Comparisons of demographic data of patients with suicide attempts from height.
\\n\\n
Dr. Pletser’s experience includes 30 years of working with the European Space Agency as a Senior Physicist/Engineer and coordinating their parabolic flight campaigns, and he is the Guinness World Record holder for the most number of aircraft flown (12) in parabolas, personally logging more than 7,300 parabolas.
\\n\\nSeeing the 5,000th book published makes us at the same time proud, happy, humble, and grateful. This is a great opportunity to stop and celebrate what we have done so far, but is also an opportunity to engage even more, grow, and succeed. It wouldn't be possible to get here without the synergy of team members’ hard work and authors and editors who devote time and their expertise into Open Access book publishing with us.
\\n\\nOver these years, we have gone from pioneering the scientific Open Access book publishing field to being the world’s largest Open Access book publisher. Nonetheless, our vision has remained the same: to meet the challenges of making relevant knowledge available to the worldwide community under the Open Access model.
\\n\\nWe are excited about the present, and we look forward to sharing many more successes in the future.
\\n\\nThank you all for being part of the journey. 5,000 times thank you!
\\n\\nNow with 5,000 titles available Open Access, which one will you read next?
\\n\\nRead, share and download for free: https://www.intechopen.com/books
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'
Preparation of Space Experiments edited by international leading expert Dr. Vladimir Pletser, Director of Space Training Operations at Blue Abyss is the 5,000th Open Access book published by IntechOpen and our milestone publication!
\n\n"This book presents some of the current trends in space microgravity research. The eleven chapters introduce various facets of space research in physical sciences, human physiology and technology developed using the microgravity environment not only to improve our fundamental understanding in these domains but also to adapt this new knowledge for application on earth." says the editor. Listen what else Dr. Pletser has to say...
\n\n\n\nDr. Pletser’s experience includes 30 years of working with the European Space Agency as a Senior Physicist/Engineer and coordinating their parabolic flight campaigns, and he is the Guinness World Record holder for the most number of aircraft flown (12) in parabolas, personally logging more than 7,300 parabolas.
\n\nSeeing the 5,000th book published makes us at the same time proud, happy, humble, and grateful. This is a great opportunity to stop and celebrate what we have done so far, but is also an opportunity to engage even more, grow, and succeed. It wouldn't be possible to get here without the synergy of team members’ hard work and authors and editors who devote time and their expertise into Open Access book publishing with us.
\n\nOver these years, we have gone from pioneering the scientific Open Access book publishing field to being the world’s largest Open Access book publisher. Nonetheless, our vision has remained the same: to meet the challenges of making relevant knowledge available to the worldwide community under the Open Access model.
\n\nWe are excited about the present, and we look forward to sharing many more successes in the future.
\n\nThank you all for being part of the journey. 5,000 times thank you!
\n\nNow with 5,000 titles available Open Access, which one will you read next?
\n\nRead, share and download for free: https://www.intechopen.com/books
\n\n\n\n
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"10134",leadTitle:null,fullTitle:"Organic Agriculture",title:"Organic Agriculture",subtitle:null,reviewType:"peer-reviewed",abstract:"Organic crop production is the science and art of growing field crops, fruits, vegetables, and flowers by adopting the essential principles of organic agriculture in soil building and conservation, pest management, and heirloom variety conservation. This book provides detailed insights into organic farming in agriculture, biological efficacy in the management of plant diseases, organic nutrient management, socio-economic dimensions of adoption of conservation practices, nonchemical weed control, plant growth promoting fungi for phytostimulation, nanotechnological approaches, and finally vermicomposting. The book primarily focuses on research and development based organic agriculture and horticulture production technologies, and has attempted to abridge information on organic crop production of the major food grain crops. The book also contains comprehensive information on the various related dimensions of organic crop production.",isbn:"978-1-78984-669-0",printIsbn:"978-1-78984-668-3",pdfIsbn:"978-1-78984-720-8",doi:"10.5772/intechopen.89775",price:119,priceEur:129,priceUsd:155,slug:"organic-agriculture",numberOfPages:168,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"a9866f9df52191cc505b27fb2abdc687",bookSignature:"Shaon Kumar Das",publishedDate:"December 2nd 2020",coverURL:"https://cdn.intechopen.com/books/images_new/10134.jpg",numberOfDownloads:6247,numberOfWosCitations:4,numberOfCrossrefCitations:19,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:39,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:62,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 9th 2019",dateEndSecondStepPublish:"February 12th 2020",dateEndThirdStepPublish:"April 12th 2020",dateEndFourthStepPublish:"July 1st 2020",dateEndFifthStepPublish:"August 30th 2020",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"182210",title:"Dr.",name:"Shaon Kumar",middleName:null,surname:"Das",slug:"shaon-kumar-das",fullName:"Shaon Kumar Das",profilePictureURL:"https://mts.intechopen.com/storage/users/182210/images/system/182210.jpg",biography:"Shaon Kumar Das is working as a Scientist SS (Agricultural Chemistry) at ICAR RC for NEH Region, Sikkim Centre, Tadong, Gangtok under the Indian Council of Agricultural Research, New Delhi. He received his M.Sc. in 2010 from IARI, New Delhi along with a gold medal for his outstanding contribution. He joined the Agricultural Research Service (ARS) in 2011 as a scientist. He completed his Ph.D in 2020 from Visva Bharati University in Soil Science and Agricultural Chemistry and worked on integrated organic nutrient management. He has published 27 national and 40 international research articles, 10 review articles in national and international journals, 30 popular articles, 28 extension folders, 2 books, and 25 book chapters in edited books. He received a DST-INSPIRE fellowship in 2010 from DST, Govt. of India. He has been awarded the best scientist award by the ICAR RC for the NEH Region, Umiam, Meghalaya in 2018. He received six young scientist awards and 3 best oral presentation awards from different reputable societies. He was the Principal Investigator (PI) of different externally funded projects like DST, DBT, NMHS, ICAR etc. He has been involved in the research on carbon sequestration, soil fertility management, soil acidity reclamation, and organic nutrient standardization of major hill crops.",institutionString:"Indian Council of Agricultural Research (ICAR)",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"1",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"307",title:"Agroecology",slug:"agroecology"}],chapters:[{id:"72994",title:"Role of Organic Farming in Agriculture",doi:"10.5772/intechopen.93431",slug:"role-of-organic-farming-in-agriculture",totalDownloads:704,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Organic farming could be an all-encompassing generation administration framework that empowers and improves agroecosystem wellbeing, counting biodiversity, natural cycles, and soil biological activity. It stresses the role of management activities in preference to the use of off-farm data, considering that regional conditions require locally adapted systems. This can be achieved using agronomic, biological, and mechanical methods, in equal share to synthetic materials, to carry out any specific role inside the organization. Organic farming is still only a small industry, which represents only 2% of global food sales. However, it is growing in importance in the world. It is hard to get information due to lack of official statistics and the level of confidentiality of systems of organic produce. Soil practices such as crop rotations, organic fertilizers, symbiotic associations, cover crops, inter-cropping, and minimum tillage are central to organic practices. The static arrangements of soil are achieved by soil fauna and vegetation. Besides, cycling of nutrients and energy is enhanced by increasing the retentive abilities of the soil for nutrients and water.",signatures:"Muthuraman Yuvaraj, Peyandi Paraman Mahendran and Eman Tawfik Hussien",downloadPdfUrl:"/chapter/pdf-download/72994",previewPdfUrl:"/chapter/pdf-preview/72994",authors:[{id:"280193",title:"Dr.",name:"Muthuraman",surname:"Yuvaraj",slug:"muthuraman-yuvaraj",fullName:"Muthuraman Yuvaraj"}],corrections:null},{id:"72269",title:"Nanotechnological Approaches in Sustainable Agriculture and Plant Disease Management",doi:"10.5772/intechopen.92463",slug:"nanotechnological-approaches-in-sustainable-agriculture-and-plant-disease-management",totalDownloads:735,totalCrossrefCites:0,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Every year approximately 30–50% of crops suffer with different kinds of biotic stresses. Rapidly growing agrochemical industries and their diverse products make the environment more toxic and simultaneously hazardous for plant heath and soil health. Such types of agrochemicals are toxic, hazardous, carcinogenic, non-eco-friendly. Therefore, this is the ideal time to think about some more effective alternatives against those problems. Nanotechnological approaches bring the alternatives in the form of decreasing toxicity, improving shelf-life, increasing solubility for poorly water-soluble agrochemicals, minimum use with maximum effect, slow leaching efficiency with long-term effect with coupling of eco-friendly naturalistic way. The way of nanoparticle application in agriculture, specifically disease management, is unique, where it can be used singly or by coupling with fungicidal, herbicidal, insecticidal, RNA-interference molecules. Though it has such a positive impact, very few products will be commercially available in our market due to high price of particular products and well-established long field trial efficacy detection among insect, pest-pathogen, and environment. Application of nanomolecules in other progressive fields has been emerging, whereas advancement in agricultural applications needs to be boosted up through skilled knowledge transfer and basic understanding of its fundamental aspect.",signatures:"Siddhartha Das and Sudeepta Pattanayak",downloadPdfUrl:"/chapter/pdf-download/72269",previewPdfUrl:"/chapter/pdf-preview/72269",authors:[{id:"320136",title:"Dr.",name:"Siddhartha",surname:"Das",slug:"siddhartha-das",fullName:"Siddhartha Das"},{id:"320228",title:"Ms.",name:"Sudeepta",surname:"Pattanayak",slug:"sudeepta-pattanayak",fullName:"Sudeepta Pattanayak"}],corrections:null},{id:"71681",title:"Packages of Organic Nutrient Management as Soil Policy for Upgrading Cropping System to Restore Soil Productivity",doi:"10.5772/intechopen.91928",slug:"packages-of-organic-nutrient-management-as-soil-policy-for-upgrading-cropping-system-to-restore-soil",totalDownloads:609,totalCrossrefCites:8,totalDimensionsCites:11,hasAltmetrics:0,abstract:"The indigenous farming systems are, by and large, organically practiced. Organic farming systems facilitate the buildup of soil organic matter, reducing risk of erosion and runoff and enhancing nutrient storehouse in soils for plants. Rapid developments in organic farming promotion necessitated continuous flow of technology to meet day-to-day challenges. Farmyard manure (FYM), compost, and green manure are the most important and widely used bulky organic manures. Manuring with different short-duration legumes is suitable for maintenance of soil quality in terms of adding nitrogen to soil. Sustainable quantity of potassium can be maintained by vegetative mulching with crop residues. The use of balanced dosages of mixed compost at 5–10 t/ha along with 2 t/ha dolomite increases yield of maize, rice, mustard, and soybean. This article briefly describes about the integrated organic nutrient management as soil policy for upgrading cropping system to restore soil productivity.",signatures:"Shaon Kumar Das and Ravikant Avasthe",downloadPdfUrl:"/chapter/pdf-download/71681",previewPdfUrl:"/chapter/pdf-preview/71681",authors:[{id:"182210",title:"Dr.",name:"Shaon Kumar",surname:"Das",slug:"shaon-kumar-das",fullName:"Shaon Kumar Das"}],corrections:null},{id:"71592",title:"Vermicomposting: An Effective Option for Recycling Organic Wastes",doi:"10.5772/intechopen.91892",slug:"vermicomposting-an-effective-option-for-recycling-organic-wastes",totalDownloads:1437,totalCrossrefCites:2,totalDimensionsCites:9,hasAltmetrics:0,abstract:"Urbanization and industrialization resulted in rapid increase in volume of solid waste; its management has become one of the biggest problems today. Solid wastes can be disposed off by methods like land filling, incineration, conversion into biogas, recycling, and