Classification of endoleaks and endotension after endovascular aortic repair.
\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\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:"5351",leadTitle:null,fullTitle:"Contemporary Challenges in Endocarditis",title:"Contemporary Challenges in Endocarditis",subtitle:null,reviewType:"peer-reviewed",abstract:"Endocarditis remains an elusive challenge for clinicians to master. As the population ages and their comorbidities increase, the risk of infecting cardiac structures - both native and, the ever-increasing use of, prosthetic support technology - also increases. In addition, the global epidemic of intravenous substance abuse has also resulted in a substantial increase in the number of infected patients. Fortunately, advances in the diagnostic testing, imaging, and recognition of the importance of a multidisciplinary management team have also contributed to advances in the care of these critically ill patients. Nevertheless, optimal therapies need to be individualized and considered in the ever-increasing body of scientific literature on this complex and difficult problem.",isbn:"978-953-51-2770-3",printIsbn:"978-953-51-2769-7",pdfIsbn:"978-953-51-7323-6",doi:"10.5772/62550",price:119,priceEur:129,priceUsd:155,slug:"contemporary-challenges-in-endocarditis",numberOfPages:178,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"7e56ebec7c0e74f37026b3ed08826e75",bookSignature:"Michael S. Firstenberg",publishedDate:"November 9th 2016",coverURL:"https://cdn.intechopen.com/books/images_new/5351.jpg",numberOfDownloads:18485,numberOfWosCitations:13,numberOfCrossrefCitations:15,numberOfCrossrefCitationsByBook:1,numberOfDimensionsCitations:26,numberOfDimensionsCitationsByBook:1,hasAltmetrics:1,numberOfTotalCitations:54,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 23rd 2016",dateEndSecondStepPublish:"March 15th 2016",dateEndThirdStepPublish:"June 19th 2016",dateEndFourthStepPublish:"September 17th 2016",dateEndFifthStepPublish:"October 17th 2016",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"64343",title:"Dr.",name:"Michael S.",middleName:null,surname:"Firstenberg",slug:"michael-s.-firstenberg",fullName:"Michael S. Firstenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/64343/images/system/64343.png",biography:"Dr. Michael S. Firstenberg is a thoracic surgeon at the St. Elizabeth Medical Center (Ascension), Appleton, Wisconsin. He attended Case Western Reserve University Medical School, Cleveland, OH, received his general surgery training at University Hospitals in Cleveland, and completed thoracic surgery fellowships at The Ohio State University and the Cleveland Clinic. He is an active member of the Society of Thoracic Surgeons (STS), American Association of Thoracic Surgeons (AATS), American College of Cardiology (ACC), and American College of Academic International Medicine (ACAIM), for which he served as president in 2021–2022. He has authored more than 250 peer-reviewed manuscripts, abstracts, and book chapters and has edited several textbooks and lectured worldwide on topics ranging from medical leadership, COVID-19, endocarditis, and extra-corporeal membrane oxygenation (ECMO).",institutionString:"St. Elizabeth Medical Center",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"26",totalChapterViews:"0",totalEditedBooks:"13",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"989",title:"Pediatric Cardiology",slug:"pediatric-cardiology"}],chapters:[{id:"52847",title:"Introductory Chapter: Endocarditis - A Diagnostic and Therapeutic Challenge",doi:"10.5772/66406",slug:"introductory-chapter-endocarditis-a-diagnostic-and-therapeutic-challenge",totalDownloads:1727,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:null,signatures:"Michael S. Firstenberg",downloadPdfUrl:"/chapter/pdf-download/52847",previewPdfUrl:"/chapter/pdf-preview/52847",authors:[{id:"64343",title:"Dr.",name:"Michael S.",surname:"Firstenberg",slug:"michael-s.-firstenberg",fullName:"Michael S. Firstenberg"}],corrections:null},{id:"52336",title:"Antibiotic Prophylactic Regimens for Infective Endocarditis in Patients Undergoing Dental Procedures",doi:"10.5772/65255",slug:"antibiotic-prophylactic-regimens-for-infective-endocarditis-in-patients-undergoing-dental-procedures",totalDownloads:1995,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Up to date causal relationship has been demonstrated between dental manipulations and the onset of infective endocarditis (IE). However, since 1955, numerous expert committees have proposed antibiotic prophylaxis (AP) to prevent bacteraemia of oral origin. Controversy regarding the efficacy of AP prior to the dental procedures has intensified in recent years because of the lack of conclusive evidence on its efficacy for the prevention of IE and on its cost-effectiveness, as well as the possibility of allergic reactions and the emergence of antibiotic resistance. Accordingly, AP is now maintained exclusively for patients at highest risk and who require the manipulation of the gingival or periapical regions of the teeth or perforation of the oral mucosa. In the context of a restrictive policy, the National Institute for Health and Clinical Excellence (NICE) of the United Kingdom published a new guideline in 2008 stating that “AP against IE is not recommended for persons undergoing dental procedures”, regardless of risk status and of the nature of the procedure to be performed. The NICE guideline has generated further controversy, and expert committees in other countries continue to publish prophylactic regimens for the prevention of IE secondary to dental procedures. In this chapter, we discuss the principal guidelines currently applicable in Europe, the USA and Australia, and we draw particular attention to the need for randomised clinical trials.",signatures:"Miguel Castro, Javier Álvarez, Javier F. Feijoo, Marcio Diniz, Lucía\nGarcía-Caballero, Pedro Diz and Jacobo Limeres",downloadPdfUrl:"/chapter/pdf-download/52336",previewPdfUrl:"/chapter/pdf-preview/52336",authors:[{id:"98186",title:"Dr.",name:"Pedro",surname:"Diz-Dios",slug:"pedro-diz-dios",fullName:"Pedro Diz-Dios"},{id:"187405",title:"Dr.",name:"Marcio",surname:"Diniz-Freitas",slug:"marcio-diniz-freitas",fullName:"Marcio Diniz-Freitas"},{id:"187408",title:"Dr.",name:"Jacobo",surname:"Limeres",slug:"jacobo-limeres",fullName:"Jacobo Limeres"},{id:"194724",title:"Prof.",name:"Miguel",surname:"Castro",slug:"miguel-castro",fullName:"Miguel Castro"},{id:"194725",title:"Dr.",name:"Francisco-Javier",surname:"Alvarez",slug:"francisco-javier-alvarez",fullName:"Francisco-Javier Alvarez"},{id:"194726",title:"Dr.",name:"Javier",surname:"Fernandez-Feijoo",slug:"javier-fernandez-feijoo",fullName:"Javier Fernandez-Feijoo"},{id:"194727",title:"Dr.",name:"Lucia",surname:"Garcia-Caballero",slug:"lucia-garcia-caballero",fullName:"Lucia Garcia-Caballero"}],corrections:null},{id:"52185",title:"Epidemiology of Infective Endocarditis",doi:"10.5772/65030",slug:"epidemiology-of-infective-endocarditis",totalDownloads:2429,totalCrossrefCites:2,totalDimensionsCites:6,hasAltmetrics:0,abstract:"Infective endocarditis is a rare disease, with an incidence of two to six episodes per 100,000 habitants/year. Incidence is higher in elderly people; besides, this group is often affected by many comorbidities. There is a clear and observable change in the spectrum of heart diseases predisposing to infective endocarditis in the last decades. Up to one-third of the patients acquire the disease on a health-care-associated environment. Despite advances in health-care logistics, infective endocarditis remains a big concern especially in low-income countries, where the main cause of infection is rheumatic fever. In-hospital mortality persists relatively high despite development in medical and surgical treatment. Patients with infective endocarditis need rapid response and prompt diagnosis from a multidisciplinary group including cardiologists, surgeons, infectologists, and radiologists.",signatures:"Fabian Andres Giraldo Vallejo",downloadPdfUrl:"/chapter/pdf-download/52185",previewPdfUrl:"/chapter/pdf-preview/52185",authors:[{id:"188071",title:"Dr.",name:"Fabian",surname:"Giraldo",slug:"fabian-giraldo",fullName:"Fabian Giraldo"}],corrections:null},{id:"52157",title:"Advanced Echocardiography for the Diagnosis and Management of Infective Endocarditis",doi:"10.5772/64800",slug:"advanced-echocardiography-for-the-diagnosis-and-management-of-infective-endocarditis",totalDownloads:3148,totalCrossrefCites:3,totalDimensionsCites:5,hasAltmetrics:0,abstract:"Echocardiography is fundamental for the management of infective endocarditis (IE) across all stages of the illness including diagnosis, surveillance during medical therapy, identification of prognostic markers, planning perioperative intervention, postoperative assessment, and follow-up after completion of definitive therapy. Modern era echocardiography (echo) offers outstanding temporal and spatial image resolution, providing the opportunity for early diagnosis of this life-threatening infection. Emerging imaging modalities, such as real-time three-dimensional (3D) echocardiography, offer a novel way of readily visualizing the extent of intracardiac infection and the relationship of pathology to adjacent cardiac structures, well before surgical intervention, without radiation exposure or significant risk to the patient. Echocardiography can have a positive impact on the management of every stage of this disease, with the opportunity to improve outcomes.",signatures:"John F. Sedgwick and Gregory M. Scalia",downloadPdfUrl:"/chapter/pdf-download/52157",previewPdfUrl:"/chapter/pdf-preview/52157",authors:[{id:"185698",title:"Prof.",name:"Gregory",surname:"Scalia",slug:"gregory-scalia",fullName:"Gregory Scalia"},{id:"205151",title:"Dr.",name:"John",surname:"Sedgwick",slug:"john-sedgwick",fullName:"John Sedgwick"}],corrections:null},{id:"52392",title:"Ocular Manifestations of Endocarditis",doi:"10.5772/65313",slug:"ocular-manifestations-of-endocarditis",totalDownloads:1933,totalCrossrefCites:3,totalDimensionsCites:3,hasAltmetrics:1,abstract:"Endocarditis is an inflammation of the inside lining of the heart chambers and heart valves. Ocular manifestations are nonspecific and could reveal the disease, justifying routine ocular examination. Staphylococcus aureus is the most incriminated in ocular complications. Endophthalmitis, retinal arterial occlusion, Roth dots, or vitreal and retinal infiltrations could be seen with endocarditis. Ocular prognosis in endophthalmitis and retinal arterial occlusion is poor. Ocular involvement was independently associated with death in infective endocarditis.",signatures:"Cheima Wathek and Riadh Rannen",downloadPdfUrl:"/chapter/pdf-download/52392",previewPdfUrl:"/chapter/pdf-preview/52392",authors:[{id:"185720",title:"M.D.",name:"Cheima",surname:"Wathek",slug:"cheima-wathek",fullName:"Cheima Wathek"}],corrections:null},{id:"52144",title:"Culture Negative Endocarditis: Advances in Diagnosis and Treatment",doi:"10.5772/64920",slug:"culture-negative-endocarditis-advances-in-diagnosis-and-treatment",totalDownloads:2701,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Culture-negative endocarditis (CNE) is a challenging clinical entity, both diagnostically and therapeutically. In this chapter, the changed epidemiology and microbiology of CNE are reviewed with cases highlighting typical pathogens in patients pre-treated with antibiotics, less common fastidious pathogens such as bacteria of the HACEK group, nutritionally deficient bacteria, Legionella spp. and Mycobacteria, “quintessential” CNE pathogens such as Bartonella spp., Coxiella burnetti and Tropheryma whipplei, as well as fungal CNE. Contemporary diagnostic methods are reviewed including polymerase chain reaction-based pathogen 16s RNA amplification coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). Finally, treatment options per the recently updated 2015 American Heart Association and European Society for Cardiology guideline are presented.",signatures:"Marion J. Skalweit",downloadPdfUrl:"/chapter/pdf-download/52144",previewPdfUrl:"/chapter/pdf-preview/52144",authors:[{id:"186717",title:"Associate Prof.",name:"Marion",surname:"Skalweit",slug:"marion-skalweit",fullName:"Marion Skalweit"}],corrections:null},{id:"52390",title:"Infective Endocarditis in End-Stage Renal Disease Patients in Developing Countries: What is the Real Problem?",doi:"10.5772/64929",slug:"infective-endocarditis-in-end-stage-renal-disease-patients-in-developing-countries-what-is-the-real-",totalDownloads:1700,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The epidemiology of infective endocarditis (IE) has changed over the last decades, due to various factors. This chapter focuses on IE in patients with end-stage renal disease. Then it reviews the most relevant reports published in the last decade worldwide; the different scenarios in developing countries versus developed countries; different microorganisms, treatment times, and outcomes; and also our own experience in these patients. Finally, it mentions the recommendations that have helped some developed countries to reduce more than 50% of bacteremia in catheter patients and how to make them possible in developing countries.",signatures:"Díaz-García Héctor Rafael, Contreras-de la Torre Nancy Anabel,\nAlemán-Villalobos Alfonso, Carrillo-Galindo María de Jesús, Gómez-\nJiménez Olivia Berenice, Esparza-Beléndez Edgar, Ramírez-Rosales\nGladys Eloísa, Portilla-d Buen Eliseo and Arreola-Torres Ramón",downloadPdfUrl:"/chapter/pdf-download/52390",previewPdfUrl:"/chapter/pdf-preview/52390",authors:[{id:"190685",title:"Dr.",name:"Héctor",surname:"Díaz García",slug:"hector-diaz-garcia",fullName:"Héctor Díaz García"},{id:"193856",title:"Dr.",name:"Nancy Anabel",surname:"Contreras-De La Torre",slug:"nancy-anabel-contreras-de-la-torre",fullName:"Nancy Anabel Contreras-De La Torre"},{id:"193857",title:"Dr.",name:"Alfonso",surname:"Alemán-Villalobos",slug:"alfonso-aleman-villalobos",fullName:"Alfonso Alemán-Villalobos"},{id:"193858",title:"Dr.",name:"María De Jesús",surname:"Carrillo-Galindo",slug:"maria-de-jesus-carrillo-galindo",fullName:"María De Jesús Carrillo-Galindo"},{id:"193859",title:"Dr.",name:"Olivia Berenice",surname:"Gómez-Jiménez",slug:"olivia-berenice-gomez-jimenez",fullName:"Olivia Berenice Gómez-Jiménez"},{id:"193861",title:"Dr.",name:"Edgar",surname:"Esparza-Beléndez",slug:"edgar-esparza-belendez",fullName:"Edgar Esparza-Beléndez"},{id:"193863",title:"Dr.",name:"Gladys Eloísa",surname:"Ramírez-Rosales",slug:"gladys-eloisa-ramirez-rosales",fullName:"Gladys Eloísa Ramírez-Rosales"},{id:"193864",title:"Dr.",name:"Eliseo",surname:"Portilla- De Buen",slug:"eliseo-portilla-de-buen",fullName:"Eliseo Portilla- De Buen"},{id:"193865",title:"Dr.",name:"Ramón",surname:"Arreola-Torres",slug:"ramon-arreola-torres",fullName:"Ramón Arreola-Torres"}],corrections:null},{id:"52116",title:"Septic Embolism: A Potentially Devastating Complication of Infective Endocarditis",doi:"10.5772/64931",slug:"septic-embolism-a-potentially-devastating-complication-of-infective-endocarditis",totalDownloads:2852,totalCrossrefCites:6,totalDimensionsCites:10,hasAltmetrics:0,abstract:"Infective endocarditis is associated with significant cardiac and noncardiac morbidity. Among many complications, septic embolism has the potential of causing devastating sequelae and even life-threatening clinical situations. This dreaded clinico-pathologic entity is characterized by its heterogeneous presentation and the ability to affect various body systems and organs. Septic emboli to the brain, kidneys, spleen, and the pulmonary system constitute the vast majority of metastatic infections. However, other organ systems can also be affected. This chapter provides an overview of septic embolism associated with infective endocarditis, focusing on key diagnostic and therapeutic considerations in the most commonly seen and clinically relevant scenarios.",signatures:"Thomas R. Wojda, Kristine Cornejo, Andrew Lin, Anthony Cipriano,\nSudip Nanda, Jose D. Amortegui, Barbara T. Wojda and Stanislaw P.\nStawicki",downloadPdfUrl:"/chapter/pdf-download/52116",previewPdfUrl:"/chapter/pdf-preview/52116",authors:[{id:"181694",title:"Dr.",name:"Stanislaw P.",surname:"Stawicki",slug:"stanislaw-p.-stawicki",fullName:"Stanislaw P. Stawicki"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"5202",title:"Extracorporeal Membrane Oxygenation",subtitle:"Advances in Therapy",isOpenForSubmission:!1,hash:"f7c8f9c0cf1cf50455fba7e2607e9268",slug:"extracorporeal-membrane-oxygenation-advances-in-therapy",bookSignature:"Michael S. Firstenberg",coverURL:"https://cdn.intechopen.com/books/images_new/5202.jpg",editedByType:"Edited by",editors:[{id:"64343",title:"Dr.",name:"Michael S.",surname:"Firstenberg",slug:"michael-s.-firstenberg",fullName:"Michael S. 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Firstenberg and Stanislaw P. Stawicki",coverURL:"https://cdn.intechopen.com/books/images_new/5948.jpg",editedByType:"Edited by",editors:[{id:"64343",title:"Dr.",name:"Michael S.",surname:"Firstenberg",slug:"michael-s.-firstenberg",fullName:"Michael S. Firstenberg"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6777",title:"Advances in Extra-corporeal Perfusion Therapies",subtitle:null,isOpenForSubmission:!1,hash:"1e52fb6e834ada962495c512111f684e",slug:"advances-in-extra-corporeal-perfusion-therapies",bookSignature:"Michael S. Firstenberg",coverURL:"https://cdn.intechopen.com/books/images_new/6777.jpg",editedByType:"Edited by",editors:[{id:"64343",title:"Dr.",name:"Michael S.",surname:"Firstenberg",slug:"michael-s.-firstenberg",fullName:"Michael S. 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Since the first endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) was introduced 20 years ago, work toward reducing the morbidity and mortality has never been halted. Technological advances, as well as increased operator experience, have significantly reduced post-EVAR complications, such as peripheral embolization, postimplantation rupture, graft migration, and contrast-induced nephropathy, et al. However, endoleak — the persistent flow of blood within the aneurysm sac — is one of the major reasons for lifelong imaging surveillance.
