Results of one-stage knee revision arthroplasty
\\n\\n
Dr. Pletser’s experience includes 30 years of working with the European Space Agency as a Senior Physicist/Engineer and coordinating their parabolic flight campaigns, and he is the Guinness World Record holder for the most number of aircraft flown (12) in parabolas, personally logging more than 7,300 parabolas.
\\n\\nSeeing the 5,000th book published makes us at the same time proud, happy, humble, and grateful. This is a great opportunity to stop and celebrate what we have done so far, but is also an opportunity to engage even more, grow, and succeed. It wouldn't be possible to get here without the synergy of team members’ hard work and authors and editors who devote time and their expertise into Open Access book publishing with us.
\\n\\nOver these years, we have gone from pioneering the scientific Open Access book publishing field to being the world’s largest Open Access book publisher. Nonetheless, our vision has remained the same: to meet the challenges of making relevant knowledge available to the worldwide community under the Open Access model.
\\n\\nWe are excited about the present, and we look forward to sharing many more successes in the future.
\\n\\nThank you all for being part of the journey. 5,000 times thank you!
\\n\\nNow with 5,000 titles available Open Access, which one will you read next?
\\n\\nRead, share and download for free: https://www.intechopen.com/books
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'
Preparation of Space Experiments edited by international leading expert Dr. Vladimir Pletser, Director of Space Training Operations at Blue Abyss is the 5,000th Open Access book published by IntechOpen and our milestone publication!
\n\n"This book presents some of the current trends in space microgravity research. The eleven chapters introduce various facets of space research in physical sciences, human physiology and technology developed using the microgravity environment not only to improve our fundamental understanding in these domains but also to adapt this new knowledge for application on earth." says the editor. Listen what else Dr. Pletser has to say...
\n\n\n\nDr. Pletser’s experience includes 30 years of working with the European Space Agency as a Senior Physicist/Engineer and coordinating their parabolic flight campaigns, and he is the Guinness World Record holder for the most number of aircraft flown (12) in parabolas, personally logging more than 7,300 parabolas.
\n\nSeeing the 5,000th book published makes us at the same time proud, happy, humble, and grateful. This is a great opportunity to stop and celebrate what we have done so far, but is also an opportunity to engage even more, grow, and succeed. It wouldn't be possible to get here without the synergy of team members’ hard work and authors and editors who devote time and their expertise into Open Access book publishing with us.
\n\nOver these years, we have gone from pioneering the scientific Open Access book publishing field to being the world’s largest Open Access book publisher. Nonetheless, our vision has remained the same: to meet the challenges of making relevant knowledge available to the worldwide community under the Open Access model.
\n\nWe are excited about the present, and we look forward to sharing many more successes in the future.
\n\nThank you all for being part of the journey. 5,000 times thank you!
\n\nNow with 5,000 titles available Open Access, which one will you read next?
\n\nRead, share and download for free: https://www.intechopen.com/books
\n\n\n\n
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"1480",leadTitle:null,fullTitle:"Multi-Agent Systems - Modeling, Interactions, Simulations and Case Studies",title:"Multi-Agent Systems",subtitle:"Modeling, Interactions, Simulations and Case Studies",reviewType:"peer-reviewed",abstract:"A multi-agent system (MAS) is a system composed of multiple interacting intelligent agents. 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One of the most devastating complications of prosthetic knee arthroplasty is a periprosthetic infection. This complication occurs in 1-2% of knee arthroplasties [1,2] and can exceed 4% in immunocompromized individuals [3] and 7% after revision surgery [4]. Prosthetic infection leads to loosening of the implant, [5,6]. In this circumstances revision surgery is required. Because of the diversity of the clinical presentation, i.e. early, intermediate or late infection [1], different surgical methods to treat infected knee prostheses were developed [5,6]. Several treatment methods became well accepted but others are still controversial. In the present review we intend to describe mainly the diagnostic tools for detection of infection and commonly used treatment methods in failed total knee arthroplasty due to infection, with special emphasis on the surgical techniques. Additionally we will describe some trends for the future improvement of the treatment modalities.
The main infecting pathogens, around 50%, of knee prostheses, are the different strains of
Microscopic image (H&E staining, scale 100μ) of biofilm found at the edge of retrieved tibial component of infected knee prosthesis. Amorphous fibrin-like substance, mostly acellular, is evident
Infections associated with prosthetic joints are classified according to time at detection as: early (develop less than 3 months after surgery), delayed [3 to 24 months after surgery) or late (more than 24 months after surgery) [10]. Clinical manifestations are in relation with timing [11]. In early cases clinical manifestations are joint pain, effusion, erythema and warmth of the joint. In delayed cases there are subtle signs such as implant loosening, persistent joint pain. Infection is generally provoked by less virulent microorganism. Late are acquired during hematogenous seeding. In a study of infection with THA during a 16 years period, 29 % of cases were early infections, 41 % delayed and 30% late infections [12]
Accurate and early diagnosis is the first step in effectively managing patients with prosthetic joint infection. Clinical history, physical examination, laboratory data and imaging studies are all taken into consideration. In addition to cultures, the most commonly used laboratory tests include serum inflammatory markers and synovial fluid cytology.