composting, but its overproduction has led to inappropriate disposal practices such as their indiscriminate and inappropriately timed application to agricultural fields that ultimately leads to water and soil pollution. However, if handled properly, these organic wastes can be used for vermicomposting; it is an effective recycling technology that improves the quality of the products which is disinfected, detoxified, and highly nutritive. It is a low cost, eco-biotechnological process of waste management in which earthworms are used to cooperate with microorganisms in order to convert biodegradable wastes into organic fertilizer. Earthworms excreta (vermicast) is a nutritive organic fertilizer rich in humus, NPK, micronutrients, beneficial soil microbes; nitrogen-fixing, phosphate solubilizing bacteria, actinomycets, and growth hormones auxins, gibberlins and cytokinins, is a suitable alternative to chemical fertilizers, being an excellent growth promoter and protector for crop plants. Thus, vermiculture not only results in management of soild waste but also produces excellent nutrient enriched vermicompost. Vermicompost is beneficial for sustainable organic agriculture and maintaining balanced ecosystem.",signatures:"Tamanreet Kaur",downloadPdfUrl:"/chapter/pdf-download/71592",previewPdfUrl:"/chapter/pdf-preview/71592",authors:[{id:"317164",title:"Dr.",name:"Tamanreet",surname:"Kaur",slug:"tamanreet-kaur",fullName:"Tamanreet Kaur"}],corrections:null},{id:"72075",title:"Application and Mechanisms of Plant Growth Promoting Fungi (PGPF) for Phytostimulation",doi:"10.5772/intechopen.92338",slug:"application-and-mechanisms-of-plant-growth-promoting-fungi-pgpf-for-phytostimulation",totalDownloads:1276,totalCrossrefCites:6,totalDimensionsCites:13,hasAltmetrics:0,abstract:"Plant growth-promoting fungi (PGPF) constitute diverse genera of nonpathogenic fungi that provide a variety of benefits to their host plants. PGPF show an effective role in sustainable agriculture. Meeting increasing demand for crop production without damage to the environment is the biggest challenge nowadays. The use of PGPF has been recognized as an environmentally friendly way of increasing crop production. These fungi have proven to increase crop yields by improving germination, seedling vigor, plant growth, root morphogenesis, photosynthesis, and flowering through either a direct or indirect mechanism. The mechanisms of PGPF involve solubilizing and mineralizing nutrients for easy uptake by plants, regulating hormonal balance, producing volatile organic compounds and microbial enzyme, suppressing plant pathogens and ameliorating abiotic stresses. Successful colonization is an intrinsic factor for most PGPF to exert their beneficial effects on plants. A certain level of specificity exists in the interactions between plant species and PGPF for root colonization and growth promoting effects. There is a gap between the number of reported efficacious PGPF and the number of PGPF as biofertilizer. Efforts should be strengthened to improve the efficacy and commercialization of PGPF. Hence, this chapter summarizes valuable information regarding the application and mechanisms of PGPF in sustainable agriculture.",signatures:"Md. Motaher Hossain and Farjana Sultana",downloadPdfUrl:"/chapter/pdf-download/72075",previewPdfUrl:"/chapter/pdf-preview/72075",authors:[{id:"318381",title:"Dr.",name:"Md. Motaher",surname:"Hossain",slug:"md.-motaher-hossain",fullName:"Md. Motaher Hossain"},{id:"318383",title:"Dr.",name:"Farjana",surname:"Sultana",slug:"farjana-sultana",fullName:"Farjana Sultana"}],corrections:null},{id:"71029",title:"Biological Efficacy of Trichoderma spp. and Bacillus spp. in the Management of Plant Diseases",doi:"10.5772/intechopen.91043",slug:"biological-efficacy-of-em-trichoderma-em-spp-and-em-bacillus-em-spp-in-the-management-of-plant-disea",totalDownloads:685,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter will cover topics about the microbial antagonists Trichoderma spp. and Bacillus spp. from the perspective of use as potential biological control agents on plant diseases. Results obtained in the laboratory about from their isolation, microbial strain collections for both genera, taxonomic identification, antifungal activity in in vitro tests, obtained evaluation of the antifungal effect of secondary metabolites from microbial antagonists will be shown. Besides, results obtained from bioassays in the greenhouse and field are used as biopesticides in the control of diseases in fruit trees and vegetables and their effects on the promotion of plant growth and increased crop yield.",signatures:"Francisco Daniel Hernández-Castillo, Francisco Castillo-Reyes, Marco Antonio Tucuch-Pérez and Roberto Arredondo-Valdes",downloadPdfUrl:"/chapter/pdf-download/71029",previewPdfUrl:"/chapter/pdf-preview/71029",authors:[{id:"76348",title:"Dr.",name:"Francisco Daniel",surname:"Hernandez Castillo",slug:"francisco-daniel-hernandez-castillo",fullName:"Francisco Daniel Hernandez Castillo"},{id:"187441",title:"Dr.",name:"Francisco",surname:"Castillo",slug:"francisco-castillo",fullName:"Francisco Castillo"},{id:"314111",title:"M.Sc.",name:"Marco Antonio",surname:"Tucuch Pérez",slug:"marco-antonio-tucuch-perez",fullName:"Marco Antonio Tucuch Pérez"},{id:"317252",title:"Dr.",name:"Roberto",surname:"Arredondo Valdes",slug:"roberto-arredondo-valdes",fullName:"Roberto Arredondo Valdes"}],corrections:null},{id:"71318",title:"Nonchemical Weed Control in Winter Oilseed Rape Crop in the Organic Farming System",doi:"10.5772/intechopen.91044",slug:"nonchemical-weed-control-in-winter-oilseed-rape-crop-in-the-organic-farming-system",totalDownloads:433,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"A field experiment was conducted during the 2014–2017 period at Aleksandras Stulginskis University (now—Vytautas Magnus University Agriculture Academy) on a Endocalcaric Endogleyic Luvisol (LV-can.gln) according to the WRB 2014. The three nonchemical weed control methods were explored: (1) thermal (using wet water steam), (2) mechanical (interrow loosening), and (3) self-regulation (smothering). In the thermal and mechanical weed control treatments, winter oilseed rape was grown with an interrow spacing of 48.0 cm and in weed smothering (self-regulation) treatment with an interrow spacing of 12.0 cm. Winter oilseed rape was grown in the soil with a regular humus layer (23–25 cm) and with a thickened humus layer (45–50 cm). Annual weeds predominated in the winter oilseed rape crop. In the soil with both humus layers, regular and thickened, the most efficient weed control method was mechanical weed management both during the autumn (efficacy 26.7–75.1%) and spring (efficacy 37.1–76.7%) growing seasons. Thermal and mechanical weed control in combination with the bio-preparations in droughty years significantly reduced the number of weed seedlings. Dry matter mass of weeds most markedly decreased through the application of the mechanical weed management method.",signatures:"Aušra Marcinkevičienė, Marina Keidan, Rita Pupalienė, Rimantas Velička, Zita Kriaučiūnienė, Lina Marija Butkevičienė and Robertas Kosteckas",downloadPdfUrl:"/chapter/pdf-download/71318",previewPdfUrl:"/chapter/pdf-preview/71318",authors:[{id:"313789",title:"Dr.",name:"Rita",surname:"Pupalienė",slug:"rita-pupaliene",fullName:"Rita Pupalienė"}],corrections:null},{id:"72832",title:"Socio-Economic Dimensions of Adoption of Conservation Practices: What Is Needed to Be Done?",doi:"10.5772/intechopen.93198",slug:"socio-economic-dimensions-of-adoption-of-conservation-practices-what-is-needed-to-be-done-",totalDownloads:370,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Promoting sustainable agricultural production requires farmers to adopt new technologies such as organic farming to increase the agricultural productivity, while conserving the environment. Adoption and diffusion of new technologies need a long process, as experienced in the past. There are social and economic factors, identified in the literature, and those could cause delays in farmers’ use of new technologies. Hence, technology adoption and diffusion are important policy issues in agriculture. For that reason, this paper provides a literature review including factors influencing the adoption and diffusion of technology in agriculture and aims to contribute to the future studies and policies, especially focusing on the social capital or the social aspects, which are proven not to be analyzed by the previous studies comprehensively. The results show that interaction with neighbors and relatives, and membership in a group or organization, which represent the social aspects, has a positive influence on adoption and diffusion of new technologies. Hence, policy-makers should incorporate the social aspects when designing the policies, such as cost sharing programmes, to promote adoption and diffusion of new technologies.",signatures:"Nisa Sansel Tandogan and Haluk Gedikoglu",downloadPdfUrl:"/chapter/pdf-download/72832",previewPdfUrl:"/chapter/pdf-preview/72832",authors:[{id:"318014",title:"Associate Prof.",name:"Haluk",surname:"Gedikoglu",slug:"haluk-gedikoglu",fullName:"Haluk Gedikoglu"},{id:"323357",title:"Ph.D. Student",name:"Nisa Sansel",surname:"Tandogan",slug:"nisa-sansel-tandogan",fullName:"Nisa Sansel Tandogan"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"4566",title:"Agroecology",subtitle:null,isOpenForSubmission:!1,hash:"9e35a4ff7bee4ab82eab2c6b3f441789",slug:"agroecology",bookSignature:"Vytautas Pilipavičius",coverURL:"https://cdn.intechopen.com/books/images_new/4566.jpg",editedByType:"Edited by",editors:[{id:"169359",title:"Dr.",name:"Vytautas",surname:"Pilipavicius",slug:"vytautas-pilipavicius",fullName:"Vytautas Pilipavicius"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6952",title:"Irrigation in Agroecosystems",subtitle:null,isOpenForSubmission:!1,hash:"1afe3f365612ea9b4f35942c69792f63",slug:"irrigation-in-agroecosystems",bookSignature:"Gabrijel Ondrašek",coverURL:"https://cdn.intechopen.com/books/images_new/6952.jpg",editedByType:"Edited by",editors:[{id:"46939",title:"Prof.",name:"Gabrijel",surname:"Ondrasek",slug:"gabrijel-ondrasek",fullName:"Gabrijel Ondrasek"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6301",title:"Vegetation",subtitle:null,isOpenForSubmission:!1,hash:"5c1b7f22f2f926f8d59ea56f2fe84c6f",slug:"vegetation",bookSignature:"Allan Sebata",coverURL:"https://cdn.intechopen.com/books/images_new/6301.jpg",editedByType:"Edited by",editors:[{id:"143409",title:"Dr.",name:"Allan",surname:"Sebata",slug:"allan-sebata",fullName:"Allan Sebata"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6485",title:"Sustainability of Agroecosystems",subtitle:null,isOpenForSubmission:!1,hash:"4ed7b8c6bce44bfaddb83c0365793742",slug:"sustainability-of-agroecosystems",bookSignature:"Alexandre Bosco de Oliveira",coverURL:"https://cdn.intechopen.com/books/images_new/6485.jpg",editedByType:"Edited by",editors:[{id:"77880",title:"Dr.",name:"Alexandre",surname:"De Oliveira",slug:"alexandre-de-oliveira",fullName:"Alexandre De Oliveira"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9345",title:"Sustainable Crop Production",subtitle:null,isOpenForSubmission:!1,hash:"5135c48a58f18229b288f2c690257bcb",slug:"sustainable-crop-production",bookSignature:"Mirza Hasanuzzaman, Marcelo Carvalho Minhoto Teixeira Filho, Masayuki Fujita and Thiago Assis Rodrigues Nogueira",coverURL:"https://cdn.intechopen.com/books/images_new/9345.jpg",editedByType:"Edited by",editors:[{id:"76477",title:"Prof.",name:"Mirza",surname:"Hasanuzzaman",slug:"mirza-hasanuzzaman",fullName:"Mirza Hasanuzzaman"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6560",title:"Plant Competition in Cropping Systems",subtitle:null,isOpenForSubmission:!1,hash:"664e0a97f4494932f6c0461f9a6e7bd6",slug:"plant-competition-in-cropping-systems",bookSignature:"Daniel Dunea",coverURL:"https://cdn.intechopen.com/books/images_new/6560.jpg",editedByType:"Edited by",editors:[{id:"180202",title:"Associate Prof.",name:"Daniel",surname:"Dunea",slug:"daniel-dunea",fullName:"Daniel Dunea"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10499",title:"Next-Generation Greenhouses for Food Security",subtitle:null,isOpenForSubmission:!1,hash:"456f82c97eafad5734cd36c48e167781",slug:"next-generation-greenhouses-for-food-security",bookSignature:"Redmond R. 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Falls from height cause significant death and disability worldwide, due to the severe traumatic load inflicted on their victims [1, 2, 3, 4]. According to the WHO, the yearly mortality due to suicide worldwide is approximately 800,000 people. What is more important is the fact that it affects mainly young people, suicide being the primary cause of death in the age group of 25–34 years [5]. The mean incidence of suicides across Europe in 2013 was of 11.7 deaths per 100,000 people. Low rates, under 8 deaths per 100,000 inhabitants were recorded in Italy, Malta, Cyprus and the United Kingdom. The lowest incidence was observed in Greece (4.8 cases per 100,000 people) [6]. There was a lag between the beginning of the economic crisis in Europe, and the manifestation of its effects on the Greek population. These became evident 3 or 4 years later, in the form of a reduction of household income and an increase in the rate of unemployment [7, 8, 9].
