The reality of myocardial revascularization strategies in patients with isolated coronary artery disease [18].
\\n\\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\\n\\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/132"}},components:[{type:"htmlEditorComponent",content:'With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 2021
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In particular, investments in Research and Development represent an important tool for promoting innovation and for enhancing the capital invested in the market. By now, innovation is linked with different concepts, from entrepreneurship to sustainability, from economics to management. The analysis of the innovation process involves different skills to overcome the high degree of competitiveness and allow higher levels of profits. In the text, the interactions among innovation, entrepreneurship, and ecosystems are investigated. It is an attempt to prepare the theoretical bases to face in an appropriate way the transformations of modern economic and organizational systems and to suggest adequate support policies.",isbn:"978-1-80355-505-8",printIsbn:"978-1-80355-504-1",pdfIsbn:"978-1-80355-506-5",doi:"10.5772/intechopen.98055",price:119,priceEur:129,priceUsd:155,slug:"innovation-research-and-development-and-capital-evaluation",numberOfPages:146,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"a644b267db0cddd8a16f0dfadf03bad6",bookSignature:"Luigi Aldieri",publishedDate:"June 8th 2022",coverURL:"https://cdn.intechopen.com/books/images_new/11258.jpg",numberOfDownloads:535,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:0,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 15th 2021",dateEndSecondStepPublish:"October 13th 2021",dateEndThirdStepPublish:"December 12th 2021",dateEndFourthStepPublish:"March 2nd 2022",dateEndFifthStepPublish:"May 1st 2022",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"246585",title:"Prof.",name:"Luigi",middleName:null,surname:"Aldieri",slug:"luigi-aldieri",fullName:"Luigi Aldieri",profilePictureURL:"https://mts.intechopen.com/storage/users/246585/images/system/246585.jpg",biography:'Luigi Aldieri is a Full Professor of Economics at the Department of Economic and Statistical Sciences of the University of Salerno. He holds a Ph.D. in Sciences Economiques et de gestion at the Solvay Business School of Economics and Management (SBS-EM) of Université Libre de Bruxelles (ULB). His Ph.D. thesis \\"Three Essays on Knowledge Diffusion and Firms\\\' Economic Performance\\" is supervised by Prof. Michele Cincera. His research interests embrace Applied Econometrics, the measurement of knowledge, geographic spillovers, and economic performance of large international firms, as well as the empirical analysis of the effects of educational level on fertility in developed countries.',institutionString:"University of Salerno",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"University of Salerno",institutionURL:null,country:{name:"Italy"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"63",title:"Business Administration",slug:"business-management-and-economics-business-administration"}],chapters:[{id:"81262",title:"The Innovative Business Model for Family-Owned Firms in the Era of Digital Entrepreneurship: Evidence from Emerging Economy",doi:"10.5772/intechopen.102459",slug:"the-innovative-business-model-for-family-owned-firms-in-the-era-of-digital-entrepreneurship-evidence",totalDownloads:67,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The current Covid-19 pandemic has been changed the businesses plans. High uncertainty can compel the organization to change the business plan according to the market demand. In the current era of digitalization, organizations are needed to modify the existing business plan and innovate it through technologies. Modifying existing resources according to the market demand is challenging for the organization; employers face many challenges and obstacles. Businesses plan to develop a long-term business model to validate the attractiveness, reduce the avoidable investment of scarce resources, and structure the business process. In the current era of digitalization, businesses, specifically, SMEs cannot compete with the competitors who can adopt digitalization systems. Therefore, the current chapter is trying to find out the challenges faced by SMEs in developing economies during the adoption of the digital business model. In the current chapter, researchers focus on three different kinds of digital technologies that must be part of the business model during the era of digitalization, such as adopting digital technologies (artificial intelligence, Internet of Thing, and virtual reality and to create a new business model following the current era issue, these are the main block to resist of these market uncertainties in a new venture of family firms.",signatures:"Rizwan Ullah Khan, Munir A. Abbasi, Azlan Amran and Arshad Fawad",downloadPdfUrl:"/chapter/pdf-download/81262",previewPdfUrl:"/chapter/pdf-preview/81262",authors:[{id:"354903",title:"Ph.D. Student",name:"Rizwan Ullah",surname:"Khan",slug:"rizwan-ullah-khan",fullName:"Rizwan Ullah Khan"},{id:"435661",title:"Mr.",name:"Munir A.",surname:"Abbasi",slug:"munir-a.-abbasi",fullName:"Munir A. 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This article aims to analyze the role of formality on product, process, organizational and commercial innovations in Cameroon and Senegal. The results obtained using a sample of 1369 firms from data collected by the International Development Research Centre (IDRC) and logistic regression show that formal firms have a better innovation capacity. But the role of formality on innovation tends to be less important for Cameroonian firms. These results show that the Cameroonian authorities must intensify measures in favor of the formalization of enterprises to boost the potential for innovation within enterprises.",signatures:"Martin Ndzana and Gregory Mvogo",downloadPdfUrl:"/chapter/pdf-download/81010",previewPdfUrl:"/chapter/pdf-preview/81010",authors:[{id:"437463",title:"Dr.",name:"Martin",surname:"Ndzana",slug:"martin-ndzana",fullName:"Martin Ndzana"},{id:"437466",title:"Dr.",name:"Gregory",surname:"Mvogo",slug:"gregory-mvogo",fullName:"Gregory Mvogo"}],corrections:null},{id:"79896",title:"The Influence of Foreign Investors on the Development of Polish Enterprises: A Case Study of Bank Polska Kasa Opieki Spółka Akcyjna",doi:"10.5772/intechopen.101453",slug:"the-influence-of-foreign-investors-on-the-development-of-polish-enterprises-a-case-study-of-bank-pol",totalDownloads:109,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Pursuant to the definition proposed by Eurostat, foreign direct investment takes place when a resident entity in one economy seeks to obtain a lasting interest in an enterprise resident in another economy. A lasting interest implies the existence of a long-term relationship between the direct investor and the enterprise, and an investor’s significant influence on the management of the enterprise. Foreign investors do not only exert impact on a given company’s board of directors but, importantly, provide production capital in privatized companies. Additionally, they equip them with both know-how on the performed economic activity and technical know-how. They send their specialists, who introduce international standards in daughter companies smoothly. In this paper, the author deals with the impact of a foreign investor on the development of Bank Pekao. A literature review is applied for this aim. It covers a detailed analysis of transaction documentation and post-audit statements of the Supreme Audit Office and delegations of the Ministry of State Treasury. Thanks to research, it can be assessed how UniCredito Italiano has positively influenced the operation of Polish bank after the acquisition of shares. Thereby, the results of this study contest popular opinion about exploitation of domestic employees by foreign companies.",signatures:"Waldemar Milewicz",downloadPdfUrl:"/chapter/pdf-download/79896",previewPdfUrl:"/chapter/pdf-preview/79896",authors:[{id:"439873",title:"Dr.",name:"Waldemar",surname:"Milewicz",slug:"waldemar-milewicz",fullName:"Waldemar Milewicz"}],corrections:null},{id:"80382",title:"Innovation and Entrepreneurial Ecosystems",doi:"10.5772/intechopen.102344",slug:"innovation-and-entrepreneurial-ecosystems",totalDownloads:162,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Nowadays special attention is paid to ecosystem conditions that encourage innovation and entrepreneurship. This chapter provides a critical review and expands the understanding of the concepts of the innovation ecosystem and entrepreneurial ecosystem. The entrepreneurial ecosystem represents a collection of actors that interact within a geographically bound entrepreneurial environment and factors, which contribute to the development of productive entrepreneurship. Innovation ecosystems represent communities of interacting actors that support innovation processes and create technologies and innovations. The focus of the innovation ecosystem is on value creation through the creation of innovations, while the focus of the entrepreneurship ecosystem is on the development of entrepreneurship. There are differences between the two concepts, but also the relationships and interactions, which are revealed in the chapter. Also, there are highlighted the framework, components and features of both entrepreneurial and innovation ecosystems.",signatures:"Alina Ianioglo",downloadPdfUrl:"/chapter/pdf-download/80382",previewPdfUrl:"/chapter/pdf-preview/80382",authors:[{id:"440960",title:"Ph.D.",name:"Alina",surname:"Ianioglo",slug:"alina-ianioglo",fullName:"Alina Ianioglo"}],corrections:null},{id:"80138",title:"Valuation and Capital Return as Inverse Problems",doi:"10.5772/intechopen.101943",slug:"valuation-and-capital-return-as-inverse-problems",totalDownloads:80,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The capital return rate is the relative time change rate of value. Correspondingly, the current value can be produced in terms of value change rate divided by capital return rate. There is a variety of ways to approximate the expected capital return rate. These are briefly discussed. The approximation of the value change rate is still more variant, depending on the type of businesses discussed. A variety of businesses may appear within a firm, in which case the value change rates must be integrated. An example is provided of a real estate firm benefiting from the growth of multiannual plants of varying age. It is found that the application of a duration-dependent reference capital return rate increases the value increment rate of juvenile stands and decreases that of mature stands, however increasing the valuation result of both.",signatures:"Petri P. Kärenlampi",downloadPdfUrl:"/chapter/pdf-download/80138",previewPdfUrl:"/chapter/pdf-preview/80138",authors:[{id:"424762",title:"Prof.",name:"Petri P.",surname:"Kärenlampi",slug:"petri-p.-karenlampi",fullName:"Petri P. 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In this chapter, we consider a centralized one-echelon supply chain with two-retailers selling products and facing stochastic demand.",signatures:"Elleuch Fadoi",downloadPdfUrl:"/chapter/pdf-download/80595",previewPdfUrl:"/chapter/pdf-preview/80595",authors:[{id:"448704",title:"Ph.D.",name:"Elleuch",surname:"Fadoi",slug:"elleuch-fadoi",fullName:"Elleuch Fadoi"}],corrections:null},{id:"81059",title:"New Product Development Strategies and Methods: Implications for the Indian Readymade Apparel Sector",doi:"10.5772/intechopen.103128",slug:"new-product-development-strategies-and-methods-implications-for-the-indian-readymade-apparel-sector",totalDownloads:37,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Today, the intense global competition in the textile and apparel industry made the firms worldwide to be more innovative and competitive by heavily investing into the New Product Development Strategies and Methods. In this context, the present study attempts to (i) understand New Product Development Approaches and Strategies adopted by key global and domestic brands operating in the Indian market and (ii) derive lessons for the development of future models of New Product Development in the Indian Textile and Apparel Industry. The brands have been selected on the basis of their popularity and positioning in the Indian Textile markets.",signatures:"Mitali Gupta",downloadPdfUrl:"/chapter/pdf-download/81059",previewPdfUrl:"/chapter/pdf-preview/81059",authors:[{id:"438907",title:"Dr.",name:"Mitali",surname:"Gupta",slug:"mitali-gupta",fullName:"Mitali Gupta"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"6725",title:"Firm Value",subtitle:"Theory and Empirical Evidence",isOpenForSubmission:!1,hash:"df56274854b9ccf88ca5c4b342713671",slug:"firm-value-theory-and-empirical-evidence",bookSignature:"Paolo Saona Hoffmann",coverURL:"https://cdn.intechopen.com/books/images_new/6725.jpg",editedByType:"Edited by",editors:[{id:"201486",title:"Ph.D.",name:"Paolo",surname:"Saona Hoffmann",slug:"paolo-saona-hoffmann",fullName:"Paolo Saona Hoffmann"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6482",title:"Digital Communication Management",subtitle:null,isOpenForSubmission:!1,hash:"bdc8d07af59256c38e787be4f8242cc0",slug:"digital-communication-management",bookSignature:"Beatriz Peña-Acuña",coverURL:"https://cdn.intechopen.com/books/images_new/6482.jpg",editedByType:"Edited by",editors:[{id:"194887",title:"Dr.",name:"Beatriz",surname:"Peña-Acuña",slug:"beatriz-pena-acuna",fullName:"Beatriz Peña-Acuña"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5753",title:"Intellectual Property Rights",subtitle:null,isOpenForSubmission:!1,hash:"c482cb3d02459eedcb10e874c078f272",slug:"intellectual-property-rights",bookSignature:"Sakthivel Lakshmana Prabu and Timmadonu Narasimman Kuppusami Suriyaprakasha",coverURL:"https://cdn.intechopen.com/books/images_new/5753.jpg",editedByType:"Edited by",editors:[{id:"91590",title:"Dr.",name:"Sakthivel",surname:"Lakshmana Prabu",slug:"sakthivel-lakshmana-prabu",fullName:"Sakthivel Lakshmana Prabu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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The general pathology refers to three situations:
\nThe predominant type is often seen with intimal fatty plaque formation including central lipid-rich core. We want to mention about this type of atherosclerosis.
