene et al (2000). Senegal | \n\t\t\t26/87 | \n\t\t\tLBW | \n\t\t\tCPITN score: <1 1- 1.99 2- 2.99 "/>3 | \n\tPeriodontal disease is a potential risk factor for LBW | \n\tSignificant | \n
Dasanayake et al(1998) Thailand | \n\t50/ 50 | \n\tLBW | \n\tDMFT and CPITN | \n\tPeriodontal disease associated with LBW | \n\tSignificant | \n
Offenbacher et al. (1996) USA | \n\t93/31 | \n\tPTB/LBW | \n\tCAL | \n\tPeriodontal disease associated with PTB/LBW | \n\tSignificant | \n
Case-control studies on the relationship between adverse pregnancy outcome and periodontal disease
PTB- Preterm Birth; PLBW- Preterm Low Birthweight; LBW- Low Birth Weight; PI-Plaque Index; GI- Gingival Index ; PD- Probing Depth; CAL- Clinical Attachment Level; CI calculus index; BOP- Bleeding On Probing; CAL - Clinical Attachment Level; CPITN- Community Periodontal Index for Treatment Needs ; DMFT - Decayed, Missing, and Filled Teeth
\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t
Muwazi et al (2014) | \n\t\t400 | \n\t\tPPD, BOP,CD GR, CPI | \n\t\tSignificant association only between gingival recession and low birth weight | \n\t\tSignificant | \n\t
Kothiwale et al (2014) | \n\t\t770 | \n\t\tPPD , CPI | \n\t\tThe severity of periodontal disease was associated with an increased rate of pre-term infants. Severe anemia and periodontal infection may have an adverse effect on pregnancy and fetal development. | \n\t\tSignificant | \n\t
Ammanagi (2014) India | \n\t\t290 | \n\t\tNot Known | \n\t\tPeriodontal disease is a risk factor for PLBW | \n\t\tSignificant | \n\t
Abati et al (2013) Italy | \n\t\t750 | \n\t\tComprehensive oral and dental examination | \n\t\tData failed to demonstrate the association between periodontitis and preterm birth and low birth weight. | \n\t\tNon - significant | \n\t
Srinivas et al. (2009) India | \n\t\t786 | \n\t\tCAL | \n\t\tNo association between Periodontal disease and Pre term birth | \n\t\tNon - significant | \n\t
Agueda et al. (2008) Spain | \n\t\t1200 | \n\t\tPD,CAL,BOP | \n\t\tNo significant association between periodontitis and low birth weight | \n\t\tNon - significant | \n\t
Mobeen et al. (2008) Pakistan | \n\t\t1152 | \n\t\tPD, CAL,PI, GI | \n\t\tPreterm birth and low birthweight were not related to measures of periodontal disease. | \n\t\tNon - significant | \n\t
Pitiphat et al. (2008) USA | \n\t\t1635 | \n\t\tSelf-reported periodontitis Radiographs | \n\t\tThe results suggest that periodontitis is an independent risk factor for poor pregnancy outcome among middle-class women. | \n\t\tSignificant | \n\t
Sharma et al. (2007) Fiji Islands | \n\t\t670 | \n\t\tCPITN | \n\t\tThere is a highly significant association between pre-term birth and moderate to severe periodontal disease | \n\t\tSignificant | \n\t
Toygar et al., (2007) Turkey | \n\t\t3576 | \n\t\tCPITN | \n\t\tMaternal periodontal disease may be a risk factor for PTB and LBW | \n\t\tSignificant | \n\t
Rajapakse et al (2005) Sri Lanka | \n\t\t227 | \n\t\tPI,CAL,BOP | \n\t\tSuggestive association between pre term low birth weight and periodontitis | \n\t\tSignificant | \n\t
Dortbudak et al. (2005) Austria | \n\t\t36 | \n\t\tPD | \n\t\tPeriodontitis can induce a primary host response in chorioamnnion leading to PTB | \n\t\tSignificant | \n\t
Moore et al (2004) UK | \n\t\t3738 | \n\t\tPI,CAL,BOP,PD | \n\t\tNo association between either PTB or LBW and periodontal disease. | \n\t\tNot Significant | \n\t
Holbrook et al. (2004) Iceland | \n\t\t96 | \n\t\tPD, gingival culture | \n\t\tNo link between low grade periodontal disease and PTB | \n\t\tNot Significant | \n\t
Romero et al (2002) Venezuela | \n\t\t69 | \n\t\tPI- Russell\'s Index | \n\t\tPeriodontal disease is a risk factor for PTB &LBW | \n\t\tSignificant | \n\t
Lopez et al (2002) Chile | \n\t\t639 | \n\t\tPD,CAL | \n\t\tPeriodontal disease is an independent risk factor for PTB and LBW | \n\t\tSignificant | \n\t
Offenbacher et al (2001) USA | \n\t\t767 | \n\t\tPD, CAL | \n\t\tPeriodontal disease is a risk factor for PTB and LBW | \n\t\tSignificant | \n\t
Jeffcoat et al. (2001) USA | \n\t\t1313 | \n\t\tCAL, PD | \n\t\tPeriodontal disease is an independent risk for PTB | \n\t\tSignificant | \n\t
Adverse outcomes of pregnancy, pregnancy : Pre term birth weight/ low birth weight and Pre term weight-Cohort Studies
PTB- Preterm Birth; PLBW- Preterm Low Birthweight; LBW- Low Birth Weight; PI-Plaque Index; GI- Gingival Index ; PD- Probing Depth; CAL- Clinical Attachment Level; CI calculus index; BOP- Bleeding On Probing; PI - Periodontal Index ; CAL - Clinical Attachment Level; PPD-Probing Pocket Depth; CD - Calculus Deposit; CPI- Community Periodontal Index
\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t
Kumar et al. (2013) India | \n\t\t61/132 | \n\t\tPI,CAL,BOP | \n\t\tMaternal periodontitis is associated with an increased risk of pre-eclampsia. | \n\t\tSignificant | \n\t
Chaparro et al (2013) Chile | \n\t\t43/11 | \n\t\tPI,CAL,BOP | \n\t\tIncreased IL-6 levels in GCF in early pregnancy were associated with increased preeclampsia risk. | \n\t\tSignificant | \n\t
Taghzouti et al (2012) Canada | \n\t\t92/245 | \n\t\tCAL,PD | \n\t\tNo association between periodontal disease and preeclampsia | \n\t\tSignificant | \n\t
Hirano et al. (2012) Japan | \n\t\t18/109 | \n\t\tPI,CAL,BOP | \n\t\tNo statistically significant association between preeclampsia and periodontitis. | \n\t\tNot Significant | \n\t