Causes for this mechanism of injury include both accidental falls and deliberate suicide attempts [10]. The latter constitutes a major social problem, with implications for the entire society, but particularly for the affected family. The psychological profile of people committing suicide is complex and unique for each case [11]. Thus, identifying contributing factors that may lead to suicide and establishing strategies for the safekeeping of mental health in communities are of paramount importance.
The type of injuries incurred after a fall constitute a unique pattern of blunt trauma, with a characteristic distribution of damage (multiple lesions in a variety of body areas) [1, 12, 13]. The most common form of trauma are fractures, followed by other areas, such as the head, the thorax, the abdomen as well as the retroperitoneum, being injured by varied degrees [14]. The quantity and the quality of traumatic load absorbed depend on factors like the height from which the fall occurred, the part of the patient’s body that had the first impact, the surface where the impact occurred and the victim’s age, taking into account the associated comorbidity, and reduced physiologic reserve that advanced age implies [15, 16, 17]. Anticipation and prediction of the exact areas being injured are not possible, because of the multitude of factors involved, and the exact unpredictability of the fall’s kinematic [18, 19].
As aforementioned, one can infer that the differential diagnosis of falls from height from other types of blunt trauma (for example, a road-traffic-collision with expulsion of the occupants from the vehicle) is difficult. Thus, a high index of suspicion must be maintained concerning the initial cause in cases of polytrauma in victims with an unknown history [20]. An array of papers have dealt with injury-related deaths in general, while others have differentiated between unintentional and intentional injury-related deaths [21, 22, 23, 24]. There are few studies though that have looked into patients with intentional or unintentional injuries, due to a fall from height, at a single centre [13, 25].
As noted by research in the past, self-harm due to a fall is a rare phenomenon, being responsible for 4–7% of deaths from suicide in the developed world [26, 27, 28, 29]. On the other hand, studies have shown that psychiatric disorders are a frequent finding in patients suffering trauma [30, 31, 32]. Nevertheless, the connection between mental disorders and specific injury patterns has not been adequately described. Furthermore, the elucidation of patterns of injury incurred after accidental falls and after intentional suicide jumps, might be of help to forensic pathologists while investigating the circumstances of a death after a fall from height.
From January 1990 to October 2012, 64 patients (15 males and 49 females) were studied as a result of falls from height. Fall from height ≥ 3 m is classified as high energy trauma in accordance to ATLS guidelines [33]. The mean patient age was 34 years (range 16–65 years). These 64 cases comprised our series and, for comparison, were divided into those without mental disorders (n = 32, group I) and those with mental disorders (n = 32, group II). Group II cases were further stratified according to their psychiatric diagnosis.
The principles of Advanced Trauma Life Support were followed in the management of all patients. Basic laboratory screening included haemoglobin level, prothrombin time, type and crossmatch and arterial blood gas analysis. Data collected included age, gender, associated trauma, injury severity score (ISS), Glasgow Coma Scale (GCS), haemodynamic status (systolic blood pressure less than 90 mm Hg on arrival), length of intensive care unit (ICU) and hospital stay.
Also, the following trauma variables were analysed: specific intracranial injuries (epidural, subdural and subarachnoid haemorrhage and brain contusion), spinal injuries (cervical, thoracic and lumbar spine), thoracic injuries, specific intra-abdominal injuries (liver, spleen, kidney, and hollow viscus) and specific fractures (pelvis, femur and tibia). The diagnosis of mental disorder was ascertained by psychiatric specialists using the criteria of the International Classification of Disease Ninth Version Clinical Modification (ICD-9CM).
The mean height of fall was 5.4 m (range, 3–25 m). The patients were separated in two groups: group I, without mental disorders (n = 32), and group II, with mental disorders (n = 32). The demographic data, including age, gender, height of fall, ISS, GCS, initial shock (SBP <90 mm Hg), hospital stay (days), ICU stay (days) and deaths are summarized in Table 1. The mean hospital stay was 29 days (range 19–45) and the mean ICU stay was 9 (range, 5–13) (Table 1).
Data | Patients |
---|---|
Age | 35 (18–65) |
Gender (M:F) | 15:49 |
ISS | 20 (12–58) |
GCS | 9 (6–13) |
Haemodynamic status-SBP <90 mmHg | 34 |
Hospital stay (days) | 29 (19–45) |
ICU stay (days) | 9 (5–13) |
Deaths | 13 |
Comparisons of demographic data of patients with suicide attempts from height.
Concerning their background psychiatric disorder in group II, the diagnosis was schizophrenia in 32 patients, depression in 12, drugs or alcohol abuse in 3, personality disorder in one, manic depression in one, another psychiatric condition in one and 14 cases without a specific diagnosis (generally marital or work related).
Patients due to suicide attempts from height comprised of 15 males and 49 females with a mean of age 35 years (range: 18–65 years). Of those, 16 were single, 14 were married and 2 were divorced. Thirty-three patients were employed, 6 were housewives, 7 were unemployed, 3 were students/pupils and 15 had various occupations. As far as religion was concerned, 48 were Christian Orthodox, one Roman Catholic, one Jewish, one Muslim and 13 of other religions.
Regarding their family status: 20 had children, 6 had only their parents, 3 had only their spouse, 2 had a step family, 2 had parents who were divorced, 6 had parents and/or siblings, one had both parents and children and 24 had no family at all.
The falls had occurred from a roof or balcony in 39 cases, from a window in 12, from a bridge in 7 and inside the house in 6. The mean injury severity score (ISS) was 20 (range 12–58) for all victims of fall. Sixteen patients arrived at the emergency department in shock. The most common body region having sustained severe trauma were the fractured extremities and/or spine, followed by the chest, the head and the abdomen for both groups (Table 2).
Fall from | Patients |
---|---|
Roof/balcony | 39 |
Window | 12 |
Bridge | 7 |
Inside the house | 6 |
Abdominal trauma | 4 |
Thoracic trauma | 32 |
Head injuries | 16 |
Extremity fractures | 199 |
Spinal fractures | 32 |
Location where the fall occurred and associated injuries.
Head injuries were revealed by CT scan in 16 patients. The mean GCS was 9 (range 6–13) for both groups. The most common intracranial injury was brain contusion and subarachnoid haemorrhage, followed by subdural hematoma and epidural hematoma. The incidence of subarachnoid haemorrhage in the suicide group was significantly higher than in the accidental group.
Associated abdominal injuries were present in 4 patients. The most common injury was liver laceration, followed by kidney and spleen laceration. One died with an operative finding of a large central retroperitoneal haematoma due to a vena cava rupture. In the remaining 3 patients, ultrasonography showed minimal intraperitoneal blood and these patients were not operated on. Thoracic injuries were present in 32 patients. The most common of these were rib fractures—26 cases. Twelve of these patients had a haemopneumothorax and 6 had a sternum fracture. Conservative treatment with assisted ventilation was necessary in these cases (Table 3).
Skull | 16 (25%) |
Shoulder | 4 (6.2%) |
Scapula | 6 (9.3%) |
Sternum | 6 (9.3%) |
Ribs | 26 (40.6%) |
Humerus | 8 (12.5%) |
Elbow joint | 8 (12.5%) |
Distal radius | 7 (10.9%) |
Hand | 4 (6.2%) |
32 (50%) | |
27 (42.1%) | |
Acetabulum | 9 (14%) |
Femoral neck | 38 (59.3%) |
Femur | 18 (28.1%) |
Knee joint | 17 (26.5%) |
Tibia | 19 (29.6%) |
Ankle joint | 36 (56.2%) |
Calcaneum | 34 (53.1%) |
The distribution of fractures in percentage across body region for the two groups of patients.
Upper extremity fractures were found in 37 patients, while pelvic and lower extremity fractures were found in 198 cases. Spinal fractures were noted in 32 patients. As far as the level of injury was concerned, in 16 cases, it was in the lumbar level, in 9 cases in the cervical, in 5 cases in thoracic and in 2 cases the sacral vertebrae were concerned. Regarding the neurologic deficit, in 23 cases, the injury was incomplete (14 with ASIA C and 9 with ASIA D), and in 9 cases, it was complete (4 with ASIA A and 5 with ASIA B). Further details with our data of 32 patients with spinal cord injury as a result of deliberate self-harm have been published previously [34]. It seems that the neurological complications of spinal injuries were correlated with the increase of the height from which the fall occurred.
Patients with psychiatric disorders were more frequently shocked on arrival at the emergency department than those in the accidental group, the most common reason for death being head injury. Fatalities were more common when patients fell from greater heights (over 4 m), or when their head hit a hard surface, such as concrete.
The final causes of inpatients’ death were: head injury in 8 cases, multiple organ failure in 3 cases, pneumonia in one case and cardiac complications in another one. The majority of patients who died of organ failure had sustained significant head injury. In one case, death occurred after a second suicide attempt 2 years later.
Each patient underwent a psychiatric evaluation by a consulting psychiatrist as soon as his condition and cooperation permitted. The assessment comprised of an interview. Regarding the type of treatment for the spinal fracture—dislocations, instrumentation devices included titanium rods, transpedicular screws, sacral bars and bone grafting in all patients. No new suicide attempt was recorded during the hospital stay.