Endoleaks are often considered significantly adverse event of EVAR since persistentce of blood flow and pressure in the aneurysm sac. It continues to be a challenge in the endovascular approach to AAA repair. Some of these leaks are related to anatomic factors and patient selection, others are device related, and some (especially type II leaks) seem to be intrinsic to the endovascular procedure. Certain endoleaks require treatment as soon as they are detected to continue to perfuse and pressurize the aneurysm sac, thereby conferring an ongoing risk of aneurysm enlargement and rupture. But the need for treatment of others remains controversial, since the associated increase in intrasac pressure varies depending on the type of endoleak. Using endovascular techniques, the majority of endoleak can be successfully treated, without the need for open surgery. In this chapter, we will introduce the classification, clinical relevance and endovascular management of the endoleaks after EVAR.
More than 20 years after the procedure was introduced to treat AAA, it is remarkable that certain aspects of endovascular treatment for AAA remain poorly understood. One major issue is the occurrence and significance of endoleaks. White et al were the first to systematically describe and classify endoleaks, describing five major categories [1]. And these five types of endoleaks have been described by Ad Hoc Committee for standardized reporting practices of EVAR in the Society for Vascular Surgery/ American Association for Vascular Surgery [2]. There were type I to IV endoleaks, and a supplementary category of “endoleaks of undefined origin” which was defined as flow visualized but source undetermined. And there was a separate adjunctive category of “endotension”, which was referred to instances of aneurysm expansion after EVAR without detectable flow in aneurysm sac.
Type I endoleak is defined as a sealing failure at one of the attachment sites of the graft to the vessel wall (proximal leak, type Ia; distal, type Ib; inadequate seal at iliac occlude plug, type Ic). Arterial flow therefore leaks alongside the graft and into the perigraft space.
Type II endoleak is defined as retrograde flow through collateral vessels (lumbar artery, inferior mesenteric artery, hypogastric artery, and accessory renal artery et al.) into the the aneurysmal sac.
Type III endoleak is defined as graft failure. Type IIIa endoleak is referred to flow from module disconnection, and type IIIb is flow from fabric disruption.
Type IV endoleak is from porous fabric of the stent graft.
A more detailed classification of endoleaks and endotension was introduced by an international consensus of experts [3]. The classification included type I to IV endoleaks, and endotension (also recognized as type V endoleak) (see Table 1). As experience has been gained, it is clear that, in some cases, an endoleak can involve more than one mechanism.
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
I | \n\t\t\tAttachment site leaks | \n\t\t
\n\t\t\t | Proximal end of endograft | \n\t\t
\n\t\t\t | Distal end of endograft | \n\t\t
\n\t\t\t | Iliac occlude (plug) | \n\t\t
II | \n\t\t\tBranch leaks (without attachment connection) | \n\t\t
\n\t\t\t | Simple or to-and-from (from only 1 patent branch) | \n\t\t
\n\t\t\t | Complex or flow-through (with 2 or more patent branches) | \n\t\t
III | \n\t\t\tGraft defect | \n\t\t
\n\t\t\t | Junction leak or modular disconnection | \n\t\t
\n\t\t\t | Fabric disruption (midgraft hole) | \n\t\t
\n\t\t\t | Minor (<2mm; eg. Suture hole) | \n\t\t
\n\t\t\t | Major (>2mm) | \n\t\t
IV Endotension | \n\t\t\tGraft wall (fabric) porosity; <30days of placement | \n\t\t
\n\t\t\t | Any elevation of intrasac pressure without evidence of endoleak | \n\t\t
\n\t\t\t | Without endoleak | \n\t\t
\n\t\t\t | With sealed endoleak (“virtual endoleak”) | \n\t\t
\n\t\t\t | With type I or type III endoleak | \n\t\t
\n\t\t\t | With type II endoleak | \n\t\t
Classification of endoleaks and endotension after endovascular aortic repair.
Adapted from Veith FJ, Baum RA, Ohki T, Amor M, Adiseshiah M, Blankensteijn JD, et al. Nature and significance of endoleaks and endotension: summary of opinions expressed at an international conference. J Vasc Surg. 2002 May;35(5):1029-35. With permission.
Besides the cause of perigraft flow, the endoleaks can be classified according to the time of first detection as perioperative (within 24 hours), early (within 90 days after the primary EVAR) and late (more than 3 months after the primary procedure). And endoleaks can also be described as persistent, transient or sealed, recurrent, successfully treated or unsuccessfully treated.
As this flow is direct and under systemic pressure, it represents a failure in treatment of the aneurysm, which continues to be pressurized and at risk of continued expansion and rupture. Previous study demonstrated that mean pressure index (sac pressure divided by systemic pressure) was varied in the liquid and in the thrombosed sections of the sac after EVAR. They found that type I endoleaks were associated with mean pressure indexes of 93% in the liquid areas and 62% in the thrombus [4]. So it is mandatory to correct type I endoleaks whenever possible, as spontaneous resolution over time cannot be expected.
The incidence of type I endoleak is not low, especially for cases with difficult anatomy situations. The incidence has been reported to be more than 10% of EVAR procedures, with 4.2% at 30 days, 3.5% within 1 year, and 6.7% at 3 year [5].
When AAA are with short neck (proximal attachment zones <15 mm), large neck (diameter >32 mm), irregular neck (such as cone-shaped neck), uneven neck (calcification or thrombus) and proximal angulations >60°, the incidence can be higher than the above mentioned [6]. In common circumstances, 20% oversizing of the proximal endograft attachment and deploying the endograft close to the origin of the renal arteries can help to prevent type Ia endoleak and achieve satisfying sealing.
In the pivotal trial period of EVAR, case selection involved adherence to fairly rigorous anatomic criteria, including vessel size, angulation, shape, length of the infrarenal neck, and adequacy of the distal landing zones. With increasing experience and the availability of newer devices, these criteria have been weakened. Nevertheless, there remain certain types of anatomy that are not well suited to EVAR and are best treated with open surgical technique. Proximal attachment zones less than 10 mm, particularly with angulation greater than 60°, present insurmountable problems with the use of currently available devices.
The development of devices more suitable to extreme degrees of angulation, fenestrated and branched devices, and improvement of sealing mechanisms (ie, endovascular stapling) have expanded the use of EVAR. But as the selection criteria of candidates for EVAR have expanded over time, the detection of type Ia endoleak has become more frequent.
The current availability of various proximal extender cuffs (Figure 1) and other modular devices (such as ballooning and bare stent, Figure 2) for dealing with attachment site leaks has allowed most of these leaks to be treated at the time of the initial procedure. Deployment of Palmaz stent (Cordis Endovascular, Johnson and Johnson Co. UK) or sinus-XL Stent (OptiMed, Ettlingen, Germany) to diminish the proximal type I endoleak was introduced [7] (Figure 3).
For abdominal aortic aneurysm with saccular neck, adjunctive short-large Cuff is effective to diminish type Ia endoleak, and realize best proximal fixation.
A: Pre-operative angiography revealed the AAA with irregular neck and severe angulation. B: Intra-operative angiography confirmed the significant type Ia endoleak. C: After proximal ballooning, the endoleak was diminished.
A: Pre-operative CTA revealed AAA, with large aneurism sac (maximal diameter≈90mm) and angulated neck. B: Pre-operative angiography confirmed the large AAA, and bilateral iliac artery aneurysms. C: After the bifurcated endograft and distal extension were deployed, there was remarkable type Ia endoleak. D: After the proximal cuff and ballooning, the type I endoleak was improved, but still significant. E: Proximal bare stent was deployed (sinus-XL Stent, OptiMed, Ettlingen, Germany)), and the final angiography evidenced the diminished endoleak.
However, under some circumstances, such as when the proximal edge of the stent-graft is very close to the renal artery, proximal cuffs cannot further extend the proximal fixation zone. If balloon dilation and additional bare stents cannot eliminate the leak alongside the graft fixation zone, then other practical options are needed to resolve the difficulty endoluminally.
Embolization techniques were introduced for treating type I endoleak >10 years ago [8]. The use of microcoils, n-butyl 2-cyanoacrylate adhesive, or other embolic agents (such as Onyx) have been utilized to treat type I endoleaks, but their effectiveness is still unproven [6,9,10]. Studies of fibrin glue embolization of endoleak are few and primarily focused on the prevention of type II endoleak [11-13]. So we examined our 5-year experience using fibrin glue to assess the technique’s feasibility, safety, and effectiveness in treating type I endoleaks in the intraoperative setting.
Between August 2002 to February 2009, 783 patients with AAA underwent EVAR at our institution. All patients were evaluated preoperatively with computed tomographic angiography (CTA); appropriate reconstructions from the CT datasets were analyzed on a workstation (Leonardo; Siemens, Erlangen, Germany) to obtain pertinent measurements for endograft sizing (20% oversizing typically used). During the EVAR procedure, endoleaks were identified by angiography and classified as delineated in the current reporting standards [2]. According to our policy, type I endoleaks were treated at the time of diagnosis. If a type I endoleak was still present after proximal balloon dilation and cuff placement, or if a proximal cuff could not be placed because of a short landing zone, a standard procedure was employed to embolize the aneurysm sac using fibrin glue.
According to our standard EVAR protocol, a 0.035-inch guidewire was positioned in the aneurysm sac before the main body of the stent-graft was deployed. In patients with a persistent type I endoleak after initial closure procedures failed, a 23-mm-long 5-F Brite Tip introducer sheath (Cordis Europe, Roden, The Netherlands) was advanced along the pre-loaded guidewire into the aneurysm sac. An aneurysmogram was performed to demonstrate the patency of the aneurysm and the flow direction in the aortic branches, such as the lumbar and hypogastric arteries. If no other source of the leak could be found, such as an accessory renal artery arising from the aneurysm or combined types I and II endoleaks, a pressure transducer (Edwards Lifesciences, Irvine, CA, USA) was connected to the 5-F catheter [14]. The intrasac pressure was measured by placing the catheter tip at 3 different locations around the nidus of the endoleak. The mean of the 3 pressures was recorded, as were the systolic, diastolic, and mean systemic pressures and the pulse pressure. The mean pressure indexes (MPI, sac pressure divided by systemic pressure) were calculated.
Next, a 25-cm-long, double-lumen Duplocath catheter (Baxter/Hyland Immuno AG, Vienna, Austria) connected to a Duploject Y-connector was introduced into the Brite Tip sheath. To block proximal blood flow when the glue was injected, a balloon was positioned in the proximal native aorta. The 5-mL aprotinin and thrombin solutions (Bei Xiu Biotech Co. Ltd., Guangzhou, PR China) were injected into the aneurysm sac through the 2 syringes of the Duploject Y-connector; the components synthesized fibrin glue in the sac as they mixed. Blocking proximal blood at this time facilitates formation of the clot. After the fibrin glue injection, the intrasac pressure was again recorded to monitor the change caused by embolization. The embolization procedure was repeated until the type I endoleak was eliminated, as evidenced by stable contrast inside the sac, a decrease in the intrasac pressure, and angiography (Figure 4).
A: Abdominal aortic aneurysm with severe calcified neck. B: The system pressure was revealed by the red wave and number: 118/50mmHg. C: The intra-operative angiography after the first endografting revealed type Ia endoleak. Proximal cuff and ballooning could not eliminate the endoleak. D: The Intra-sac Pressure was measured by pre-placed intrasac catheter. The sac pressure was 92/56 mmHg. E: After intra-sac jel coagulation, the endoleak was eliminated. F: The intra-sac pressure decreased. The amplitude of the systolic-diastolic waveform was reduced significantly after the fibrin glue embolization, which was considered as a sign of diminish of endoleak.
In follow-up, CTA was performed at 3, 6, and 12 months and annually thereafter. Maximum aneurysm diameter and the presence of endoleaks were recorded. A >2-mm decrease in sac diameter was considered significant. The endpoints of follow-up were death and severe ischemic events, such as paraplegia, ischemic intestinal obstruction, renal artery occlusion, and lower limb ischemia.