Wang et al. (2012) Japan | \n\t\t13/106 | \n\t\tCAL | \n\t\tPolymorphism and subgingival DNA level of A. actinomycetemcomitans were significantly associated with preeclampsia. | \n\t\tSignificant | \n\t
Ha et al. (2011) Korea | \n\t\t16/48 | \n\t\tCAL | \n\t\tPeriodontal disease could be associated with preeclampsia | \n\t\tSignificant | \n\t
Politano et al (2011) Brazil | \n\t\t58/58 | \n\t\tCAL,BOP,PD | \n\t\tThere was an association between preeclampsia and periodontitis | \n\t\tSignificant | \n\t
Shetty et al. (2010) India | \n\t\t30/100 | \n\t\tPD,CAL,GI | \n\t\tPeriodontitis both at enrolment (OR = 5.78, 95% CI 2.41-13.89) as well as within 48 hours of delivery (OR = 20.15, 95% CI 4.55-89.29), may be associated with an increased risk of preeclampsia. | \n\t\tSignificant | \n\t
Nabet et al. (2010) France | \n\t\t1108/1094 | \n\t\tCAL.PD,BOP | \n\t\tMaternal periodontitis is associated with an increased risk of induced preterm birth due to pre-eclampsia. | \n\t\tSignificant | \n\t
Lohsoonthorn et al. (2009) Thailand | \n\t\t150/150 | \n\t\tPD,CAL | \n\t\tNo association between periodontal disease and preeclampsia | \n\t\tNot Significant | \n\t
Srinivas et al (2009) India | \n\t\t786 \n\t\t | \n\t\tCAL \n\t\t | \n\t\tNo association between periodontitis and pre-eclampsia \n\t\t | \n\t\tNot Significant \n\t\t | \n\t
Siqueira et al.(2008) Brazil | \n\t\t164/1042 | \n\t\tPD,CAL,BOP | \n\t\tMaternal periodontitis is a risk factor associated with preeclampsia. | \n\t\tSignificant | \n\t
Canakci et al (Canakci et al., 2007) Turkey | \n\t\t38/21 | \n\t\tPD, CAL, BOP | \n\t\tMild to severe periodontal disease is associated with an increased risk for development of preeclampsia | \n\t\tSignificant | \n\t
Kunnen et al (2007) Netherlands | \n\t\t17/35 | \n\t\tPI, CI, BOP, R, PD | \n\t\tSevere periodontal disease was associated with increase of early onset preeclampsia | \n\t\tSignificant | \n\t
Barak et al (2007) Israel | \n\t\t16/14 | \n\t\t\n\t\t | Women with preeclampsia had higher prevalence of periopathogenic in bacterial placental tissue than controls | \n\t\tSignificant | \n\t
Contreas et al (2006) Columbia | \n\t\t130/243 | \n\t\tPD, CAL | \n\t\tPeriodontal disease is associated with an increased risk for development of preeclampsia | \n\t\tSignificant | \n\t
Cota et al (2006) Brazil | \n\t\t109/479 | \n\t\tPI, CI, BOP, R, PD | \n\t\tPeriodontal disease is associated with an increased risk for development of preeclampsia | \n\t\tSignificant | \n\t
Khader et al (2006) Jordan | \n\t\t115/230 | \n\t\tPD, CAL,PI,CI | \n\t\tNo association between periodontal disease and preeclampsia | \n\t\tSignificant | \n\t
Oettinger et al. (2005) Israel | \n\t\t15/15 | \n\t\tPD, CAL,PI,CI | \n\t\tPeriodontal disease is associated with an increased risk for development of preeclampsia | \n\t\tSignificant | \n\t
Canakci et al. (2004) Turkey | \n\t\t41/41 | \n\t\tPD, CAL, BOP | \n\t\tPeriodontal disease is associated with an increased risk for development of preeclampsia | \n\t\tSignificant | \n\t
Castaldi et al (2006) Argentina | \n\t\t1562 | \n\t\tCAL, PD | \n\t\tNo association between periodontal disease and preeclampsia | \n\t\tNot significant | \n\t
Boggess et al (2003) USA | \n\t\t763 | \n\t\tPI,CAL,BOP,PD | \n\t\tAssociation between periodontal disease and preeclampsia | \n\t\tSignificant | \n\t
The relationship between periodontal disease and Preeclampsia : Observational studies
CAL- Clinical Attachment Level; PTB- Preterm Birth; PLBW- Preterm Low Birthweight; LBW- Low Birth Weight; PD- Probing Depth; BOP- Bleeding On Probing; CAL - Clinical Attachment Level; PPD-Probing Pocket Depth; CD - Calculus Deposit; CPI- Community Periodontal Index
\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t
Albert (2011) | \n\t\t464/12321 | \n\t\tLBW,PTB | \n\t\tPeriodontal treatment | \n\t\tSignificant | \n\t
Tarannum and Faizuddin (2007) | \n\t\t53/68 | \n\t\tPTB, LBW | \n\t\tScaling and root planning (SRP) and Plaque control instructions | \n\t\tSignificant | \n\t
Michalowicz et al.(2006) | \n\t\t413/410 | \n\t\tPTB, LBW | \n\t\tScaling and oral hygiene instructions | \n\t\tNon-significant | \n\t
Offenbacher et al.(2006) | \n\t\t40/34 | \n\t\tPTB | \n\t\tSRP and advised to use of a sonic toothbrush | \n\t\tSignificant | \n\t
Sadatmansouri et al. (2006) | \n\t\t30/30 | \n\t\tPLBW | \n\t\tOral hygiene instructions, 0.2% Chlorhexidine mouth | \n\t\tSignificant | \n\t
Lopez et al.(2005) | \n\t\t580/290 | \n\t\tPLBW | \n\t\tScaling, Plaque control, 0.12% chlorhexidine | \n\t\tSignificant | \n\t
Jeffcoat et al. (2003) | \n\t\t366/723 | \n\t\tPTB | \n\t\tScaling and root planning | \n\t\tSignificant | \n\t
Lopez et al.(2002) | \n\t\t163/188 | \n\t\tPLBW | \n\t\tscaling and root planing (SRP) and Oral Hygiene instructions | \n\t\tSignificant | \n\t
Mitchell-Lewis et al (2001) | \n\t\t74/ 90 | \n\t\tPLBW | \n\t\tOral prophylaxis | \n\t\tSignificant | \n\t
Studies showing the relationship of periodontal therapy on preventing adverse pregnancy outcomes
PTB- Preterm Birth; PLBW- Preterm Low Birthweight; LBW- Low Birth Weight
\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t