\nThe second morphologic type of atherosclerosis, Mönckeberg’s medial calcific sclerosis, is seen in the muscular arteries with a medial calcification. This form is not prominent as classic atherosclerosis and mostly seen after the age of 50. This can be seen radiologically and can be felt with palpation.
\nThe third type is the disorders of the small arteries and arterioles, named arteriosclerosis. This is seen mostly with hypertensive and diabetic patients. This refers to stiffening or hardening of the artery walls.
\nThe final result of atherosclerosis is that arteries become narrowed and hardened due to an excessive buildup of plaque around the artery wall. The disease disrupts the flow of blood around the body, posing serious cardiovascular complications.
\nAtherosclerosis can be seen in all arteries in the body. But we will instruct about the coronary atherosclerosis. Atherosclerosis is the most common cause of death in the western countries [1].
\nArteries contain what is called an endothelium, a thin layer of cells that keeps the artery smooth and allows blood to flow easily. Endothelial damage starts the first step of atherosclerosis. After this LDL cholesterol accumulates in the artery wall. Inflammatory process starts after this accumulation, and macrophages reach the endothelium to clean up cholesterol. But some macrophages stuck in the affected part of the artery wall in this process. Over time this results in plaque being built up, consisting of cholesterol and macrophage white blood cells.
\nThe plaque clogs up the artery, disrupting the flow of blood. This potentially causes blood clots that can result in life-threatening conditions such as
Some risk factors are follows: age, sex, familial predisposition, hyperlipidemia, hypertension, diabetes mellitus, smoking, obesity, insufficient physical activity, etc. Whatever the main reason or the risk factor is, once atherosclerosis is formed, several life-threatening cardiovascular disorders can be seen. So, it has to be revealed.
\nThe role of the circulation is to service the needs of the tissues. It includes transporting nutrients to thecells of the body and waste products away from the cells of the body. And finally transporting hormones from one part of the body to another. Naturally, circulation maintains an appropriate environment in all the tissue fluids of the body for optimal survival and function of the cells.
\nSystemic circulation, pulmonary circulation, peripheral circulation, etc. have some details to maintain the blood flow. The arteries are the large conductive vessels that transport blood under high pressure to the tissues. The arterioles are the last small branches of the arterial system. And, the capillaries are where the exchange of fluid, electrolytes, nutrients, hormones, and other substances occurs. And, of course veins, venules, collect blood from the capillaries. Our main subject is atherosclerosis of arterial vessels.
\nWe have to learn the normal state before discussing the pathological status. The normal artery wall is consisting of intima, media, and adventitia. Lumen is lined by a monolayer of endothelial cells that overlies smooth muscle cells. The inner layer of smooth muscle cells, known as the intima, is circumscribed by the internal elastic lamina. The media layer is between the internal elastic lamina and external elastic lamina. The media is another layer of smooth muscle cells. Outside the external elastic lamina is an adventitia part that is rarely populated by cells and microvessels of the vasa vasorum.
\nAtherosclerosis is a progressive disease of medium- and large-sized arteries characterized by focal intimal lesions called atheromas or atherosclerotic plaques that protrude into vessel lumen and eventually leading to various complications [2]. There are several diseases led by atherosclerosis: coronary artery disease, peripheral artery disease, and carotid artery disease. These are real threats for mortality and morbidity in the developed countries.
\nAtherosclerosis is a chronic, inflammatory, fibroproliferative disease of medium- and large-sized arteries [3]. There are different stages to form the atherosclerotic plaque. The initiation phase is the beginning and the progression of the plaque and the final complication stage.
\nChronic or recurrent endothelial damage is the cornerstone of the “response to damage” hypothesis. Hyperlipidemia, hypertension, smoking, immunoreactions, hemodynamic factors, toxins, and viruses can cause this chronic endothelial damage. Hemodynamic deformities such as endothelial shear stress, turbulent flow, or unfavorable effects of hypercholesterolemia have a role in the initiation phase. Due to endothelial damage and turbulent flow, endothelial permeability, cell regeneration, and receptor-mediated LDL endocytosis and leukocyte adhesion to endothelium increase.
\nHyperlipidemia has an important role in the atherogenesis [4]. Chronic hyperlipidemia especially hypercholesterolemia can start the endothelial damage. After all, lipoproteins accumulate in these damaged endothelial sites. The cellular response after endothelial damage continues with increased permeability, leukocyte adhesion, monocyte migration, and increased adhesion. This is no longer the initiation phase after this stage; progression has started.
\nSome cellular events take an important part in this phase. Smooth muscles migrate from the media layer to intima and macrophages activated. Monocytes turn to macrophages. Activated macrophages, and smooth muscle cells absorb lipids. Modified lipid molecules due to the oxidative mechanisms of modified LDL arise. Oxide LDL makes some additive affects, in order; (a) with the help of altered receptors LDL absorbed easily by macrophages (b) they are chemotactic to circulating monocytes (c) they enhance adhesion of monocytes (d) they prevent the mobility of macrophages because of this macrophages remain their position and hold on to there (e) they are cytotoxic to endothelium and smooth muscle cells (f) they are immunogenic.
\nThe endothelial damage is like as peeling of the endothelium, because of this damage platelets hold on to the endothelium. Smooth muscle cells derived from media layer migrate to here and starts to duplicate and some of them absorb lipids inside and turns to the foam like cells. And this is shown as fatty streaks.
\nAfter this stage macrophages take a leading role in atherosclerosis. Macrophages secrete interleukin-1 (IL-1) and tumor necrosis factor (TNF), and they are increasing leukocyte adhesion. Again, monocyte chemoattractant protein-1 (MCP-1) produced by macrophages collects leukocytes in the plaque. They have a role to oxidate the LDL. And finally, they secrete stimulators to affecting the smooth muscle cell growth [5].
\nFatty streaks are seen in the childhood phase. This lesion starts as a small 1-mm-diameter intimal color change. With the organization of atherosclerosis, this lesion varies 1–3 mm in diameter and 1–2 cm long. Some of them are raised and some of them not.
\nAtheromatous plaque is the definitive lesion, and it is rich in lipids, but more often it is a lipid and fibrotic lesion. Sometimes, this solid and fibrotic characterized plaque can be rich with cells. Plaques’ diameter can reach to a few cm. Its color changes according to the amount of the lipid. It is changed to a round shape and has an irregular shape.
\nAtheromatous plaques can be seen in the different parts of the body. The prevelence of involvement is in order; Abdominal aorta, coronary arteries, popliteal arteries, descending thoracic aorta, internal carotid arteries and the circle of Willis.
\nFinally, microscopically atherosclerotic plaque has got the main components. These are lipids, vascular smooth cells, monocytes/macrophages, rarely lymphocytes, connective tissue matrix, and fibrils (Figure 1).
\nThe stages of the progression of atherosclerosis.
But more importantly, atherosclerotic plaque changes to four different types. These are complicated plaques:
Calcification of the arteries. They can be seen as a consecutive island, and some of them can be in the whole artery.
Ulceration of the surface of the atherosclerotic plaque. This can cause embolization.
Platelet aggregation can occur on the ulcerated plaque. This can lead to total occlusion of the artery. The most devastating effect of atherosclerosis such as heart attack and stroke is caused by the superimposed thrombosis.
Atherosclerotic aneurysm can occur due to atherosclerosis.
This ulceration can break endothelial integrity, and this can causes rupture of the plaque and can cause bleeding.
Due to the asymptomatic phase of atherosclerosis, it is impossible to say the frequency of atherosclerosis, because the process of atherosclerosis starts with fatty streak in the first decade of lifetime. More advanced lesions begin to develop when individuals are in their second and third decade. Complicated coronary atherosclerosis causes coronary artery disease (CAD) after all. CAD remains the most common pathology with which cardiologists and cardiac surgeons are facing. It is the most common cause of death in Turkey in 2013 [6]; 38.8% of the deaths were due to the ischemic cardiovascular disease. Ischemic heart disease is the most common cause of death in the world as reported by the World Health Organization (WHO) in 2012 [7].
\nInactivation of genes coding for monocyte chemotactic protein-1 (MCP-1), its receptor on monocyte/macrophages (CCR2), and macrophage colony-stimulating factor has a profound impact on the development of atherosclerosis in otherwise identical mice that have been shown in the experimental studies [8]. The etiology of atherosclerosis is unknown, but in the development process of atherosclerosis, the pathophysiology is important to explain the nature. There are some important risk factors in this process. We have to classify risk factors in two. These are modifiable and non-modifiable risk factors.
\n\n
Increased age.
Male gender: lack of atheroprotective properties of estrogen which raises HDL and lowers LDL.
Hereditary factors: history of coronary artery disease (CAD) among first-degree relatives at a young age (before 55 for males and before 65 for females). New markers of the cardiovascular risk factors:
Increased lipoprotein(a) level.
Increased homocysteine level: high levels may promote oxidative stress, vascular inflammation, and platelet adhesiveness. And, this process leads to atherosclerosis. A meta-analysis that collected a large number of prospective studies showed a significant association between the serum level of homocysteine and the incidence of cardiovascular disease [9]. Not just with it, increased blood homocysteine levels are shown in patients with acute myocardial infarction [10].
C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), and other markers of inflammation: activate complement and contribute to a sustained inflammatory state. CRP is a biomarker of tissue damage and inflammation. It is an acute-phase reactant and increases in the inflammatory process. But nowadays, it has been used in the diagnosis of the cardiovascular diseases such as CAD. Sara et al. have showed that hs-CRP is associated with coronary endothelial dysfunction in the asymptomatic coronary artery disease [11].