A retrospective review of records and our department’s vascular database was conducted to identify all patients who underwent fibrin glue sac embolization for type I endoleak. The search found 42 (5.4%) patients (37 men; mean age 73±8 years, range 51–88) who had persistent type I endoleaks treated intraoperatively with intrasac fibrin glue injection. Patient and aneurysm characteristics are given in Table 1. The mean maximal aneurysm diameter was 59.5±14.7 mm (range 41–100). The mean diameter of the proximal neck was 21.4±4.5 mm, and the mean length was 22.7±14.7 mm; notably, 16 (38.1%) patients had proximal necks <10 mm long. Five (11.9%) patients had proximal neck angulation >60o.
\n\t\t\t\t | \n\t\t\t\n\t\t |
Age, y | \n\t\t\t73.31±8.35 | \n\t\t
Men | \n\t\t\t37 (88.1%) | \n\t\t
Comorbidities | \n\t\t\t38 (90.5%) | \n\t\t
Hypertension | \n\t\t\t28 (66.7%) | \n\t\t
Hyperlipidemia | \n\t\t\t8 (19.0%) | \n\t\t
Diabetes | \n\t\t\t3 (7.1%) | \n\t\t
Urinary system diseases* | \n\t\t\t8 (19.0%) | \n\t\t
Coronary heart disease | \n\t\t\t8 (19.0%) | \n\t\t
Pulmonary disease† | \n\t\t\t7 (16.7%) | \n\t\t
Tobacco use ("/>20 years) | \n\t27 (62.3%) | \n
Aneurysm characteristics | \n\t\n |
Maximal aneurysm diameter, mm | \n\t59.5±14.7 | \n
Aneurysm length, mm | \n\t84.1±30.4 | \n
Proximal neck diameter, mm | \n\t21.4±4.5 | \n
Proximal neck length, mm | \n\t22.7±14.7 | \n
Proximal neck length <10 mm | \n\t16 (38.1%) | \n
Proximal neck angulation | \n\t38.5±30.7 | \n
Proximal neck angle "/>60° | \n5 (11.9%) | \n
Patient and Aneurysm Characteristics
Continuous data are presented as means ± standard deviation; categorical data are given as counts (percentages).
*Chronic renal failure, cyst, urinary stone, renal artery stenosis.
†Chronic obstructive pulmonary disease, tuberculosis.
The most commonly used stent-graft was the Talent model (Medtronic Vascular, Santa Rosa, CA, USA) in 32 (76.2%) patients, following by the Zenith (Cook Inc., Bloomington, IN, USA) in 6 (14.3%), and the Aegis (MicroPort Medical, Shanghai, People’s Republic of China) in 4 (9.5%). Twenty (47.6%) patients had more than 1 stent-graft deployed to exclude the aneurysm. The mean oversizing rate was 21.2%±12.0% in this cohort.
Parametric data are presented as mean ± standard deviation; nonparametric data (e.g., follow-up time) are given as median and range. Survival analysis was performed using the Kaplan-Meier method; comparisons were examined using a paired sample
In the 42 patients with type I endoleak resistant to first-line procedures (balloon dilation and stent/cuff placement), 22 additional devices (8 stents, 14 cuffs) were placed in the initial attempts to resolve the endoleak. After fibrin glue injection, 41 (97.6%) of the 42 endoleaks were resolved with a mean 15±10 ml of glue. Nearly half of the patients (20, 47.6%) received ≤10 mL of glue; 5 (11.9%) patients needed >30 ml. One endoleak persisted despite proximal cuff implantation and the use of 30 ml of glue.
Systolic, diastolic, mean, and pulse pressures and the MPI were all significantly decreased after fibrin glue embolization, especially the pulse pressure (Table 2). The amplitude of the systolic-diastolic waveforms of the 41 successfully treated patients were reduced significantly after the fibrin glue embolization, which was considered as a sign of diminish of endoleak.
\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t|||
\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t\t\n\t\t\t | \n\t|
Systolic | \n\t\t119.3±18.6 | \n\t\t92.2±5.3 | \n\t\t44.7±9.4 | \n\t\t34.1±6.2 | \n\t\t74.5±12.1* | \n\t\t57.9±4.2* | \n\t
Diastolic | \n\t\t70.3±9.3 | \n\t\t79.5±7.6 | \n\t\t38.7±5.9 | \n\t\t43.2±6.7 | \n\t\t31.7±5.7* | \n\t\t27.0±5.1* | \n\t
Mean | \n\t\t86.6±12.2 | \n\t\t87.8±4.4 | \n\t\t40.7±6.9 | \n\t\t35.6±6.4 | \n\t\t46.0±7.5* | \n\t\t51.2±3.2* | \n\t
Pulse | \n\t\t48.8±10.3 | \n\t\t124.1±8.4 | \n\t\t6.0±4.0 | \n\t\t15.3±9.5 | \n\t\t42.8±8.0* | \n\t\t108.5±6.2* | \n\t
Comparison Between Pre- and Post-embolization Intrasac Pressures
Data are presented as means ± standard deviation.
MPI: mean pressure index.
*p<0.05.
No patient exhibited an allergic response to fibrin glue injection, but 1 (2.4%) patient developed right lower extremity ischemia, which was related to wire/catheter manipulations rather than the fibrin glue treatment itself. The 80-year-old patient who had a failed fibrin glue attempt was converted to open surgery; he died in the Intensive Care Unit 2 months later from multiorgan dysfunction syndrome. Two patients who were successfully treated by fibrin glue injection succumbed to myocardial infarction within 5 days of the EVAR procedure (30-day mortality 4.8%).
Over a median follow-up of 39.9 months (range 10–88), the surviving patients complied with the surveillance protocol without loss to follow-up. Three patients died; 1 death was due to progression of an untreated AAA and the others to causes unrelated to aortic aneurysm disease. Cumulative survival was 90.5% at 1 year, 87.0% at 3 years, 82.6% at 5 years.
The mean maximal aneurysm diameter at the latest follow-up visit in 39 patients was 49.0±11.6 mm, significantly different from the 59.5±14.7 mm preoperative maximal aneurysm diameter (p<0.001). Postoperative maximal aneurysm diameters decreased in 25 patients and were stable in 10 patients. Of the 4 patients with increased aneurysm diameter detected during follow-up, a 73-year-old patient had a 22-mm increase after 44 months owing to a type IV endoleak; this patient was converted to open surgery. Two other patients (81 and 77 years of age) had diameter increases of 23 mm after 4 months and 6 mm after 34 months, respectively, but no blood flow within the aneurysm sac was found by CTA. Considering their advanced age, these patients are being closely followed. The last patient had a 20-mm increase after 4 months; he died of renal failure brought on by renal artery compression from the enlarged aneurysm, but no endoleak could be found. No stent-graft dislocation, fracture, or other complication was found in the follow-up period; in particular, no recurrence of type I endoleak was revealed by follow-up CTA.
Various proximal extender cuffs and other adjuncts, such as balloon molding and bare stents, can deal with most of type I endoleaks once detected. However, when no sufficient landing zone is available proximally, the potential to occlude the renal arteries precludes the deployment of a proximal cuff. In some cases, even proximal balloon dilation and extension cuff implantation cannot resolve the type I endoleak. Under these circumstances, catheter-based procedures, including glue and/or coil deposition, can be performed [9,10]. Maldonado et al. reported the success rates for several methods of treating type I endoleaks: n-butyl cyanoacrylate 92.3%, extender cuffs 80%, and coils with or without thrombin 75%. Microcoil embolization can be laborious and time-consuming. Moreover, when numerous coils are deployed, the financial burden is too great for our patients without medical insurance, so we employed fibrin glue. In our study, which had a larger sample and longer follow-up, 98% of the type I endoleaks were eliminated by transcatheter fibrin glue embolotherapy, superior to the other methods tested so far.
Fibrin glue is a non-cytotoxic, fully resorbable biological adhesive matrix. The 2 main components are a fibrinogen solution containing plasmatic proteins and factor XIII and a thrombin solution with calcium chloride and an antifibrinolytic agent, such as aprotinin. The fibrinogen component, when mixed with thrombin, is converted into polymerizing fibrin monomers. Factor XIII is activated by thrombin in the presence of calcium ions, and the premature lysis of the clot is prevented by aprotinin. Mixing fibrinogen and thrombin simulates the environment of the last stages of the natural coagulation cascade to form a structured fibrin clot similar to a physiological clot, which may be naturally degraded by proteolytic enzymes from the fibrinolytic system, such as plasmin. As a result of its hemostatic and adhesive properties, fibrin glue has been extensively used in Europe in most surgical specialties for over 3 decades to reduce postoperative bleeding, to increase tissue plane adherence, for drug delivery, and in regenerative medicine or tissue engineering [15]. In animal experiments, Pacanowski et al. showed that fibrin glue injection could reduce the strain and pressure transmitted to the aortic aneurysm wall after endovascular exclusion, similar to fresh thrombus [16].
Several studies have reported the safety and effectiveness of fibrin glue for preventing/treating type II endoleaks by the transarterial or direct sac puncture method [11-13,17]. However, the application of fibrin glue to treat type I endoleak has evoked several concerns, namely, the possibility of outflow vessel embolization (such as inferior mesenteric artery and lumbar artery), which may cause ischemia or infarction; the potential for aneurysm thrombosis under systematic pressure; and endoleak recurrence in the long term.
To counter these concerns, we performed angiography to rule out collateral circulation, so all of our patients had pure type I endoleaks. Second, before the injection of fibrin glue, blood flow in the proximal native aorta was blocked by a balloon so that the glue mixture could form a structured fibrin clot and achieve aneurysm sac thrombosis. This procedure prevented embolic clot runoff into a collateral channel. Third, fibrin glue injection in our hands was highly effective in eliminating type I endoleaks, with sustained resolution through a mean 40 months of follow-up. During that time, the mean maximal aneurysm diameter decreased significantly by 9 mm, a strong indicator of durable aneurysm exclusion [18]. Moreover, no fibrin glue–related complication or mortality was encountered in follow-up.
To monitor the effects of glue injection, intrasac pressure and MPI were measured routinely in our patients. Type I endoleaks were associated with elevated MPI in the majority of cases, which was similar to the data from Dias et al [4]. According to the physical theory Tc = pR/2, tension (Tc) in the aneurysm wall rises with increased intrasac pressure (p) [19]. Comparing pre- and post-embolization intrasac pressures, we found significant pressure reductions after embolization, especially in the pulse pressure, reflecting diminished radial tension in the aneurysm wall.
Intrasac pressure monitoring is still a controversial issue. Some studies have discussed the relationship between intrasac pressure and endoleak changes [14, 20], citing these variables as markers of successful embolization. Dias et al. found that the pressure varied in different areas of the perigraft space and according to the content within the aneurysm sac, which brought into question the accuracy of the intrasac pressure monitoring [4]. So, for every pressure measurement, we placed the catheter tip at 3 different locations around the endoleak. Moreover, the intrasac pressures, especially the pulse pressure, did indeed decrease in the same measurement location after fibrin glue embolization. Thus, the intrasac pressure measurement, accompanied by final angiography, provided reliable proof of endoleak elimination.
Fibrin glue sac embolization to eliminate type I endoleak after EVAR yielded optimal results in our study, with nearly all the type I endoleaks resolved and no recurrence in follow-up. We believe that fibrin glue embolization may be an ideal option for treating type I endoleak in patients with unfavorable proximal neck anatomy and an alternative to cuff extension with chimney graft rescue of covered renal arteries [21]. Balloon occlusion of the proximal aorta must be done during glue injection to block proximal flow and facilitate formation of a structured fibrin clot. Intrasac pressure monitoring, as well as aortography, appear to be reliable methods of evaluating the effectiveness of fibrin glue sac embolization.
As to prevent the type Ia endoleak on unfavorable aneurysm neck, branched stent-graft, fenestrated stent-graft, or chimney techniques can extend the proximal sealing zone. We believe that this is the trend to decrease the incidence of type Ia endoleak. So in this way, in the last 3 years, the frequency of fibrin glue sac embolization has been significantly reduced.
A. Juxta-renal AAA. B. Home-made fenestrated stent-graft of vascular surgery department, Changhai hospital, Shanghai, China. C. Intra-operative alignment. D: 2-year follow-up CTA showed complete exclusion of the AAA, and patent RA and SMA.
A. Juxta-renal AAA. B. Stenting the RA and SMA before the endografting. C and D: 1-year follow-up demonstrated complete exclusion of the aneurysm and patent branch arteries.
The type Ib endoleak is more common in patients with dilated, calcified, short and tortuous iliac arteries. This can occur when the limb of the graft is too short or migrates upwards due to sac retraction and aortic distortion. Sometimes, when the common iliac artery is short, and the hypogastric artery need to be preserved, distal bare stent can be used to prevent upwards migrates of the iliac extension (Figure 7).
A: 3D reconstruction of pre-operative CTA revealed AAA. The bilateral iliac arteries were in normal diameter. And the common iliac arteries are short. B to C: Distal bare stents were deployed and overlapped with distal extension endograft, to prevent upwards migrates of the iliac extension.
If both sides of hypogastric arteries are involved by the iliac aneurysm, Iliac Branched Device (IBD) or the Sandwich technique with external iliac artery and internal iliac artery stent-grafting can be used to preserve the one hypogastric artery. And the other one could be occluded. These techniques are proven to be feasible to prevent pelvic ischemic complications and type Ib endoleak (Figure 8).
A to C: Iliac Branched Device (IBD) with extension into internal iliac artery. D to F: the Sandwich technique with separated external iliac artery limb and internal iliac artery limb.
Type Ib endoleak is usually treated by distal extension, while distal embolization with microcatheters and glues is less often required as a result of the variety of extender limbs and covered stents available as effective tools. However, sometimes, hypogastric arteries need to be preserved. If required, distal embolization is easier to perform than proximal embolization, as the leak is readily located with a simple curved catheter (Figure 9).
A: Pre-operative angiography revealed AAA (thrombosed) and left common iliac artery aneurysm. B: After bifurcated endografting with left extention were deployed, the type Ib endoleak was noted (as black arrow showed). C to D: Ballooning could not diminish the endoleak. E: The distal edge of the extension was probed from the ipsilateral femoral artery. After the tip of the simple curved catheter engaged the channel of leak, a smooth microcatheter could be advanced into this channel. As the black arrow showed, it is essential to pass the microcatheter into the perigraft space and perform angiography to rue out a combined type I and type II endoleak, which is quite common. F: The white arrow showed the proximal ballooning before the embolic agent was injected. G: Final angiography confirmed the satisfying exclusion of the AAA. H: One year follow-up CTA showed no endoleak existed, and the aneurysm was completely excluded.
Type II endoleak is the most commonly encountered endoleak, and it is much more controversial than type I endoleak. Defined as retrograde flow through collateral vessels into the perigraft space, type II endoleaks prevent thrombosis of the sac and create a potential risk of continued aneurysm expansion and possible rupture. They do not appear to be related to the specific design or material of the endograft used and may appear immediately at the time of graft implantation, at the time of the first follow-up imaging study, or in a delayed fashion months or years after the EVAR procedure [22]. These leaks have also been noted to show resolution and then reappear on subsequent studies. The significance of type II leaks has long been debated, as have appropriate methods of follow-up and determination of the need for intervention. Because at least some of these endoleaks will persist and be associated with aneurysm expansion, there is a need for repeated follow-up imaging studies, which add to the expense of the endovascular approach. There is also the issue of the anxiety engendered in the patient who is uncertain whether his or her aneurysm has been adequately treated.