Radiograph of right knee (anterior-posterior view) showing radiolucency under the tibial component indicating periprosthetic infection.
Elevated serum interleukin-6 level correlated positively with the presence of periprosthetic infection in patients undergoing a reoperation at the site of a total hip or knee arthroplasty. In a prospective, case-control study of 58 patients undergoing revision surgery of total hip and knee arthroplasties, serum Interleukin-6 values >10 pg/mL was reported to have a sensitivity of 100%, specificity of 95%, positive predictive value of 89%, negative predictive value of 100% and accuracy of 97% [16].
There are several options when it comes to managing an infected TKA. But before we select any of these, we must take into consideration a series of factors. These factors include the amount of time elapsed from infection, host-related factors, condition of the soft tissues, condition of the implant, virulence of microorganism present and its degree of sensitivity and, last but not least, the patient’s expectations and functional needs.
Planning for any one option requires having detailed clinical records, cultures, x-rays and information of previously received treatment. It is important to identify high-risk patients, i.e. those receiving immunosuppressive treatment or suffering from malnutrition or systemic disease, trying to improve their general condition as much as possible before surgery. Physical examination should provide information about the patient’s neurovascular situation, articular mobility, the condition of their extensor mechanism and their soft tissues as well as about any previous incisions or the need of skin coverage by a plastic surgeon. Preoperative planning is important. The final goal of treatment is to eradicate infection, ease the pain and preserve the limb’s function.
Efficiency of infection eradication with antibiotic therapy only is limited mainly due to the presence of foreign bodies, as implant and acrylic cement, and bacterial biofilm, therefore its use should be restricted to specific circumstances [21,22].
Indications for this type of treatment are as follows: 1) High operative risk due to medical co-morbidities; 2) Presence of low-virulence micro-organisms susceptible oral antibiotics that can be tolerated by the patient; 3) Mechanically stable prosthesis.
Antibiotic treatment should follow 3 basic principles: 1) Use of antibiotics of proven intracellular efficacy such as rifampicin, and new anti-staphylococcal agents. 2) Antibiotics should be combined, using a minimum of two to enhance the possibility of therapeutic success. 3) Long-standing administration, i.e. treatment should last a minimum of 6 months.
The use of new antibiotics could improve results for resistant bacteria. The oxazolidinone linezolid is a new wide-spectrum antibiotic with very attractive pharmacokinetic and activity profiles. It is an antibiotic that acts against methicillin-resistant staphylococci and vancomycin-resistant enterococci.
In early infection debridement and irrigation, without removing the implant, are usually chosen for surgical treatment.
The approach is through the previous surgical wound. Following division the subcutaneous tissue the knee is aspirated again.
Beforehand, the surgeon should carefully evaluate the knee radiographs for any sign of loosening, slight change in the components position, heterotrophic bone formation. All these may indicate chronic situation. Following the surgical exposure the stability of the implant should be evaluated. If reactive tissue found to sprout at the edge of the implant, it also might indicate on chronicity of the infection.[23, 24, 25]
Extensive debridement should be performed followed with vigorous irrigation. The debrided tissue is sent for cultures and pathology while the implant preserved. When no reactive tissue left, last survey should include the gutters, the patellar tracking and the back fold of the knee.
Closure of the knee might need multi layers sutures, using non absorbable materials over heavy drain, which could be left in place for several days to the discharge to stop. Most surgeons allow regular rehabilitation and long term IV antibiotics. Some surgeons leave antibiotic beads and perform recurrent debridement prior to knee rehabilitation [23]
With delayed or late infection the orthopedic surgeon might face various clinical uncertainties with regard of decision making. The following are the most common clinical situations that are usually encountered:
Suppurating knee with positive cultures
Clinically infected knee with positive laboratory data but negative cultures
Clinically suspected infected knee without support of laboratory data
Clinically not infected knee with positive cultures
Identification of the infective germ prior to surgery allows preparation of appropriate antibiotics use within the operation. In some centers single stage revision preferred in cases of low virulence germ, effective antibiotics available both for embedding in the cement and the parenteral line.
Most surgeons favor a two-stage revision instead of a one-stage procedure [26, 27]
The two-stage procedure is indicated particularly to treat overt infections with an active discharge and virulent organism on culture such as
Intraoperative image of the grossly infected knee prosthesis before retrieval
The use of tourniquet without Esmarch bandage is advisable. Careful marking of the scars allows excision of the scars with old suture material. The arthrotomy should follow the original cut with extended lengths if necessary. Careful dissection is utilized in order to protect the vulnerable subcutaneous flaps. If open sinuses exist they should be debrided through the track. Pus and soft tissue are sent to culture with long incubation [28]. Extensive meticulous debridement is performed to the level of natural tissue, removing all synovial necrotic and non viable tissue. [27,29]. All prosthetic components and acrylic cement are removed.
After the implants are exposed from all soft tissue, the anterior surface of the femoral component is gently released as with Gigli saw, the distal part of it is detached by thin osteotome and gentle mallet percussions saving the bone stock, without leaning on the soft infected bone. Following removal of the femoral component the undersurface of the tibial tray is released with a saw and osteotomes which are inserted medially and laterally. Then hammering of the tray away from the tibia is performed. Meticulous removal of
A cement spacer impregnated with eluting antimicrobial drugs, according the sensitivity of the infective microorganism, is then interposed between distal femur and proximal tibia. This keeps the limb at its correct length and allows partial joint mobility Non-articulating, or articulated, spacers, can be used according to preference. Few spacer types are used: antibiotic cemented beads, antibiotic cement block, articulating spacer etc [30, 31, 32] (Figure 4).