\n
Dyslipidemia: increased LDL and decreased high-density lipoprotein (HDL).
Tobacco smoking: enhances oxidative modification of LDL, contributes to endothelial dysfunction via oxidant stress, and increases expression of leukocyte adhesion molecules.
Hypertension: increases permeability of the vessel wall to lipoproteins and promotes retention of LDL in the vessel intima by accentuating production of LDL-binding proteoglycans by smooth muscle cells.
Diabetes mellitus: enhances glycation of LDL and is associated with endothelial dysfunction.
Obesity and lack of physical activity: can cause dyslipidemia, hypertension, and insulin resistance.
Stressful lifestyle: better known as Type A personality.
\n
Exercise
High-density lipoprotein (HDL) and its major apolipoprotein (ApoA1)
Coronary atherosclerosis is an important site of atherosclerosis. There are various types of results due to coronary atherosclerosis. Especially, the size of the plaque and the type of the complicated plaque are important for this. Whatever the beginning of the atheromatous plaque, the result can be a fatal heart attack. In developed countries atherosclerosis causes more than half of total mortality. Coronary artery disease (CAD) is responsible for a major proportion of these deaths [12].
\nOnset of the atherosclerotic plaque and speed of the growth and complications, there are several signs and symptoms. Atherosclerosis can be seen in every artery, but for the coronary atherosclerosis, the result of the disease is coronary artery disease, and the symptoms and the signs are due to this. Because of the impaired blood flow, there is a sort of symptoms. Some of them are in the side of the chest, and some of them are systemic because of the impaired circulation.
Chest pain
Shortness of breath
Weakness, tiredness, reduced exertional capacity
Dizziness, palpitations
Leg swelling
Weight gain
Diaphoresis
Tachycardia: common in persons with acute coronary syndrome (ACS) and acute myocardial infarction (AMI)
High or low blood pressure
S4 gallop: a common early finding
S3 gallop: an indication of reduced left ventricular function
Heart murmurs
Tachypnea
Xanthelasmas
Livedo reticularis
Syncope
Leg edema
Rales
Coronary atherosclerosis causes coronary artery disease. Complicated atherosclerotic plaque disrupts the blood flow in the coronary circulation. Impaired blood flow causes a corrupted supply and demand of the oxygen and the metabolites in the heart. This results in a decrease in coronary arterial blood flow and a decrease in oxygen supply. There are several symptoms such as chest pain (angina pectoris), dyspnea, syncope, and sometimes pulmonary edema. Increased demand of blood supply and oxygen starts the angina pectoris. Because of the decreased blood flow in coronary artery, sufficient blood cannot be supplied in the increased effort capacity. The spectrum of presentation includes symptoms and signs consistent with the following conditions:
Asymptomatic state (subclinical phase)
Stable angina pectoris
Unstable angina (i.e., acute coronary syndrome)
Acute myocardial infarction (AMI)
Chronic ischemic cardiomyopathy
Congestive heart failure
Sudden cardiac arrest
Atherosclerosis can be seen in all the arterial sites in the whole body as mentioned before. So, the physical examination can give us very important findings. A well-taken medical history and physical examination can be helpful for the diagnosis. Suspicious findings can lead us to make a decision for the advanced examination.
\nMedical history is the cornerstone of diagnosis. A positive history of typical chest pain, shortness of breath, impaired physical capacity, and the other signs and symptoms are very useful to diagnosis.
\nAtherosclerosis can cause both coronary artery and peripheral artery diseases. Concomitant coronary and peripheral artery disease prevalence is varied 28–94% in published reports [13]. So, on the calcified peripheral artery, palpation or lack of pulse in the peripheral arteries or signs of the peripheral artery disease are important parts of the physical examination.
\nWhat are the parts of the advanced examination?
\nThe purpose is to assess the exercise tolerance of the heart. If there is a myocardial perfusion defect due to coronary artery disease, stress echocardiography can give information about this. The severity of the coronary artery disease can be assessed with this test. Before and after revascularization either PCI or CABG cardiac risk can be evaluated. It can be performed for cardiac risk analyses for noncardiac surgeries. Exercise echocardiography can be used for risk stratification in asymptomatic patients with severe aortic stenosis too [14]. Yao et al. have showed in their clinical study; as the result of the exercise tests, monophasic/normal wall motion was associated with a benign prognosis, but abnormal wall motion responses were associated with a worse prognosis [15].
\nCoronary angiography can come out to such results. This can be a follow-up with medical therapy, a percutaneous coronary intervention can be necessary, or a coronary artery bypass grafting (CABG) is essential to be performed to the patient. All of the interventions are selected due to the percentage of the affected coronary artery lesion, the lesion type, lesion location, the number of the affected coronary artery, and of course the general condition of the patient.
\nSome urgent cases such as acute myocardial infarction PCI can be performed emergent. Primary PCI is called in this situation. But also PCI is used for elective coronary artery disease usually. The procedure starts with a local anesthesia from the arterial puncture side; this can be even femoral or radial artery. Hydrophilic and micro-catheters and guidewires are used to reach coronary arteries. These radiopaque wires are seen easily on fluoroscopy. A balloon angioplasty can be performed to the occlusive lesion. Coronary stents can be implanted to the occluded lesion. Coronary stents vary from bare metal stents to drug eluding stent. These drug eluding stents vary to the first, second, and third generation. Nowadays, fourth-generation bioresorbable stents are mentioned in some clinical trials [17]. Whatever the kind of the stents, the main purpose is to improve blood flow of the myocardium tissue.
\nBefore explaining CABG, we have to mention the indications and guidelines (Table 1 and 2).
\nRevascularization | \nCABG | \nDES | \n||||
---|---|---|---|---|---|---|
\n | No risk | \nDM | \nLVD | \nNo risk | \nDM | \nLVD | \n
One-vessel disease Proximal LAD | \nN | \nN | \nN | \nY | \nY | \nY | \n
Y | \nY | \nY | \nN | \nN | \nN | \n|
Two-vessel disease without LAD Two-vessel disease with LAD | \nN | \nN | \nN | \nY | \nY | \nY | \n
Y | \nY | \nY | \nY | \nY | \nY | \n|
Two-vessel disease + proximal LAD Three-vessel disease | \nY | \nY | \nY | \nN | \nN | \nN | \n
Y | \nY | \nY | \nC | \nC | \nC | \n|
Three-vessel + proximal LAD LMC ± other lesions | \nY | \nY | \nY | \nN | \nN | \nN | \n
Y | \nY | \nY | \nN | \nN | \nN | \n
The reality of myocardial revascularization strategies in patients with isolated coronary artery disease [18].
CABG, coronary artery bypass grafting; DES, drug-eluting stent; DM, diabetes mellitus; LAD, left anterior descending artery; LMC, left main coronary artery disease; LVD, left ventricular dysfunction. *Y, yes; N, no; C, controversial.
Recommendation | \nCABG | \nPCI | \n||
---|---|---|---|---|
\n | Class | \nLevel | \nClass | \nLevel | \n
One or two-vessel disease without LAD | \nIIb | \nC | \nI | \nC | \n
One-vessel disease with proximal LAD | \nI | \nA | \nI | \nA | \n
Two-vessel disease with proximal LAD | \nI | \nB | \nI | \nC | \n
LMC with SYNTAX score < 22 | \nI | \nB | \nI | \nB | \n
LMC with SYNTAX score 23–32 | \nI | \nB | \nIIb | \nB | \n
LMC with SYNTAX score > 32 | \nI | \nB | \nIII | \nB | \n
Three-vessel disease SYNTAX score > 22 | \nI | \nA | \nI | \nB | \n
Three-vessel disease SYNTAX score 23–32 | \nI | \nA | \nIII | \nB | \n
Three-vessel disease SYNTAX score > 32 | \nI | \nA | \nIII | \nB | \n
2014 ESC/EACTS Guidelines on myocardial revascularization guidelines.
Recommendation for the type of revascularization (CABG or PCI) in patients with stable CAD with suitable coronary anatomy for both procedures [19].
(1) Proximal LAD (one- or two-vessel disease)
\n(1) One- or two-vessel disease not involving proximal LAD (if a large territory at risk on noninvasive studies or LVEF <50%, class IIa and IIb become class I indications)
\n1. LMC stenosis.
\n2. LMCE disease.
\n3. Three-vessel disease.
\n4. Two-vessel disease with proximal LAD stenosis and LVEF <50% or demonstrable ischemia.
\n5. One- or two-vessel disease without proximal LAD stenosis but with a large territory at risk and high-risk criteria on noninvasive testing.
\n6. Disabling angina refractory to medical therapy.
\n1. Proximal LAD stenosis with one-vessel disease.
\n2. One- or two-vessel disease without proximal LAD stenosis, but with a moderate territory at risk and demonstrable ischemia.
\n1. LMC stenosis.
\n2. LMCE disease.
\n3. Ongoing ischemia not responsive to maximal nonsurgical therapy.
\nProximal LAD stenosis with one- or two-vessel disease.
\nOne- or two-vessel disease without proximal LAD stenosis when PCI not possible (becomes class I if high-risk criteria on noninvasive testing).
\n1. Failed PCI with persistent pain or shock and anatomically feasible.
\n2. Persistent or recurrent ischemia refractory to medical treatment with acceptable anatomy, which has a significant territory at risk and not a candidate for PCI.
\n3. Requires surgical repair of post-infarct VSD or MR.
\n4. Cardiogenic shock in patients <75 years of age who have ST elevation, LBBB, or a posterior MI within 18 hours onset.
\n5. Life-threatening ventricular arrhythmias in the presence of ≥50% LMC stenosis or three-vessel disease.
\n1. Primary reperfusion in patients who have failed fibrinolytics or PCI and are in the early stages (6–12 h) of an evolving STEMI.
\n2. Mortality with CABG is elevated in the first 3–7 days after STEMI/NSTEMI. After 7 days, criteria for CABG in previous section are applied.
\n1. LMC.
\n2. LMCE.
\n3. Proximal LAD stenosis and two- to three-vessel disease.
\nSignificant viable territory and noncontractile myocardium.
\n1. LMC.
\n2. Three-vessel disease.
\n1. Bypassable one- or two-vessel disease.
\n2. Proximal LAD disease and one- or two-vessel disease. These become class I indications if arrhythmia is resuscitated cardiac death or sustained ventricular tachycardia.
\n1. Ongoing ischemia with significant territory at risk.
\n2. Shock.
\n1. Foreign body in critical position.
\n2. Shock with coagulopathy and no previous sternotomy.
\nShock with coagulopathy and previous sternotomy.
\n1. Disabling angina refractory to medical therapy.
\n2. Nonpatent previous bypass grafts, but with class I indications for native CAD.
\n1. Large territory at risk.
\n2. Vein grafts supplying LAD or large territory are “/> 50% stenosed.
\nClass I: Conditions for which there is evidence and/or general agreement that a given procedure or treatment is useful and effective.
\nClass II: Conditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness or efficacy of a procedure.
\nClass IIa: Weight of evidence/opinion is in favor of usefulness/efficacy.
\nClass IIb: Usefulness/efficacy is less well established by evidence/opinion.
\nClass III: Conditions for which there is evidence and/or general agreement that the procedure/treatment is not useful/effective and in some cases may be harmful.