The best indicator of hemodynamic significance of a type II endoeak is the associated change in the aneurysm sac: if the sac increases in size, higher pressure and a relatively higher risk of long-term rupture are implied. If the sac is stable or decreasing in size, the risk is likely to be less. An analysis of a large EVAR series found that intervention was necessary only when the sac expanded and that persistent type II endoleaks in the absence of sac expansion could be safely observed [23]. These data are consistent with the earlier recommendations from the EUROSTAR study [5].
After a type II endoleak has been identified on imaging studies, aortography above and within the endograft usually permits exclusion of a type I endoleak and sometimes demonstrates the type II endoleak, particularly on late-phase images. Flush aortography is the starting point but is clearly inadequate to investigate an endoleak, as the majority will not be demonstrated without selective angiography. If the flush study does not show a leak that is present on the imaging study, selective angiography of the superior mesenteric artery and at least one hypogastric artery is performed with prolonged imaging to identify collateral pathways. Specific findings on the imaging study are often suggestive of the source of the leak (eg, left anterolateral blush from the IMA or posterolateral blush for lumbar artery), but may be misleading. The superior mesenteric artery will sometimes fill an IMA endoleak via the middle colic and marginal arteries, but the actual leak may not be demonstrated on main superior mesenteric artery injection. A microcatheter placed superselectively in the marginal artery will be more definitive, showing retrograde filling of the native origin of the IMA with filling of the leak if present. If the marginal artery is of adequate diameter and it is not excessively tortuous, it may be possible to pass the microcatheter back to the origin of the vessel and into the perigraft space. Angiography will then demonstrate the actual size of the leak and demonstrate the direction of flow. Embolization can then be carried out with use of NBCA adhesive, coils, or Onyx co- polymer (Micro Therapeutics, Irvine, California) [24]. Transvascular embolization in the IMA distribution should not be performed if the origin of the vessel cannot be reached, as there is a significant risk of creating colonic ischemia. If a transvascular approach is not possible, the leak can be approached directly by the sac puncture technique described later in the present report. Clipping of the IMA via a laparoscopic approach has also been reported [25].
If the endoleak cannot be reached by transvascular methods, direct puncture of the aneurysm sac with CT, fluoroscopic, or US guidance can be performed [26]. Proper positioning of the catheter in the endoleak cavity is signaled by pulsatile return of blood and opacification of lumbar arteries or IMA on manual injection of contrast. Coils, glue, or thrombin are then deployed until there is no further blood return. There also have been promising results using transcaval embolization for the treatment of type II endoleak. The success rate was reported to be 83% after one year [27].
Type III endoleaks arise from inadequate or ineffective seal at the graft junction points between overlapped graft segments or from disconnections and separation of components. Less often they are the result of fabric erosion related to material fatigue (Figure 10). Type III endoleak are infrequent, and the incidence was reported to be 4% after 1 year [28]. Because either of these problems results in arterial flow directly into the perigraft space, they are similar to a type I endoleak and always require intervention. Some failures related to modular dysjunction are preventable by the operator in terms of ensuring adequate overlap of graft components, a parameter that is generally specified by the manufacturer. Extreme angulation of the neck or iliac segments may also be a contributing factor, and may also increase the risk of device migration. Most fabric failures are associated with specific graft materials and designs that have been subsequently modified or withdrawn from the market. Type III endoleaks can generally be treated with deployment of additional stent graft components.
A: Six years after primary EVAR, type III endoleak was identified by routine follow-up CTA. The pre-operative angiography confirmed the graft erosion. B to C: A new one-piece bifurcated endograft was deployed in the previous one,and ballooning was performed. D to E: Aortography above and within the endograft was then performed to confirm the successful exclusion of the endoleak.
Type IV endoleaks are not true leaks but represent passage of blood through the graft fabric as a result of porosity. Typically this type of endoleak is transient and only noted at the time of repair appearing as a blush on the post-deployment angiogram, when patients are often fully anticoagulated, and resolve spontaneously after the withdrawal of anticoagulation [29]. This type of endoleak has been eliminated by changes in graft porosity.
Type V “endoleak” is defined as continued aneurysm sac expansion without a demonstrable leak on any imaging modality. Also referred to as “endotension,” this phenomenon remains poorly understood, but is likely caused by pulsation of the graft wall, with transmission of the pulse wave through the perigraft space to the native aneurysm wall. It is therefore likely to be related to the graft design, including stent structure and fabric compliance. But we observed persistent pressurization of an aneurysm sac with slow blood flow (slow flow endoleak), which is below the sensitivity limits for detection with current imaging technology. A considerable ultrafiltrate across a microporous fabric can fill the aneurysm and increase the pressure. Endotension seemed more common with expanded ePTFE fabric grafts rather than a woven polyester fabric [30].
Since the source of endotension can be difficult to detect, treatment strategies must be individualized. Relining devices with different low porosity endografts may abolish sac growth or induce sac shrinkage. Occasionally, endograft explantation and conversion to open surgery may be required when no clear cause of endotension can be detected, and endoleak cannot be ruled out (Figure 11).
A: Post-operative angiography indicated the successful exclusion of the AAA. B: Four years after the primary EVAR, the aneurysm sac increased in size, without visible endoleak. C: Type V Endoleak was found during the secondary open surgery. The seepage flow and graft erosion was found. When the previous graft was removed and the infra-renal abdominal aorta was reconstructed by a new prosthesis, this patient was successfully treated.
Endoleaks continue to be a challenge in the endovascular approach to aneurysm repair. Some of these leaks are device-related and their occurrence has been reduced with continuously improving graft design, whereas type II endoleaks appear to be an intrinsic risk of the endovascular approach. According to our experience, the vast majority of these endoleaks can be treated endoluminally, without resorting to open surgical repair.
Fibrin glue sac embolization to eliminate type I endoleak after EVAR yielded optimal results in our study. We believe that fibrin glue embolization may be an ideal option for treating type I endoleak in patients with unfavorable proximal neck anatomy and an alternative to cuff extension with chimney graft rescue of covered renal arteries. It is our hope that successful embolization of endoleaks can eliminate or at least reduce the need for lifelong follow-up imaging studies, an important goal in improving patient satisfaction and the economics of the endovascular approach to aneurysm repair. In recent years, the fenestrated stent-graft, branched stent-graft, chimney technique, sandwich technique and Iliac Branched Device, et al, significantly expanded the indication of EVAR, and remarkably reduced the incidence of type I endoleak. We believe that new devices and techniques are the trend to prevent the occurrence of type I endoleak, and finally diminish the usage of glue embolization technique.
In some studies, type II endoleak was aggressively evaluated and treated: if they persist beyond the 6-month study unless there has been shrinkage of the aneurysm sac. But we hold conservative attitude. Persistent type II endoleaks, in the absence of sac expansion, could be safely observed.
In his book “The 40-Knot Sailboat” [1] Bernard Smith, the former director of the United States Naval Weapons Laboratory in Dahlgren, Virginia, gives a very illustrative history of the sailing ship development over the past five millennia. It is quite apparent that throughout this long history the cloth sail was considered the obvious best choice because of its ease to adjust to fast changing wind conditions. It is also apparent that the sail aerodynamics remained poorly understood before the pioneering insights of Kutta and Joukowski about the principles of lift generation in the early 1900s. At about this time interest in the sailing ship as a commercially or militarily important technology waned due to the transition to the steamship. Since then, the sailboat is largely regarded as a vehicle of interest only to competitive and recreational sailors. It is therefore not surprising that the cloth sail remained to be regarded as the logical tool to be used for lift, or thrust, generation.
In the early days of aeronautics the very thin foil was also regarded as the most plausible lift generator, inspired by the observation of bird flight. Lilienthal and the Wright brothers pioneered its use and it remained in use until 1917 when the Dutch airplane builder Anthony Fokker showed that relatively thick airfoils provided the German fighter airplanes with better maneuverability in WWI. Since then, their use has become standard practice in aeronautical engineering.
When Bernard Smith began his search for greatly increased sailing speeds in the 1950s he started with the observation: “After centuries of struggle, the fastest sailboats of our time, whether clipper ships, America’s Cup racers, inland lake scows or the amazing double-hulled canoes of the Pacific Islanders, are, after all, only a little faster than the speediest vessels Magellan saw in his day”. He recognized the need for superior aerodynamic sail characteristics offered by modern airfoils and similar characteristics offered by modern hydrofoils. His pioneering developments ultimately led to the “sail rocket” which achieved speeds exceeding 60 knots.
High-performance sails, such as the ones used on the America Cup boats, require sails whose aerodynamic characteristics approach those of rigid wings, yet permit a reduction in sail area in high wind and sea conditions. To this end, two-cloth sails are coming into use. These sails are constructed out of an articulated forebody that is a truncated ellipse, the aft of which has sail tracks, or rollers, along the edges to accommodate the twin sails. As the sails on either side need to be of the same length, due to the requirement to sail on different tacks, the two cloth sections need to be of equal length. The requirement then is to have their clews separated and able to slide over each other. More importantly, the transition between the rigid mast section and sails needs to be as aerodynamically smooth as possible in order to reduce drag and hence maximize the lift to drag ratio of the airfoil section that is made up of the mast and twin sails. Applications may soon extend beyond competitive sailing purposes for use on sailing ships equipped with hydrokinetic turbines to produce hydrogen via electrolysis (energy ships), as proposed in Ref. [2]. In this application it will again be very important to maximize the sail thrust while minimizing the ship drag by means of hydrofoils.
A computational analysis using ANSYS CFX is presented in this chapter which shows that the aerodynamic characteristics of this type of two-skin mainsail are almost as performant as those of two-element rigid wing sections [3]. Optimum sail trim configurations are analyzed in order to maximize the thrust production.
The use of sails on large vessels, including cargo ships and tankers, is not a new idea. It has been proposed countless times and many concepts for sail assisted vessels have been proposed [3]. The use of sails may serve to lower carbon emissions from large scale shipping or even be used to harvest energy using hydrokinetic turbines, see References [2, 4]. Generally, the proposed concepts make use of either traditional cloth sails or articulating wing sails. However, the latest edition of the America’s Cup, the most technological advanced sailing competition, may have pioneered another sail configuration that could provide the usability advantages of cloth sails and the performance gains of a rigid wing sail.
The America’s Cup has long been the pinnacle of high-performance sailboat design. Ever since the cup was first competed for in 1851, by the ‘radical’ looking schooner
Possible configuration of a rigid wing sail [
These difficulties as well as the increased cost and technical complexity pushed America’s Cup organizers to specify the use of a double skin mainsail for the 36th America’s Cup. Twin-skin mainsails are not a new concept, however. The idea was first filed for patent by the famous sailboat designer Lewis Herreshoff in 1925, shown in Figure 2 [8]. This design uses two cloth mainsails that are attached to an elliptic mast section to create an airfoil like shape with finite thickness. The aerodynamic performance of this sail configuration is mostly unknown because most of the development of twin-skin mainsails was done in secrecy by teams competing in the 36th America’s Cup. However, these designs seem to promise greater performance than traditional cloth sails without the hassle of a fully rigid wing.
Drawing from original Herreshoff patent [
In order to get estimates of the performance that can be expected from these twin skin mainsail sections, a CFD study was conducted on a representative two-dimensional twin skin mainsail section. The analysis was conducted two dimensionally using ANSYS CFX software. The section selected was designed to represent what a twin skin mainsail may look like when hoisted. This chapter will present the results of this modeling and the challenges experienced while attempting to accurately predict the aerodynamic characteristics of the twin-skin mainsail.
The section was designed around the use of a two-to-one elliptic mast section that would serve as the leading edge of the mast. In practice this mast section would be designed to rotate in order to be able to present a smoother airfoil like section for varying angles of incidence. This technique is already used onboard high-performance sailboats and has proven its feasibility in numerous circumnavigations. The sails are then connected to the mast section on either outboard edge. Each sail is of identical chord length so that the configuration can be articulated to accommodate sailing on either tack. In order to induce camber in this section while imposing the condition that each sail is of equal length, the trailing edges are designed to slide over one another. This artificially allows the leeward side of the setup to be moved towards the mast inducing camber into the suction side of the sail. This design is shown in Figure 3. For ease of meshing in CFD, the trailing edge treatment shown in Figure 4 was used. This close up also shows in detail how the upper sail is allowed to move forward to induce camber and account for mast rotation.
Twin-skin mainsail geometry.
Trailing edge diagonal cut treatment for simplified meshing.
The nature of the boundary conditions in CFD simulations requires the edges of the computational domain to be sufficiently far away from the object being tested. To find a domain size, a simple square domain was created around the proposed geometry. Domain size was slowly increased, and aerodynamic coefficients were monitored. To minimize computational time a small range of angles of attack were chosen for analysis at each domain size. The model was run with inflation layers clustered around the sail providing a non-dimensional distance of the first grid from the sail (Y+) of approximately one across the entire sail. Y+ is a non-dimensional distance from wall boundary conditions calculated based on turbulent skin-friction on the wall. For accurate resolution of boundary layer affects, Y+ should be in the single-digits. For this study the turbulent kinetic energy and dissipation (k-e) turbulence modeling was used to provide a fully turbulent solution.
As domain size was increased (Figure 5), measured as the distance to the boundary from the sail, the lift coefficient begins to asymptote as the boundary distance reaches 70 meters, shown in Figure 6. In addition, the variation of the vertical velocity along the top of the domain (Figure 5) was deemed to be sufficiently small and is shown in Figure 7. This leads to a 140 m by 140 m, or approximately 60 chord-lengths, domain around the twin-skin sail. From this exploration, it was decided that all future simulations would be conducted with this domain size.
Configuration of boundary conditions.
Change in lift coefficient at 2 degree angle-of attack, Re = 2,000,000, as domain size is increased.
Variation of vertical velocity on the entrainment boundary for 2 degree angle-of-attack.
From the domain size determined, two different CFX jobs were created. The only difference between them was turbulence modeling. The first job used k-epsilon turbulence with scalable wall functions. The second used Shear Stress Transport model (SST) with Gamma Theta transition. This turbulence model predicts the transition of flow from laminar to turbulent using turbulent kinetic energy and vorticity. The boundary conditions are also shown in Figure 5 (annotate, Inlet, Bottom, Top, Outlet). The angle of attack was specified by changing the u and v velocity at the inlet boundary condition, which was spread across two faces. An entrainment boundary condition was located at either the top or the bottom of the domain depending on the angle of attack to allow for circulation affects. Further details regarding this research can be found in Caraher’s thesis available through the Naval Postgraduate School, Monterey, California [9].
The results from the two different models show stark differences in how aerodynamic coefficients were estimated and how the flow fields behaved. The Shear Stress Transport (SST) turbulence model and Intermittency Momentum Thickness (g-q) transition model struggled to resolve the flow field near stall, shown in Figure 8 by the inconsistent calculation of lift coefficient above 12 degrees angle of attack. The SST model is a blending of the k-w (vorticity) and k-e turbulence models, with the k-w equations being solved near the wall. In comparison the k-e fully-turbulent solution shows a benign stall. This stall begins at the trailing edge as slowly works forward as angle-of-attack is increased, shown in Figure 9 for the k-e case.
Cl comparison between SST and fully turbulent at Re = 2,000,000.