Ide and Papapanou (2013) | \n\t\tCross-sectional, case-control or prospective cohort epidemiological studies on the association between periodontal status and preterm birth, low birthweight (LBW) or preeclampsia.Preterm birth (<37 weeks gestation), LBW (<2500 g), gestational age, small for gestational age, birthweight, pregnancy loss or miscarriage, or pre-eclampsia. | \n\t\tAlthough significant associations emerge from case-control and cross-sectional studies using periodontitis “case definitions,” these were substantially attenuated in studies assessing periodontitis as a continuous variable. | \n\t\tMaternal periodontitis is modestly but significantly associated with LBW and preterm birth, but the definition of periodontitis appears to impact the findings. Data from prospective studies followed a similar pattern, but associations were generally weaker. Maternal periodontitis was significantly associated with pre-eclampsia. It is suggested that future studies employ both continuous and categorical assessments of periodontal status. Further use of the composite outcome preterm LBW is not encouraged. | \n\t
Michalowicz et al. (2013) | \n\t\tTo identify randomized controlled trials (RCTs) published between January 2011 and July 2012 and discuss all published RCTs testing whether periodontal therapy reduces rates of preterm birth and low birthweight. | \n\t\tThe single RCT identified showed no significant effect of periodontal treatment on birth outcomes. | \n\t\tNon-surgical periodontal therapy, scaling and root planing, does not improve birth outcomes in pregnant women with periodontitis. | \n\t
Polyzos et al. (2010) | \n\t\t11 Case control studies trials (with 6558 women) | \n\t\tPeriodontal treatment had no significant effect on the overall rate of preterm birth (odds ratio 1.15, 95% confidence interval 0.95 to 1.40; P=0.15).Furthermore, treatment did not reduce the rate of low birthweight infants (odds ratio 1.07, 0.85 to 1.36;P=0.55). | \n\t\tTreatment of periodontal disease with scaling and root planing during pregnancy does not reduce the risk of preterm birth and should not be routinely recommended as a measure to prevent preterm birth | \n\t
Polyzos et al (2009) | \n\t\tSeven randomized trials were included based on the criteria.There were 2663 patients: 1491 had been randomized to receive periodontal treatment and 1172 to no treatment. | \n\t\tTreatment resulted in significantly lower PTB (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.350.86; P = .008) and borderline significantly lower LBW (OR, 0.48; 95% CI, 0.23-1.00;P = .049), whereas no difference was found for spontaneous abortion/stillbirth (OR, 0.73; 95% CI, 0.41-1.31; P = .292). | \n\t\tThe analysis showed that treatment with scaling and/or root planing during pregnancy significantly reduces the rate of PTB and may reduce the rate of LBW infants. | \n\t
Vergnes and Sixou (2007) | \n\t\t17 observational studies (11 case/controls, four cohorts, and two cross-sectionals) | \n\t\tPreterm low birth weight:OR = 2.83 (95% CI: 1.95-4.10, P < 0.0001)LBW: OR = 4.03 (95% CI: 2.05-7.93, P < 0.0001) | \n\t\tThese findings indicate a likely association, but it needs to be confirmed by large, well- designed, multicenter trials | \n\t
Xiong et al. (2006) | \n\t\t44 studies (26 case-control studies, 13 cohort studies, and five controlled trials) | \n\t\tTwenty nine suggested an association between periodontal disease and increased risk of adverse pregnancy outcome (ORs ranging from 1.10 to 20.0) and 15 found no evidence of an association (ORs ranging from 0.78 to 2.54) Preterm Low birth weight:RR = 0.53, 95% CI: 0.30-0.95, P < 0.05Preterm birth: RR = 0.79, 95% CI: 0.55-1.11, P "/> 0.05 Low birth weight: RR = 0.86, 95% CI: 0.58%1.29, P "/> 0.05 | \nThe published literature is not vigorous to clinically link periodontal disease and/or its treatment to specific adverse pregnancy outcomes | \n
Khader and Ta’ani (2005) | \n\t5 studies (two case-control and three prospective cohorts) | \n\tPTB: OR = 4.28 (95% CI: 2.62-6.99; P < 0.005)PTLBW: OR = 5.28 (95% CI: 2.21-12.62; P < 0.005)Either PTB or LBW: OR = 2.30 (95% CI: 1.21-4.38; P < 0.005) | \n\tPeriodontal diseases in the pregnant mother significantly increase the risk of subsequent preterm birth or low birth weight | \n
Meta-analysis on periodontal disease and adverse pregnancy outcomes
PTB- Preterm Birth; PLBW- Preterm Low Birthweight; LBW- Low Birth Weight; PI-Plaque Index; GI- Gingival Index ; PD- Probing Depth; CAL- Clinical Attachment Level; CI calculus index; BOP- Bleeding On Probing; PI - Periodontal Index ; CAL - Clinical Attachment Level; PPD-Probing Pocket Depth; CD - Calculus Deposit; CPI- Community Periodontal Index ;
Heavy metal contamination and pollution in soils and environment are still of a serious concern since the presence of heavy metal may directly and indirectly endanger living things [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12]. Reports on the occurrence of soil contamination and pollution come intensively from all over the world related to modern industries [1, 2, 3, 4, 7, 10, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31]. The negative effects of heavy metals on plants, animals and human beings are also documented in the current literature [5, 6, 8, 9, 25, 26, 30, 32, 33, 34, 35]. One important case of the negative effects currently documented was the occurrence of Minamata and Itai-itai diseases in Japan [2]. These suggest that the problem related to heavy metals in the soil environment must be more extensively studied.