\nACC, American College of Cardiology; AHA, American Heart Association; CABG, coronary artery bypass grafting; CAD, coronary artery disease; LAD, left anterior descending artery; LBBB, left bundle branch block, LMC, left main coronary artery; LMCE, left main coronary equivalent; LVEF, left ventricular ejection fraction; MI, myocardial infarction; MR, mitral regurgitation; NSTEMI, non-ST elevation myocardial infarction; PCI, percutaneous transluminal coronary angioplasty; STEMI, ST elevation myocardial infarction; VSD, ventricular septal defect [20].
\nThere are several grafts that are used in CABG. Arterial grafts such as left internal and right internal mammary artery (LIMA and RIMA), especially LIMA has got the longest patency rate (10-year patency is 95%). Radial artery can be used, but it is a muscular artery and has got a predisposition to vasospasm. Vena saphena magna is the most used venous graft.
\nThis procedure can be performed with cardiopulmonary bypass (CPB) machine (on-pump), without CPB (off-pump CABG-OPCAB), or beating heart procedures. In the last decade, minimally invasive techniques are rising to individual cases. MIDCAB (minimally invasive direct coronary artery bypass) can be performed without full median sternotomy. This can serve minimal surgical trauma and avoid wound complication.
\nTECAB: this is a robotically assisted total endoscopic coronary artery bypass procedure. This is a complex procedure; surgeon has to steep a learning curve. This procedure can perform both on-pump and off-pump CABG.
\nAwake coronary artery bypass (ACAB) procedure: This avoids side effects of general anesthesia. This includes a minimal invasive procedure without intubation and mechanical ventilatory support. A somatosensory and motor block is made via the T1–T8 level of vertebra. This preserves diaphragmatic ventilation.
\nEarly outcomes after CABG continue to improve, and the early cumulative mortality rate is below 2% and lower than 1% in lower-risk patients. The most common reasons for death are heart failure (65%), neurologic events (7.5%), hemorrhage (7%), respiratory failure (5.5%), and dysrhythmia (5.5%).
\nThe survival rate after isolated CABG is higher than 98% for the first month and 97% for first year, 92% for 5 years, 80% for 10 years, 65% for 15 years, and 51% for 20 years. Usage of LIMA is a predictive parameter for late survival.
\nPrevention of the coronary atherosclerosis has to be lifelong. Individuals need to be careful for risk factors. Adopting a healthy lifestyle. What is inside of this healthy lifestyle?
\nHealthy eating habit for the heart: eating habits are very important in the process of developing atherosclerosis. Healthy diet consists of low amounts of white bread, unsaturated fat products, fast foods, salt, and sugar. It also includes eating dairy products, fruits, vegetables, whole grain, seafood, poultry without skin, lean meats, low-fat milk, or fat-free milk.
\nAfter the start of healthy diet for the heart, weight control can be achieved, because overweight and obese people have high risk for coronary atherosclerosis.
\nPhysical activity: stressful and sedentary lifestyles are the risk factors for coronary atherosclerosis. So, a programmed physical activity can improve the fitness level and the health of the individuals.
\nWe have to mention about risk scores and charts. Risk scores can give us several information about the cardiac risk of our body. This can lead the person to change avoidable habits.
\nFramingham Risk Score: age, sex, cigarette smoking, cholesterol level, high-density lipoprotein (HDL) cholesterol level, systolic blood pressure, and usage of antihypertensive drugs. Some clinics include diabetes mellitus (DM), low-density lipoprotein (LDL) cholesterol, and diastolic blood pressure to modify this risk score.
\nAnother risk score system is SCORE risk charts. This includes SCORE—European High Risk Chart and SCORE—European Low Risk Chart. This score system is based on gender, age, total cholesterol, systolic blood pressure, and cigarette smoking (Figures 2 and 3).
\nTen year risk of fatal CVD in high risk regions of Europe by gender, age, systolic blood pressure, total cholesterol and smoking status.
Ten year risk of fatal CVD in low risk regions of Europe by gender, age, systolic blood pressure, total cholesterol and smoking status.
Coronary atherosclerosis and coronary artery disease (CAD) are the most frequent causes of hospitalization in western countries. It is an important mortality and morbidity cause. The onset of the first lesions begins in the first decade of the life period and proceeds with the lifetime. Risk factors are important and decisive for the progression of the atheromatous plague. A healthy and modified life is the key to prevent from the disease.
\nAccording to the WHO World report on disability 2011, About 15% of the world’s population lives with some form of disability, of whom 2–4% experience significant difficulties in functioning. The global disability prevalence is higher than previous WHO estimates, which date from the 1970s and suggested a figure of around 10%. This global estimate for disability is on the rise due to population aging and the rapid spread of chronic diseases, as well as improvements in the methodologies used to measure disability.
Individuals with disabilities have generally poorer health, lower education, fewer economic opportunities, and higher rates of poverty than people without disabilities. This is mainly due to the obstacles they face in their daily lives and the lack of services available to them. Regarding oral health and access to dental care, the same obstacles are of concern. Oral health is mostly ignored, oral hygiene is neglected, and dental treatments are postponed after other health issues. As a result, individuals with special needs present more dental caries, periodontal problems, orthodontic anomalies, and are more prone to dental diseases compared with the healthy population.
Cerebral palsy is a non-progressive movement, posture, and tone disorder characterized by the impairment of motor activities in the developing fetal or infant brain. Motor disorders are often accompanied by sensory, perception, communication, and behavioral disorders, epilepsy, and musculoskeletal problems [1]. In these patients, muscle weakness or paralysis, unbalanced and irregular gait, uncoordinated movements, sudden seizures, mental retardation, emotional disorders, learning, speech communication disorders, and weakness of swallowing, and coughing reflexes are seen. Because brain development continues during the first 2 years of life, cerebral palsy may develop as a result of brain damage occurring in the prenatal, perinatal, or postnatal periods [2]. However, more than 80% of cases are due to problems in the prenatal period.
Etiologically, in the prenatal period; maternal diseases, trauma, genetics, drug use, bleeding, consanguineous marriage, radiation, in the natal period; premature/late birth, birth trauma due to inappropriate position, low/high birth weight, cord entanglement, lack of oxygen, multiple pregnancies, difficult birth, birth trauma, in the postnatal period; febrile diseases, trauma, hyperbilirubinemia, hypoglycemia, seizure, and cerebral hemorrhage are risk factors for cerebral palsy [3].
It has been reported that the rate of drooling in children with cerebral palsy is 10–58% [4]. Although drooling is normal in infants and young children, it is considered pathological after 4 years of age. Most children with cerebral palsy, who are drooling, are unable to swallow normal saliva due to oral-motor dysfunction, although not much saliva is produced. Perioral eczema, infection, and dehydration occur as a result of drooling out of the mouth [5].
Bruxism, especially in the “Spastic” type, is commonly observed in individuals with cerebral palsy [6]. It has been reported that 36.9–51% of children with cerebral palsy have bruxism. In addition to bruxism, the presence of parafunctional habits such as pacifier-finger sucking, biting objects have also been detected [7].
Periodontal diseases occur more often in children with cerebral palsy due to physical inadequacies, malocclusions, poor oral hygiene, chewing, swallowing difficulties, and consumption of soft food with high carbohydrate content. Besides, the use of phenytoin for seizure control causes gingival hyperplasia [8].
Caries formation is observed at a high rate in children with cerebral palsy. The most important reason for this situation is poor oral hygiene. Other risk factors for caries formation are mouth breathing, the effect of drugs used, and enamel hypoplasia [8]. Differences in food form, increased duration of food consumption, difficult cooperation, and structural defects in the teeth cause an increase in the prevalence of dental caries in children with cerebral palsy, and it has been reported that there are more extracted and untreated teeth compared with healthy children [9].
Malocclusions are observed two times more when compared with healthy individuals, and these patients have unilateral crossbite with excessive overbite and overjet. It has been reported that patients with cerebral palsy have a higher prevalence of malocclusion than healthy individuals, but the severity of malocclusion varies according to the degree of neurological disorder. In these individuals, musculoskeletal anomalies, altered cranial base relationships, premature tooth eruption, mouth breathing, and inadequate lip closure, as well as increased overjet and overbite, can be observed [10, 11].
It has been reported that cerebral palsy is not an etiological factor for erosion, but an increase in erosion since gastro-esophageal reflux is frequently observed in these individuals [12]. It has been reported that in children with cerebral palsy accompanied by gastro-esophageal reflux, especially in the quadriplegia type, the risk of dental erosion is considerably increased and the incidence of oral diseases is quite high [13].
Neuromuscular problems specific to cerebral palsy affect oral health in different ways. Changes in the orofacial region cause nutritional problems as well as the development of parafunctional habits and difficulties in maintaining oral hygiene [14]. In addition, dyskinetic movements cause pathological oral reflexes such as sudden biting or nausea. Gastric reflux associated with a blended diet, often rich in sugar, further puts these patients’ oral health at risk. Neuromuscular problems also prevent the patient from brushing their teeth correctly [15]. Patients with cerebral palsy have difficulty in chewing and swallowing due to changes in tongue, cheek, and lip motility. In these patients, there is an imbalance in the oral microbiota, which favors the proliferation of acidogenic bacterial species, which initiate the caries process [15].
Treatment sessions should be kept brief for patients with cerebral palsy. Patients may need to be moved from a wheelchair to a dental chair. The patient should be placed in the middle of the dental chair with arms and legs as close to the body as possible. After the patient is placed properly in a dental chair, the patient should be checked whether he/she is comfortable and the position of the extremities is correct. To keep the airway open, the patient should be seated at a 45-degree angle, but not in the supine position. The dental chair should be moved slowly, and the light reflector should be turned on slowly to prevent spastic muscle movements and to eliminate the risk of seizure. Myorelaxant agents should be used when necessary.
During dental treatment procedures, it is crucial to balance the patient’s head at all stages. Various mouthguards should be used to control involuntary jaw movements and accidental bites. The airway should be controlled, and frequent breaks should be given to allow the patient to relax and breathe normally. To minimize the startle reflex, the patient should be warned at every stage. The use of stimuli such as sudden movements, sounds, and lights should be avoided. Efficient, fast treatment should be done, and chair time should be minimized to reduce muscle fatigue. In patients with more complex situations, sedation or general anesthesia may be an option [15, 16, 17].
Down syndrome, defined by Down in 1866, is an autosomal anomaly associated with the trisomy of the 21st chromosome pair. Its incidence in the population is 1/800, and it is the most common chromosomal change. There is an extra 21st chromosome (trisomy) in 95% of cases. In some cases, there are 46 normal chromosomes, but the 21st chromosome has been replaced with another chromosome [18, 19]. Mosaic Down syndrome, on the other hand, is caused by the inability of chromosomes to fully divide during cell division in the embryonic period. Some cells of the mosaic type have 47 chromosomes, while others have 46 chromosomes [19]. Individuals with Down syndrome represent learning difficulties, neuropsychiatric disorders, and behavioral problems as well as congenital cardiac anomalies, thyroid problems, seizures, visual and hearing disorders, early-onset dementia, and frequent infections. Also, some individuals with Down syndrome are hepatitis B carriers, and leukemia can be seen in patients with Down syndrome [20].