Growth of trailing edge separation in K-epsilon model stall. (a) 13 degrees, (b) 15 degrees, (c) 17 degrees, and (d) 19 degrees.
The two models produce different predictions of drag especially at lower angles of attacks, see Figure 10. The transition model shows a laminar drag bucket between −5 and 5 degrees angle-of attack. This drag bucket was unexpected and the sharp increase in drag shown by the transition model occurs over a quarter degree change in angle-of-attack.
Cd comparison between SST and fully turbulent at Re = 2,000,000.
This drag bucket is caused by the transition models resolution of laminar flow on the upper surface on the twin-skin mainsail at these angles of attack. This is shown by examining the pressure and skin friction coefficients. Both models predict similar pressure coefficients both in the drag bucket and at higher angles of attack, shown in Figures 11 and 12. However, skin-friction coefficients differ within the region of the drag bucket, plotted in Figure 13. This plot shows that laminar flow on the lower surface transitions relatively early on the twin-skin mainsail, shown by a sharp increase in skin-friction coefficient as the flow transitions. This area of transition is visible in the flow field as a separation bubble, shown in Figure 14. From this point aft, the skin friction coefficients predicted on the lower surface by each model are nearly identical. However, the SST model does not predict transition on the upper surface until 70% chord within the region of the drag bucket. This results in much lower skin-friction coefficients on most of the upper surface, shown in Figure 13.
Surface pressure coefficients at AoA = 1 degree, Re = 2,000,000.
Surface pressure coefficients at AoA = 10 degrees, Re = 2,000,000.
Surface friction coefficients at AoA = 1 degree, Re = 2,000,000.
Leading edge velocity field at 1 degree, Re = 2,000,000.
At higher angles of attack, laminar flow is no longer predicted along much of the upper surface. In this region, SST predicts transition as the flow accelerates around the leading edge of the mast section, shown as a separation bubble in Figure 15. SST’s prediction of early transition means that most of the flow around the twin-skin mainsail at higher angles of attack is turbulent, and therefore both models predict similar skin friction coefficients, shown in Figure 16. This results in closer prediction of drag coefficients between the two models above 5 degrees angle of attack.
Leading edge velocity field at 10 degrees, Re = 2,000,000.
Surface friction coefficients at AoA = 10 degrees, Re = 2,000,000.
The environment in which the twin-skin mainsail will be operating dictates that the fully turbulent solution will likely be closer to actual performance. This is due to the constantly changing flow-field that sails experience when deployed. Variations in wind speed and movement of the vessel mean that the velocity and angle of attack that a sail experiences is also constantly varying. This variation will suppress the formation of laminar flow as the chaotic flow-field should favor a turbulent boundary layer. In addition, these models were run without the influence of surface roughness. A real sail will have finite roughness caused by cloth texture as well as imperfections in the surface caused by seams. This should serve as a second factor that should promote turbulent flow around the twin-skin mainsail when deployed.
The ANSYS CFX analysis of two-dimensional flow past twin-skin mainsails presented in this paper yielded the following major results:
The sail is able to produce lift coefficients up to a maximum of 2.0
The drag coefficient predictions vary significantly depending on the choice of turbulence and transition modeling. This was to be expected. Nevertheless, a low drag region is predicted in either case between lift coefficients of zero to 1.4.
The twin-skin sail presents the ANSYS CFX analysis with a greater than usual challenge because of the slope discontinuities caused by the transition from the elliptic leading edge to the upper and lower skins and on the upper surface near the trailing edge.
In a previous analysis of the NACA 0012 airfoil [6] the code produced a remarkable agreement with the experiment in the low angle of attack range, thus giving confidence in its ability to predict transitional flows.
The prediction of separation bubbles and the onset of stall requires further detailed study. Fully turbulent calculations predict a rather benign trailing edge stall. If validated in future computational and experimental investigations this feature will be very welcome.
The CFD data that is presented has not been validated by comparison to known data sets. Publicly available data sets concerning the performance of twin-skin mainsails do not exist. These data sets may exist within internal team documentation for the 36th America’s Cup, but due to the competitive nature of the event, teams have not published their findings. Despite this there is high confidence that the performance estimations presented in this paper are accurate due to validation of CFX code by Johnson [6].
It appears likely that the twin-skin mainsail will find further application in highly competitive sailing competitions, such as the America’s Cup race. In addition, another application may occur in the operation of autonomous sailing ships equipped with hydrokinetic turbines and electrolyzers to produce hydrogen. As explained in Ref. [1], such energy ships require highly efficient sails to produce the propulsive power necessary to overcome the turbine drag and maximize energy production.
When deployed on an ocean-going vessel twin-skin sails should offer an advantage over rigid sails because of ease of stowage and operation. Cloth twin-skin sails can be stowed in either the mast or boom section by rolling the cloth within these sections, unlike rigid sails that cannot easily be stowed. This provides a distinct advantage when operating away from shore in extreme weather and sea-states. By optimizing the sail’s performance and aerodynamics, it facilitates the overall system optimization including path planning. In the case of a sail assisted cargo vessel, path planning will consist of optimizing the vessels route to take advantage both weather and sea conditions to minimize fuel consumption.
A detailed investigation into the two-dimensional aerodynamics of a twin skin sail has been completed. The simulations included the effect of computational domain size upon the induced circulation around the airfoil. Additionally, both fully turbulent boundary layer flow as well as transitional flow was investigated. It was hypothesized that sailing ships will likely experience fully turbulent flow over most of the sail due to surface roughness and unsteady flow hence these simulations were most realistic.
Based on the success of the most recent America’s Cup competition, twin-skin cloth sails appear to be the most suited to high performance as well as ease of use both in raising and lowering the sails. Hence this concept could be used on large ocean-going ships for either primary propulsion or as auxiliary propulsion to reduce overall fuel burn during transit.
The authors gratefully acknowledge helpful comments and advice from Professor Anthony Gannon, Naval Postgraduate School, Monterey.
The authors declare no conflict of interest.
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Generally, the phytochemical constituents of plants fall into two categories based on their role in basic metabolic processes, namely primary and secondary metabolites. Primary plant metabolites are involved in basic life functions; therefore, they are more or less similar in all living cells. On the other hand, secondary plant metabolites are products of subsidiary pathways as the shikimic acid pathway. In the course of studying, the medicinal effect of herbals is oriented towards the secondary plant metabolites. Secondary plant metabolites played an important role in alleviating several aliments in the traditional medicine and folk uses. In modern medicine, they provided lead compounds for the production of medications for treating various diseases from migraine up to cancer. Secondary plant metabolites are classified according to their chemical structures into various classes. In this chapter, we will be presenting various classes of secondary plant metabolites, their distribution in different plant families and their important medicinal uses.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Rehab A. Hussein and Amira A. El-Anssary",authors:[{id:"212117",title:"Dr.",name:"Rehab",middleName:null,surname:"Hussein",slug:"rehab-hussein",fullName:"Rehab Hussein"},{id:"221140",title:"Dr.",name:"Amira",middleName:null,surname:"El-Anssary",slug:"amira-el-anssary",fullName:"Amira El-Anssary"}]},{id:"64851",doi:"10.5772/intechopen.80348",title:"Herbal Medicines in African Traditional Medicine",slug:"herbal-medicines-in-african-traditional-medicine",totalDownloads:14206,totalCrossrefCites:30,totalDimensionsCites:52,abstract:"African traditional medicine is a form of holistic health care system organized into three levels of specialty, namely divination, spiritualism, and herbalism. The traditional healer provides health care services based on culture, religious background, knowledge, attitudes, and beliefs that are prevalent in his community. Illness is regarded as having both natural and supernatural causes and thus must be treated by both physical and spiritual means, using divination, incantations, animal sacrifice, exorcism, and herbs. Herbal medicine is the cornerstone of traditional medicine but may include minerals and animal parts. The adjustment is ok, but may be replaced with –‘ Herbal medicine was once termed primitive by western medicine but through scientific investigations there is a better understanding of its therapeutic activities such that many pharmaceuticals have been modeled on phytochemicals derived from it. Major obstacles to the use of African medicinal plants are their poor quality control and safety. Traditional medical practices are still shrouded with much secrecy, with few reports or documentations of adverse reactions. However, the future of African traditional medicine is bright if viewed in the context of service provision, increase of health care coverage, economic potential, and poverty reduction. Formal recognition and integration of traditional medicine into conventional medicine will hold much promise for the future.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Ezekwesili-Ofili Josephine Ozioma and Okaka Antoinette Nwamaka\nChinwe",authors:[{id:"191264",title:"Prof.",name:"Josephine",middleName:"Ozioma",surname:"Ezekwesili-Ofili",slug:"josephine-ezekwesili-ofili",fullName:"Josephine Ezekwesili-Ofili"},{id:"211585",title:"Prof.",name:"Antoinette",middleName:null,surname:"Okaka",slug:"antoinette-okaka",fullName:"Antoinette Okaka"}]},{id:"54028",doi:"10.5772/67291",title:"Chemical Composition and Biological Activities of Mentha Species",slug:"chemical-composition-and-biological-activities-of-mentha-species",totalDownloads:7474,totalCrossrefCites:13,totalDimensionsCites:46,abstract:"The genus Mentha L. (Lamiaceae) is distributed all over the world and can be found in many environments. Mentha species, one of the world’s oldest and most popular herbs, are widely used in cooking, in cosmetics, and as alternative or complementary therapy, mainly for the treatment of gastrointestinal disorders like flatulence, indigestion, nausea, vomiting, anorexia, and ulcerative colitis. Furthermore, it is well documented that the essential oil and extracts of Mentha species possess antimicrobial, fungicidal, antiviral, insecticidal, and antioxidant properties. The economic importance of mints is also evident; mint oil and its constituents and derivatives are used as flavoring agents throughout the world in food, pharmaceutical, herbal, perfumery, and flavoring industry. To provide a scientific basis for their traditional uses, several studies have been conducted to determine the chemical composition of mints and assess their biological activities. This chapter describes the therapeutic effects and uses of Mentha species and their constituents, particularly essential oils and phenolic compounds; some additional biological activities will also be considered.",book:{id:"5612",slug:"aromatic-and-medicinal-plants-back-to-nature",title:"Aromatic and Medicinal Plants",fullTitle:"Aromatic and Medicinal Plants - Back to Nature"},signatures:"Fatiha Brahmi, Madani Khodir, Chibane Mohamed and Duez Pierre",authors:[{id:"193281",title:"Dr.",name:"Fatiha",middleName:null,surname:"Brahmi",slug:"fatiha-brahmi",fullName:"Fatiha Brahmi"},{id:"199693",title:"Prof.",name:"Khodir",middleName:null,surname:"Madani",slug:"khodir-madani",fullName:"Khodir Madani"},{id:"199694",title:"Prof.",name:"Pierre",middleName:null,surname:"Duez",slug:"pierre-duez",fullName:"Pierre Duez"},{id:"203738",title:"Prof.",name:"Mohamed",middleName:null,surname:"Chibane",slug:"mohamed-chibane",fullName:"Mohamed Chibane"}]},{id:"58270",doi:"10.5772/intechopen.72437",title:"Toxicity and Safety Implications of Herbal Medicines Used in Africa",slug:"toxicity-and-safety-implications-of-herbal-medicines-used-in-africa",totalDownloads:3376,totalCrossrefCites:16,totalDimensionsCites:39,abstract:"The use of herbal medicines has seen a great upsurge globally. In developing countries, many patronize them largely due to cultural acceptability, availability and cost. In developed countries, they are used because they are natural and therefore assumed to be safer than allopathic medicines. In recent times, however, there has been a growing concern about their safety. This has created a situation of ambivalence in discussions regarding their use. Some medicinal plants are intrinsically toxic by virtue of their constituents and can cause adverse reactions if inappropriately used. Other factors such as herb-drug interactions, lack of adherence to good manufacturing practice (GMP), poor regulatory measures and adulteration may also lead to adverse events in their use. Many in vivo tests on aqueous extracts largely support the safety of herbal medicines, whereas most in vitro tests on isolated single cells mostly with extracts other than aqueous ones show contrary results and thus continue the debate on herbal medicine safety. It is expected that toxicity studies concerning herbal medicine should reflect their traditional use to allow for rational discussions regarding their safety for their beneficial use. While various attempts continue to establish the safety of various herbal medicines in man, their cautious and responsible use is required.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Merlin L.K. Mensah, Gustav Komlaga, Arnold D. Forkuo, Caleb\nFirempong, Alexander K. Anning and Rita A. Dickson",authors:[{id:"190435",title:"Dr.",name:"Caleb",middleName:null,surname:"Firempong",slug:"caleb-firempong",fullName:"Caleb Firempong"},{id:"212111",title:"Dr.",name:"Gustav",middleName:null,surname:"Komlaga",slug:"gustav-komlaga",fullName:"Gustav Komlaga"},{id:"217045",title:"Dr.",name:"Arnold Forkuo",middleName:null,surname:"Donkor",slug:"arnold-forkuo-donkor",fullName:"Arnold Forkuo Donkor"},{id:"217049",title:"Prof.",name:"Merlin Lincoln Kwao",middleName:null,surname:"Mensah",slug:"merlin-lincoln-kwao-mensah",fullName:"Merlin Lincoln Kwao Mensah"},{id:"217488",title:"Dr.",name:"Alexander K.",middleName:null,surname:"Anning",slug:"alexander-k.