All patients were discharged from hospital approximately 6–8 weeks after the operation with a custom-made thermoplastic thoracolumbar or lumbosacral orthosis for another 8 weeks and instructions for physical therapy and rehabilitation programs. The mean follow-up was 6 years (12 months to 10 years range). At follow-up, 27 patients were available for evaluation due to the death of 5 patients, 1–3 years post initial injury, because of suicide in one case (patient 7 of group II) and medical complications in 4 cases [renal failure in 3 cases (patients 8, 14 and 30 in group II) and pneumonia in one (patient 21)]. In the remaining patients, new unsuccessful attempts were recorded in 2 cases (7%) due to psychiatric disorders, 1–3 years after the first attempt (patients 10 and 24). All survivors received psychiatric follow-up. The overall mortality was significantly higher in those patients who fell from more than 10 m.
Suicides and suicide attempts constitute a major concern for public health services, with implications for both families and society [35]. Trauma incurred due to falls from height poses a great burden on health services due to its severity. This is particularly important if we take into account the fact that this is a largely preventable mechanism of injury. Prior knowledge of the possible traumatic patterns incurred after a fall from height can prove helpful in the initial evaluation of this group of patients. From an epidemiologic point of view, trauma due to falls may occur across all age groups, but it is the two extremes, the very young and elderly, which are particularly susceptible to it [36].
In this study, we have considered two groups of patients. Group I represented patients with no mental disorders and group II with mental disorders. It is quite difficult to identify someone who is prone to committing suicide. In addition, the observed number of suicides and suicide attempts being committed at a younger age (i.e. adolescence) has been a cause of concern worldwide and particularly in Europe [37]. The male-female ratio of suicide attempts varies across age groups. Thus, in the younger age group (15–24 years old), it is 1:1.9; and in the middle age group (45–54 years old) it is 1:1.7. This ratio further decreases for those older than 55 years to 1:1.4 [38]. In this study, the male-female ratio was 1:3. The female sex was associated with an increased likelihood of death due to a higher amount of energy involved in their attempted fall.
According to other studies [39, 40], young males tend to repeat suicide attempts more frequently than females and the methods used by them lead to an increased mortality. A suicide attempt in the past is a red flag for a possible attempt in the future; so, there is a strong correlation between suicide attempts and deaths from suicide both regionally and nationally, and particularly in young males [41]. Also, there is a strong correlation between repeated attempts and completed suicide, especially in the group of males who have used a violent method [42, 43].
The study by Dickson et al. had the aim of establishing a correlation between mortality and various factors, such as the patients’ injury severity score (ISS), the height from which the fall took place, the patient’s intention and the body regions that were injured. In addition, the height of the fall strongly correlated with the patient’s ISS and was an important predictor of mortality [44]. Head and/or chest injuries, if due to a fall from height, were strongly associated with an increased incidence of death. According to the authors, this mechanism of injury should be a triage priority when tasking ambulances. In addition, the best way of treating these injuries is their prevention. No other significant predictors of mortality were found in this study.
In the case series by Kent and Pearce, 282 suicide attempts were studied, 13 of which were completed. Of those, 8 happened at home, all patients were older than 49 years; and in 7 out of 8 deaths, ladders were implicated [45]. The retrospective study by Petratos et al. analysed in detail the musculoskeletal traumatic pattern resulting from falls from height, and focused particularly on the correlation between specific fracture patterns and the height from which the fall happened, as well as on the causation of the fall (suicide attempt vs. accident). According to their findings, with an increase in the height from which the fall occurred, the frequency of limb, thoracic and pelvic fractures also increased. Such a correlation was not evident for head injuries. Nevertheless, the anatomical regions having sustained fractures (including the cranium) varied in accordance with the height of the fall. Thus, we can infer a mechanism of injury that is varying proportionately to the height of the fall. There was no significant difference between the patients who attempted suicide and those who fell by accident as far as the number of fractures incurred or the regions having been injured were concerned. Nevertheless, with regard to our results that have been published previously, patients who attempted suicide had a significantly greater number of bilateral lower limb fractures than their accidental fall counterpart. In addition, logistic regression analysis shows a significant correlation between the cause of the fall and the presence of lower limb fractures. According to the authors, further research is necessary in order to establish a correlation between incurred traumatic pattern, the height of the fall and the patient’s intention [46].
Choi et al. in his recent study attempted to differentiate the characteristics of traumatic pattern between intentional and non-intentional falls [47]. In addition, he attempted to determine prognostic factors for suicide attempt-related injury and promote adequate measures for the prevention and management of such injuries. In this study, 8992 patients with an accidental fall (non-intentional group) and 144 patients who committed a suicide attempt (intentional group) were included. Falls from a height greater than 4 metres were more frequently encountered in the intentional group. Death prior to patient’s arrival in the accident and emergency department occurred in 54.9% of the cases of suicide attempt. Patients within the intentional group, having sustained increased traumatic load, had fallen from higher, were older and were more likely to be of lower educational level (high-school graduates, instead of college). Due to the fact that injuries sustained after an intentional fall were more likely to have a reserved outcome, the authors highlighted the importance of prevention. Such measures include telephone support and counselling lines, the installation of signs advising against suicide in high risk areas for an intentional fall, such as bridges, along with suggestions for government-coordinated programs aiming for the education of the public and the improvement of social conditions generally and the support of the community and family in particular.
The reasons behind a suicide attempt are multifactorial, hard to quantify and unique in every case. Nevertheless, the study of multiple suicide attempts puts into evidence some risk factors that would lead to such a decision. These are common across all age groups and include: the presence of mental illness, either currently or in the past, a history of alcohol or drug dependence, as well as the presence of depression [10]. Epidemiologically, one out of five persons who have attempted suicide will try once more within a year, and 10% of them will succeed in the end. Drug ingestion is the most common mechanism for a suicide attempt. Violent mechanisms such as hanging, falls from height and use of weapons are not common [48]. The persons who have attempted suicide by falling from height usually become polytrauma patients. The types of injuries incurred are two: deceleration injuries due to inertial phenomena, usually at viscera with vascular pedicles, and direct impact injuries [49].
The severity of fractures incurred will depend on factors like the area over which the impact is applied [50]. The smaller the area of spread of the impact, the greater the local load. Therefore, patients landing on their legs tend to suffer more severe injuries than those who have landed on their flanks, or prone, or supine [51]. Patients due to accidental falls mostly suffered spinal fractures and upper extremities fractures in an attempt to protect themselves. Patients due to suicidal high falls attempts suffered mostly of lower limb fractures, pelvis, spinal fractures and head injuries. Distal radius and hand was the most common affected region in upper extremities in patients with non-intentional falls, in an attempt to protect mainly the head and grab something stable to prevent further fall. In patients with intentional falls, kinetic energy is absorbed mainly by the lower limbs, pelvis, spine and head, leading to characteristic fracture patterns [52]. The most common cause for death is head injury [51, 53, 54] and this is accordance to our results. Turk and Tsokos reviewed 68 medicolegal autopsy cases (22 females, 46 males, age range 13–89 years) of fatal falls from height from 1997 to 2001 [55]. The cause of instant death was head trauma in 24 (35%), internal blood loss in 9 (13%) and polytrauma in 30 (44%) cases. Other causes of death, when the individuals survived the trauma for a longer period, included septic multiple organ dysfunction syndrome and pulmonary embolism. In general, suicides were from greater heights than accidents (mean height 22.7 m for suicides and 10.8 m for accidents, respectively). Strikingly, severe head injuries predominantly occurred in falls from heights below 10 m (84%) and above 25 m (90%). Head trauma was the cause of death in 11 of the 19 cases that were from 9 m or less (58%). Of all cases, 51 (75%) died within a few minutes. A survival time of several hours up to 1 day was observed in 8 cases. Nine patients survived for several days (up to 16 days). Five of them fell from heights below 10 m. Patients with intentional fall from height have a higher early mortality than patients due to accidental fall from height [56].
The easiest way to underline the suspicion that the mode is suicide is if a suicide note is found at the jumping site; this is, however, closer to being the exception than the rule. Analysing the distance of the body from the site of descent may sometimes also help us determine the manner of death. The distance of the body from the site of descent includes the falling height and the horizontal distance. The falling height in suicide was statistically higher than that in accident [57, 58]. For similar heights, Wischhusen et al. have demonstrated that in passive falls, the horizontal distance is usually farther than jumps [59]. From a mechanical point of view, during a fall from height, potential (dynamic) energy is converted into kinetic and this leads to fractures upon impact. Another important factor of the severity of injuries is the height of fall, as the kinetic energy is increasing due to acceleration during the fall and is maximum at the time of impact [60]. In suicide falls, kinetic energy is absorbed mainly by the lower limbs, pelvis and spine, leading to characteristic fracture patterns. In accidental falls, patients most probably extend their arms and flex their hips, which lead to a damping effect that protects the spine [61]. Hence, the most important determinant of survival after a free fall is the position of the body at the time of impact [49]. There were only 3 patients (cases 1, 22 and 31) in group II who have sustained solely upper extremity fractures. The most common body position at the time of impact is with the patient standing and landing with the lower extremities first. This usually leads to calcaneal or pilon fractures, as well as thoracolumbar fractures. If the impact takes place with the patient seated, then higher thoracic or cervical injuries are more likely to happen, which are associated with a higher rate of mortality. Finally, an unpredictable fracture pattern takes place when the victim suffers multiple secondary impacts, in various postures, after bouncing from the primary impact. The amount of injury incurred will depend on the rate of dissipation and absorption of energy, through the patient’s body.
According to the paper by Teh et al., there is a difference to the traumatic pattern incurred by jumpers compared to fallers [13]. Namely, the jumpers tend to impact their dominant lower limb first, as well as sustaining right sided thoracic injuries in the process. We did not confirm the above-mentioned findings in our study. The severity of spinal cord injuries was more important in the suicide than the accidental group [52]. This was in accordance with studies performed in the past, which also showed the early neurologic involvement in such cases. As far as prognosis of spinal cord injury is concerned, complete injuries will be unaltered both in level and extent in a year’s time. On the other hand, incomplete injuries may show signs of improvement for a period of 2 years after the impact [62]. Our results regarding prognosis for ambulation in ASIA A patients and for functionality in ASIA C patients are in accordance with current knowledge [63].
Anderson et al. performed a retrospective study, regarding the rehabilitation outcome of patients with spinal cord injury, as a result of deliberate self-harm (DSH) [29]. According to them, spinal fractures in the DSH group were mainly the result of falls from height. Underlying causes were revealed, such as psychiatric disorders and substance abuse, necessitating formal psychiatric review. There was no difference in short-term rehabilitation results between the DSH and accidental spinal cord injury group. In addition, DSH seemed to impact the length of stay only in patients with a spinal fracture, but without cord injury.
According to the literature, there are three studies on the subject of acute spinal cord injury following a suicide attempt that stand apart. The first is by Stanford et al. In his paper, 56 cases were followed over a period of 30 years (1970–2000). Fifty five cases were due to a fall from height and one open injury, through the use of a gun. Follow-up of 8 years on average was available for 47 cases (84%). The vertebral levels most frequently injured were C5 and L1. About 23 patients suffered from a complete spinal cord injury and 32 had a severe traumatic load (ISS > 15). The psychiatric background of these patients included personality disorder in 27, schizophrenia in 16, depression in 14 and substance abuse/dependence in 20. Of these patients, 4 were successful in subsequent suicide attempts [28].