Knee radiographs showing different types of cement spacers
The non articulated spacer is a fixed one, with inherited stability that allows post op full weight bearing but no knee movement. Sometimes an intramedullary nail (abut 30-36 cm long) used to bridge the knee with cement for the enhanced stability. Care should be taken to prevent thermal injuries by the inserted cement at its’ extension under the patella.
A divided or articulated spacer contains two parts: one piece should be attached to the proximal tibia and the other to the distal femur. The articulating cement spacer allows the patient to bend his knee, to exercise for range of movement, thus preventing joint contractures and keeping the extensor mechanism integrity.
Adequate hemostasis should follow tourniquet release, irrigation and closure of the wound over a large bore drain.
Antibiotics are administered intravenously according to microbial sensitivity for an average of six weeks. The interval can vary between the two stages, e.g. between six weeks to three months, when the clinical condition is settled. During this period, the clinical recovery is carefully evaluated by the laboratory tests for infection control (ESR and CRP). If there is no clear evidence of clinical improvement, re-arthrotomy and debridement should be considered.
The second stage requires re-arthrotomy through the old scar, tissue is sent for cultures, for pathologic examination, including high power field microscopic examination. The cement spacer is removed; the surgeon should patiently repeat the meticulous debridement. Intense irrigation and change of knee dressing followed by bone preparation and revision implant cementing are performed. A constrained rotating knee prosthesis is generally the most suitable implant particularly in cases of bone loss.
The use of a single-stage revision is advocated by some in certain patients with known causative organism, when no discharging sinuses are present, the patient is not immunocompromized, and there is no radiological evidence of component loosening or osteitis.
This type of revision is considered when pathogen germ has been definitely identified with appropriate sensitive antibiotic. The cement should contain suitable antibiotics according the sensitivity of the infective pathogen, if it is known; antimicrobial treatment is given 2-3 weeks before prosthesis exchange.
Technically one stage revision procedure includes removal of all foreign material, implant components and cement, thorough the same steps of meticulous debridement, as stated above, and re-implantation of a new prosthesis at the same surgical session.
Clinical infection with negative cultures is not rare. A patient may present painful and swollen knee, with synovitis and intraarticular fluid, elevated ESR and CRP, with positive leukocyte bone scan, while aspirated fluid reveal negative cultures. In such a case the aspiration should be repeated, and microbiological studies for rare microorganisms, including PCR should be performed.
The clinical suspicion mandates the type of surgery: The surgical process should be identical to 1st stage revision with extensive debridement and removal of the implant. Multiple bone and soft tissue cultures and pathology should be obtained intraoperatively. Sonication of the prosthesis might be indicated. The cement spacer should contain antibiotics relevant against the common bacteria. Post operative intravenous antibiotics should be administered for six weeks. The 2nd stage is similar to those performed for the positive culture group.
The one-stage type of revision can also be considered in presence of low grade clinical expression, such as long relentless pain, local heat, tenderness and slow rehabilitation milestones, negative preoperative aspiration cultures and intraoperative gram stains, as well as frozen section demonstrating less than 5 polymorphonuclears per high power field. Aged patients with positive cultures for low virulence strains, such as
This group of patients is presented with swollen painful knee, sometimes with synovitis and loosening. Usually not long from the primary surgery, with no sign of polyethylene wear, normal laboratory tests as CRP or ESR, normal blood leukocytes count and negative leukocytes bone scan. Knee aspiration could reveal not clear fluid but with negative culture. In such circumstances repeated aspiration performed and the workup should be extended for material allergy such as nickel and chrome. If the clinical suspicion for infection is significant the surgeon might take steps as for fully infected case, performing two or single stage revision. The decision making in these circumstances lacks a high level of evidence support.
Bone and soft tissue cultures are part of all knee revision as well as routine sonication of the retrieved implants. Sometimes a positive culture might be discovered in routine, not infected, with normal blood tests, negative leukocyte bone scan and without gross intraoperative signs of infected knee prosthesis. The finding should be carefully evaluated for contamination. If high suspicion for masked infection exists, six weeks of parenteral antibiotic should be administered.
As a rule, revision Total Knee Arthroplasty offers inferior results and higher complication rates compared to primary arthroplasty [33].
According to the published data the successful functional results following the treatment of late infection of a total knee arthroplasty by a two-stage re-implantation of a new prosthesis should be expected in about 90% of patients [34, 35, 36, 37].
In spite of its high personal and financial burden the two-stage re-implantation is recognized as the most reliable method for eradicating infection [38]. Although one-stage revision is appealing and less technically demanding, the risk of re-infection is a deterring factor.
Two-stage revision procedures may encounter bone loss, obscure landmarks, structural weakness and soft tissue deficiency, which may result in continued pain, decreased mobility and rarely fractures. Nevertheless, the success rate of this method was found to be in the range of 82-93%, whereas the success rate of the one-stage procedure was of 71-81% [34]. Therefore two-stage re-implantation technique represents the procedure of choice for definitive eradication of infection and preservation of knee function.