-anning",fullName:"Alexander K. Anning"},{id:"223959",title:"Prof.",name:"Akosua Rita",middleName:null,surname:"Dickson",slug:"akosua-rita-dickson",fullName:"Akosua Rita Dickson"}]},{id:"26489",doi:"10.5772/28224",title:"Alternative and Traditional Medicines Systems in Pakistan: History, Regulation, Trends, Usefulness, Challenges, Prospects and Limitations",slug:"alternative-and-traditional-medicines-systems-in-pakistan-history-regulation-trends-usefulness-chall",totalDownloads:9199,totalCrossrefCites:9,totalDimensionsCites:21,abstract:null,book:{id:"542",slug:"a-compendium-of-essays-on-alternative-therapy",title:"A Compendium of Essays on Alternative Therapy",fullTitle:"A Compendium of Essays on Alternative Therapy"},signatures:"Shahzad Hussain, Farnaz Malik, Nadeem Khalid, Muhammad Abdul Qayyum and Humayun Riaz",authors:[{id:"73162",title:"Dr.",name:"Shahzad",middleName:null,surname:"Hussain",slug:"shahzad-hussain",fullName:"Shahzad Hussain"},{id:"82266",title:"Dr.",name:"Farnaz",middleName:null,surname:"Malik",slug:"farnaz-malik",fullName:"Farnaz Malik"},{id:"124185",title:"Dr.",name:"Humayun",middleName:null,surname:"Riaz",slug:"humayun-riaz",fullName:"Humayun Riaz"},{id:"124186",title:"Mr.",name:"Muhammad Abdul",middleName:null,surname:"Qayyum",slug:"muhammad-abdul-qayyum",fullName:"Muhammad Abdul Qayyum"},{id:"125340",title:"Mr.",name:"Nadeem",middleName:null,surname:"Khalid",slug:"nadeem-khalid",fullName:"Nadeem Khalid"}]}],mostDownloadedChaptersLast30Days:[{id:"64851",title:"Herbal Medicines in African Traditional Medicine",slug:"herbal-medicines-in-african-traditional-medicine",totalDownloads:14207,totalCrossrefCites:30,totalDimensionsCites:52,abstract:"African traditional medicine is a form of holistic health care system organized into three levels of specialty, namely divination, spiritualism, and herbalism. The traditional healer provides health care services based on culture, religious background, knowledge, attitudes, and beliefs that are prevalent in his community. Illness is regarded as having both natural and supernatural causes and thus must be treated by both physical and spiritual means, using divination, incantations, animal sacrifice, exorcism, and herbs. Herbal medicine is the cornerstone of traditional medicine but may include minerals and animal parts. The adjustment is ok, but may be replaced with –‘ Herbal medicine was once termed primitive by western medicine but through scientific investigations there is a better understanding of its therapeutic activities such that many pharmaceuticals have been modeled on phytochemicals derived from it. Major obstacles to the use of African medicinal plants are their poor quality control and safety. Traditional medical practices are still shrouded with much secrecy, with few reports or documentations of adverse reactions. However, the future of African traditional medicine is bright if viewed in the context of service provision, increase of health care coverage, economic potential, and poverty reduction. Formal recognition and integration of traditional medicine into conventional medicine will hold much promise for the future.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Ezekwesili-Ofili Josephine Ozioma and Okaka Antoinette Nwamaka\nChinwe",authors:[{id:"191264",title:"Prof.",name:"Josephine",middleName:"Ozioma",surname:"Ezekwesili-Ofili",slug:"josephine-ezekwesili-ofili",fullName:"Josephine Ezekwesili-Ofili"},{id:"211585",title:"Prof.",name:"Antoinette",middleName:null,surname:"Okaka",slug:"antoinette-okaka",fullName:"Antoinette Okaka"}]},{id:"61866",title:"Plants Secondary Metabolites: The Key Drivers of the Pharmacological Actions of Medicinal Plants",slug:"plants-secondary-metabolites-the-key-drivers-of-the-pharmacological-actions-of-medicinal-plants",totalDownloads:8875,totalCrossrefCites:56,totalDimensionsCites:140,abstract:"The vast and versatile pharmacological effects of medicinal plants are basically dependent on their phytochemical constituents. Generally, the phytochemical constituents of plants fall into two categories based on their role in basic metabolic processes, namely primary and secondary metabolites. Primary plant metabolites are involved in basic life functions; therefore, they are more or less similar in all living cells. On the other hand, secondary plant metabolites are products of subsidiary pathways as the shikimic acid pathway. In the course of studying, the medicinal effect of herbals is oriented towards the secondary plant metabolites. Secondary plant metabolites played an important role in alleviating several aliments in the traditional medicine and folk uses. In modern medicine, they provided lead compounds for the production of medications for treating various diseases from migraine up to cancer. Secondary plant metabolites are classified according to their chemical structures into various classes. In this chapter, we will be presenting various classes of secondary plant metabolites, their distribution in different plant families and their important medicinal uses.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Rehab A. Hussein and Amira A. El-Anssary",authors:[{id:"212117",title:"Dr.",name:"Rehab",middleName:null,surname:"Hussein",slug:"rehab-hussein",fullName:"Rehab Hussein"},{id:"221140",title:"Dr.",name:"Amira",middleName:null,surname:"El-Anssary",slug:"amira-el-anssary",fullName:"Amira El-Anssary"}]},{id:"77433",title:"Extraction of Bioactive Compounds from Medicinal Plants and Herbs",slug:"extraction-of-bioactive-compounds-from-medicinal-plants-and-herbs",totalDownloads:1266,totalCrossrefCites:2,totalDimensionsCites:5,abstract:"Human beings have relied on herbs and medicinal plants as sources of food and remedy from time immemorial. Bioactive compounds from plants are currently the subject of much research interest, but their extraction as part of phytochemical and/or biological investigations present specific challenges. Herbalists or scientists have developed many protocols of extraction of bioactive ingredients to ensure the effectiveness and the efficacy of crude drugs that were used to get relief from sickness. With the advent of new leads from plants such as morphine, quinine, taxol, artemisinin, and alkaloids from Voacanga species, a lot of attention is paid to the mode of extraction of active phytochemicals to limit the cost linked to the synthesis and isolation. Thus, the extraction of active compounds from plants needs appropriate extraction methods and techniques that provide bioactive ingredients-rich extracts and fractions. The extraction procedures, therefore, play a critical role in the yield, the nature of phytochemical content, etc. This chapter aims to present, describe, and compare extraction procedures of bioactive compounds from herbs and medicinal plants.",book:{id:"10356",slug:"natural-medicinal-plants",title:"Natural Medicinal Plants",fullTitle:"Natural Medicinal Plants"},signatures:"Fongang Fotsing Yannick Stéphane, Bankeu Kezetas Jean Jules, Gaber El-Saber Batiha, Iftikhar Ali and Lenta Ndjakou Bruno",authors:[{id:"224515",title:"Dr.",name:"Fongang Fotsing",middleName:null,surname:"Yannick Stéphane",slug:"fongang-fotsing-yannick-stephane",fullName:"Fongang Fotsing Yannick Stéphane"},{id:"227816",title:"Dr.",name:"Bankeu Kezetas",middleName:null,surname:"Jean Jules",slug:"bankeu-kezetas-jean-jules",fullName:"Bankeu Kezetas Jean Jules"},{id:"227817",title:"Prof.",name:"Lenta Ndjakou",middleName:null,surname:"Bruno",slug:"lenta-ndjakou-bruno",fullName:"Lenta Ndjakou Bruno"},{id:"349790",title:"Prof.",name:"Gaber",middleName:null,surname:"El-Saber Batiha",slug:"gaber-el-saber-batiha",fullName:"Gaber El-Saber Batiha"},{id:"357350",title:"Dr.",name:"Iftikhar",middleName:null,surname:"Ali",slug:"iftikhar-ali",fullName:"Iftikhar Ali"}]},{id:"26491",title:"Homeopathy: Treatment of Cancer with the Banerji Protocols",slug:"homeopathy-treatment-of-cancer-with-the-banerji-protocols",totalDownloads:54048,totalCrossrefCites:1,totalDimensionsCites:2,abstract:null,book:{id:"542",slug:"a-compendium-of-essays-on-alternative-therapy",title:"A Compendium of Essays on Alternative Therapy",fullTitle:"A Compendium of Essays on Alternative Therapy"},signatures:"Prasanta Banerji and Pratip Banerji",authors:[{id:"79939",title:"Dr",name:"Prasanta",middleName:null,surname:"Banerji",slug:"prasanta-banerji",fullName:"Prasanta Banerji"},{id:"79943",title:"Dr.",name:"Pratip",middleName:null,surname:"Banerji",slug:"pratip-banerji",fullName:"Pratip Banerji"}]},{id:"54028",title:"Chemical Composition and Biological Activities of Mentha Species",slug:"chemical-composition-and-biological-activities-of-mentha-species",totalDownloads:7474,totalCrossrefCites:13,totalDimensionsCites:46,abstract:"The genus Mentha L. (Lamiaceae) is distributed all over the world and can be found in many environments. Mentha species, one of the world’s oldest and most popular herbs, are widely used in cooking, in cosmetics, and as alternative or complementary therapy, mainly for the treatment of gastrointestinal disorders like flatulence, indigestion, nausea, vomiting, anorexia, and ulcerative colitis. Furthermore, it is well documented that the essential oil and extracts of Mentha species possess antimicrobial, fungicidal, antiviral, insecticidal, and antioxidant properties. The economic importance of mints is also evident; mint oil and its constituents and derivatives are used as flavoring agents throughout the world in food, pharmaceutical, herbal, perfumery, and flavoring industry. To provide a scientific basis for their traditional uses, several studies have been conducted to determine the chemical composition of mints and assess their biological activities. This chapter describes the therapeutic effects and uses of Mentha species and their constituents, particularly essential oils and phenolic compounds; some additional biological activities will also be considered.",book:{id:"5612",slug:"aromatic-and-medicinal-plants-back-to-nature",title:"Aromatic and Medicinal Plants",fullTitle:"Aromatic and Medicinal Plants - Back to Nature"},signatures:"Fatiha Brahmi, Madani Khodir, Chibane Mohamed and Duez Pierre",authors:[{id:"193281",title:"Dr.",name:"Fatiha",middleName:null,surname:"Brahmi",slug:"fatiha-brahmi",fullName:"Fatiha Brahmi"},{id:"199693",title:"Prof.",name:"Khodir",middleName:null,surname:"Madani",slug:"khodir-madani",fullName:"Khodir Madani"},{id:"199694",title:"Prof.",name:"Pierre",middleName:null,surname:"Duez",slug:"pierre-duez",fullName:"Pierre Duez"},{id:"203738",title:"Prof.",name:"Mohamed",middleName:null,surname:"Chibane",slug:"mohamed-chibane",fullName:"Mohamed Chibane"}]}],onlineFirstChaptersFilter:{topicId:"991",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:31,numberOfPublishedChapters:314,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:11,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:105,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:19,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:14,numberOfOpenTopics:5,numberOfUpcomingTopics:0,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:"June 20th, 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,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,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,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:{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"}}},editorThree:null},{id:"13",title:"Plant Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/13.jpg",isOpenForSubmission:!0,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:45,paginationItems:[{id:"82135",title:"Carotenoids in Cassava (Manihot esculenta Crantz)",doi:"10.5772/intechopen.105210",signatures:"Lovina I. Udoh, Josephine U. Agogbua, Eberechi R. Keyagha and Itorobong I. Nkanga",slug:"carotenoids-in-cassava-manihot-esculenta-crantz",totalDownloads:4,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Carotenoids - New Perspectives and Application",coverURL:"https://cdn.intechopen.com/books/images_new/10836.jpg",subseries:{id:"13",title:"Plant Physiology"}}},{id:"82112",title:"Comparative Senescence and Lifespan",doi:"10.5772/intechopen.105137",signatures:"Hassan M. Heshmati",slug:"comparative-senescence-and-lifespan",totalDownloads:7,totalCrossrefCites:0,totalDimensionsCites:0,authors:[{name:"Hassan M.",surname:"Heshmati"}],book:{title:"Mechanisms and Management of Senescence",coverURL:"https://cdn.intechopen.com/books/images_new/10935.jpg",subseries:{id:"11",title:"Cell Physiology"}}},{id:"81796",title:"Apoptosis-Related Diseases and Peroxisomes",doi:"10.5772/intechopen.105052",signatures:"Meimei Wang, Yakun Liu, Ni Chen, Juan Wang and Ye Zhao",slug:"apoptosis-related-diseases-and-peroxisomes",totalDownloads:11,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"The Metabolic Role of Peroxisome in Health and Disease",coverURL:"https://cdn.intechopen.com/books/images_new/10837.jpg",subseries:{id:"11",title:"Cell Physiology"}}},{id:"81723",title:"Peroxisomal Modulation as Therapeutic Alternative for Tackling Multiple Cancers",doi:"10.5772/intechopen.104873",signatures:"Shazia Usmani, Shadma Wahab, Abdul Hafeez, Shabana Khatoon and Syed Misbahul Hasan",slug:"peroxisomal-modulation-as-therapeutic-alternative-for-tackling-multiple-cancers",totalDownloads:4,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"The Metabolic Role of Peroxisome in Health and Disease",coverURL:"https://cdn.intechopen.com/books/images_new/10837.jpg",subseries:{id:"11",title:"Cell Physiology"}}}]},overviewPagePublishedBooks:{paginationCount:11,paginationItems:[{type:"book",id:"7264",title:"Calcium and Signal Transduction",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7264.jpg",slug:"calcium-and-signal-transduction",publishedDate:"October 24th 2018",editedByType:"Edited by",bookSignature:"John N. Buchholz and Erik J. Behringer",hash:"e373a3d1123dbd45fddf75d90e3e7c38",volumeInSeries:1,fullTitle:"Calcium and Signal Transduction",editors:[{id:"89438",title:"Dr.",name:"John N.",middleName:null,surname:"Buchholz",slug:"john-n.-buchholz",fullName:"John N. Buchholz",profilePictureURL:"https://mts.intechopen.com/storage/users/89438/images/6463_n.jpg",biography:"Full Professor and Vice Chair, Division of Pharmacology, Loma Linda University, School of Medicine. He received his B.S. Degree in Biology at La Sierra University, Riverside California (1980) and a PhD in Pharmacology from Loma Linda University School of Medicine (1988). Post-Doctoral Fellow at University of California, Irvine, College of Medicine 1989-1992 with a focus on autonomic nerve function in blood vessels and the impact of aging on the function of these nerves and overall blood vessel function. Twenty years of research funding and served on NIH R01 review panels, Editor-In-Chief of Edorium Journal of Aging Research. Serves as a peer reviewer for biomedical journals. Military Reserve Officer serving with the 100 Support Command, 100 Troop Command, 40 Infantry Division, CA National Guard.",institutionString:null,institution:{name:"Loma Linda University",institutionURL:null,country:{name:"United States of America"}}}]},{type:"book",id:"6925",title:"Endoplasmic Reticulum",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/6925.jpg",slug:"endoplasmic-reticulum",publishedDate:"April 17th 2019",editedByType:"Edited by",bookSignature:"Angel Català",hash:"a9e90d2dbdbc46128dfe7dac9f87c6b4",volumeInSeries:2,fullTitle:"Endoplasmic Reticulum",editors:[{id:"196544",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",profilePictureURL:"https://mts.intechopen.com/storage/users/196544/images/system/196544.jpg",biography:"Angel Catalá studied chemistry at Universidad Nacional de La Plata, Argentina, where he received a Ph.D. in Chemistry (Biological Branch) in 1965. From 1964 to 1974, he worked as an Assistant in Biochemistry at the School of Medicine at the same university. From 1974 to 1976, he was a fellow of the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor of Biochemistry at the Universidad Nacional de La Plata. He is a member of the National Research Council (CONICET), Argentina, and the Argentine Society for Biochemistry and Molecular Biology (SAIB). His laboratory has been interested for many years in the lipid peroxidation of biological membranes from various tissues and different species. Dr. Catalá has directed twelve doctoral theses, published more than 100 papers in peer-reviewed journals, several chapters in books, and edited twelve books. He received awards at the 40th International Conference Biochemistry of Lipids 1999 in Dijon, France. He is the winner of the Bimbo Pan-American Nutrition, Food Science and Technology Award 2006 and 2012, South America, Human Nutrition, Professional Category. In 2006, he won the Bernardo Houssay award in pharmacology, in recognition of his meritorious works of research. Dr. Catalá belongs to the editorial board of several journals including Journal of Lipids; International Review of Biophysical Chemistry; Frontiers in Membrane Physiology and Biophysics; World Journal of Experimental Medicine and Biochemistry Research International; World Journal of Biological Chemistry, Diabetes, and the Pancreas; International Journal of Chronic Diseases & Therapy; and International Journal of Nutrition. He is the co-editor of The Open Biology Journal and associate editor for Oxidative Medicine and Cellular Longevity.",institutionString:"Universidad