The following two studies on this subject are from the UK [26] and Denmark [27]. Both of those are observational and retrospective, with a long follow-up. According to the latter, there is an increasing incidence of suicide attempts and associated spinal cord injury from 1965 to 1987. Approximately one third of the patients who attempted suicide suffered from schizophrenia. According to other papers [64, 65], schizophrenia is strongly correlated with falls from height (from bridges in particular). There were 7 patients in our study who have sustained a fall from a bridge. Damage control surgery principles are followed initially for the treatment of life-threatening injuries and for both limb and spinal trauma [66]. The primary goals of fracture fixation are timely mobilization and safe transfer to psychiatric services. Conservative treatment measures are not usually recommended for this group of patients.
Our findings are in accordance with relevant bibliography [67, 68], regarding the psychiatric background of patients who attempt suicide by falling from height. The spectrum of conditions encountered encompasses bipolar disorder, substance dependence and abuse, personality disorder and schizophrenia.
From an epidemiological point of view, schizophrenia is encountered in 5–10% of cases of suicide attempt. These patients may have well planned their suicide or even suffered from an active self-harm ideation. From the above-mentioned, we gather that management of these patients from a trauma point of view must take into consideration their psychiatric needs. The latter may cause significant disturbance in the delivery of medical care [69]. Most of the patients in this study had a positive response following adequate psychiatric intervention. Hence, we gather that prevention and early identification of persons at risk for a suicide attempt with the use of appropriate screening tools by health care professionals are invaluable.
Education of medical and nursing staff regarding the demands and particularities of care of this population, suffering from both spinal cord injury and psychiatric disorders, cannot be overemphasized. Regular follow-up with multidisciplinary team input and future research are necessary for the provision of high-quality care to this population.
According to the literature, it has been difficult to obtain comparable international data on suicide attempts, owing to disparities in definitions, survey designs and study methods, because the combination of free falls and mental disorders produces a unique group of patients. It has been our experience that psychiatric conditions, and especially the suicidal risk, should be evaluated and treated as early as possible during the orthopaedic or surgical hospitalization. Management requires both psychopharmacological therapy and psychotherapy. It has to be directed towards the achievement of symptomatic relief and, if possible, towards the remission of the primary psychiatric disorder.
The management of these patients in the orthopaedic or surgical ward is difficult, because of restlessness, non-cooperation of the patient and the problem of staff inexperienced in handling the psychiatric patient. When prolonged orthopaedic and rehabilitation management are necessary, it is suggested that the patient be transferred to a psychiatric hospital while continuing the necessary orthopaedic treatment. The outcome data provide critical information concerning those individuals who have attempted suicide and suggests future methods for the identification of suicidal factors.
The authors declare that they have no conflicts of interest.
An obturator hernia (OH) is the protrusion of either an intraperitoneal or an extraperitoneal organ or tissue through the obturator canal [1]. The development of ossification of the ischium and pubis occurs between the 4th and 5th months of gestation, so perhaps it can be assumed that potential bone formation to fill the obturator foramen stops during this period. For anatomical purposes, the obturator foramen is a lacuna, and the obturator canal is the true foramen [2]. The obturator hole is an orifice located in the lower half of the iliac bone, below the acetabulum, limited by the pubis and the ischium (Figure 1). This orifice is almost completely blocked by the obturator membrane, a fibrous membrane in continuity with the periosteum of the margins of the foramen itself. This membrane consists of two layers and is covered by the internal and external obturator muscles that latch on it and the bone margin (Figure 2) [2].
Endopelvic view of the obturatory canal. 1: superficial epigastric vessels; 2: anastomosis between epigastric and obturator vessels; 3: obturator foramen; 4: ileo-psoas muscle; 5: obturator nerve; 6: obturator vessels; 7: internal obturator muscle. with permission from Ref. [
In vivo anatomy of the right obturator foramen. (with permission from Ref. [
The obturator membrane does not cover the entire foramen: upwards it leaves a passage between its upper edge and the lower border of the horizontal branch of the pubis. This path is the obturator canal: an osteo-fibrous duct 2–3 cm long, directed obliquely from the inside out, which connects the pelvic cavity with the pre-obturator space of the thigh, between the external obturator muscle dorsally and muscles long adductor, comb, ileo-psoas ventrally. Its upper wall is the lower face of the horizontal branch of the pubis and as a floor, the obturator membrane, reinforced by an internal ligament. The canal is crossed by the obturator artery, vein and nerve. The obturator canal inwards is closed by the peritoneum, which may have a dimple at this level (obturator dimple) (Figure 1), enough to explain the possibility of obturator hernias, which occur in the upper part of the inner thigh region [5]. The canal offers a passage to the obturator peduncle, where the nerve is located above the artery and vein, and which contains a portion of adipose tissue. The obturator nerve, originating from L2, L3 and L4, divides into two branches at the emergence of the obturator canal. The ventral branch innervates the pectinate and the adductors muscles and supplies sensory branches to the medial face of the thigh; the dorsal branch also innervates the adductors and ends at the knee joint level. This anatomical arrangement explains the Howship–Romberg sign: in case of compression of the obturator nerve by a strangulated hernia, it occurs obturator neuralgia exacerbated by extension, abduction and internal rotation of the thigh, resolved by flexion [6].
The obturator artery originates from the internal iliac artery and it is divided into two branches, medial and lateral, forming a circle around the perimeter of the obturator foramen, in the thickness of its musculoaponeurotic operculum.
There is an anastomosis between the obturator artery and inferior or superficial epigastric artery which crosses the horizontal branch of the pubis. There may be an aberrant obturator artery that can originate from the superficial epigastric artery or the external iliac artery. These arteries are accompanied by satellite veins. This vascular circle has been called “corona mortis”, due to the high risk of bleeding. An anatomic variant has also been reported in which a pubic branch of the epigastric artery descending into the obturator foramen can replace the obturator artery, and a larger pubic vein draining into the iliac vein may replace the obturator vein.
Arnaud de Ronsil in 1724 first described the obturator hernia, and then Henry Obre first successfully repaired it in 1851 [7].
Three anatomic stages in the formation of obturator hernia have been described. The first stage is the entrance of the pre-peritoneal fat tissue into the pelvic orifice of the obturator canal, forming a pilot fat plug. During the second stage, a peritoneal dimple develops through the canal and progresses to the formation of a peritoneal sac. The third stage consists of the onset of symptoms resulting from the herniation of the viscera into this sac [7, 8]. The formation of obturator hernia is favored by weight loss which involves the disappearance of the adipose tissue at the level of the obturator canal. This hernia is mainly formed in the elderly and thin women. In the beginning, the penetration of the extra-peritoneal tissue into the sub-pubic canal, then there is the formation of a dimple at the level of the peritoneum that covers it. Finally, a sac is formed with the risk of intestinal loops being inserted and their throttling due to the stiffness of the margins of the orifice. The sac can externalize directly through the exopelvic orifice of the canal, between the external obturator and pectineus muscles. However, it can also pass through the external obturator muscle or even fit between the two obturator muscles. The contents of the sac are usually the small intestine, more seldom an annex or ovary, bladder, appendix or epiploon. The narrowness of the orifice favors strangulation.
Obturator hernia is a rare pelvic hernia, accounting for the 0.5–1.4% of all hernias (Table 1) [9] that frequently causes bowel obstruction; the hernia passes through the obturator canal, bounded above by the obturator groove of the pubic bone, and below by the obturator membrane (Figures 3 and 4). The obturator canal is usually filled with fat and allows no space for hernia [3]. The fat disappears in patients who have had massive weight loss or are very thin indeed it is observed in elderly emaciated and multiparous women, so it’s also called “little old’s lady hernia” [10]. Right-sided OH is commoner than the left in the ratio of 2:1, as the left obturator foramen may be covered by the sigmoid colon [11], although an incidence of 6% bilateral hernias have been reported [12]. The hernia sac usually contains small bowel, rarely appendix, colon, Meckel diverticulum, or omentum [13]. A prompt diagnosis and treatment could avoid complications such as necrosis of the intestine that increases morbidity and mortality. Signs such as Howship–Romberg and Hannington–Kiff are aspecific and they should be associated with a CT-scan which is clearly the choice radiological exam. Symptoms such as the pain radiating from the inner parts of the thigh, the knee, or the hip could be confused with the dorso-lumbar intervertebral disc pathology or gonarthrosis [14, 15].
Hernia type | Percentage of presentation |
---|---|
Inguinal | 75% |
Incisional | 10–15% |
Femural | 5–10% |
Umbilical | |
Spigelian (at linea semilunaris) | |
Epigastric (linea alba) | |
Obturator | 0.5–1.6% |
The frequency of presentation in the general population of the types of abdominal wall hernia.
Depiction of strangulated obturator hernia. (with permission from Ref. [
Intraoperative findings: the small intestine is incarcerated in the obturator foramen. (with the permission from Ref. [
Obturator hernia poses a diagnostic challenge and the signs and symptoms are often aspecific, which makes a preoperative diagnosis difficult. Obturator hernia should be included in the differential diagnosis of intestinal obstruction of unknown origin, especially in emaciated elderly women with chronic disease. The almost exclusive incidence of obturatory hernia in women can be explained by the greater extension of the obturator foramen and from the different obliquity of the pelvis that exposes it to a direct action of abdominal pressure in women. More frequent symptoms are due to an intestinal obstruction like abdominal pain, distension, nausea, vomiting and constipation [16]. They may also have recurrent attacks of intestinal obstruction in the past with or without a palpable mass in the groin. On physical examination, it may be evident the Howship–Romberg sign: in case of compression of the obturatory nerve by a strangulated hernia, it occurs an obturator neuralgia exacerbated by extension, abduction and internal rotation of the thigh, resolved by flexion. It is considered pathognomonic and presents in 15–50% of cases. The Hannington–Kiff sign (absent adductor reflex and an intact patellar reflex) is reported as more specific [17]. It would be necessary to perform a computed tomography (CT) to make a diagnosis. The CT has an accuracy of 90% [18]. An emergency exploratory laparotomy is fundamental in patients presenting with an acute abdomen.
Abdominal plain radiograph shows aspecific signs of intestinal obstruction and very rarely may show a gas shadow in the area of obturator foramen, therefore, it is not an informative exam [19].
Herniography with the intraperitoneal injection of contrast material under local anesthesia was reported to be useful for demonstrating the hernial sac but it is not a reproducible examination in emergency conditions because it can be done only in elective cases [20].
Ultrasonography (US) is a noninvasive, cheap, and easily available diagnostic tool that can be used to diagnose OH accurately, especially in the emergency setup when patients present with the acute abdomen of uncertain cause, hence allowing early operative treatment. Using a high-frequency probe, the examiner could detect a hypoechoic mass corresponding to the dilated and edematous segment of the intestine posterior to the pectineus muscle [21]. The major advantages of US are that it is a non-invasive and allows for comparison with the asymptomatic side. Limiting factors are dependence on examiner experience (who may at times miss the diagnosis by not scanning the femoral region or may not recognize the hernia as it is small and found deep within the pelvic musculature) and the relatively long learning curve. Also, too much pressure on the transducer can reduce the sensitivity of detection of hernias [22].