According to the published data on one-stage revisions (Table 1) in the large series of patients, with mid-term follow up, around 80% success rate in eradication of infection should be expected.
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
Foerster et al39\n\t\t\t | \n\t\t\t1991 | \n\t\t\t104 | \n\t\t\t5-15 years | \n\t\t\t80% | \n\t\t
Lu et al49\n\t\t\t | \n\t\t\t1997 | \n\t\t\t8 | \n\t\t\t20.1 months | \n\t\t\t100% | \n\t\t
Siegel et al50\n\t\t\t | \n\t\t\t2000 | \n\t\t\t31 | \n\t\t\t2-15 years | \n\t\t\t71% (22/31) | \n\t\t
Buechel et al27\n\t\t\t | \n\t\t\t2004 | \n\t\t\t22 | \n\t\t\t10.2 years | \n\t\t\t90.9% | \n\t\t
Soudry et al42\n\t\t\t | \n\t\t\t2009 | \n\t\t\t20 | \n\t\t\t8 years | \n\t\t\t80% (16/20) | \n\t\t
Results of one-stage knee revision arthroplasty
* Rates of infection eradication
As early as 1983, Windsor and Insall reported a success rate of 97.4% in two-stage revision surgery in 38 patients, with four years of follow-up, but other reports had slightly lower success rates, around 90% (Table 2).
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
Windsor & Insall 40\n\t\t\t | \n\t\t\t1983 | \n\t\t\t384 | \n\t\t\t4 years | \n\t\t\t97.4% | \n\t\t
Hannsen et al 51\n\t\t\t | \n\t\t\t1994 | \n\t\t\t36 | \n\t\t\t52 months | \n\t\t\t89% | \n\t\t
Goldman et al 52\n\t\t\t | \n\t\t\t1996 | \n\t\t\t64 | \n\t\t\t7.5 years | \n\t\t\t97% | \n\t\t
Gacon et al 53\n\t\t\t | \n\t\t\t1997 | \n\t\t\t29 | \n\t\t\t3.5 years | \n\t\t\t82.7% | \n\t\t
Hirakawa et al 53\n\t\t\t | \n\t\t\t1998 | \n\t\t\t55 | \n\t\t\t61.9 months | \n\t\t\t87.2% | \n\t\t
Siebel et al 55\n\t\t\t | \n\t\t\t2002 | \n\t\t\t10 | \n\t\t\t13.5 months | \n\t\t\t100% | \n\t\t
Pietsch et al 56\n\t\t\t | \n\t\t\t2003 | \n\t\t\t24 | \n\t\t\t14.8 months | \n\t\t\t95.8% | \n\t\t
Haleem et al 37\n\t\t\t | \n\t\t\t2004 | \n\t\t\t96 | \n\t\t\t7.2 years | \n\t\t\t91% | \n\t\t
Soudry et al 42\n\t\t\t | \n\t\t\t2009 | \n\t\t\t21 | \n\t\t\t8 years | \n\t\t\t100% | \n\t\t
Results of two-stage knee revision arthroplasty
* Rates of infection eradication
In our series of 43 patients with infected TKA, with characteristic 50% rate of infection with Staphylococcal strains [7], twenty patients underwent a one-stage procedure and 21 patients underwent a two-stage procedure. Our overall data indicate 83% postoperative satisfaction with 87% good and excellent results after revision [41,42]. After an average follow-up of 8 years, subjective satisfaction was reported by 80% of patients without any evidence of re-infection in the whole group of these patients. However in one-stage group a recurrent infection was noted in 20% of cases. We use a constrained design of revision prosthesis in order to overcome the expected soft tissue insufficiency in the revised knee (Figure 5).
A : Knee radiographs ( Anterior-Posterior and Lateral views). Radiolucency is evident around the tibial component indicating septic loosening. B: Knee radiographs (Anterior-Posterior and Lateral views) following revision with a constrained type prosthesis (CCK).
In failed treatment of revision TKA or in case of a multioperated knee and a debilitated patient another surgical procedure might be required for limb salvage.
Knee arthrodesis should be considered as a therapeutic option when other described above techniques have failed, especially in young patients with high functional demands or in patients with extensive deformities, advanced alterations of the extensor mechanism, deficient soft tissues, immunosuppression or infections by highly virulent bacteria. Arthrodesis provides a stable and pain-free limb. However, there is no flexion and the function of the knee is sacrificed, causing an advanced functional impairment. This is generally an irreversible situation. The procedure can be performed with intramedullary nail, metallic plate or external fixation [43, 44] (Figure 6). We have a good clinical experience using the Ilizarov external fixator for this purpose. We used this method in twelve consecutive patients following failed revision TKA surgery performed as treatment for infected initial knee prosthesis. Solid fusion was achieved in all patients within an average healing time of 27.6 weeks. Average shortening of the affected lib was 3.7 cm. We concluded that the Ilizarov fixator for knee arthrodesis after failed TKR produced favorable results and should be considered for the use by surgeons who are familiar with this technique [44]. The success is dependent on the proficiency of the surgeons in Ilizarov method and patient cooperation
Radiographs of fused knees, following failed revision of TKA, by: A: Intramedullary nail, B: Tubular external fixator. C: Internal fixation by plate and screws, D: Ilizarov external fixator.