Among the various chemical methods available to cope with heavy metal contamination and pollution in soils is the use of organic materials [13, 36, 37, 38, 39, 40, 41, 42, 43]. Organic materials such as plant compost may enhance the capability of soil materials to immobilize soil mobile heavy metals. Composted organic matters may effectively lower the soil mobile heavy metals to lower their concentrations to the levels that are not harmful to plants and animals. Organic matters may consist of various functional groups such as phenolic, carboxylic and hydroxyl that may increase the soil cation adsorption capacity [2]. Therefore, the addition of organic matter compost into heavy-metal polluted soils was reported to significantly decrease the soil mobile heavy metals [41, 42]. For example, the addition of cassava (
Some researchers [41, 42, 44] reported that the effect of organic matter compost was more significant when added simultaneously with other potential materials. The addition of organic matter compost and lime was shown to better decrease the soil mobile heavy metals [37, 41, 42, 44]. The results of research in [41, 42] showed that the lowering effect on soil heavy metals of cassava-leaf compost and CaCO3 was significantly greater than addition of organic matter or lime alone. The DTPA extracted Cd from Ultisols, Oxisols and Alfisols was significantly lowered by additions of cassava leaf compost and lime [41, 42]. The residual Cu and Zn were also lower in soils amended with cassava-leaf compost and CaCO3 than with organic compost or CaCO3 alone [42]. The presence of increasing OH− ion by the increase in soil pH [45] may have stimulated the H releases from the organic functional groups and thus widened the capability of the soil materials in adsorbing the heavy metal ions from the soil solution. The adsorption of heavy metal free ions by soil materials may stimulate the releases of heavy metals held as chelates and complexes and also soil heavy metal precipitates and thus finally lower the soil extracted heavy metals.
As shown by numerous data, organic matter compost may significantly affect the soil concentrations of heavy metals. Most reports show that various organic matter may significantly decrease the soil concentrations of heavy metals. However, several reports demonstrated that organic matter may relatively quickly decay in soil system [13, 42, 43, 46]. These observations suggest that the use of organic matters to lower the concentrations of heavy metals in soils is limited for a short duration. Their effectiveness is lower for long-time uses. The problem will be more significant in tropical regions where the soil average temperature and moisture content are relatively high. Therefore, other materials with high durability to organic decomposition are needed. Current literature suggests that biochar will be the best candidate for this purpose [38, 44, 45, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62]. As reported by [45, 57], biochar is produced through pyrolysis or charring, causing their structure and composition to be more stable and durable in soil system. In addition, biochar also possesses chemical properties better than ordinary organic materials in terms of cation exchange capacity, pH, specific surface area and nutrient contents.
This chapter was to evaluate the properties and effects of biochar in restoring heavy metal–contaminated or contaminated soils and their effect on the concentration of heavy metals in soils affected by heavy metal–containing materials like industrial wastes.
Heavy metals are detrimental to living things, particularly at high concentrations [2]. As mentioned previously, their negative effects are reported from various sites in the world. Research report in [63] shows the negative effect of heavy metal–containing waste on the growth of water spinach, caisim and lettuce in 23 years old heavy metal–containing waste amended tropical soils. Clearly found that the growth of these plants was depressed at high heavy metals and the growth in control soil was the best (Figure 1). Lettuce was not survived at high heavy metal contents only until 2 weeks after planting (WAP). It is also obvious that water spinach grew better than the other two plants at any level of soil-heavy metals.
The growth of several plants in heavy metal contaminated soil (S1 control, S2 low heavy metals, S3 high heavy metals; lettuce dead in S3, WAP weeks after planting) (after [
The data above demonstrated that high concentrations of heavy metals (in this case Cu and Zn) were detrimental to plants (Figure 1). Their effects are dependent on their concentrations and plant species. Higher concentration of heavy metals gave more significant effects. Water spinach was more adaptable to high concentrations of heavy metal and therefore it grew much better. It is possible to employ plants like water spinach in phytoremediation. Biomass analysis showed also that the plant uptake of Cu and Zn of water spinach was much higher than were other two plants [63].
A similar phenomenon was demonstrated by thorny amaranth. The growth of thorny amaranth was significantly retarded in 24 years old waste amended soils with high heavy metals (treated with 60 Mg waste ha−1) (Figure 2). The retardation occurred along the growing time from 0 to 6 WAP. Low heavy metals (treated with 15 Mg waste ha−1) only slightly lowered the growth of this plant.