The only factor known to cause Down syndrome is the age of the mother during pregnancy, the risk increases in pregnancies over the age of 35. However, because young women, in general, have more babies, 75–80% of children with Down syndrome are babies of young mothers. There is no difference between country, nationality, or socioeconomic status [21].
Craniofacial features of individuals with Down syndrome include brachycephaly, broad and short neck, maxillary hypoplasia, sloping palpebral fissures, short ears, midface hypoplasia, curved eyes, narrow, flat nose [22].
Although individuals with Down syndrome have usually a cooperative personality, providing sufficient oral hygiene depends on the family’s knowledge and education level. Down syndrome children might also experience anxiety or fear of dental visits and parents are usually not aware of the dental problems of their children. Also, Down syndrome children using medical agents suffering from seizures experience dry mouth due to a decrease in the salivary flow rate, which may lead to xerostomia preparing a suitable environment for caries and periodontal problems [29, 30]. In addition, high levels of tooth wear are observed in these patients. This is mainly due to bruxism and the acidic oral environment (reflux and vomiting) [22].
The behavior management skills of the dental professional are the key factor in a child’s acceptance of dental treatment [19]. Before determining the right approach to the Down syndrome child, the dentist should consider the level of the mental, emotional, and social development of the child [31]. Most Down syndrome children are affectionate and cooperative for their dental treatment and can be treated easily with the tell-show-do technique [32].
When treating Down Syndrome children, the need for prophylaxis of subacute bacterial endocarditis and the patient’s compliance level should be considered [22]. During treatment, the gag reflex can be reduced by behavioral management techniques, as comforting and distracting patients. It can also be reduced by intraoral massage and pharmacological or non-pharmacological interventions [33]. The recalls should be planned frequently, and preventive dental treatments should be included in the treatment plan. The education of caregivers is crucial for sufficient oral hygiene provision and follow-ups. Mild sedation may be used in children with moderate anxiety. Extremely resistant patients may require general anesthesia [17].
Autism was first described in 1943 by an American child psychiatrist, Leo Kanner. Autism spectrum disorder (ASD) is a neurodevelopmental disorder, characterized by difficulties in communication, social relationships, and limited and repetitive behaviors [34, 35].
Individuals with ASD have characteristics such as stereotypical or repetitive motor behavior (flapping, rocking back and forth), repetitive use of objects (turning coins, putting objects in order), or making repetitive speeches. Many patients adhere to rigid routines in their lives and may have a more rigid thinking pattern. They react negatively to even minor changes or transitions [36].
No specific etiology has been identified for ASD. However, studies indicate a combination of genetical and environmental factors before and after birth, such as parental age, fetal environment (e.g., sex steroids, maternal infections/immune activation, obesity, diabetes, hypertension, or ultrasound examinations), perinatal and obstetric events (e.g., hypoxia), medication (valproate, selective serotonin reuptake inhibitors), smoking and alcohol use, nutrition (e.g., short inter-pregnancy intervals, e.g., vitamin D, iron, zinc, and copper), vaccination, and toxic exposures (air pollution, heavy metals, pesticides, organic pollutants) and low birth weight [37, 38].
In addition, problems such as tongue thrusting, erosion, hyperactive gag reflex, and some malocclusions such as anterior open bite and maxillary retrognathia were also reported in these individuals [42, 43].
Clinical conditions that ASD children present, such as sensorimotor and attention deficits, anxiety and related emotion regulation, comprehensive difficulties, and general speech disorders, create various difficulties for families, educators, and dentists in the provision of oral health care of these children [44]. Besides, parents face difficulties in brushing the teeth of the ASD children due to the sensory sensitivities of their children and the unpredictable or aggressive behavior that may require physical restraints.
In the literature, the caries experience of ASD individuals is controversial. Research reports state that ASD children are more prone to dental caries due to the consumption of sugar-containing food [45, 46, 47]. Besides, insufficient chewing and prolonged time of food staying in the mouth also increase caries formation [48]. The fact that autistic individuals are more difficult to accept oral and dental health care than healthy individuals and that their hand skills are not sufficiently developed and that they cannot perform adequate and effective tooth brushing is also effective in the formation of caries [49].
The impaired behavioral activities and complicated medical conditions make the dental management of patients with ASD challenges. Children with ASD have remarkable difficulties in establishing relationships with other people, understanding and the following information, and dentists may be insufficient in providing cooperation during the dental treatment process [40]. Furthermore, the invasive nature of dental treatment procedures along with the hypersensitivity of children with ASD to sensory stimulation (sound, touch, and light) may trigger undesired responses during dental treatment.
In the dental treatment of autistic individuals, many basic behavior management techniques such as tell-show-do, desensitization, and voice control behavior management can be successfully applied [50].
The dental treatment sessions of autistic individuals should be kept short and the sensory stimulation should be minimized. However, it has been reported that in many cases it may be necessary to use advanced behavior management techniques including sedation and general anesthesia [51, 52]. Also, a dental office filled with unpleasant smells, sounds, and colors can be an overstimulating environment for patients with autism [53].
To minimize anxiety and uncooperative behavior pattern, soothing light, rhythmic music with or without headphones, and having minimal visual stimuli on the walls should be considered. It may also be beneficial to improve cooperation by having the same dental professional in the same operating room at all sessions [54].
If traumatic ulcers or lesions are observed on oral mucosa or gingiva, a mouth guard may be prescribed for patients who have problems with self-injurious behavior or bruxism.
The term intellectual disability (ID) is generally used to describe mental retardation. The most widely used current definition of disability is the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF), which incorporates the complex interactions between health conditions, environmental factors, and personal factors. Regarding a person with an ID, this definition would consider how their factors, health condition, and environment affect their lives (WHO 2001). Three elements are common for people with ID:
Significant impairment of intelligence,
A resultant significant reduction in adaptive behavior/social functioning and
The development of the condition (which persists throughout life) before the age of 18 years.
Mental retardation is a developmental disorder that occurs before the age of 18. In addition to having significant retardation in normal functions, there is an inadequacy in the adaptive skills necessary to maintain daily life. Adaptive skills cover skill areas such as self-care skills such as feeding, dressing, bathing, home life skills such as housekeeping, speaking and understanding language, as well as communication skills, social skills, social usefulness, and professional skills [55].
Intellectual disability may be caused by a problem that starts any time before a child turns 18 years old—even before birth. It can be caused by injury, disease, or a problem in the brain. For many children, the cause of their intellectual disability is not known. Some of the most common known causes of intellectual disability—such as Down syndrome, fetal alcohol syndrome, fragile X syndrome, genetic conditions, birth defects, and infections—occur before birth. Others occur during or soon after birth. Besides, other reasons for intellectual disability do not occur until a child is older; these include serious head injury, stroke, or certain infections [56].
Patients with intellectual disability associated with a syndrome may present typical facial appearance; e.g., in these individuals, the tongue is placed in a protruding position due to macroglossia with micrognathia. Malocclusion, enamel defects, short conical roots, delayed eruption of teeth, congenital tooth agenesis, and tooth malformation are other common intraoral findings [57]. Due to certain genetic conditions or a history of high fever, children with disabilities may have their enamel defects or malformation and thus be more prone to dental caries.
These individuals also have inadequate lip closure, impaired tongue movement, and destabilization of the chewing muscles [55]. Salivary flow rate alterations due to the use of multiple medications along with poor oral hygiene may increase dental plaque and calculus formation, which may lead to dental and periodontal disease and halitosis.
Due to early loss of teeth, speech disorders may also be observed in these individuals [58]. Individuals with intellectual disabilities often consume a cariogenic and soft diet. Besides, individuals consuming daily medicine in the form of syrup constantly have a high risk of caries due to the high sugar content.
It has been shown that individuals with MR (mental retardation) aged 4–18 present significantly higher mean DMFT and dental erosion scores than healthy individuals [59].
Individuals with severe intellectual disability present impaired oral motor functions and weakened muscles, which cause chewing and swallowing problems. These patients often consume a soft diet including puree or semi-solid foods. In addition, individuals with an intellectual disability usually need the help of their caregivers to consume liquids and do not benefit enough from the washing and cleansing effect of liquids because they consume less liquid than healthy individuals. Oral hygiene procedures such as tooth brushing, which require manual dexterity, may not be performed adequately due to varying degrees of motor dysfunction as well as cognitive deficiencies in mentally retarded individuals [55].
Medical history is quite essential to assess the degree and type of ID and associated medical problems [60]. Complete information should be obtained from the parents/caregivers about the medical background, the medicine consumption, the level of communication of the child, the daily functions she/he can perform individually, and if there are behavior problems at home/institution [61].
It may be helpful to familiarize patients and/or caregivers with the clinical environment without any treatment at the first appointment. Dental office and instruments should be introduced patiently, and the tell-show-do method may be also introduced.
In the next session, the dental instruments that may cause anxiety are introduced, and then treatment may start. It is essential to keep the sessions short. The treatment session should begin with the easy-to-tolerate procedures and no pain stimulus should be created during the first procedure.
Behavior management with positive direction and distraction with movies or music may be applied. Perception difficulties are observed in patients with MR. In these patients, directions and explanations should be short and simple and the instructions should be repeated. General anesthesia or sedation should be considered in patients who do not comply and cannot cooperate [55].
Visual impairment was defined as visual acuity less than 20/40 in the better eye. Hearing impairment was defined as the pure-tone average air-conduction hearing threshold worse than 25-dB hearing level (dB HL) in the better ear, averaged over four frequencies: 500, 1000, 2000, and 4000 Hz. [62] Hearing loss can be mild, moderate, moderate, severe, or profound and can affect one or both ears.
Major causes of hearing loss include congenital or early-onset childhood hearing loss due to various chronic middle ear infections, noise-induced hearing loss, age-related hearing loss, and ototoxic drugs that damage the inner ear [62]. Hereditary hearing loss can be conductive, sensorineural, or mixed and is sometimes the result of a genetic trait passed down from a parent.
Children with hearing loss experience social isolation, loneliness, and frustration, and delayed language development due to the loss of ability to communicate with others [62].
Visual impairment is usually defined as a best-corrected visual acuity worse than 20/40 or 20/60 [63]. Visual impairment, or vision loss, is a degree of reduced vision that causes problems that cannot be corrected by general methods, such as with glasses [64]. The term blindness is used for complete or near-complete loss of vision. Physical injury risks such as falling, hitting, and traumatic injuries are reported higher in visually impaired children. Besides, their conceptual development and cognitive skills may be delayed, and they have challenges especially in skills that require abstract thinking [65].
The most common causes of visual impairment are globally uncorrected refractive error (43%), cataracts (33%), and glaucoma (2%). Refractive errors include myopia, hypermetropia, presbyopia, and astigmatism. Cataracts are the most common cause of blindness [66]. Other disorders that may cause visual problems include age-related macular degeneration, diabetic retinopathy, corneal clouding, childhood blindness, and several infections [67]. Visual impairment can also be caused by problems in the brain due to stroke, premature birth, or trauma, among others [68].