Nacional de La Plata",institution:{name:"National University of La Plata",institutionURL:null,country:{name:"Argentina"}}}]},{type:"book",id:"6924",title:"Adenosine Triphosphate in Health and Disease",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/6924.jpg",slug:"adenosine-triphosphate-in-health-and-disease",publishedDate:"April 24th 2019",editedByType:"Edited by",bookSignature:"Gyula Mozsik",hash:"04106c232a3c68fec07ba7cf00d2522d",volumeInSeries:3,fullTitle:"Adenosine Triphosphate in Health and Disease",editors:[{id:"58390",title:"Dr.",name:"Gyula",middleName:null,surname:"Mozsik",slug:"gyula-mozsik",fullName:"Gyula Mozsik",profilePictureURL:"https://mts.intechopen.com/storage/users/58390/images/system/58390.png",biography:"Gyula Mózsik MD, Ph.D., ScD (med), is an emeritus professor of Medicine at the First Department of Medicine, Univesity of Pécs, Hungary. He was head of this department from 1993 to 2003. His specializations are medicine, gastroenterology, clinical pharmacology, clinical nutrition, and dietetics. His research fields are biochemical pharmacological examinations in the human gastrointestinal (GI) mucosa, mechanisms of retinoids, drugs, capsaicin-sensitive afferent nerves, and innovative pharmacological, pharmaceutical, and nutritional (dietary) research in humans. He has published about 360 peer-reviewed papers, 197 book chapters, 692 abstracts, 19 monographs, and has edited 37 books. He has given about 1120 regular and review lectures. He has organized thirty-eight national and international congresses and symposia. He is the founder of the International Conference on Ulcer Research (ICUR); International Union of Pharmacology, Gastrointestinal Section (IUPHAR-GI); Brain-Gut Society symposiums, and gastrointestinal cytoprotective symposiums. He received the Andre Robert Award from IUPHAR-GI in 2014. Fifteen of his students have been appointed as full professors in Egypt, Cuba, and Hungary.",institutionString:"University of Pécs",institution:{name:"University of Pecs",institutionURL:null,country:{name:"Hungary"}}}]},{type:"book",id:"8008",title:"Antioxidants",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/8008.jpg",slug:"antioxidants",publishedDate:"November 6th 2019",editedByType:"Edited by",bookSignature:"Emad Shalaby",hash:"76361b4061e830906267933c1c670027",volumeInSeries:5,fullTitle:"Antioxidants",editors:[{id:"63600",title:"Prof.",name:"Emad",middleName:null,surname:"Shalaby",slug:"emad-shalaby",fullName:"Emad Shalaby",profilePictureURL:"https://mts.intechopen.com/storage/users/63600/images/system/63600.png",biography:"Dr. Emad Shalaby is a professor of biochemistry on the Biochemistry Department Faculty of Agriculture, Cairo University. He\nreceived a short-term scholarship to carry out his post-doctoral\nstudies abroad, from Japan International Cooperation Agency\n(JICA), in coordination with the Egyptian government. Dr.\nShalaby speaks fluent English and his native Arabic. He has 77\ninternationally published research papers, has attended 15 international conferences, and has contributed to 18 international books and chapters.\nDr. Shalaby works as a reviewer on over one hundred international journals and is\non the editorial board of more than twenty-five international journals. He is a member of seven international specialized scientific societies, besides his local one, and\nhe has won seven prizes.",institutionString:"Cairo University",institution:{name:"Cairo University",institutionURL:null,country:{name:"Egypt"}}}]}]},openForSubmissionBooks:{paginationCount:6,paginationItems:[{id:"11669",title:"Fatty Acids - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11669.jpg",hash:"9117bd12dc904ced43404e3383b6591a",secondStepPassed:!0,currentStepOfPublishingProcess:3,submissionDeadline:"May 3rd 2022",isOpenForSubmission:!0,editors:[{id:"415310",title:"Assistant Prof.",name:"Erik",surname:"Froyen",slug:"erik-froyen",fullName:"Erik Froyen"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{id:"11674",title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg",hash:"5d7d49bd80f53dad3761f78de4a862c6",secondStepPassed:!0,currentStepOfPublishingProcess:3,submissionDeadline:"May 6th 2022",isOpenForSubmission:!0,editors:[{id:"238047",title:"Dr.",name:"Gaia",surname:"Favero",slug:"gaia-favero",fullName:"Gaia Favero"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{id:"11672",title:"Chemokines Updates",coverURL:"https://cdn.intechopen.com/books/images_new/11672.jpg",hash:"c00855833476a514d37abf7c846e16e9",secondStepPassed:!0,currentStepOfPublishingProcess:3,submissionDeadline:"May 6th 2022",isOpenForSubmission:!0,editors:[{id:"14794",title:"Prof.",name:"Murat",surname:"Şentürk",slug:"murat-senturk",fullName:"Murat Şentürk"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{id:"11670",title:"Chitin-Chitosan - Isolation, Properties, and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11670.jpg",hash:"69f009be08998711eecfb200adc7deca",secondStepPassed:!0,currentStepOfPublishingProcess:3,submissionDeadline:"May 26th 2022",isOpenForSubmission:!0,editors:[{id:"176093",title:"Dr.",name:"Brajesh",surname:"Kumar",slug:"brajesh-kumar",fullName:"Brajesh Kumar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{id:"12215",title:"Cell Death and Disease",coverURL:"https://cdn.intechopen.com/books/images_new/12215.jpg",hash:"dfd456a29478fccf4ebd3294137eb1e3",secondStepPassed:!0,currentStepOfPublishingProcess:3,submissionDeadline:"June 24th 2022",isOpenForSubmission:!0,editors:[{id:"59529",title:"Dr.",name:"Ke",surname:"Xu",slug:"ke-xu",fullName:"Ke Xu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{id:"11673",title:"Stem Cell Research",coverURL:"https://cdn.intechopen.com/books/images_new/11673.jpg",hash:"13092df328080c762dd9157be18ca38c",secondStepPassed:!1,currentStepOfPublishingProcess:2,submissionDeadline:"July 13th 2022",isOpenForSubmission:!0,editors:[{id:"203598",title:"Ph.D.",name:"Diana",surname:"Kitala",slug:"diana-kitala",fullName:"Diana Kitala"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},onlineFirstChapters:{paginationCount:43,paginationItems:[{id:"82374",title:"The Potential of the Purinergic System as a Therapeutic Target of Natural Compounds in Cutaneous Melanoma",doi:"10.5772/intechopen.105457",signatures:"Gilnei Bruno da Silva, Daiane Manica, Marcelo Moreno and Margarete Dulce Bagatini",slug:"the-potential-of-the-purinergic-system-as-a-therapeutic-target-of-natural-compounds-in-cutaneous-mel",totalDownloads:4,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Purinergic System",coverURL:"https://cdn.intechopen.com/books/images_new/10801.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82103",title:"The Role of Endoplasmic Reticulum Stress and Its Regulation in the Progression of Neurological and Infectious Diseases",doi:"10.5772/intechopen.105543",signatures:"Mary Dover, Michael Kishek, Miranda Eddins, Naneeta Desar, Ketema Paul and Milan Fiala",slug:"the-role-of-endoplasmic-reticulum-stress-and-its-regulation-in-the-progression-of-neurological-and-i",totalDownloads:5,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}},{id:"82212",title:"Protein Prenylation and Their Applications",doi:"10.5772/intechopen.104700",signatures:"Khemchand R. 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She is now a lecturer at the University of Witwatersrand, South Africa, and a principal researcher at the Health Economics and Epidemiology Research Office (HE2RO), South Africa. Dr. Moolla holds a Ph.D. in Psychology with her research being focused on mental health and resilience. In her professional work capacity, her research has further expanded into the fields of early childhood development, mental health, the HIV and TB care cascades, as well as COVID. She is also a UNESCO-trained International Bioethics Facilitator.",institutionString:"University of the Witwatersrand",institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"342152",title:"Dr.",name:"Santo",middleName:null,surname:"Grace Umesh",slug:"santo-grace-umesh",fullName:"Santo Grace Umesh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/342152/images/16311_n.jpg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"333647",title:"Dr.",name:"Shreya",middleName:null,surname:"Kishore",slug:"shreya-kishore",fullName:"Shreya Kishore",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333647/images/14701_n.jpg",biography:"Dr. Shreya Kishore completed her Bachelor in Dental Surgery in Chettinad Dental College and Research Institute, Chennai, and her Master of Dental Surgery (Orthodontics) in Saveetha Dental College, Chennai. She is also Invisalign certified. She’s working as a Senior Lecturer in the Department of Orthodontics, SRM Dental College since November 2019. She is actively involved in teaching orthodontics to the undergraduates and the postgraduates. Her clinical research topics include new orthodontic brackets, fixed appliances and TADs. She’s published 4 articles in well renowned indexed journals and has a published patency of her own. Her private practice is currently limited to orthodontics and works as a consultant in various clinics.",institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"323731",title:"Prof.",name:"Deepak M.",middleName:"Macchindra",surname:"Vikhe",slug:"deepak-m.-vikhe",fullName:"Deepak M. Vikhe",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/323731/images/13613_n.jpg",biography:"Dr Deepak M.Vikhe .\n\n\t\n\tDr Deepak M.Vikhe , completed his Masters & PhD in Prosthodontics from Rural Dental College, Loni securing third rank in the Pravara Institute of Medical Sciences Deemed University. He was awarded Dr.G.C.DAS Memorial Award for Research on Implants at 39th IPS conference Dubai (U A E).He has two patents under his name. He has received Dr.Saraswati medal award for best research for implant study in 2017.He has received Fully funded scholarship to Spain ,university of Santiago de Compostela. He has completed fellowship in Implantlogy from Noble Biocare. \nHe has attended various conferences and CDE programmes and has national publications to his credit. His field of interest is in Implant supported prosthesis. Presently he is working as a associate professor in the Dept of Prosthodontics, Rural Dental College, Loni and maintains a successful private practice specialising in Implantology at Rahata.\n\nEmail: drdeepak_mvikhe@yahoo.com..................",institutionString:null,institution:{name:"Pravara Institute of Medical Sciences",country:{name:"India"}}},{id:"204110",title:"Dr.",name:"Ahmed A.",middleName:null,surname:"Madfa",slug:"ahmed-a.-madfa",fullName:"Ahmed A. Madfa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204110/images/system/204110.jpg",biography:"Dr. Madfa is currently Associate Professor of Endodontics at Thamar University and a visiting lecturer at Sana'a University and University of Sciences and Technology. He has more than 6 years of experience in teaching. His research interests include root canal morphology, functionally graded concept, dental biomaterials, epidemiology and dental education, biomimetic restoration, finite element analysis and endodontic regeneration. Dr. Madfa has numerous international publications, full articles, two patents, a book and a book chapter. Furthermore, he won 14 international scientific awards. Furthermore, he is involved in many academic activities ranging from editorial board member, reviewer for many international journals and postgraduate students' supervisor. Besides, I deliver many courses and training workshops at various scientific events. Dr. Madfa also regularly attends international conferences and holds administrative positions (Deputy Dean of the Faculty for Students’ & Academic Affairs and Deputy Head of Research Unit).",institutionString:"Thamar University",institution:null},{id:"210472",title:"Dr.",name:"Nermin",middleName:"Mohammed Ahmed",surname:"Yussif",slug:"nermin-yussif",fullName:"Nermin Yussif",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210472/images/system/210472.jpg",biography:"Dr. Nermin Mohammed Ahmed Yussif is working at the Faculty of dentistry, University for October university for modern sciences and arts (MSA). Her areas of expertise include: periodontology, dental laserology, oral implantology, periodontal plastic surgeries, oral mesotherapy, nutrition, dental pharmacology. She is an editor and reviewer in numerous international journals.",institutionString:"MSA University",institution:null},{id:"204606",title:"Dr.",name:"Serdar",middleName:null,surname:"Gözler",slug:"serdar-gozler",fullName:"Serdar Gözler",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204606/images/system/204606.jpeg",biography:"Dr. Serdar Gözler has completed his undergraduate studies at the Marmara University Faculty of Dentistry in 1978, followed by an assistantship in the Prosthesis Department of Dicle University Faculty of Dentistry. Starting his PhD work on non-resilient overdentures with Assoc. Prof. Hüsnü Yavuzyılmaz, he continued his studies with Prof. Dr. Gürbüz Öztürk of Istanbul University Faculty of Dentistry Department of Prosthodontics, this time on Gnatology. He attended training programs on occlusion, neurology, neurophysiology, EMG, radiology and biostatistics. In 1982, he presented his PhD thesis \\Gerber and Lauritzen Occlusion Analysis Techniques: Diagnosis Values,\\ at Istanbul University School of Dentistry, Department of Prosthodontics. As he was also working with Prof. Senih Çalıkkocaoğlu on The Physiology of Chewing at the same time, Gözler has written a chapter in Çalıkkocaoğlu\\'s book \\Complete Prostheses\\ entitled \\The Place of Neuromuscular Mechanism in Prosthetic Dentistry.\\ The book was published five times since by the Istanbul University Publications. Having presented in various conferences about occlusion analysis until 1998, Dr. Gözler has also decided to use the T-Scan II occlusion analysis method. Having been personally trained by Dr. Robert Kerstein on this method, Dr. Gözler has been lecturing on the T-Scan Occlusion Analysis Method in conferences both in Turkey and abroad. Dr. Gözler has various articles and presentations on Digital Occlusion Analysis methods. He is now Head of the TMD Clinic at Prosthodontic Department of Faculty of Dentistry , Istanbul Aydın University , Turkey.",institutionString:"Istanbul Aydin University",institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"240870",title:"Ph.D.",name:"Alaa Eddin Omar",middleName:null,surname:"Al Ostwani",slug:"alaa-eddin-omar-al-ostwani",fullName:"Alaa Eddin Omar Al Ostwani",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/240870/images/system/240870.jpeg",biography:"Dr. Al Ostwani Alaa Eddin Omar received his Master in dentistry from Damascus University in 2010, and his Ph.D. in Pediatric Dentistry from Damascus University in 2014. Dr. Al Ostwani is an assistant professor and faculty member at IUST University since 2014. \nDuring his academic experience, he has received several awards including the scientific research award from the Union of Arab Universities, the Syrian gold medal and the international gold medal for invention and creativity. Dr. Al Ostwani is a Member of the International Association of Dental Traumatology and the Syrian Society for Research and Preventive Dentistry since 2017. He is also a Member of the Reviewer Board of International Journal of Dental Medicine (IJDM), and the Indian Journal of Conservative and Endodontics since 2016.",institutionString:"International University for Science and Technology.",institution:{name:"Islamic University of Science and Technology",country:{name:"India"}}},{id:"42847",title:"Dr.",name:"Belma",middleName:null,surname:"Işik Aslan",slug:"belma-isik-aslan",fullName:"Belma Işik Aslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/42847/images/system/42847.jpg",biography:"Dr. Belma IşIk Aslan was born in 1976 in Ankara-TURKEY. After graduating from TED Ankara College in 1994, she attended to Gazi University, Faculty of Dentistry in Ankara. She completed her PhD in orthodontic education at Gazi University between 1999-2005. Dr. Işık Aslan stayed at the Providence Hospital Craniofacial Institude and Reconstructive Surgery in Michigan, USA for three months as an observer. She worked as a specialist doctor at Gazi University, Dentistry Faculty, Department of Orthodontics between 2005-2014. She was appointed as associate professor in January, 2014 and as professor in 2021. Dr. Işık Aslan still works as an