The growth of thorny amaranth in heavy-metal polluted soils (C control, LHM low heavy metal, HHM high heavy metal, WAP weeks after planting).
The effect of heavy metals was more clearly shown by the growth of plant roots. In general, the growth of plant roots may adjust to the high concentrations of Cu and Zn and probably of other heavy metals. This environmental stress by heavy metals may stimulate plant roots to work harder and cause plant biomass to distribute more to plant roots (Figure 3). The root/shoot was shown to positively and linearly correlate with the soil-heavy metal concentration. The writer in [64] stated that higher root weight may cause higher root cation exchange capacity (CEC) that may retain more heavy metal cations on the surface of plants’ roots so that less heavy metals may move to plant shoots. Higher soil CEC may then lower the stimulation of the growth of plant roots. High concentrations of heavy metals in soils caused more biomass distribution to plant roots (Figure 3). Higher CEC can be attained by increasing soil pH [2, 65]. Plant roots also produce some exudates such as low molecular organic acids that may chelate heavy metal cations in soil solution and lower heavy metal effects on plants [66, 67].
The relationship between the root/shoot and the soil DTPA extracted Cu and Zn (after [
Organic compost is significantly different from biochar both in the process of production and in its properties. Organic compost was produced by a complete decomposition of plant materials in the presence of microorganisms in a well-regulated condition of O2, heat and water moisture. Urea N is usually added to accelerate the decomposition process while the soil pH is maintained high by lime addition. Microorganism is introduced through cow dung addition. Low C/N ratio is used as a measure of compost maturity. Biochar is produced by incomplete thermo-decomposition of some feedstocks like woods, leaves, feces, straws, husks and manure in a limited or no oxygen supply called pyrolysis or charring [45, 57]. Therefore, biochar consists of much higher C content and consequently, it is more stable with high durability in soils. Reports of [45, 57] show that biochar also showed several better physical and chemical properties. Some of feedstocks abundantly available in Indonesia are woods, straws of corn and rice, bagasse and dairy manure. Therefore, application of biochar may provide a low-cost method of coping with environmental problems. One example of biochar is shown in Figure 4, which shows the production of biochar from rice husk and the physical appearance of the rice husk biochar.
The production of rice husk biochar in the University of Lampung experimental farm (courtesy of Sri Yusnaini with permission).
Biochar shows porous surfaces so that in the soil system it may physically absorb pollutants like heavy metals. Combined with the increase in the soil adsorption capacity the biochar porosity may significantly enhance the soil retainment on heavy metal cations in biochar-treated soils. In addition to the better physical properties, biochar also shows better, interesting and useful chemical properties [45, 57]. Like organic matters in general, biochar possesses some functional groups like hydroxyl and carboxyl that may bear great amounts of negative charges. It shows a high CEC of 28.8–327 mmol kg−1 and high pH depending on the charring temperature, higher at higher charring temperature. The pH of biochar ranges from 5.81−10.1. Biochar also shows high specific surface area (SSA) ranging from 40.99 to 189.8 m2 g−1.
The potential of biochar at increasing the soil pH may raise the soil adsorption capacity. The increase in OH-ions by biochar treatment may dehydrogenase the biochar functional groups of hydroxyl and carboxyl raising the soil adsorption capacity. Finally, through the synergic works of its high porosity, abundant functional groups and potential to increase the soil pH, biochar may significantly immobilize heavy metal cations in soils.
Therefore, the most important properties of biochar useful in the management of heavy metals in soils is its high SSA, abundant functional groups, high cation exchange capacity and potential to increase the soil pH [45, 57]. Therefore, its presence in heavy metal contaminated or polluted soils may significantly lower heavy metal contaminants. Several mechanisms may involve in the immobilization of heavy metals in soil-biochar mixtures that include physical sorption, ion exchange, chemisorption, complexation and precipitation. Biochar may eventually reduce heavy metal mobility and bioavailability [45]. Wastewater treatment with biochar is reported to immobilize up to 99% of Cd, Pb and Zn in an optimum condition [57]. The effectiveness of biochar is dependent on biomass and soil types and also on heavy metals [60].
There are several forms of heavy metals in the soil environment [2]. Of which, heavy metal cation is the most directly affected by the active negative charges of soils through adsorption and desorption processes [68, 69, 70, 71, 72]. The adsorption of heavy metals that decrease the concentration of heavy metal cations in soil solution may, of course, stimulate the release of heavy metals of other forms such as chelates through de-chelation, complexes through decomplexation, precipitates through dissolution, and other soil chemical reactions that may altogether lower the total concentration of total soil heavy metals as shown in Figure 5 [2].
The interrelationships between various forms of dissolved and structural heavy metals in soils, plants and human (after [
The above interrelationship shows the importance of heavy metal cation form in the soil environment and therefore the effort to cope with the problem of heavy metals in soils must be first focused on lowering the concentration of heavy metal cations. The increase in the soil’s negative surfaces was repeatedly suggested to suffice this relationship [2]. The presence of soil solid negative surfaces may electrostatically decrease the mobility of heavy metals cations through immobilization process. Heavy metal cations are strongly held by the soil materials and finally decreased the total soil heavy metals in soils as shown in Figure 6.
The effect of biochar application on the soil heavy metal levels and plant growth.
The quantity of heavy metals held by soil materials is negatively charged surface-dependent. High amounts of negative charges are attainable by enrichment with high quantity of negatively charged materials and/or negative charge stimulating materials. Previous observation shows that this condition can be attained by the addition of cassava leaf compost and/or lime materials that were reported to lower the soil concentration of Cd [41]. The cassava leaf compost may provide high amounts of negative charges to its various functional groups. The lime materials may raise the soil pH that may then stimulate the release of H ions from organic matter functional groups. The addition of organic materials and lime material may then finally widen the total negative charges and may increase the immobilization of heavy metal cations in soils.