By this salvage method a permanent removal of the implant and cement with local debridement, without re-implantation, are performed. The purpose of this technique is to create a false joint that may allow a certain range of motion. The leg is immobilized for a period between 3 and 6 months in order to allow the soft tissues retraction with creation of free area for movement with a certain degree of stability. Candidates for this type of treatment are patients with low functional demands [45].
This technique should be considered the last resort when dealing with salvage of a prosthetic infection. Its indications are as follows: an uncontrolled infection that threatens the patient\'s life, large bone loss and severe soft tissue defects [46]. Functional results tend to be extremely poor and patients often end up in a wheelchair. However a successful above knee amputation may provide the best function for patients who otherwise would have a functionless knee joint. In the past limb amputation was required most frequently in infected TKA with cemented stem hinges.
The best solution is to prevent infection rather than treat it. Nowadays the trend is to design an implant that is less susceptible to infection by using surfaces that will be resistant to bacterial adhesion and generation of biofilm. These designs will be appropriate to prevent infection originating via hematogeous spread. Another approach is to use local slowly released antibacterial agents, such as antibiotics or chemical free radicals, that will keep an efficient periprosthetic high concentration antimicrobial milieu in order to prevent biofilm bacterial masking [47]. This is a very important factor since the effective concentration of antibiotics for penetration of biofilm masking should be 1000 times higher than can be achieved following they usual oral or parenteral administration.
Most of the efforts for generation of anti-biofilm surfaces of the prostheses are still in development stage and still have not gain wide clinical use. Currently three main directions are utilized for this purpose. The most common method is to use titanium surfaces that release bactericidal superoxide radicals [48]. This method is especially appealing since TiO2 is has no significant cytotoxic effect on mammalian cells. We observed that human osteoblast-like cells in culture remain viable after exposure to high concentration of TiO2 0.1 mm granules in culture media (10% v:v). Another metal that has bactericidal properties is silver. There are a lot of efforts in designing prosthetic surfaces containing silver [48]. We found that it has a bactericidal effect on different
There is also a possibility to use immobilized antibiotic coverage for prosthetic surfaces. This method is still has not reached a proved clinical use [48].
Currently the widespread method of prosthetic fixation with methyl methacrylate bone cement, containing broad spectrum antibiotics, is the only proven way to create an antimicrobial periprosthetic surrounding. The uncontrolled release of the antibiotics and potential reduced fixation characteristics of the cement containing antibiotics are the main disadvantage of this method, but it is no clinical evidence that might support these concerns.
Despite considerable advances in surgical techniques and preoperative care, a 0.5-2% prevalence of infection in total knee arthroplasty (TKA) still poses a great challenge in the treatment of this devastating and costly complication. Current solutions to treat periprosthetic infection remain imperfect. Treatment strategy varies from conservative life-long antibiotic suppression therapy in the very high risk patient, arthroscopic or surgical debridement, revision in one or two-stage, arthrodesis or resection arthroplasty as a salvage procedure, and amputation in life-threatening conditions. The decision on the best method of treatment should be personalized to the patient’s general health, the severity of the infection and the complexity of the surgery. Currently most of the surgeons have adopted the two-stage protocol, where prosthetic removal, debridement and culture-specific I.V. therapy prior to re-implantation are regarded as standards of care. Although one-stage revision procedure is practiced by some, there is no clear evidence to define when this procedure can be safely applied, because there is no sufficient reliable data on a clinical reliability of this approach. The quest to perform one-stage revision should be continued, as two-stage operations classify the patient in a multiple operations category, with all the resulting potential complications, such as arthrodesis and amputation. Nevertheless, the threat of re-infection after the one-stage procedure surpasses the potential benefits. Judicious selection of patients is the key for successful mode of treatment. Currently the two-stage exchange arthroplasty, with all its inherent problems and drawbacks, allows only a partial success in treatment of TKA infection. New modalities or avenues for treatment of prosthetic infection are desirable.
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Family planning is indispensable in facilitating the prosperity and autonomy of women, their families, and their communities. Contraceptive choices, maternal and newborn health care, sexually transmitted infections, and sexual health are the main concepts of reproductive health [1]. The states agreed in 2001 that among the Millennium Development Goals (MDGs), target 5b was called for by 2015 for universal access to reproductive health. Global contraceptive prevalence is 64% (41% in low-income countries) and the global unmet need for family planning is 12% (22% in low-income countries) as reported at the end of the MDGs period. Sustainable Development Goals (SDGs) targets 3.7 and 5.6 call for universal access to sexual and reproductive health care services and sexual and sexual and reproductive health and reproductive rights, respectively [2, 3].
It has been calculated that maternal mortality has been reduced globally by 30% by the increase in contraceptive use [4]. Unintended pregnancies, pregnancy spacing, and reducing high-risk pregnancies are the consequences of contraceptive use [5, 6, 7]. Current studies show that every year, contraceptive use could reduce nearly 230 million births by stopping unwanted pregnancies [8]. As a result, the use of contraception improves the health of women and their children [6, 9]. However, the prevalence of contraceptive practice varied between 11.3% and 72.1% in different countries, namely Mozambique, 11.3%, Ghana, 21.5%, Bangladesh (modern method), 54.0%, and Sweden, 72.1% [9, 10, 11, 12].