Visual impairment may have a negative impact on an individual’s oral hygiene. As a result of the inability to remove the microbial dental plaque appropriately, visually impaired individuals experience more dental caries, calculus, and gingivitis compared with healthy individuals [69]. Reluctance to consume solid foods due to prolonged infantile swallowing patterns and poor oral hygiene may be the main reason for the oral health problems. Besides, enamel hypomineralization has been identified as a possible oral manifestation in visually impaired children.
Visually impaired children are more prone to traumatic dental injuries, especially in the anterior teeth is also a predisposing factor. Visually impaired people generally require a high level of orthodontic treatment due to the increasing prevalence and severity of malocclusions [70].
Hard tissue anomalies such as enamel hypoplasia and higher rates of demineralization in the teeth are seen in patients with hearing impairment. Also, a high incidence of bruxism is one of the problems that occur especially when the individual has both hearing loss and visual impairment [71].
Due to the difficulties of providing oral hygiene, diet type, and problems of accessibility to the routine dental check-ups, dental caries are quite often seen in patients with hearing impairment [72]. The prevalence of gingivitis is also higher in these individuals due to poor oral hygiene and mouth breathing, and they are more prone to develop periodontitis early in life [73, 74].
Visually impaired individuals experience difficulties maintaining oral hygiene since they cannot visualize plaque on the tooth surface and adequately assess whether dental plaque is removed effectively. This leads to the progression of dental caries and also to oral inflammatory diseases [74].
Compared with healthy children, individuals with hearing impairment may have a higher risk of experiencing oral diseases, including dental caries or periodontal disease, as they have difficulties maintaining good oral hygiene [75].
Individuals with hearing impairment should be informed about the procedures to be performed at the first appointment, and an individual method should be developed for the communication during treatment sessions.
The degree of hearing loss should be noted in the patient’s medical history. In the first appointment, it is necessary to avoid exaggerated facial movements and mimics when communicating with the patient, not to cause difficulty to read lips. Comforting the child patient and increasing the sense of trust by smiling will help to establish confidence and healthy communication with the dental professional.
Before starting the dental treatment session, the instruments should be introduced using the show-tell-do method. If the hearing-impaired patient feels that she/he is unable to understand directions, she/he may show fear or aggression. For this reason, communication should be facilitated by reducing external sounds such as high-speed air turbines, dental aspirator, and radio or TV as much as possible. Mirrors, models, pictures, and written information should be used to establish communication [71].
In visually impaired individuals, treatment should be explained using the senses of touch, taste, and smell instead of the tell-show-do technique. The environment should be introduced, and necessary definitions should be made before each treatment. The dental professional should speak to the patient in a clear, warm tone of voice and should use a descriptive manner to explain the procedures. Also, patients should be informed about how the equipment may feel and sound and how the procedures will be performed before the instruments are inserted into the mouth.
The dental restorative materials should be placed in small pieces as the sharp taste may irritate the patient. Since such patients cannot see and remove dental plaque, tooth brushing should be explained by the dentist by holding the brush together with the patient. Oral hygiene education and motivation should be given by the doctor to whom he is accustomed to the treatment of the patient [70, 75].
Special healthcare need patients are literally special patients who need special attention by means of healthcare provision including dental care. The major challenges they have with their overall health may create barriers to access to proper oral healthcare. Oral healthcare for this special group is often neglected or down the list, and as a result, they often attend to dental clinics with emergency.
Individuals with special needs are the most underserved regarding healthcare needs in almost all populations. Due to the challenges of nutrition and insufficient oral hygiene provision, this population is usually more prone to dental caries, periodontal disease, and orthodontic problems. Besides, they face more difficulties accessing professional dental care than other segments of the population.
The field of special care dentistry is attracting more interest of pediatric dentists and general dental practitioners. The inclusion of the specialty programs in the dentistry faculty curriculum may initiate the ideal treatment procedures and regular recalls of these special patients, which may facilitate the access to sufficient dental care provision and regular check-ups for this special group.
Though many countries developed community-based systems to improve oral health for people with special needs, providing good oral health mainly depends on the effort of the families. Therefore the education of the caregiver about oral hygiene provision is also critical for the special needs patient to enjoy a lifetime of oral health the same as other members of the society.
The author declares no conflict of interest.
These Terms and Conditions outline the rules and regulations pertaining to the use of IntechOpen’s website www.intechopen.com and all the subdomains owned by IntechOpen located at 5 Princes Gate Court, London, SW7 2QJ, United Kingdom.
',metaTitle:"Terms and Conditions",metaDescription:"These terms and conditions outline the rules and regulations for the use of IntechOpen Website at https://intechopen.com and all its subdomains owned by Intech Limited located at 7th floor, 10 Lower Thames Street, London, EC3R 6AF, UK.",metaKeywords:null,canonicalURL:"/page/terms-and-conditions",contentRaw:'[{"type":"htmlEditorComponent","content":"By accessing the website at www.intechopen.com you are agreeing to be bound by these Terms of Service, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. Use and/or access to this site is based on full agreement and compliance of these Terms. All materials contained on this website are protected by applicable copyright and trademark laws.
\\n\\nThe following terminology applies to these Terms and Conditions, Privacy Statement, Disclaimer Notice, and any or all Agreements:
\\n\\n“Client”, “Customer”, “You” and “Your” refers to you, the person accessing this website and accepting the Company’s Terms and Conditions;
\\n\\n“The Company”, “Ourselves”, “We”, “Our” and “Us”, refers to our Company, IntechOpen;
\\n\\n“Party”, “Parties”, or “Us”, refers to both the Client and ourselves, or either the Client or ourselves.
\\n\\nAll Terms refer to the offer, acceptance, and consideration of payment necessary to provide assistance to the Client in the most appropriate manner, whether by formal meetings of a fixed duration, or by any other agreed means, for the express purpose of meeting the Client’s needs in respect of provision of the Company’s stated services/products, and in accordance with, and subject to, the prevailing laws of the United Kingdom.
\\n\\nAny use of the above terminology, or other words in the singular, plural, capitalization and/or he/she or they, are taken as interchangeable.
\\n\\nUnless otherwise stated, IntechOpen and/or its licensors own the intellectual property rights for all materials on www.intechopen.com. All intellectual property rights are reserved. You may view, download, share, link and print pages from www.intechopen.com for your own personal use, subject to the restrictions set out in these Terms and Conditions.
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\\n\\nIn no circumstances shall IntechOpen or its suppliers be liable for any damages (including, without limitation, damages for loss of data or profit, or due to business interruption) arising out of the use, or inability to use, the materials on IntechOpen's websites, even if IntechOpen or an IntechOpen authorized representative has been notified orally or in writing of the possibility of such damage. Some jurisdictions do not allow limitations on implied warranties, or limitations of liability for consequential or incidental damages; consequently, these limitations may not apply to you.
\\n\\nIntechopen.com website content and services are provided on an "AS IS" and an "AS AVAILABLE" basis. Material appearing on www.intechopen.com could include minor technical, typographical, or photographic errors. IntechOpen may make changes to any material contained on its website at any time without notice.
\\n\\nIntechOpen has no formal affiliation to any external sites that link to www.intechopen.com, unless otherwise specifically stated. As such, it is not responsible for content that appears on any such sites. The inclusion of any link to IntechOpen does not imply endorsement by IntechOpen. Use of any such linked website is done solely at the user's own discretion.
\\n\\nWe reserve the right of ownership over our entire website www.intechopen.com, and all contents. By using our services, you agree to remove all links to our website immediately upon request. We also reserve the right to amend these Terms and Conditions and our linking policy at any time. By continuing to link to our website, you agree to be bound to, and abide by, these linking Terms and Conditions.
\\n\\nIf you find any link on our website, or any linked website, objectionable for any reason, please Contact Us. We will consider all requests to remove links but will have no obligation to do so.
\\n\\nWithout prior approval and express written permission, you may not create frames around our web pages or use other techniques that alter in any way the visual presentation or appearance of our website.
\\n\\nIntechOpen may revise its Terms of Service for its website at any time without notice. By using this website, you are agreeing to be bound by the current version of all Terms at the time of use.
\\n\\nThese Terms and Conditions are governed by and construed in accordance with the laws of the United Kingdom and you irrevocably submit to the exclusive jurisdiction of the courts in London, United Kingdom.
\\n\\nCroatian version of Terms and Conditions available here
\\n"}]'},components:[{type:"htmlEditorComponent",content:'By accessing the website at www.intechopen.com you are agreeing to be bound by these Terms of Service, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. Use and/or access to this site is based on full agreement and compliance of these Terms. All materials contained on this website are protected by applicable copyright and trademark laws.
\n\nThe following terminology applies to these Terms and Conditions, Privacy Statement, Disclaimer Notice, and any or all Agreements:
\n\n“Client”, “Customer”, “You” and “Your” refers to you, the person accessing this website and accepting the Company’s Terms and Conditions;
\n\n“The Company”, “Ourselves”, “We”, “Our” and “Us”, refers to our Company, IntechOpen;
\n\n“Party”, “Parties”, or “Us”, refers to both the Client and ourselves, or either the Client or ourselves.
\n\nAll Terms refer to the offer, acceptance, and consideration of payment necessary to provide assistance to the Client in the most appropriate manner, whether by formal meetings of a fixed duration, or by any other agreed means, for the express purpose of meeting the Client’s needs in respect of provision of the Company’s stated services/products, and in accordance with, and subject to, the prevailing laws of the United Kingdom.
\n\nAny use of the above terminology, or other words in the singular, plural, capitalization and/or he/she or they, are taken as interchangeable.
\n\nUnless otherwise stated, IntechOpen and/or its licensors own the intellectual property rights for all materials on www.intechopen.com. All intellectual property rights are reserved. You may view, download, share, link and print pages from www.intechopen.com for your own personal use, subject to the restrictions set out in these Terms and Conditions.
\n\nWe employ the use of cookies. By using the IntechOpen website you consent to the use of cookies in accordance with IntechOpen’s Privacy Policy. Most modern day interactive websites use cookies to enable the retrieval of user details for each visit. On our site, cookies are predominantly used to enable functionality and ease of use for those visiting the site.
\n\nIn no circumstances shall IntechOpen or its suppliers be liable for any damages (including, without limitation, damages for loss of data or profit, or due to business interruption) arising out of the use, or inability to use, the materials on IntechOpen's websites, even if IntechOpen or an IntechOpen authorized representative has been notified orally or in writing of the possibility of such damage. Some jurisdictions do not allow limitations on implied warranties, or limitations of liability for consequential or incidental damages; consequently, these limitations may not apply to you.
\n\nIntechopen.com website content and services are provided on an "AS IS" and an "AS AVAILABLE" basis. Material appearing on www.intechopen.com could include minor technical, typographical, or photographic errors. IntechOpen may make changes to any material contained on its website at any time without notice.
\n\nIntechOpen has no formal affiliation to any external sites that link to www.intechopen.com, unless otherwise specifically stated. As such, it is not responsible for content that appears on any such sites. The inclusion of any link to IntechOpen does not imply endorsement by IntechOpen. Use of any such linked website is done solely at the user's own discretion.
\n\nWe reserve the right of ownership over our entire website www.intechopen.com, and all contents. By using our services, you agree to remove all links to our website immediately upon request. We also reserve the right to amend these Terms and Conditions and our linking policy at any time. By continuing to link to our website, you agree to be bound to, and abide by, these linking Terms and Conditions.