The improvement of the soil negative charges by biochar application may give more significant effect on the amount of the soil negative charges since as stated previously the biochar possesses high amounts of negative charges [57, 59]. The CEC of biochar ranges from 28.8 to 327 mmol kg−1 [45, 57]. The increase in soil pH caused by biochar addition may increase the significance of biochar application. Consequently, biochar application may enhance the retainment of soluble heavy metals in soils and finally lower the total extractable heavy metals in soils. This process will provide suitable soluble heavy metal levels in soils and enable plants to grow better.
The relationship between the biochar application, the increase in the soil negative charges, and the improvement of plant growth stated in Section 4 is exemplified in Figure 6. The improvement of plant growth by this process is expected in soil contaminated or polluted by heavy metals. Better growth of plants may absorb heavy metals at safe levels and may lower the soil heavy metals from immobilized forms like soil precipitates or soil adsorbed heavy metals much faster. The danger of heavy metals to plants may also be alleviated since plants may absorb heavy metals at lower levels of solubility in the presence of biochar. By this means, the soil’s heavy metals are lowered by plants that grow better at safe levels of heavy metals. Thereby plants may also grow better in heavy metal polluted soils.
The decrease in soil Cu and Zn levels in the presence of biochar was currently reported from 23-years old polluted tropical soils planted with corn (
The effect of biochar on Cu and Zn concentrations in waste-amended soil extracted by
As the consequence (Figures 5 and 6), the growth of corn plants was significantly altered by biochar application, which was indicated by plant height (Figure 8) and plant biomasses (Figure 9). The trend in the corn plant height was clearly associated with the significant increase in the soil Cu and Zn concentration and the significant decrease in the soil Cu and Zn in the presence of biochar (Figure 7). The decrease in plant height was associated with the increase in the levels of amended soils that increase the soil Cu and Zn while the increase in plant height was associated with the decrease in heavy metal concentrations stimulated by the presence of biochar. A similar trend was also indicated by the changes in the plant biomasses as affected by the levels of amended waste and biochar application (Figure 9). The corn plant biomasses including corn roots and corn shoots were lowered by soil concentrations of heavy metals and increased in the presence of biochar associated with the decrease in the soil heavy metals (Figure 9).
The improvement of corn plant height in waste-amended soil by biochar (after [
The improvement of corn plant biomasses in waste-amended soil by biochar (after [
The research result in [73] showed that the related analysis of variance (ANOVA) also indicated that the amended waste levels significantly enhanced the soil concentrations of heavy metals particularly Cu and Zn and significantly depressed the plant height and plant biomasses (roots, shoots, and the whole plant). Several previous research also showed that the waste-borne Cu and Zn in the soils depressed the growth of several other plants including caisim, corn plant, lettuce, Napier grass, and water spinach [63, 64, 73]. Elevated concentrations of heavy metals in soil system are detrimental to plants. Biochar at 5−10 Mg ha−1 was generally effective in changing plant characteristics in heavy metal–containing waste-amended tropical soils. Biochar significantly affected the soil heavy metals, organic C and pH, and also Cu accumulated in corn plant shoots as well as plant height and biomass dry-weight.
The effect of biochar in alleviating the high concentration of heavy metals particularly Cu and Zn was also reported for thorny amaranth [74]. Thorny amaranth was demonstrated to absorb quite high heavy metals from polluted soils and shown to be one of the heavy-metal bio-accumulators and therefore significantly decreased the Cu and Zn concentrations in the 23 years old waste amended tropical soils (Figure 10). The presence of thorny amaranth was shown to significantly lower the soil Cu from 79.3 to 60.0 mg kg−1 (24.3% decrease) and the soil Zn from 69.2 to 57.4 mg kg−1 (17.1% decrease) at the waste level of 60 Mg ha−1. The decreases were much higher or 46.0% for Cu and 24.3% for Zn at lower waste level of 15 Mg ha−1. Copper and Zn showed similar behavior in response to planting but the per cent decrease of Cu was higher than that of Zn, demonstrating that Zn was less mobile and less easily absorbed by plant roots than was Cu. It is stated in [74] that not all lost Cu and Zn was absorbed by plant roots. Some of these heavy metals may have also shifted to more strongly adsorbed heavy metals due to the increase in soil pH caused by planting. Copper was probably more easily and strongly adsorbed by soil colloids or precipitated than was Zn.
The effect of thorny amaranth on the concentrations of Cu and Zn in a heavy-metal-polluted tropical soil treated with biochar (after [
The lowering of total heavy metals was also expected in phytoremediation. As stated in [75], at suitable levels, the absorption of heavy metals by plant roots may proceed fast enough since the presence of lower levels of heavy metals will not disturb the physics and works of plant roots during phytoremediation. The amount of heavy metal removal may be higher at lower than that at higher levels of heavy metals. Therefore, the presence of biochar, which lowers the soil concentrations of heavy metals (Figure 10), may fasten the cleaning of heavy metals in soils by phytoremediation.