Previous research has shown that various variables are significantly associated with contraceptive use, such as maternal age, maternal and husband’s educational level, wealth status, maternal age at first marriage, and so on [11, 13]. Through the promotion of family planning, appropriate diagnostics, and interventions, the prevalence of contraceptive use is increasing. Popular statistical methods (binary logistic regression) have been applied to determine important indicators of contraceptive use among women. But the main goal is to predict contraceptive practice among women aged between 15 and 49 in Bangladesh. Machine learning is a scientific method that can build models for prediction purposes. According to the research, traditional statistical procedures were shown to be ineffective in this form of modeling. Machine learning approaches have long been shown to be more successful and promising in handling a variety of complicated and nonlinear issues [14, 15, 16].
However, not many studies have explored machine learning methods to develop predictive models for studying contraceptive methods. Therefore, various well-known machine learning algorithms were applied to predict contraceptive practices among 15–49-year-old women in Bangladesh in this study. Before prediction, we applied a Hierarchical Logistic Regression classifier in machine learning approaches that were used to select potential risk factors associated with the contraceptive practice of women. To our best knowledge, the originality of the study is that it is almost new in the field of machine learning classifier approach in the contraceptive practice of Bangladesh context, for the first time using such methods, which will assist future data scientists.
In this study, the necessary information has been extracted from a representative secondary national data set, the Bangladesh Demographic and Health Survey (BDHS), 2014. This survey was carried out through a joint effort of the National Institute of Population Research and Training (Bangladesh), Mitra Associates (Bangladesh), and ICF International (USA).
The entire list of enumeration areas (EAs) that encompasses the entire country, provided by the Bangladesh Bureau of Statistics (BBS) for the 2011 population and housing census of the People’s Republic of Bangladesh, served as the sampling frame for the 2014 BDHS. An EA was a geographical zone with an average of 120 households. The survey uses a two-stage stratified sampling process that includes information on the EA region, residence (urban or rural), and the number of residential households counted. Viable interviews were conducted in 98% of the selected households (out of 17,989 total). For this study, 17,863 ever-married women aged 15–49 years were included in the final analysis. Note that to learn more about the detailed sampling procedure of the 2014 BDHS, see the final published report of the survey [17].
Since the main purpose of this study was to predict contraception practice among women aged 15–49 years, the response variable was “current contraception use”, which was classified as “Yes or No”. If the respondent currently utilizes a contraceptive method, she falls into the “Yes” group, otherwise, she falls into the “No” group.
Besides the response variable, a set of 21 demographic and socioeconomic risk factors were included in the analysis, which was associated with contraceptive practice and considered predictor variables. Several studies found that demographic and socioeconomic characteristics such as current age, division, religion, residence, respondent’s working status, FP media exposure, age at first marriage, currently breastfeeding, wealth status, women’s education, husband’s education, child ever born, number of living children, ideal number of children, fertility preference, marital status, and decision making for using contraception are potential risk factors that determine contraception practice among women [10, 11, 18, 19, 20, 21, 22, 23, 24]. The list of independent variables and their measures are presented in Table 1.
No. | Variables | Measures |
---|---|---|
1 | Women current age (years) | 15–19, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49 |
2 | Division | Barisal, Chittagong, Dhaka, Khulna, Rajshahi, Rangpur, Sylhet |
3 | Religion | Islam, other |
4 | Sex of household head | Male, female |
5 | Residence | Urban, rural |
6 | Respondent working status | No, yes |
7 | Family planning (FP) media exposure | No, yes |
8 | Age at first marriage | <18, 18+ |
9 | Currently breastfeeding | No, yes |
10 | Currently amenorrhoeic | No, yes |
11 | Currently abstaining | No, yes |
12 | Wealth status | Poor, middle, rich |
13 | Women education | No education, primary education, secondary+ |
14 | Husband education | No education, primary education, secondary+ |
15 | Sexually transmitted infection (STI) | No, yes |
16 | Children ever born | 0–1, 2–3, 4+ |
17 | Number of living children | None, 1–2, 3+ |
18 | Ideal number of children | 0–1, 2–3, 4+ |
19 | Fertility preference | No more, have another, undecided, declared infecund, sterilized |
20 | Marital Status | Married, others |
21 | Decision making for using contraception | Respondent, others |
Description of independent variables.
The frequency distribution was used to describe the background characteristics of the respondents. In this study, we developed a Hierarchical Logistic Regression classifier in machine learning approaches that were used to select potential risk factors related to the contraceptive practice of women in Bangladesh by using the largest value of AUC (
Flow diagram for hierarchical logistic regression classifier in the machine learning process.
To meet the objective of the study, we fitted numerous numbers of model where the full model is denoted by
After selecting the final model, we applied the 7 most popular machine learning classifiers to predict contraceptive practice among ever-married women aged 15–49 in Bangladesh. In this study, we used seven different popular ML algorithms (Logistic Regression (LR), Random Forest (RF), Naïve Bayes (NB), Least Absolute Shrinkage and Selection Operation (LASSO), Classification Trees (CT), AdaBoost, and Neural Network (NN)). A detailed description of the algorithms used is available in the literature [27, 28, 29, 30, 31, 32].