\n\nIf you find any link on our website, or any linked website, objectionable for any reason, please Contact Us. We will consider all requests to remove links but will have no obligation to do so.
\n\nWithout prior approval and express written permission, you may not create frames around our web pages or use other techniques that alter in any way the visual presentation or appearance of our website.
\n\nIntechOpen may revise its Terms of Service for its website at any time without notice. By using this website, you are agreeing to be bound by the current version of all Terms at the time of use.
\n\nThese Terms and Conditions are governed by and construed in accordance with the laws of the United Kingdom and you irrevocably submit to the exclusive jurisdiction of the courts in London, United Kingdom.
\n\nCroatian version of Terms and Conditions available here
\n'}]},successStories:{items:[]},authorsAndEditors:{filterParams:{},profiles:[{id:"396",title:"Dr.",name:"Vedran",middleName:null,surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/396/images/7281_n.png",biography:"After obtaining his Master's degree in Mechanical Engineering he continued his education at the Vienna University of Technology where he obtained his PhD degree in 2004. He worked as a researcher at the Automation and Control Institute, Faculty of Electrical Engineering, Vienna University of Technology until 2008. His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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In the Engineering side, Digital Signal Processing, Computer Architecture, Electronics Devices, Digital Filtering and Engineering Management.\nApart from his Academic Interest and activities he loves sport especially, Cricket, Football, Snooker and Squash. He plays cricket for Esbjerg city in the second division team as an opener wicket keeper batsman. 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This chapter dwells on the sources and reactivity of phenolic compounds in water, their toxic effects on humans, and methods of their removal from water. Specific emphasis is placed on the techniques of their removal from water with attention on both conventional and advanced methods. Among these methods are ozonation, adsorption, extraction, photocatalytic degradation, biological, electro‐Fenton, adsorption and ion exchange and membrane‐based separation.",book:{id:"6029",slug:"phenolic-compounds-natural-sources-importance-and-applications",title:"Phenolic Compounds",fullTitle:"Phenolic Compounds - Natural Sources, Importance and Applications"},signatures:"William W. Anku, Messai A. Mamo and Penny P. 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Morales and Sagrario Martínez-Ramírez",authors:[{id:"107401",title:"Dr.",name:"Lucia J",middleName:null,surname:"Fernández",slug:"lucia-j-fernandez",fullName:"Lucia J Fernández"}]},{id:"53128",doi:"10.5772/66368",title:"Phenolic Compounds: Functional Properties, Impact of Processing and Bioavailability",slug:"phenolic-compounds-functional-properties-impact-of-processing-and-bioavailability",totalDownloads:9381,totalCrossrefCites:77,totalDimensionsCites:148,abstract:"In this chapter, we discuss the influence of the processing methods on the content of phenolic compounds in fruits and vegetables. The intake of fruits and vegetables based‐foods are associated with delayed aging and a decreased risk of chronic disease development. Fruits and vegetables can be consumed in natura, but the highest amounts are ingested after some processing methods, such as cooking procedures or sanitizing methods. These methods are directly methods are directly related to alteration on the phenolic content. In addition, the postharvest conditions may modify several phytochemical substances. Phenolic compounds are referred to as phytochemicals found in a large number of foods and beverages. The relative high diversity of these molecules produced by plants must be taken into account when methods of preparation are employed to obtain industrial or homemade products. Phenolic compounds comprise one (phenolic acids) or more (polyphenols) aromatic rings with attached hydroxyl groups in their structures. Their antioxidant capacities are related to these hydroxyl groups and phenolic rings. Despite the antioxidant activity, they have many other beneficial effects on human health. However, before attributing health benefits to these compounds, absorption, distribution, and metabolism of each phenolic compound in the body are important points that should be considered.",book:{id:"5609",slug:"phenolic-compounds-biological-activity",title:"Phenolic Compounds",fullTitle:"Phenolic Compounds - Biological Activity"},signatures:"Igor Otavio Minatel, Cristine Vanz Borges, Maria Izabela Ferreira,\nHector Alonzo Gomez Gomez, Chung-Yen Oliver Chen and\nGiuseppina Pace Pereira Lima",authors:[{id:"146379",title:"Dr.",name:"Giuseppina",middleName:null,surname:"Lima",slug:"giuseppina-lima",fullName:"Giuseppina Lima"},{id:"194002",title:"MSc.",name:"Cristine",middleName:null,surname:"Vanz Borges",slug:"cristine-vanz-borges",fullName:"Cristine Vanz Borges"},{id:"194003",title:"Prof.",name:"Igor Otavio",middleName:null,surname:"Minatel",slug:"igor-otavio-minatel",fullName:"Igor Otavio Minatel"},{id:"194004",title:"Dr.",name:"Maria Izabela",middleName:null,surname:"Ferreira",slug:"maria-izabela-ferreira",fullName:"Maria Izabela Ferreira"},{id:"194005",title:"Prof.",name:"Hector",middleName:null,surname:"Gomez-Gomez",slug:"hector-gomez-gomez",fullName:"Hector Gomez-Gomez"},{id:"194006",title:"Prof.",name:"Chung-Yen Oliver",middleName:null,surname:"Chen",slug:"chung-yen-oliver-chen",fullName:"Chung-Yen Oliver Chen"}]}],mostDownloadedChaptersLast30Days:[{id:"55500",title:"Interpretation of Mass Spectra",slug:"interpretation-of-mass-spectra",totalDownloads:12503,totalCrossrefCites:12,totalDimensionsCites:25,abstract:"The chapter includes an introduction to the main ionisation techniques in mass spectrometry and the way the resulting fragments can be analysed. First, the fundamental notions of mass spectrometry are explained, so that the reader can easily cover this chapter (graphs, main pick, molecular ion, illogical pick, nitrogen rule, etc.). Isotopic percentage and nominal mass calculation are also explained along with fragmentation mechanism. A paragraph emphasises the ionisation energy issues, the basics of ionisation voltage, the developing potential and the energy balance. A frame time of the main theoretical milestones in both theory and experimental mass spectrometry is highlighted here. In the second part of the chapter, the molecular fragmentation for alkanes, iso-alkanes, cycloalkanes, halogen, alcohols, phenols, ethers, carbonyl compounds, carboxylic acids and functional derivatives, nitrogen compounds (amines, nitro compounds), sulphur compounds, heterocycles and biomolecules (amino acids, steroids, triglycerides) is explained. Fragmentation schemes are followed by the simplified spectra, which help the understanding of such complex phenomena. At the end of the chapter, acquisition of mass spectrum is discussed. The chapter presented here is an introduction to mass spectrometry, which, we think, helps the understanding of the mechanism of fragmentation corroborating spectral data and molecular structures.",book:{id:"5735",slug:"mass-spectrometry",title:"Mass Spectrometry",fullTitle:"Mass Spectrometry"},signatures:"Teodor Octavian Nicolescu",authors:[{id:"196775",title:"Dr.",name:"Teodor Octavian",middleName:"Octavian",surname:"Nicolescu",slug:"teodor-octavian-nicolescu",fullName:"Teodor Octavian Nicolescu"}]},{id:"57909",title:"Validation of Analytical Methods",slug:"validation-of-analytical-methods",totalDownloads:6989,totalCrossrefCites:13,totalDimensionsCites:21,abstract:"Method validation is a key element in the establishment of reference methods and within the assessment of a laboratory’s competence in generating dependable analytical records. Validation has been placed within the context of the procedure, generating chemical data. Analytical method validation, thinking about the maximum relevant processes for checking the best parameters of analytical methods, using numerous relevant overall performance indicators inclusive of selectivity, specificity, accuracy, precision, linearity, range, limit of detection (LOD), limit of quantification (LOQ), ruggedness, and robustness are severely discussed in an effort to prevent their misguided utilization and ensure scientific correctness and consistency among publications.",book:{id:"6379",slug:"calibration-and-validation-of-analytical-methods-a-sampling-of-current-approaches",title:"Calibration and Validation of Analytical Methods",fullTitle:"Calibration and Validation of Analytical Methods - A Sampling of Current Approaches"},signatures:"Tentu Nageswara Rao",authors:[{id:"220824",title:"Dr.",name:"Tentu",middleName:null,surname:"Nageswara Rao",slug:"tentu-nageswara-rao",fullName:"Tentu Nageswara Rao"}]},{id:"55440",title:"Solubility Products and Solubility Concepts",slug:"solubility-products-and-solubility-concepts",totalDownloads:3090,totalCrossrefCites:6,totalDimensionsCites:7,abstract:"The chapter refers to a general concept of solubility product Ksp of sparingly soluble hydroxides and different salts and calculation of solubility of some hydroxides, oxides, and different salts in aqueous media. A (criticized) conventional approach, based on stoichiometry of a reaction notation and the solubility product of a precipitate, is compared with the unconventional/correct approach based on charge and concentration balances and a detailed physicochemical knowledge on the system considered, and calculations realized according to generalized approach to electrolytic systems (GATES) principles. An indisputable advantage of the latter approach is proved in simulation of static or dynamic, two-phase nonredox or redox systems.",book:{id:"5891",slug:"descriptive-inorganic-chemistry-researches-of-metal-compounds",title:"Descriptive Inorganic Chemistry Researches of Metal Compounds",fullTitle:"Descriptive Inorganic Chemistry Researches of Metal Compounds"},signatures:"Anna Maria Michałowska-Kaczmarczyk, Aneta Spórna-Kucab and\nTadeusz Michałowski",authors:[{id:"35273",title:"Prof.",name:"Tadeusz",middleName:null,surname:"Michalowski",slug:"tadeusz-michalowski",fullName:"Tadeusz Michalowski"},{id:"203867",title:"Dr.",name:"Anna Maria",middleName:null,surname:"Michałowska-Kaczmarczyk",slug:"anna-maria-michalowska-kaczmarczyk",fullName:"Anna Maria Michałowska-Kaczmarczyk"},{id:"203868",title:"Dr.",name:"Aneta",middleName:null,surname:"Spórna-Kucab",slug:"aneta-sporna-kucab",fullName:"Aneta Spórna-Kucab"}]},{id:"62736",title:"Radioisotope: Applications, Effects, and Occupational Protection",slug:"radioisotope-applications-effects-and-occupational-protection",totalDownloads:4543,totalCrossrefCites:10,totalDimensionsCites:17,abstract:"This chapter presents a brief introduction to radioisotopes, sources and types of radiation, applications, effects, and occupational protection. The natural and artificial sources of radiations are discussed with special reference to natural radioactive decay series and artificial radioisotopes. Applications have played significant role in improving the quality of human life. The application of radioisotopes in tracing, radiography, food preservation and sterilization, eradication of insects and pests, medical diagnosis and therapy, and new variety of crops in agricultural field is briefly described. Radiation interacts with matter to produce excitation and ionization of an atom or molecule; as a result physical and biological effects are produced. These effects and mechanisms are discussed. The dosimetric quantities used in radiological protection are described. Radiological protections and the control of occupational and medical exposures are briefly described.",book:{id:"5903",slug:"principles-and-applications-in-nuclear-engineering-radiation-effects-thermal-hydraulics-radionuclide-migration-in-the-environment",title:"Principles and Applications in Nuclear Engineering",fullTitle:"Principles and Applications in Nuclear Engineering - Radiation Effects, Thermal Hydraulics, Radionuclide Migration in the Environment"},signatures:"Sannappa Jadiyappa",authors:[{id:"239626",title:"Dr.",name:null,middleName:null,surname:"Sannappa J.",slug:"sannappa-j.",fullName:"Sannappa J."