Barium enema fluoroscopy can demonstrate a hank of intestinal loops but is very time-consuming and not feasible in cases of acute abdomen. Also, retained barium in the bowel loop may increase the risk of subsequent complications, hence it is not routinely advocated [23].
Magnetic resonance is a comparable method to CT scan for diagnosis but is not always available in urgency or in most cases of obturator hernia presentation [24].
CT scan (Figure 5) is more sensitive and specific, showing a mass-like lesion between the obturator externus and pectineus muscles (Figure 6), it is useful to shorten the lapse of time from presentation to appropriate diagnosis and spontaneously subjecting a patient to definitive surgery, and thus also giving a choice in the surgical approach required [14].
CT scan, coronal: the arrow identifies the right obturator hernia sac; the small intestine is dilated. (with permission from Ref. [
CT scan transverse section. (with permission from Ref. [
Once the diagnosis is obtained or in the diagnostic suspicion of obturator hernia, therapy is exclusively surgical: in the presence of signs of intestinal obstruction or incarceration, surgical exploration is mandatory. The manual reduction of an incarcerated obturator hernia has been described in cases of patients considered unfit for surgery, but two aspects must be considered: the early recurrence and the impossibility to explore the incarcerated viscera in case of possible evolution to gangrene or bowel infarction. If the incarcerated obturator hernia is not treated, it can be fatal and in any case, should always be repaired both in case of urgency and in case of non-acute symptomatology attributable to the hernia; it should be remembered that symptoms may persist and then result in incarceration. The current trend is to repair the obturatory foramen with the use of prostheses primarily made of polypropylene; however, if the orifice is less than 1 cm, the approach could also consist of direct repair. Currently, there is no consensus on the repair technique but it is all based on the surgeon’s experience and preference. The different feasible surgical approaches are intraabdominal, inguinal extraperitoneal, obturator or crural, Cheatle–Henry retropubic and laparoscopic approach [24, 25, 26, 27].
In an emergency set-up usually, a midline incision by laparotomy is required to allow a wider exposure of the obturator ring, the pelvic floor and the lower abdomen, especially in the case of gangrenous bowel resection. Uncoiling the bowel discovers the dilated tract at the border with the strangulated one, usually with a lateral clamping: it is necessary to gently pull the bowel to reduce it in the abdomen avoiding rupture that would lead to septic contamination. The bowel is treated as in all cases of strangulation, preserving or resecting it depending on the degree of intestinal wall perfusion. Suturing the small orifice can be done with several techniques: simple direct closure with several stitches, two layers closure of peritoneum (Figure 7). For large defect: patching and plugging the canal with rib cartilage, peritoneal patch, periosteal patch, pectineal or adductor longus muscle flap with external oblique aponeurosis, greater omentum, round ligament, uterine fundus, ovary, urinary bladder wall, ox fascia, tantalum gauze, teflon cloth, marlex mesh, oxidized cellulose gauze (oxycel), polytetrafluoroethylene (PTFE), polypropylene mesh, Kugel patch, permacol patch plug [19] of mersilene, rolled up marlex mesh as a “cigar roll” plug and titanium alloy staples without mesh [24, 25, 26, 27, 28].
Trocars placement in obturator hernia laparoscopic repair.
The laparoscopic approach, both–trans-abdominal pre-peritoneal (TAPP) or total extraperitoneal (TEP) [29], is feasible in expert settings: the position of the trocars, patient and operators is similar to that of the TAPP and TEP repair for inguinal hernia (Figure 8) [30, 31, 32]. Placement of a double-layer prosthesis is not recommended in the same manner as in abdominal wall hernias because the peripheral anchorage is not safe due to the presence of vascular and nerve structures. It is necessary to proceed as in TAPP repair for inguinal hernia: the peritoneum is dissected above the inguinal dimples, the dissection is conducted lower than the orifice of the obturator canal, the sac is reduced in the abdomen, and the prosthesis is placed in the extraperitoneal space with an overlap of at least 3–4 cm. The peritoneum is sutured above the prosthesis.
The obturator orifice (A) is repaired with direct intra-abdominal suture (B). (with permission from Ref. [
The procedure is similar to the Stoppa inguinal hernia repair. Through a median or Pfannenstiel incision, the Retzius’ space is dissected, posterior to the pubic symphysis, the dissection is extended laterally to the antero-superior iliac spine. The peritoneum is detached from the anterior abdominal wall and the epigastric vessels are left attached. Once the sac is reduced in the abdomen, it is possible to place a large prosthesis covering the inguinal, femoral and obturator region attached to the transverse and rectus abdominis muscles medially and on the pubic symphysis inferiorly.
A 10-cm vertical incision is made on the medial margin of the femoral triangle medial to the femoral vessels and adductor muscles, passed by blunt dissection between the pectinate and middle adductor muscles. The sac can be resected and the orifice closed with a plug or direct suture. This approach is not the recommended one [3].
Other possible approaches can be performed via combined abdomino-crural, cruro-obturator, inguino-obturator, subcrural intraperitoneal [33, 34, 35]. The obturator dimple can be repaired using a direct suture (Figure 9), with a recurrence rate lower than 3%, or use a resorbable mesh or plug [36, 37]. Patches of peritoneum or omentum may be used in cases of small orifices [38, 39].
Primary laparoscopic repair by using non-absorbable suture. (with permission from Ref. [
Due to its rarity of presentation obturator hernia presents a diagnostic challenge and should be included in the differential diagnosis of intestinal obstruction of unknown origin, especially in emaciated elderly women with chronic disease; a prompt suspect based on aspecific symptoms is crucial for the diagnosis. CT scan has a major sensitivity than other radiological exams. Late diagnosis of obturator hernia can lead to ischemia and bowel necrosis with bowel perforation and then localized or generalized peritonitis as a life-threatening condition. Postoperative complications have been reported in 11.6% of patients as pneumonia, sepsis, wound infection [40, 41] and mesh migration which may be prevented with metal anchors [42, 43]. The resultant morbidity and mortality rates are around 38% and 12–70%, respectively. Surgical management depends on early diagnosis and it is the only possible treatment for this pathology [4].
This work has been funded by AUSL Piacenza, Unit of Research and Quality.
Dr. Conti conceived the book chapter; Dr. Conti and Dr. Bonfili wrote the chapter and processed the images. Dr. Baldini and Dr. Conti performed the surgery. Dr. Cattaneo, Dr. Grassi, Dr. Banchini and Dr. Capelli reviewed the literature. All authors reviewed and approved the chapter.
The authors declare no conflict of interest.
We would like to thank the physicians of the Acute Care Surgery team of AUSL Piacenza, Dr. Sonia Agrusti, Dr. Mauro Filosa, Dr. Luigi Percalli, Dr. Gabriele Regina, Dr. Giandomenico Arzu, Dr. Giancarlo Giannone and Dr. Antonio Caizzone for their contributions and expertise in the field of hernia surgery.
We would also like to thank the editor Elsevier-Masson, SAS Paris, for the kind permission to reuse the iconography from the EMC Surgical techniques book.
IntechOpen implements a robust policy to minimize and deal with instances of fraud or misconduct. As part of our general commitment to transparency and openness, and in order to maintain high scientific standards, we have a well-defined editorial policy regarding Retractions and Corrections.
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\\n\\nA Statement of Concern detailing alleged misconduct will be issued by the Academic Editor or publisher following a 3rd party report of scientific misconduct when:
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\\n\\n3.1. ERRATUM
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\\n\\nA published Erratum will adhere to the Retraction Notice publishing guidelines outlined above.
\\n\\n3.2. CORRIGENDUM
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\\n\\n4. FINAL REMARKS
\\n\\nIntechOpen wishes to emphasize that the final decision on whether a Retraction, Statement of Concern, or a Correction will be issued rests with the Academic Editor. The publisher is obliged to act upon any reports of scientific misconduct in its publications and to make a reasonable effort to facilitate any subsequent investigation of such claims.
\\n\\nIn the case of Retraction or removal of the Work, the publisher will be under no obligation to refund the APC.
\\n\\nThe general principles set out above apply to Retractions and Corrections issued in all IntechOpen publications.
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\n\nA formal Retraction will be issued when there is clear and conclusive evidence of any of the following:
\n\nPublishing of a Retraction Notice will adhere to the following guidelines:
\n\n1.2. REMOVALS AND CANCELLATIONS
\n\n2. STATEMENTS OF CONCERN
\n\nA Statement of Concern detailing alleged misconduct will be issued by the Academic Editor or publisher following a 3rd party report of scientific misconduct when:
\n\nIntechOpen believes that the number of occasions on which a Statement of Concern is issued will be very few in number. In all cases when such a decision has been taken by the Academic Editor the decision will be reviewed by another editor to whom the author can make representations.
\n\n3. CORRECTIONS
\n\nA Correction will be issued by the Academic Editor when:
\n\n3.1. ERRATUM
\n\nAn Erratum will be issued by the Academic Editor when it is determined that a mistake in a Chapter originates from the production process handled by the publisher.
\n\nA published Erratum will adhere to the Retraction Notice publishing guidelines outlined above.
\n\n3.2. CORRIGENDUM
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\n\n4. FINAL REMARKS
\n\nIntechOpen wishes to emphasize that the final decision on whether a Retraction, Statement of Concern, or a Correction will be issued rests with the Academic Editor. The publisher is obliged to act upon any reports of scientific misconduct in its publications and to make a reasonable effort to facilitate any subsequent investigation of such claims.
\n\nIn the case of Retraction or removal of the Work, the publisher will be under no obligation to refund the APC.
\n\nThe general principles set out above apply to Retractions and Corrections issued in all IntechOpen publications.
\n\nAny suggestions or comments on this Policy are welcome and may be sent to permissions@intechopen.com.