The Statistical Package for Social Science (SPSS) version 25 and R version 4.0.0 software were used for data management and analysis.
Data from ever-married women aged 15–49 was used in this study. Only ever-married women aged 15–49 was considered for the final analysis based on this criterion. Then, apply data preparation methods; for example, first find out missing data from the overall dataset. It is well known that the main drawbacks of missing information in a dataset are the reduced statistical power (because it reduces the number of samples n, the estimates will have larger standard errors). The main disadvantages of missing data in a dataset are statistical power reductions, which are well-known (because it reduces the number of samples n, the estimates will have larger standard errors). There are numerous imputation methods for imputing missing values nowadays, including direct deletion, mode imputation, hot-deck imputation, and so on [33]. A lower threshold of 5% missingness has been suggested in the literature [34]. We utilized the direct deletion method because this study had a low rate of missing values, which means we removed all missing values from the data set and conducted the analysis using the entire data set. The next step after missing value processing is to normalize/standardize the variables, which is useful when the data distribution is unknown. As a result, normalization is not required for any machine learning approach, especially in categorical data. Finally, all machine learning classifiers included in this study were performed on 70% of the respondents in each group (training data set,
Flow chart of the development of the seven machine learning classifiers.
We used the following criteria to evaluate the ML algorithms’ performance: confusion matrix, receiver operating characteristic (ROC), and the area under that curve (AUC). Generally, a confusion matrix has four possible prediction outcomes, such as TR = true positives, TN = true negatives, FP = false positives, and FN = false negatives. Several performance measures, including accuracy, precision, recall, and the F1 score, are usually calculated using these four potential outcomes to assess the classifier. The ROC curves have been calculated by utilizing the predicted outcomes as well as the true outcomes. To examine the ML algorithms’ discriminating powers, the AUC of the ROC has been averaged for the test data sets [35]. Theoretically, the AUC should be between 0 and 1, with 1 being the most extreme value for an ideal classifier. Since the usual lower bound for random classification is 0.5, an AUC greater than 0.5 has at least some capacity to separate between cases and non-cases [36]. In addition to these measures, we also used Cohen’s kappa statistic, which is a better measure to examine the agreement between two raters. It is calculated by utilizing the predicted and the actual classifications in a data set. The value of Cohen’s kappa statistic is
Table 2 shows the percentage distribution of women according to the selected socio-demographic characteristics of Bangladesh. The majority of women (19%) are between the ages of 25 and 29. The majority of them (35%) are from the Dhaka division, Muslims (90%), living in male-headed households (89%), and in the rural areas (72%). In terms of working status, slightly more than two-thirds (67%) of women are not currently involved in any kind of income-generating activities, and 80% of them do not have any media exposure. The majority of women (77% of them) married before their 18th birthday, and 79% of them were not breastfeeding their children at the time of the survey. The findings also show that around 96 to 97% of women are not amenorrheic (96%) or abstaining (97%). In terms of wealth status, 42% of the women were from rich families. Approximately half of the women (46%) had secondary or higher education. The majority of the husbands (44%) had a secondary or higher level of education. The number of women who knew about sexually transmitted infections (STIs) was found to be 67%. The majority of women (46%) have had 2–3 children, while 53% have 1–2 living children. The ideal number of children was 2–3 (86%) and more than half (57%) of the women were not interested in having another child. The vast majority of women are currently married (94%), and only 9% can make the decision to use a contraception method on their own. Regarding contraception use, according to the 2014 BDHS, 58.9% of women used it.
Characteristics | Sample women | |
---|---|---|
No. | % | |
15–19 | 2029 | 11.4 |
20–24 | 3224 | 18.0 |
25–29 | 3390 | 19.0 |
30–34 | 3047 | 17.1 |
35–39 | 2315 | 13.0 |
40–44 | 2092 | 11.7 |
45–49 | 1766 | 9.9 |
Barisal | 1111 | 6.2 |
Chittagong | 3301 | 18.5 |
Dhaka | 6223 | 34.8 |
Khulna | 1838 | 10.3 |
Rajshahi | 2103 | 11.8 |
Rangpur | 2056 | 11.5 |
Sylhet | 1232 | 6.9 |
Islam | 16,096 | 90.1 |
Other | 1767 | 9.9 |
Male | 15,854 | 88.8 |
Female | 2009 | 11.2 |
Urban | 5047 | 28.3 |
Rural | 12,816 | 71.7 |
No | 11,947 | 66.9 |
Yes | 5912 | 33.1 |
No | 14,316 | 80.1 |
Yes | 3547 | 19.9 |
<18 | 13,657 | 76.5 |
18+ | 4206 | 23.5 |
No | 14,033 | 78.6 |
Yes | 3830 | 21.4 |
No | 17,054 | 95.5 |
Yes | 809 | 4.5 |
No | 17,341 | 97.1 |
Yes | 522 | 2.9 |
Poor | 6767 | 37.9 |
Middle | 3560 | 19.9 |
Rich | 7536 | 42.2 |
No education | 4455 | 24.9 |
Primary | 5209 | 29.2 |
Secondary + | 8199 | 45.9 |
No education | 5189 | 29.0 |
Primary | 4289 | 27.3 |
Secondary+ | 7795 | 43.6 |
No | 11,947 | 66.9 |
Yes | 5912 | 33.1 |
0–1 | 5670 | 31.7 |
2–3 | 8139 | 45.6 |
4+ | 4054 | 22.7 |
None | 1814 | 10.2 |
1–2 | 9478 | 53.1 |
3+ | 6571 | 36.8 |
0–1 | 1127 | 6.3 |
2–3 | 15,308 | 85.7 |
4+ | 1429 | 8.0 |
No more | 9555 | 56.7 |
Have another | 5293 | 31.4 |
Undecided | 462 | 2.7 |
Declared infecund | 561 | 3.3 |
Sterilized | 986 | 5.8 |
Married | 16,858 | 94.4 |
Others | 1005 | 5.6 |
Respondent | 1515 | 8.5 |
Others | 16,348 | 91.5.5 |
Using | 10,527 | 58.9 |
Not Using | 7336 | 41.1 |
Percentage distribution of ever- married women age between 15 and 49 by selected socio-demographic characteristics.