}]},{id:"58596",title:"Linearity of Calibration Curves for Analytical Methods: A Review of Criteria for Assessment of Method Reliability",slug:"linearity-of-calibration-curves-for-analytical-methods-a-review-of-criteria-for-assessment-of-method",totalDownloads:8095,totalCrossrefCites:19,totalDimensionsCites:44,abstract:"Calibration curve is a regression model used to predict the unknown concentrations of analytes of interest based on the response of the instrument to the known standards. Some statistical analyses are required to choose the best model fitting to the experimental data and also evaluate the linearity and homoscedasticity of the calibration curve. Using an internal standard corrects for the loss of analyte during sample preparation and analysis provided that it is selected appropriately. After the best regression model is selected, the analytical method needs to be validated using quality control (QC) samples prepared and stored in the same temperature as intended for the study samples. Most of the international guidelines require that the parameters, including linearity, specificity, selectivity, accuracy, precision, lower limit of quantification (LLOQ), matrix effect and stability, be assessed during validation. Despite the highly regulated area, some challenges still exist regarding the validation of some analytical methods including methods when no analyte-free matrix is available.",book:{id:"6379",slug:"calibration-and-validation-of-analytical-methods-a-sampling-of-current-approaches",title:"Calibration and Validation of Analytical Methods",fullTitle:"Calibration and Validation of Analytical Methods - A Sampling of Current Approaches"},signatures:"Seyed Mojtaba Moosavi and Sussan Ghassabian",authors:[{id:"216099",title:"Dr.",name:"Sussan",middleName:null,surname:"Ghassabian",slug:"sussan-ghassabian",fullName:"Sussan Ghassabian"},{id:"216101",title:"Mr.",name:"Seyed Mojtaba",middleName:null,surname:"Moosavi",slug:"seyed-mojtaba-moosavi",fullName:"Seyed Mojtaba Moosavi"}]}],onlineFirstChaptersFilter:{topicId:"8",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"83005",title:"Catalytic Behavior of Extended π-Conjugation in the Kinetics of Sensitizer-Mediator Interaction",slug:"catalytic-behavior-of-extended-conjugation-in-the-kinetics-of-sensitizer-mediator-interaction",totalDownloads:1,totalDimensionsCites:0,doi:"10.5772/intechopen.106511",abstract:"This chapter discusses the catalytic effect of extended π-conjugation on the electron transfer process between ferricyphen-ferrocyanide and ferricypyr-ferrocyanide in an aqueous medium. Ferricyphen and ferricypyr may be feasible options for the sensitizer in dye-sensitized solar cells due to their high reduction potential, stability, capability as an outer-sphere oxidant, and photosensitivity. Meanwhile, ferrocyanide could be used as a mediator in DSSCs instead of iodide to avoid iodate production and achieve a similar reduction potential and stability. This chapter compared the ability of competent putative sensitizers to oxidize the likely mediator in water. In contrast to the 2,2′-dipyridyl chelate, the extended π-conjugation in 1,10-phenanthroline accelerated the redox process by increasing the electron affinity of ferricyphen as compared to ferricypyr. The reactions had the same kinetics but different rate constants, indicating that the ferricyphen-ferrocyanide reaction was several times faster than the ferricypyr-ferrocyanide reaction, revealing and confirming the catalytic influence of extended π-conjugation on the redox process.",book:{id:"11217",title:"Recent Advances in Chemical Kinetics",coverURL:"https://cdn.intechopen.com/books/images_new/11217.jpg"},signatures:"Rozina Khattak"},{id:"83004",title:"Pyridine Heterocycles in the Therapy of Oncological Diseases",slug:"pyridine-heterocycles-in-the-therapy-of-oncological-diseases",totalDownloads:1,totalDimensionsCites:0,doi:"10.5772/intechopen.106406",abstract:"Oncological diseases pose a major challenge for modern medicine. Heterocyclic compounds play a vital role in modern medical and pharmaceutical science as most medicinal substances incorporate them. Nitrogen-containing heterocycles serve as the basis of numerous drugs and, therefore, are deeply involved in the design and synthesis of promising new therapeutic agents. Pyridine or pyrimidine scaffolds, with a number of substituents attached, comprise a large portion of FDA-approved drugs. They are chemically stable in the human body, manifest an affinity for DNA via hydrogen bonding, and present an opportunity for the development of novel anticancer agents. A large number of pyridine-based molecules are synthesized and tested for anticancer activity each year. The present chapter aims to introduce the most current synthetic approaches, published in scientific literature, and would also elaborate on structure-activity relationships described therein.",book:{id:"11562",title:"Chemistry with Pyridine Derivatives",coverURL:"https://cdn.intechopen.com/books/images_new/11562.jpg"},signatures:"Lozan T. Todorov and Irena P. Kostova"},{id:"82969",title:"Utilizing Photocatalysts in Reducing Moisture Absorption in Composites of Natural Fibers",slug:"utilizing-photocatalysts-in-reducing-moisture-absorption-in-composites-of-natural-fibers",totalDownloads:1,totalDimensionsCites:0,doi:"10.5772/intechopen.106543",abstract:"Due to growing environmental consciousness and the depletion of oil supplies, numerous efforts have been made to replace synthetic fibers in fiber-reinforced composites with natural fibers (NFr). The low cost and abundance of NFr and its biodegradability and low density have encouraged researchers worldwide to study their potential applications in several industrial sectors. However, NFr has several disadvantages: excessive moisture absorption and subsequent swelling and degradation, low chemical and fire resistance, and insufficient interfacial interactions with polymers. Consequently, there is great interest in modifying the surface of NFr using a variety of methods. This chapter presents an overview of the NFr, its characterization, the problems associated with adding NFr to polymer composites. This literature survey suggests an in-depth review of photocatalysis by utilizing photocatalysts nanoparticle (PHNPs) aimed at increasing the hydrophobicity and interfacial bonding between the NFr and the matrix Using a photo-induced oxidation mechanism to disassemble water molecules, pollutants, and bacteria in a wet environment. Additionally, we reviewed the effects of these PHNPs on the moisture absorption, mechanical characteristics, and dimensional stability of NFr composites. As a result, this review article may make a valuable contribution to researchers interested in coating and treating NFr to further enhance their surface characteristics.",book:{id:"11559",title:"Photocatalysts - New Perspectives",coverURL:"https://cdn.intechopen.com/books/images_new/11559.jpg"},signatures:"Mohammed Mohammed and Rozyanty Rahman"},{id:"82853",title:"Revealing Retention Mechanisms in Liquid Chromatography: QSRR Approach",slug:"revealing-retention-mechanisms-in-liquid-chromatography-qsrr-approach",totalDownloads:9,totalDimensionsCites:0,doi:"10.5772/intechopen.106245",abstract:"One-factor-at-a-time experimentation was used for a long time as gold-standard optimization for liquid chromatographic (LC) method development. This approach has two downsides as it requires a needlessly great number of experimental runs and it is unable to identify possible factor interactions. At the end of the last century, however, this problem could be solved with the introduction of new chemometric strategies. This chapter aims at presenting quantitative structure–retention relationship (QSRR) models with structuring possibilities, from the point of feature selection through various machine learning algorithms that can be used in model building, for internal and external validation of the proposed models. The presented strategies of QSRR model can be a good starting point for analysts to use and adopt them as a good practice for their applications. QSRR models can be used in predicting the retention behavior of compounds, to point out the molecular features governing the retention, and consequently to gain insight into the retention mechanisms. In terms of these applications, special attention was drawn to modified chromatographic systems, characterized by mobile or stationary phase modifications. Although chromatographic methods are applied in a wide variety of fields, the greatest attention has been devoted to the analysis of pharmaceuticals.",book:{id:"11557",title:"Chemometrics - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11557.jpg"},signatures:"Jovana Krmar, Bojana Svrkota, Nevena Đajić, Jevrem Stojanović, Ana Protić and Biljana Otašević"},{id:"82796",title:"A Revisit of the Underlying Fundamentals in the Laser Emission from BODIPYs",slug:"a-revisit-of-the-underlying-fundamentals-in-the-laser-emission-from-bodipys",totalDownloads:13,totalDimensionsCites:0,doi:"10.5772/intechopen.106334",abstract:"This chapter aims to provide a comprehensive assessment of the laser performance of commercially available laser dyes based on the boron-dipyrromethene (BODIPY) chromophore in a liquid state, as well as to remark the main underlying photophysical signatures triggering such photonic behavior. First, we describe their light absorption and fluorescence properties in solution. This spectroscopic study is supplemented with quantum mechanics calculations and electrochemical measurements. Afterward, the dyes are tested as active media of tunable lasers under transversal pumping. The recorded laser efficiencies and photostabilities are correlated with the registered photophysical properties identifying the main structural guidelines and photonic parameters, which rule the laser bands’ position, intensity, and stability. As a result, we provide a comparative dataset of the laser performance, not available hitherto. Besides, the unraveling of the complex molecular structure-photophysics-laser relationship should help in the rational design of new tunable dye lasers with an improved photonic response along the entire visible region and reaching eventually the near infrared.",book:{id:"12081",title:"Dyes and Pigments - Insights and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/12081.jpg"},signatures:"Alaitz Peñafiel, Ainhoa Oliden-Sánchez, Edurne Avellanal-Zaballa, Leire Gartzia-Rivero, Rebeca Sola-Llano and Jorge Bañuelos"},{id:"82706",title:"Applications of Near-Infrared Spectroscopy (NIRS) in Fish Value Chain",slug:"applications-of-near-infrared-spectroscopy-nirs-in-fish-value-chain",totalDownloads:18,totalDimensionsCites:0,doi:"10.5772/intechopen.105736",abstract:"Near-infrared spectroscopy (NIRS) has undergone a significant evolution in the last years due to the numerous scientific studies that revealed its potential for industrial applications, attracting a growing interest in the food sector. Furthermore, new advances have allowed the reduction in size and cost of the NIR devices, making them appropriate for on-site determinations. The complex structure of the fish value chain, combined to its high market value, makes this sector particularly vulnerable to fraud and adulteration practices. Also, the perishable nature of fish and fish products, as well as the lack of traceability, arises the urgent need for a fast, reliable and portable tool capable of precisely characterizing the quality and authenticity of the product while also ensuring its safety. In this chapter, the capabilities of NIRS combined to several chemometric techniques for quality, authenticity and safety applications are presented through an extensive review of the most recent research works.",book:{id:"11564",title:"Infrared Spectroscopy - Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11564.jpg"},signatures:"Sonia Nieto-Ortega, Rebeca Lara, Giuseppe Foti, Ángela Melado-Herreros and Idoia Olabarrieta"}],onlineFirstChaptersTotal:58},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:"2753-6580",scope:"