\n\nPolicy last updated: 2017-09-11
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As this indicates, their removal is insufficient by means of conventional modern water treatment techniques. In the search for a cost-effective solution, advanced oxidation processes have recently gained more attention since they are the most effective available techniques to decompose biorecalcitrant organics. As a main drawback, however, their energy costs are high up to now, preventing their implementation on large scale. For the specific case of water treatment by means of electrical discharge, further optimization is a complex task due to the wide variety in reactor design and materials, discharge types, and operational parameters. In this chapter, an extended overview is given on plasma reactor types, based on their design and materials. Influence of design and materials on energy efficiency is investigated, as well as the influence of operational parameters. 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This is seen with, for example, refractive-index sensing, detection of ad−/desorption and ligand-exchange processes, as well as ultrasensitive chemical sensing utilizing well-defined nanocrystals or discrete self-assembled superstructures in 2D and 3D. Apart from individual NPs, the rational design of self-assembled nanostructures grants spectroscopic access to unprecedented physicochemical information. This involves selected research examples on molecular trapping, ligand corona analysis, SERS-encoding, and biosensing. The origin of the SERS effect, also in regard to hot spot formation by off-resonant excitation, is reviewed and discussed in the context of the current challenge to formulate a generalized metric for high SERS efficiency. 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The possible interferences of atomic or molecular species are used to specify organic, inorganic or biological materials which allows critical applications in defense (landmines, explosive, forensic (trace of explosive or organic materials), public health (toxic substances pharmaceutical products), or environment (organic wastes). Laser induced plasma for organic material potentially provide fast sensor systems for explosive trace and pathogen biological agent detection and analysis. The laser ablation process starts with electronic energy absorption (~fs) and ends at particle recondensation (~ms). Then, the ablation process can be governed by thermal, non-thermal processes or a combination of both. There are several types of models, i.e., thermal, mechanical, photophysical, photochemical and defect models, which describe the ablation process by one dominant mechanism only. Plasma ignition process includes bond breaking and plasma shielding during the laser pulse. Bond breaking mechanisms influence the quantity and form of energy (kinetic, ionization and excitation) that atoms and ions can acquire. Plasma expansion depends on the initial mass and energy in the plume. The process is governed by initial plasma properties (electron density, temperature, velocity) after the laser pulse and the expansion medium. During first microsecond after the laser pulse, plume expansion is adiabatic afterwards line radiation becomes the dominant mechanism of energy loss.",book:{id:"5093",slug:"plasma-science-and-technology-progress-in-physical-states-and-chemical-reactions",title:"Plasma Science and Technology",fullTitle:"Plasma Science and Technology - Progress in Physical States and Chemical Reactions"},signatures:"Kashif Chaudhary, Syed Zuhaib Haider Rizvi and Jalil Ali",authors:[{id:"176684",title:"Dr.",name:"Kashif Tufail",middleName:null,surname:"Chaudhary",slug:"kashif-tufail-chaudhary",fullName:"Kashif Tufail Chaudhary"},{id:"176867",title:"Dr.",name:"Syed Zuhaib",middleName:null,surname:"Haider Rizivi",slug:"syed-zuhaib-haider-rizivi",fullName:"Syed Zuhaib Haider Rizivi"},{id:"176868",title:"Prof.",name:"Jalil",middleName:null,surname:"Ali",slug:"jalil-ali",fullName:"Jalil Ali"}]},{id:"63194",doi:"10.5772/intechopen.80433",title:"Electrical Diagnostics of Dielectric Barrier Discharges",slug:"electrical-diagnostics-of-dielectric-barrier-discharges",totalDownloads:1967,totalCrossrefCites:6,totalDimensionsCites:14,abstract:"Atmospheric pressure dielectric barrier discharges (DBD) has many industrial applications and remains a focus of academic research. This chapter provides a thorough overview of electrical diagnostics for DBD, with a specific focus on charge-voltage measurement techniques. These methods are often underutilised in the existing scientific literature, despite the fact that they can provide useful insights into plasma behaviour. Both optimization of the electrical measurement setup and the interpretation of results are treated in-depth. The diagnostic techniques are discussed for a range of applications, from classic planar DBDs, to catalyst packed beds, plasma actuators, as well as techniques for measuring single microdischarges.",book:{id:"7393",slug:"atmospheric-pressure-plasma-from-diagnostics-to-applications",title:"Atmospheric Pressure Plasma",fullTitle:"Atmospheric Pressure Plasma - from Diagnostics to Applications"},signatures:"Floran Peeters and Tom Butterworth",authors:null},{id:"64351",doi:"10.5772/intechopen.80798",title:"Progress in Plasma-Assisted Catalysis for Carbon Dioxide Reduction",slug:"progress-in-plasma-assisted-catalysis-for-carbon-dioxide-reduction",totalDownloads:1895,totalCrossrefCites:3,totalDimensionsCites:13,abstract:"Production of chemicals and fuels based on CO2 conversion is attracting a special attention nowadays, especially regarding the fast depletion of fossil resources and increase of CO2 emissions into the Earth’s atmosphere. Recently, plasma technology has gained increasing interest as a non-equilibrium medium suitable for CO2 conversion, which provides a promising alternative to the conventional pathway for greenhouse gas conversion. The combination of plasma and catalysis is of great interest for turning plasma chemistry in applications related to pollution and energy issues. In this chapter a short review of the current progress in plasma-assisted catalytic processes for CO2 reduction is given. The most widely used discharges for CO2 conversion are presented and briefly discussed, illustrating how to achieve a better energy and conversion efficiency. The chapter includes the recent status and advances of the most promising candidates (plasma catalysis) to obtain efficient CO2 conversion, along with the future outlook of this plasma-assisted catalytic process for further improvement.",book:{id:"7502",slug:"plasma-chemistry-and-gas-conversion",title:"Plasma Chemistry and Gas Conversion",fullTitle:"Plasma Chemistry and Gas Conversion"},signatures:"Guoxing Chen, Ling Wang, Thomas Godfroid and Rony Snyders",authors:[{id:"199226",title:"Mr.",name:"Guoxing",middleName:null,surname:"Chen",slug:"guoxing-chen",fullName:"Guoxing Chen"}]}],mostDownloadedChaptersLast30Days:[{id:"49562",title:"Laser-Induced Plasma and its Applications",slug:"laser-induced-plasma-and-its-applications",totalDownloads:4645,totalCrossrefCites:11,totalDimensionsCites:25,abstract:"The laser irradiation have shown a range of applications from fabricating, melting, and evaporating nanoparticles to changing their shape, structure, size, and size distribution. Laser induced plasma has used for different diagnostic and technological applications as detection, thin film deposition, and elemental identification. The possible interferences of atomic or molecular species are used to specify organic, inorganic or biological materials which allows critical applications in defense (landmines, explosive, forensic (trace of explosive or organic materials), public health (toxic substances pharmaceutical products), or environment (organic wastes). Laser induced plasma for organic material potentially provide fast sensor systems for explosive trace and pathogen biological agent detection and analysis. The laser ablation process starts with electronic energy absorption (~fs) and ends at particle recondensation (~ms). Then, the ablation process can be governed by thermal, non-thermal processes or a combination of both. There are several types of models, i.e., thermal, mechanical, photophysical, photochemical and defect models, which describe the ablation process by one dominant mechanism only. Plasma ignition process includes bond breaking and plasma shielding during the laser pulse. Bond breaking mechanisms influence the quantity and form of energy (kinetic, ionization and excitation) that atoms and ions can acquire. Plasma expansion depends on the initial mass and energy in the plume. The process is governed by initial plasma properties (electron density, temperature, velocity) after the laser pulse and the expansion medium. During first microsecond after the laser pulse, plume expansion is adiabatic afterwards line radiation becomes the dominant mechanism of energy loss.",book:{id:"5093",slug:"plasma-science-and-technology-progress-in-physical-states-and-chemical-reactions",title:"Plasma Science and Technology",fullTitle:"Plasma Science and Technology - Progress in Physical States and Chemical Reactions"},signatures:"Kashif Chaudhary, Syed Zuhaib Haider Rizvi and Jalil Ali",authors:[{id:"176684",title:"Dr.",name:"Kashif Tufail",middleName:null,surname:"Chaudhary",slug:"kashif-tufail-chaudhary",fullName:"Kashif Tufail Chaudhary"},{id:"176867",title:"Dr.",name:"Syed Zuhaib",middleName:null,surname:"Haider Rizivi",slug:"syed-zuhaib-haider-rizivi",fullName:"Syed Zuhaib Haider Rizivi"},{id:"176868",title:"Prof.",name:"Jalil",middleName:null,surname:"Ali",slug:"jalil-ali",fullName:"Jalil Ali"}]},{id:"67663",title:"Electrical Breakdown Behaviors in Microgaps",slug:"electrical-breakdown-behaviors-in-microgaps",totalDownloads:1191,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The study of electrical breakdown behaviors in microgaps has drawn intensive attention around the world due to the miniaturization of electronic devices that allows electronic circuits to be packaged more densely, making possible compact computers, advanced radar and navigation systems, and other devices that use very large numbers of components. Therefore, a clear understanding of the electrical breakdown behaviors in microgaps is required to avoid the dielectric breakdown or to trigger the breakdown at microscale. This chapter introduces the significance of understanding breakdown characterization and reliability assessment for electrostatically actuated devices, magnetic recording devices, photomasks, RF MEMS switches, and micromachines and points out the derivation of the classical Paschen’s law at microscale. Then it summarizes the state-of-the-art research work on the methodology, influencing factors, dynamics, and physical mechanisms of electrical breakdown in microgaps, which is expected to expand the general knowledge of electrical breakdown to the microscale regime or more and benefits the reliability assessment and ESD protection of microscale and nanoscale devices.",book:{id:"8856",slug:"electrostatic-discharge-from-electrical-breakdown-in-micro-gaps-to-nano-generators",title:"Electrostatic Discharge",fullTitle:"Electrostatic Discharge - From Electrical breakdown in Micro-gaps to Nano-generators"},signatures:"Guodong Meng and Yonghong Cheng",authors:null},{id:"66524",title:"Low-C ESD Protection Design in CMOS Technology",slug:"low-c-esd-protection-design-in-cmos-technology",totalDownloads:1584,totalCrossrefCites:1,totalDimensionsCites:0,abstract:"Electrostatic discharge (ESD) protection design is needed for integrated circuits in CMOS technology. The choice for ESD protection devices in the CMOS technology includes diode, MOSFET, and silicon controlled rectifier (SCR). These ESD protection devices cause signal losses at high-frequency input/output (I/O) pads due to the parasitic capacitance. To minimize the impacts from ESD protection circuit on high-frequency performances, ESD protection circuit at I/O pads must be carefully designed. A review on ESD protection designs with low parasitic capacitance for high-frequency applications in CMOS technology is presented in this chapter. With the reduced parasitic capacitance, ESD protection circuit can be easily combined or co-designed with high-frequency circuits. As the operating frequencies of high-frequency circuits increase, on-chip ESD protection designs for high-frequency applications will continuously be an important design task.",book:{id:"8856",slug:"electrostatic-discharge-from-electrical-breakdown-in-micro-gaps-to-nano-generators",title:"Electrostatic Discharge",fullTitle:"Electrostatic Discharge - From Electrical breakdown in Micro-gaps to Nano-generators"},signatures:"Chun-Yu Lin",authors:null},{id:"67235",title:"Nanogenerators from Electrical Discharge",slug:"nanogenerators-from-electrical-discharge",totalDownloads:1060,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Electrical discharge is generally considered as a negative effect in the electronic industry and often causes electrostatic discharge (ESD) and thus failure of electronic components and integrated circuits (IC). However, this effect was recently used to develop a new energy-harvesting technology, direct-current triboelectric nanogenerator (DC-TENG). In this chapter, its fundamental mechanism and the working modes of the nanogenerator will be presented. They are different from the general alternating current TENG (AC-TENG) invented in 2012, which is based on triboelectrification and electrostatic induction. Taking advantage of the electrostatic discharge, it can not only promote the miniaturization trend of TENG and self-powered systems, but