A similar trend with that in the growth of corn plants was observed in the plant root and shoot dry weights of thorny amaranth (Figure 11). The waste origin Cu and Zn may have disturbed the physiological functions in plant tissues and inhibited the growth of plant roots and shoots. It is clearly shown in Figure 11 that, without biochar, waste treatments lowered the shoot dry weights by about 25.8% and 36.4% at waste treatment of 15 and 60 Mg ha−1, respectively. These values were related to the increase of 8.90 (24.5%) and 43.0 mg kg−1 (116%) in Cu or 6.9 (23.5%) and 32.9 mg kg−1 (112%) in Zn caused by the respective waste addition. The higher the soil Cu and Zn concentrations the more effective the heavy metal effect on plant shoot growth retardation. A similar trend was observed in the same soil samples for other plant species like caisim (
The growth of thorny amaranth in heavy-metal polluted tropical soil treated with biochar (after [
The root dry-weight increased by waste addition at 15 Mg ha−1 (Figure 9), suggesting that the growth of roots was more progressive under high concentrations of Cu, Zn and other heavy metals. This pattern was also reported by [74]. The study in [64] showed high correlation between the root/shoot of Napier grass with the soil concentration of Cu and/or Zn (Figure 3). However, high concentrations of heavy metals were found to decrease the root weight of thorny amaranth, suggesting that these plant roots were negatively affected by the higher concentration of Cu and Zn at a waste level of 60 Mg ha−1.
Since it is reported to have high cation exchange capacity and high effect on soil pH [18, 35, 36], biochar was shown to improve the above agronomic responses of thorny amaranth (Figures 11 and 12). The presence of biochar may have increased the soil adsorption capacity and lowered the soil labile fractions of Cu and Zn, thereby alleviating their phytotoxicities and finally stimulating the plant growth. Numerous observations demonstrated that high soil Cu and Zn in general decreased with biochar treatment. Calculation shows that the extracted Cu at waste levels of 60 Mg ha−1 were 60.0, 59.8 and 46.1 mg kg−1 with biochar treatment of 0, 5 and 10 Mg ha−1, respectively, and those for Zn were 57.4, 54.0 and 45.5 mg kg−1, respectively. The increase in the soil adsorption capacity caused by the presence of biochar significantly decreased the soil labile Cu and Zn about 0.33 and 0.59%, respectively, at 5 Mg biochar ha−1 and 23.2 and 20.7% at 10 Mg biochar ha−1, respectively. The increase in the soil adsorption capacity towards Cu and Zn was probably to be originated from the unique characteristic of biochar that possessed high amounts of organic functional groups that may provide abundant negative charges. Copper and Zn in biochar-treated soils were transformed into less soluble forms with higher bonding energy. The amount of stabilized heavy metals was determined by the biochar-treated soil-adsorptive surfaces. Therefore, biochar 10 Mg ha−1 was more effective than 5 Mg ha−1 in decreasing heavy metals at waste level of 60 Mg ha−1 (Figure 10). These changes may lower the negative effect of heavy metals on the growth of thorny amaranth. Therefore, the treatment of soil with biochar may improve the growth of thorny amaranth in heavy metal polluted soils.
The effect of biochar on the dry weights of thorny amaranth biomasses in tropical soil polluted with heavy metals (after [
The increase in soil pH induced by biochar treatment may have stimulated the enlargement of the soil adsorptive sites caused by the dissociation of biochar and soil colloid functional groups. However, as pointed out previously, a biochar level of 5 Mg ha−1 was probably not sufficient to handle heavy metals at a waste level of 60 Mg ha−1, and the growth of plants at this treatment was in general not better than those without biochar (Figure 12). It is obvious that the effect of biochar was dependent on its level. The level of 5 Mg biochar ha−1 was effective at a waste level of 15 Mg ha−1 but not at a waste level of 60 Mg ha−1. Biochar level of 10 Mg ha−1 was effective at waste levels of 15 and 60 Mg ha−1. The improvement effect of biochar was also observed on plant shoot and root dry-weight (Figure 12). The improvement of shoot dry weight was clear; the effect of 5 Mg ha−1 was more effective than that of 10 Mg ha−1 as also that on root dry-weight (Figure 12).
The increase in the soil and environmental concentrations of heavy metals are reported from all over the world. The increase in heavy metal concentration may occur stimulated by industrialization. Since they are toxic and detrimental at high concentrations, the increase in the soil’s heavy metal concentrations is reported to induce plant growth retardation. The presence of biochar that possesses high amounts of negative charges and may increase the soil pH may enlarge the soil’s heavy metal cation retention. Therefore, the biochar application may increase the heavy metal immobilization in soil and cause a decrease in the soil available heavy metals. By these means, biochar application may also increase the growth of plants.
The biochar application may lower the soil concentration to the level at which plants may absorb heavy metals at suitable levels so that the absorption of heavy metals and the decrease of heavy metals in soil occur faster without physical and physiological disturbance. In phytoremediation, the use of biochar may accelerate the heavy metal absorption without physical and physiological disturbance on plant roots by the presence of high concentration of heavy metals.
However, in addition to its advantages to lower the concentrations of the polluting heavy metals in the environment, the use of biochar shows drawbacks, among which is the fact that biochar is bulky. The levels used in most experiments which were 5−10 Mg ha−1 are of great amount. It will cause difficulty in its field transportation and treatment. This needs further research to utilize biochar at lower levels without decreasing its effectiveness, for example by adjusting its particle size.
This is a brief overview of the main steps involved in publishing with IntechOpen Compacts, Monographs and Edited Books. Once you submit your proposal you will be appointed a Author Service Manager who will be your single point of contact and lead you through all the described steps below.
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\n\nPlease complete the publishing proposal form. The completed form should serve as an overview of your future Compacts, Monograph or Edited Book. Once submitted, your publishing proposal will be sent for evaluation, and a notice of acceptance or rejection will be sent within 10 to 30 working days from the date of submission.