instructor at the same faculty. She has published a total of 35 articles, 10 book chapters, 39 conference proceedings both internationally and nationally. Also she was the academic editor of the international book 'Current Advances in Orthodontics'. She is a member of the Turkish Orthodontic Society and Turkish Cleft Lip and Palate Society. She is married and has 2 children. Her knowledge of English is at an advanced level.",institutionString:"Gazi University Dentistry Faculty Department of Orthodontics",institution:null},{id:"178412",title:"Associate Prof.",name:"Guhan",middleName:null,surname:"Dergin",slug:"guhan-dergin",fullName:"Guhan Dergin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178412/images/6954_n.jpg",biography:"Assoc. Prof. Dr. Gühan Dergin was born in 1973 in Izmit. He graduated from Marmara University Faculty of Dentistry in 1999. He completed his specialty of OMFS surgery in Marmara University Faculty of Dentistry and obtained his PhD degree in 2006. In 2005, he was invited as a visiting doctor in the Oral and Maxillofacial Surgery Department of the University of North Carolina, USA, where he went on a scholarship. Dr. Dergin still continues his academic career as an associate professor in Marmara University Faculty of Dentistry. He has many articles in international and national scientific journals and chapters in books.",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"178414",title:"Prof.",name:"Yusuf",middleName:null,surname:"Emes",slug:"yusuf-emes",fullName:"Yusuf Emes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178414/images/6953_n.jpg",biography:"Born in Istanbul in 1974, Dr. Emes graduated from Istanbul University Faculty of Dentistry in 1997 and completed his PhD degree in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery in 2005. He has papers published in international and national scientific journals, including research articles on implantology, oroantral fistulas, odontogenic cysts, and temporomandibular disorders. Dr. Emes is currently working as a full-time academic staff in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery.",institutionString:null,institution:{name:"Istanbul University",country:{name:"Turkey"}}},{id:"192229",title:"Ph.D.",name:"Ana Luiza",middleName:null,surname:"De Carvalho Felippini",slug:"ana-luiza-de-carvalho-felippini",fullName:"Ana Luiza De Carvalho Felippini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192229/images/system/192229.jpg",biography:null,institutionString:"University of São Paulo",institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"256851",title:"Prof.",name:"Ayşe",middleName:null,surname:"Gülşen",slug:"ayse-gulsen",fullName:"Ayşe Gülşen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256851/images/9696_n.jpg",biography:"Dr. Ayşe Gülşen graduated in 1990 from Faculty of Dentistry, University of Ankara and did a postgraduate program at University of Gazi. \nShe worked as an observer and research assistant in Craniofacial Surgery Departments in New York, Providence Hospital in Michigan and Chang Gung Memorial Hospital in Taiwan. \nShe works as Craniofacial Orthodontist in Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, University of Gazi, Ankara Turkey since 2004.",institutionString:"Univeristy of Gazi",institution:null},{id:"255366",title:"Prof.",name:"Tosun",middleName:null,surname:"Tosun",slug:"tosun-tosun",fullName:"Tosun Tosun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255366/images/7347_n.jpg",biography:"Graduated at the Faculty of Dentistry, University of Istanbul, Turkey in 1989;\nVisitor Assistant at the University of Padua, Italy and Branemark Osseointegration Center of Treviso, Italy between 1993-94;\nPhD thesis on oral implantology in University of Istanbul and was awarded the academic title “Dr.med.dent.”, 1997;\nHe was awarded the academic title “Doç.Dr.” (Associated Professor) in 2003;\nProficiency in Botulinum Toxin Applications, Reading-UK in 2009;\nMastership, RWTH Certificate in Laser Therapy in Dentistry, AALZ-Aachen University, Germany 2009-11;\nMaster of Science (MSc) in Laser Dentistry, University of Genoa, Italy 2013-14.\n\nDr.Tosun worked as Research Assistant in the Department of Oral Implantology, Faculty of Dentistry, University of Istanbul between 1990-2002. \nHe worked part-time as Consultant surgeon in Harvard Medical International Hospitals and John Hopkins Medicine, Istanbul between years 2007-09.\u2028He was contract Professor in the Department of Surgical and Diagnostic Sciences (DI.S.C.), Medical School, University of Genova, Italy between years 2011-16. \nSince 2015 he is visiting Professor at Medical School, University of Plovdiv, Bulgaria. \nCurrently he is Associated Prof.Dr. at the Dental School, Oral Surgery Dept., Istanbul Aydin University and since 2003 he works in his own private clinic in Istanbul, Turkey.\u2028\nDr.Tosun is reviewer in journal ‘Laser in Medical Sciences’, reviewer in journal ‘Folia Medica\\', a Fellow of the International Team for Implantology, Clinical Lecturer of DGZI German Association of Oral Implantology, Expert Lecturer of Laser&Health Academy, Country Representative of World Federation for Laser Dentistry, member of European Federation of Periodontology, member of Academy of Laser Dentistry. Dr.Tosun presents papers in international and national congresses and has scientific publications in international and national journals. He speaks english, spanish, italian and french.",institutionString:null,institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",biography:"Zühre Akarslan was born in 1977 in Cyprus. She graduated from Gazi University Faculty of Dentistry, Ankara, Turkey in 2000. \r\nLater she received her Ph.D. degree from the Oral Diagnosis and Radiology Department; which was recently renamed as Oral and Dentomaxillofacial Radiology, from the same university. \r\nShe is working as a full-time Associate Professor and is a lecturer and an academic researcher. \r\nHer expertise areas are dental caries, cancer, dental fear and anxiety, gag reflex in dentistry, oral medicine, and dentomaxillofacial radiology.",institutionString:"Gazi University",institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"256417",title:"Associate Prof.",name:"Sanaz",middleName:null,surname:"Sadry",slug:"sanaz-sadry",fullName:"Sanaz Sadry",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256417/images/8106_n.jpg",biography:null,institutionString:null,institution:null},{id:"272237",title:"Dr.",name:"Pinar",middleName:"Kiymet",surname:"Karataban",slug:"pinar-karataban",fullName:"Pinar Karataban",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272237/images/8911_n.png",biography:"Assist.Prof.Dr.Pınar Kıymet Karataban, DDS PhD \n\nDr.Pınar Kıymet Karataban was born in Istanbul in 1975. After her graduation from Marmara University Faculty of Dentistry in 1998 she started her PhD in Paediatric Dentistry focused on children with special needs; mainly children with Cerebral Palsy. She finished her pHD thesis entitled \\'Investigation of occlusion via cast analysis and evaluation of dental caries prevalance, periodontal status and muscle dysfunctions in children with cerebral palsy” in 2008. She got her Assist. Proffessor degree in Istanbul Aydın University Paediatric Dentistry Department in 2015-2018. ın 2019 she started her new career in Bahcesehir University, Istanbul as Head of Department of Pediatric Dentistry. In 2020 she was accepted to BAU International University, Batumi as Professor of Pediatric Dentistry. She’s a lecturer in the same university meanwhile working part-time in private practice in Ege Dental Studio (https://www.egedisklinigi.com/) a multidisciplinary dental clinic in Istanbul. Her main interests are paleodontology, ancient and contemporary dentistry, oral microbiology, cerebral palsy and special care dentistry. She has national and international publications, scientific reports and is a member of IAPO (International Association for Paleodontology), IADH (International Association of Disability and Oral Health) and EAPD (European Association of Pediatric Dentistry).",institutionString:null,institution:null},{id:"202198",title:"Dr.",name:"Buket",middleName:null,surname:"Aybar",slug:"buket-aybar",fullName:"Buket Aybar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202198/images/6955_n.jpg",biography:"Buket Aybar, DDS, PhD, was born in 1971. She graduated from Istanbul University, Faculty of Dentistry, in 1992 and completed her PhD degree on Oral and Maxillofacial Surgery in Istanbul University in 1997.\nDr. Aybar is currently a full-time professor in Istanbul University, Faculty of Dentistry Department of Oral and Maxillofacial Surgery. She has teaching responsibilities in graduate and postgraduate programs. Her clinical practice includes mainly dentoalveolar surgery.\nHer topics of interest are biomaterials science and cell culture studies. She has many articles in international and national scientific journals and chapters in books; she also has participated in several scientific projects supported by Istanbul University Research fund.",institutionString:null,institution:null},{id:"260116",title:"Dr.",name:"Mehmet",middleName:null,surname:"Yaltirik",slug:"mehmet-yaltirik",fullName:"Mehmet Yaltirik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/260116/images/7413_n.jpg",biography:"Birth Date 25.09.1965\r\nBirth Place Adana- Turkey\r\nSex Male\r\nMarrial Status Bachelor\r\nDriving License Acquired\r\nMother Tongue Turkish\r\n\r\nAddress:\r\nWork:University of Istanbul,Faculty of Dentistry, Department of Oral Surgery and Oral Medicine 34093 Capa,Istanbul- TURKIYE",institutionString:null,institution:null},{id:"172009",title:"Dr.",name:"Fatma Deniz",middleName:null,surname:"Uzuner",slug:"fatma-deniz-uzuner",fullName:"Fatma Deniz Uzuner",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/172009/images/7122_n.jpg",biography:"Dr. Deniz Uzuner was born in 1969 in Kocaeli-TURKEY. After graduating from TED Ankara College in 1986, she attended the Hacettepe University, Faculty of Dentistry in Ankara. \nIn 1993 she attended the Gazi University, Faculty of Dentistry, Department of Orthodontics for her PhD education. After finishing the PhD education, she worked as orthodontist in Ankara Dental Hospital under the Turkish Government, Ministry of Health and in a special Orthodontic Clinic till 2011. Between 2011 and 2016, Dr. Deniz Uzuner worked as a specialist in the Department of Orthodontics, Faculty of Dentistry, Gazi University in Ankara/Turkey. In 2016, she was appointed associate professor. Dr. Deniz Uzuner has authored 23 Journal Papers, 3 Book Chapters and has had 39 oral/poster presentations. She is a member of the Turkish Orthodontic Society. Her knowledge of English is at an advanced level.",institutionString:null,institution:null},{id:"332914",title:"Dr.",name:"Muhammad Saad",middleName:null,surname:"Shaikh",slug:"muhammad-saad-shaikh",fullName:"Muhammad Saad Shaikh",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Jinnah Sindh Medical University",country:{name:"Pakistan"}}},{id:"315775",title:"Dr.",name:"Feng",middleName:null,surname:"Luo",slug:"feng-luo",fullName:"Feng Luo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Sichuan University",country:{name:"China"}}},{id:"423519",title:"Dr.",name:"Sizakele",middleName:null,surname:"Ngwenya",slug:"sizakele-ngwenya",fullName:"Sizakele Ngwenya",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"419270",title:"Dr.",name:"Ann",middleName:null,surname:"Chianchitlert",slug:"ann-chianchitlert",fullName:"Ann Chianchitlert",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"419271",title:"Dr.",name:"Diane",middleName:null,surname:"Selvido",slug:"diane-selvido",fullName:"Diane Selvido",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"419272",title:"Dr.",name:"Irin",middleName:null,surname:"Sirisoontorn",slug:"irin-sirisoontorn",fullName:"Irin Sirisoontorn",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"355660",title:"Dr.",name:"Anitha",middleName:null,surname:"Mani",slug:"anitha-mani",fullName:"Anitha Mani",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"355612",title:"Dr.",name:"Janani",middleName:null,surname:"Karthikeyan",slug:"janani-karthikeyan",fullName:"Janani Karthikeyan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"334400",title:"Dr.",name:"Suvetha",middleName:null,surname:"Siva",slug:"suvetha-siva",fullName:"Suvetha Siva",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"334239",title:"Prof.",name:"Leung",middleName:null,surname:"Wai Keung",slug:"leung-wai-keung",fullName:"Leung Wai Keung",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Hong Kong",country:{name:"China"}}}]}},subseries:{item:{id:"22",type:"subseries",title:"Applied Intelligence",keywords:"Machine Learning, Intelligence Algorithms, Data Science, Artificial Intelligence, Applications on Applied Intelligence",scope:"This field is the key in the current industrial revolution (Industry 4.0), where the new models and developments are based on the knowledge generation on applied intelligence. The motor of the society is the industry and the research of this topic has to be empowered in order to increase and improve the quality of our lives.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11418,editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",slug:"carlos-travieso-gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",biography:"Carlos M. Travieso-González received his MSc degree in Telecommunication Engineering at Polytechnic University of Catalonia (UPC), Spain in 1997, and his Ph.D. degree in 2002 at the University of Las Palmas de Gran Canaria (ULPGC-Spain). He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. He won the “Catedra Telefonica” Awards in Modality of Knowledge Transfer, 2017, 2018, and 2019 editions, and awards in Modality of COVID Research in 2020.\n\nPublic References:\nResearcher ID http://www.researcherid.com/rid/N-5967-2014\nORCID https://orcid.org/0000-0002-4621-2768 \nScopus Author ID https://www.scopus.com/authid/detail.uri?authorId=6602376272\nScholar Google https://scholar.google.es/citations?user=G1ks9nIAAAAJ&hl=en \nResearchGate https://www.researchgate.net/profile/Carlos_Travieso",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,series:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403"},editorialBoard:[{id:"13633",title:"Prof.",name:"Abdelhamid",middleName:null,surname:"Mellouk",slug:"abdelhamid-mellouk",fullName:"Abdelhamid 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Her fields of interest are entomology, toxicology, forensic entomology.",institutionString:"Classes et Events in Sciences (C.E.S.)",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"6",totalChapterViews:"0",totalEditedBooks:"7",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"12223",title:"Sustainable Management of Natural Resources",subtitle:null,isOpenForSubmission:!0,hash:"1881a08bbd8f5dc1102c5cb7c635bc35",slug:null,bookSignature:"Dr. Mohd Nazip Suratman and Dr. Engku Azlin Rahayu Engku Ariff",coverURL:"https://cdn.intechopen.com/books/images_new/12223.jpg",editedByType:null,submissionDeadline:"July 19th 2022",editors:[{id:"144417",title:"Dr.",name:"Mohd Nazip",middleName:null,surname:"Suratman",slug:"mohd-nazip-suratman",fullName:"Mohd Nazip Suratman",profilePictureURL:"https://mts.intechopen.com/storage/users/144417/images/system/144417.jpg",biography:"Mohd Nazip Suratman is a Professor of Forestry at the Faculty of Applied Sciences, and a Principal Fellow at the Institute for Biodiversity and Sustainable Development, Universiti Teknologi MARA (UiTM), Malaysia, He earned a B. Sc in Forestry from Universiti Putra Malaysia (UPM) and an M. S from the University of Nebraska-Lincoln (UNL), USA. He was then honored with a prestigious fellowship from the Canadian Commonwealth to pursue a Ph.D. degree at the University of British Columbia (UBC), Canada, where he worked on the application of remote sensing for forest resources management. He has been involved in numerous collaborative international research projects that led to publications in reputable journals. Altogether, he has published a total of 14 books and more than 200 research publications. His research interests cover several aspects of forestry, mainly forest modeling, forest ecology, and biodiversity. He received the UiTM’s Best Researcher and Top Talent Awards in 2015 and 2021, respectively. 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