also provide a paradigm shifting technique to in situ gain electrical energy.",book:{id:"8856",slug:"electrostatic-discharge-from-electrical-breakdown-in-micro-gaps-to-nano-generators",title:"Electrostatic Discharge",fullTitle:"Electrostatic Discharge - From Electrical breakdown in Micro-gaps to Nano-generators"},signatures:"Jie Wang, Di Liu, Linglin Zhou and Zhong Lin Wang",authors:null},{id:"62567",title:"Plasma Damage on Low-k Dielectric Materials",slug:"plasma-damage-on-low-k-dielectric-materials",totalDownloads:1572,totalCrossrefCites:1,totalDimensionsCites:4,abstract:"Low dielectric constant (low-k) materials as an interconnecting insulator in integrated circuits are essential for resistance-capacitance (RC) time delay reduction. Plasma technology is widely used for the fabrication of the interconnects, such as dielectric etching, resisting ashing or stripping, barrier metal deposition, and surface treatment. During these processes, low-k dielectric materials may be exposed to the plasma environments. The generated reactive species from the plasma react with the low-k dielectric materials. The reaction involves physical and chemical effects, causing degradations for low-k dielectric materials. This is called “plasma damage” on low-k dielectric materials. Therefore, this chapter is an attempt to provide an overview of plasma damage on the low-k dielectric materials.",book:{id:"6735",slug:"plasma-science-and-technology-basic-fundamentals-and-modern-applications",title:"Plasma Science and Technology",fullTitle:"Plasma Science and Technology - Basic Fundamentals and Modern Applications"},signatures:"Yi-Lung Cheng, Chih-Yen Lee and Chiao-Wei Haung",authors:[{id:"59549",title:"Prof.",name:"Yi-Lung",middleName:null,surname:"Cheng",slug:"yi-lung-cheng",fullName:"Yi-Lung Cheng"}]}],onlineFirstChaptersFilter:{topicId:"229",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:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:99,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:289,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:104,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:12,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,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. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"10",title:"Physiology",doi:"10.5772/intechopen.72796",issn:"2631-8261",scope:"Modern physiology requires a comprehensive understanding of the integration of tissues and organs throughout the mammalian body, including the cooperation between structure and function at the cellular and molecular levels governed by gene and protein expression. While a daunting task, learning is facilitated by identifying common and effective signaling pathways mediated by a variety of factors employed by nature to preserve and sustain homeostatic life. \r\nAs a leading example, the cellular interaction between intracellular concentration of Ca+2 increases, and changes in plasma membrane potential is integral for coordinating blood flow, governing the exocytosis of neurotransmitters, and modulating gene expression and cell effector secretory functions. Furthermore, in this manner, understanding the systemic interaction between the cardiovascular and nervous systems has become more important than ever as human populations' life prolongation, aging and mechanisms of cellular oxidative signaling are utilised for sustaining life. \r\nAltogether, physiological research enables our identification of distinct and precise points of transition from health to the development of multimorbidity throughout the inevitable aging disorders (e.g., diabetes, hypertension, chronic kidney disease, heart failure, peptic ulcer, inflammatory bowel disease, age-related macular degeneration, cancer). With consideration of all organ systems (e.g., brain, heart, lung, gut, skeletal and smooth muscle, liver, pancreas, kidney, eye) and the interactions thereof, this Physiology Series will address the goals of resolving (1) Aging physiology and chronic disease progression (2) Examination of key cellular pathways as they relate to calcium, oxidative stress, and electrical signaling, and (3) how changes in plasma membrane produced by lipid peroxidation products can affect aging physiology, covering new research in the area of cell, human, plant and animal physiology.",coverUrl:"https://cdn.intechopen.com/series/covers/10.jpg",latestPublicationDate:"May 14th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:11,editor:{id:"35854",title:"Prof.",name:"Tomasz",middleName:null,surname:"Brzozowski",slug:"tomasz-brzozowski",fullName:"Tomasz Brzozowski",profilePictureURL:"https://mts.intechopen.com/storage/users/35854/images/system/35854.jpg",biography:"Prof. Dr. Thomas Brzozowski works as a professor of Human Physiology and is currently Chairman at the Department of Physiology and is V-Dean of the Medical Faculty at Jagiellonian University Medical College, Cracow, Poland. His primary area of interest is physiology and pathophysiology of the gastrointestinal (GI) tract, with the major focus on the mechanism of GI mucosal defense, protection, and ulcer healing. He was a postdoctoral NIH fellow at the University of California and the Gastroenterology VA Medical Center, Irvine, Long Beach, CA, USA, and at the Gastroenterology Clinics Erlangen-Nuremberg and Munster in Germany. He has published 290 original articles in some of the most prestigious scientific journals and seven book chapters on the pathophysiology of the GI tract, gastroprotection, ulcer healing, drug therapy of peptic ulcers, hormonal regulation of the gut, and inflammatory bowel disease.",institutionString:null,institution:{name:"Jagiellonian University",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"10",title:"Animal Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/10.jpg",isOpenForSubmission:!0,annualVolume:11406,editor:{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",biography:"Catrin Rutland is an Associate Professor of Anatomy and Developmental Genetics at the University of Nottingham, UK. She obtained a BSc from the University of Derby, England, a master’s degree from Technische Universität München, Germany, and a Ph.D. from the University of Nottingham. She undertook a post-doctoral research fellowship in the School of Medicine before accepting tenure in Veterinary Medicine and Science. Dr. Rutland also obtained an MMedSci (Medical Education) and a Postgraduate Certificate in Higher Education (PGCHE). She is the author of more than sixty peer-reviewed journal articles, twelve books/book chapters, and more than 100 research abstracts in cardiovascular biology and oncology. She is a board member of the European Association of Veterinary Anatomists, Fellow of the Anatomical Society, and Senior Fellow of the Higher Education Academy. Dr. Rutland has also written popular science books for the public. https://orcid.org/0000-0002-2009-4898. www.nottingham.ac.uk/vet/people/catrin.rutland",institutionString:null,institution:{name:"University of Nottingham",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null},{id:"11",title:"Cell Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/11.jpg",isOpenForSubmission:!0,annualVolume:11407,editor:{id:"133493",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",profilePictureURL:"https://mts.intechopen.com/storage/users/133493/images/3091_n.jpg",biography:"Prof. Dr. Angel Catalá \r\nShort Biography Angel Catalá was born in Rodeo (San Juan, Argentina). He studied \r\nchemistry at the Universidad Nacional de La Plata, Argentina, where received aPh.D. degree in chemistry (Biological Branch) in 1965. From\r\n1964 to 1974, he worked as Assistant in Biochemistry at the School of MedicineUniversidad Nacional de La Plata, Argentina. From 1974 to 1976, he was a Fellowof the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor oBiochemistry at the Universidad Nacional de La Plata, Argentina. He is Member ofthe National Research Council (CONICET), Argentina, and Argentine Society foBiochemistry and Molecular Biology (SAIB). His laboratory has been interested for manyears in the lipid peroxidation of biological membranes from various tissues and different species. Professor Catalá has directed twelve doctoral theses, publishedover 100 papers in peer reviewed journals, several chapters in books andtwelve edited books. Angel Catalá received awards at the 40th InternationaConference Biochemistry of Lipids 1999: Dijon (France). W inner of the Bimbo PanAmerican Nutrition, Food Science and Technology Award 2006 and 2012, South AmericaHuman Nutrition, Professional Category. 2006 award in pharmacology, Bernardo\r\nHoussay, in recognition of his meritorious works of research. Angel Catalá belongto the Editorial Board of Journal of lipids, International Review of Biophysical ChemistryFrontiers in Membrane Physiology and Biophysics, World Journal oExperimental Medicine and Biochemistry Research International, W orld Journal oBiological Chemistry, Oxidative Medicine and Cellular Longevity, Diabetes and thePancreas, International Journal of Chronic Diseases & Therapy, International Journal oNutrition, Co-Editor of The Open Biology Journal.",institutionString:null,institution:{name:"National University of La Plata",institutionURL:null,country:{name:"Argentina"}}},editorTwo:null,editorThree:null},{id:"12",title:"Human Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",isOpenForSubmission:!0,annualVolume:11408,editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. His interest later turned to the molecular mechanism and attenuating strategy of sarcopenia (age-related muscle atrophy). His opinion is to attenuate sarcopenia by improving autophagic defects using nutrient- and pharmaceutical-based treatments.",institutionString:null,institution:{name:"Tokyo Institute of Technology",institutionURL:null,country:{name:"Japan"}}},editorTwo:null,editorThree:{id:"331519",title:"Dr.",name:"Kotomi",middleName:null,surname:"Sakai",slug:"kotomi-sakai",fullName:"Kotomi Sakai",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000031QtFXQA0/Profile_Picture_1637053227318",biography:"Senior researcher Kotomi Sakai, Ph.D., MPH, works at the Research Organization of Science and Technology in Ritsumeikan University. She is a researcher in the geriatric rehabilitation and public health field. She received Ph.D. from Nihon University and MPH from St.Luke’s International University. Her main research interest is sarcopenia in older adults, especially its association with nutritional status. Additionally, to understand how to maintain and improve physical function in older adults, to conduct studies about the mechanism of sarcopenia and determine when possible interventions are needed.",institutionString:null,institution:{name:"Ritsumeikan University",institutionURL:null,country:{name:"Japan"}}}},{id:"13",title:"Plant Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/13.jpg",isOpenForSubmission:!0,annualVolume:11409,editor:{id:"332229",title:"Prof.",name:"Jen-Tsung",middleName:null,surname:"Chen",slug:"jen-tsung-chen",fullName:"Jen-Tsung Chen",profilePictureURL:"https://mts.intechopen.com/storage/users/332229/images/system/332229.png",biography:"Dr. Jen-Tsung Chen is currently a professor at the National University of Kaohsiung, Taiwan. He teaches cell biology, genomics, proteomics, medicinal plant biotechnology, and plant tissue culture. Dr. Chen\\'s research interests include bioactive compounds, chromatography techniques, in vitro culture, medicinal plants, phytochemicals, and plant biotechnology. He has published more than ninety scientific papers and serves as an editorial board member for Plant Methods, Biomolecules, and International Journal of Molecular Sciences.",institutionString:"National University of Kaohsiung",institution:{name:"National University of Kaohsiung",institutionURL:null,country:{name:"Taiwan"}}},editorTwo:null,editorThree:null}]},overviewPageOFChapters:{paginationCount:17,paginationItems:[{id:"81791",title:"Self-Supervised Contrastive Representation Learning in Computer Vision",doi:"10.5772/intechopen.104785",signatures:"Yalin Bastanlar and Semih Orhan",slug:"self-supervised-contrastive-representation-learning-in-computer-vision",totalDownloads:12,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Pattern Recognition - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/11442.jpg",subseries:{id:"26",title:"Machine Learning and Data Mining"}}},{id:"79345",title:"Application of Jump Diffusion Models in Insurance Claim Estimation",doi:"10.5772/intechopen.99853",signatures:"Leonard Mushunje, Chiedza Elvina Mashiri, Edina Chandiwana and Maxwell Mashasha",slug:"application-of-jump-diffusion-models-in-insurance-claim-estimation-1",totalDownloads:2,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Data Clustering",coverURL:"https://cdn.intechopen.com/books/images_new/10820.jpg",subseries:{id:"26",title:"Machine Learning and Data Mining"}}},{id:"81557",title:"Object Tracking Using Adapted Optical Flow",doi:"10.5772/intechopen.102863",signatures:"Ronaldo Ferreira, Joaquim José de Castro Ferreira and António José Ribeiro Neves",slug:"object-tracking-using-adapted-optical-flow",totalDownloads:10,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Information Extraction and Object Tracking in Digital Video",coverURL:"https://cdn.intechopen.com/books/images_new/10652.jpg",subseries:{id:"24",title:"Computer Vision"}}},{id:"81558",title:"Thresholding Image Techniques for Plant Segmentation",doi:"10.5772/intechopen.104587",signatures:"Miguel Ángel Castillo-Martínez, Francisco Javier Gallegos-Funes, Blanca E. Carvajal-Gámez, Guillermo Urriolagoitia-Sosa and Alberto J. 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