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To this end, the feasibility of two techniques to increase the conversion efficiency of few-cycle OPCPA systems is demonstrated and discussed. The techniques result in 2.5 mJ, 7.5 W pulses and correspond to a pump-to-signal conversion efficiency of 30%. The broadband amplified spectrum supports 5.7 fs. 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After presenting the technique and its variants, we will show its ability to study cultural heritage materials through a few examples.",book:{id:"8628",slug:"synchrotron-radiation-useful-and-interesting-applications",title:"Synchrotron Radiation",fullTitle:"Synchrotron Radiation - Useful and Interesting Applications"},signatures:"Philippe Sciau and Tian Wang",authors:[{id:"98593",title:"Dr.",name:"Philippe",middleName:null,surname:"Sciau",slug:"philippe-sciau",fullName:"Philippe Sciau"},{id:"285658",title:"Dr.",name:"Tian",middleName:null,surname:"Wang",slug:"tian-wang",fullName:"Tian Wang"}]},{id:"65550",title:"Fundamental of Synchrotron Radiations",slug:"fundamental-of-synchrotron-radiations",totalDownloads:1555,totalCrossrefCites:0,totalDimensionsCites:3,abstract:"Synchrotron radiations are emerging as a real-time probing tool for the wide range of applied sciences. Synchrotron radiations have unique properties because of their high brilliance, collimations, broad energy spectrum, and coherence power that break the limits to characterize the material properties than previous laboratory-based tabletop sources. The third-generation synchrotron light sources are capable of producing 1012 times higher brilliance than laboratory-based sources using insertion devices. In this chapter, the fundamental aspects of synchrotron radiations and their generation process have been discussed. The effect of insertion devices and the double-crystal monochromator (DCM) toward the X-ray beam optics has been also discussed.",book:{id:"8628",slug:"synchrotron-radiation-useful-and-interesting-applications",title:"Synchrotron Radiation",fullTitle:"Synchrotron Radiation - Useful and Interesting Applications"},signatures:"Amardeep Bharti and Navdeep Goyal",authors:[{id:"267703",title:"Dr.",name:"Amardeep",middleName:null,surname:"Bharti",slug:"amardeep-bharti",fullName:"Amardeep Bharti"},{id:"280741",title:"Prof.",name:"Navdeep",middleName:null,surname:"Goyal",slug:"navdeep-goyal",fullName:"Navdeep Goyal"}]},{id:"51599",title:"Undulators for Short Pulse X-Ray Self-Amplified Spontaneous Emission-Free Electron Lasers",slug:"undulators-for-short-pulse-x-ray-self-amplified-spontaneous-emission-free-electron-lasers",totalDownloads:1619,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"We review the synchrotron type radiation sources with focus on undulator and free-electron laser (FEL) schemes, aimed on working in X-ray range and ultra-short time interval. Main FEL schemes, useful for generation of high frequency radiation, extending to X-rays, are presented. High harmonic generation is explored. The advantages and disadvantages of single pass and of multipass designs are discussed. The viable ways to reduce the duration of the pulse, with the goal to generate femtosecond pulses, are indicated. Future developments of X-ray FELs (X-FELs) and the ways to improve the quality of the FEL radiation in this context are discussed.",book:{id:"5236",slug:"high-energy-and-short-pulse-lasers",title:"High Energy and Short Pulse Lasers",fullTitle:"High Energy and Short Pulse Lasers"},signatures:"K. Zhukovsky",authors:[{id:"183581",title:"Dr.",name:"K.",middleName:null,surname:"Zhukovsky",slug:"k.-zhukovsky",fullName:"K. Zhukovsky"}]},{id:"50815",title:"Phase Manipulation of Ultrashort Soft X-Ray Pulses by Reflective Gratings",slug:"phase-manipulation-of-ultrashort-soft-x-ray-pulses-by-reflective-gratings",totalDownloads:1585,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"In this chapter, we discuss the use of reflective diffraction gratings to manipulate the phase of ultrashort pulses in the extreme ultraviolet (XUV) and soft X-ray spectral regions. Gratings may be used to condition the spectral phase of ultrashort pulses, e.g., to compensate for the pulse chirp and compress the pulse, similarly to what is routinely realized for visible and infrared pulses. The chirped pulse amplification technique has been already proposed for soft X-ray free-electron laser radiation; however, it requires the use of a compressor to compensate for the pulse chirp and get closer to the Fourier limit. There are fundamental differences when operating the gratings at wavelengths shorter than ≈40 nm on a broad band: (a) the gratings are operated at grazing incidence; therefore, the optical design has to be consequently tailored to this peculiar geometry; (b) the grating efficiency is definitely lower; therefore, the number of diffractions has to be limited to two. We discuss the different configurations that can be applied to the realization of a grating stretcher/compressor.",book:{id:"5236",slug:"high-energy-and-short-pulse-lasers",title:"High Energy and Short Pulse Lasers",fullTitle:"High Energy and Short Pulse Lasers"},signatures:"Fabio Frassetto, Paolo Miotti and Luca Poletto",authors:[{id:"4861",title:"Dr.",name:"Luca",middleName:null,surname:"Poletto",slug:"luca-poletto",fullName:"Luca Poletto"},{id:"186618",title:"Dr.",name:"Fabio",middleName:null,surname:"Frassetto",slug:"fabio-frassetto",fullName:"Fabio Frassetto"},{id:"186619",title:"MSc.",name:"Paolo",middleName:null,surname:"Miotti",slug:"paolo-miotti",fullName:"Paolo Miotti"}]}],onlineFirstChaptersFilter:{topicId:"1227",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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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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He has published research in Research Policy, Applied Economics, Review of Economic Philosophy, Strategic Change, International Journal of Logistics, Sustainability, Journal of Environmental Management, Journal of Global Information Management, Journal of Cleaner Production, M@N@GEMENT, and more. He is a member of CEDIMES Institut (France), Academy of International Business (AIB), Strategic Management Society (SMS), Academy of Management (AOM), Administrative Science Association of Canada (ASAC), and Canadian council of small business and entrepreneurship (CCSBE). He is currently the director of the Research Group on Contemporary Asia (GERAC) at Laval University. 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Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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