In the initial step of the analysis, we applied hierarchal logistic regression to select the final model. Here, each variable was considered as one model. We added a potential risk factor (variable) to the previous model that was considered a new model in this analysis (Table 3). For example, in the initial model
Model | Model |
---|---|
M1 = respondent age | M12 = M11 + wealth status |
M2 = M1 + division | M13 = M12 + women education |
M3 = M2 + religion | M14 = M13 + husband education |
M4 = M3 + Sex of household head | M15 = M14 + sexually transmitted infection (STI) |
M5 = M4 + residence | M16 = M15 + children ever born |
M6 = M5 + respondent working status | M17 = M16 + number of living children |
M7 = M6 + FP media exposure | M18 = M17 + ideal number of children |
M8 = M7 + age at first marriage | M19 = M18 + fertility preference |
M9 = M8 + currently breastfeeding | M20 = M19 + marital status |
M10 = M9 + currently amenorrhoeic | M21 = M20 + decision making for using contraception |
M11 = M10 + currently abstaining |
Create a model-based hierarchical approach.
All models were statistically significant (
Model | AUC | DeLong’s test for AUC ( | Decision | Model selection |
---|---|---|---|---|
M1 | 0.629 | −9.26 (0.000) | M2 has a significantly different AUC from M1 | M2 is selected |
M2 | 0.660 | |||
M3 | 0.662 | −2.16 (0.031) | M3 significantly different AUC from M2 | M3 is selected |
M4 | 0.713 | −16.21 (0.000) | M4 significantly different AUC from M3 | M4 is selected |
M5 | 0.714 | −2.03 (0.041) | M5 had significantly different AUC from M4 | M5 is selected |
M6 | 0.715 | −2.24 (0.025) | M6 had significantly different AUC from M5 | M6 is selected |
M7 | 0.716 | −0.61 (0.545) | M7 had not significantly different AUC from M6 | M7 is not selected |
M8 | 0.716 | −2.63 (0.008) | M8 had a significantly different AUC from M6 | M8 is selected |
M9 | 0.723 | −4.34 (0.000) | M9 had a significantly different AUC from M8 | M9 is selected |
M10 | 0.762 | −14.38 (0.000) | M10 had a significantly different AUC from M9 | M10 is selected |
M11 | 0.773 | −8.05 (0.000) | M11 had a significantly different AUC from M10 | M11 is selected |
M12 | 0.773 | −0.72 (0.472) | M12 had not a significantly different AUC from M11 | M12 is not selected |
M13 | 0.774 | −2.22 (0.029) | M13 had a significantly different AUC from M11 | M13 is selected |
M14 | 0.775 | −2.17 (0.030) | M14 had a significantly different AUC from M13 | M14 is selected |
M15 | 0.776 | −2.13 (0.033) | M15 had a significantly different AUC from M14 | M15 is selected |
M16 | 0.799 | −11.81 (0.000) | M16 had a significantly different AUC from M15 | M16 is selected |
M17 | 0.813 | −9.26 (0.000) | M17 had a significantly different AUC from M16 | M17 is selected |
M18 | 0.816 | −4.74 (0.000) | M18 had a significantly different AUC from M17 | M18 is selected |
M19 | 0.828 | −11.45 (0.000) | M19 had a significantly different AUC from M18 | M19 is selected |
M20 | 0.847 | −14.69 (0.000) | M20 had a significantly different AUC from M19 | M20 is selected |
M21 | 0.866 | −21.75 (0.000) | M21 had a significantly different AUC from M20 | M21 is selected |
Best model selection based on Delong’s test.
This study used seven different machine algorithms to classify contraceptive practices among married women both training and an experimental/test dataset. Performance parameters (such as accuracy, precision, recall, F1, specificity, and AUC value) were used to compare the predictive performance of these algorithms. In addition, Cohen Kappa’s statistical information was used to determine the discriminant accuracy of the algorithm. The prediction results with performance parameters for each algorithm are shown in Table 5 and Figure 3.
Model name | Accuracy (95% CI) | Cohen’s kappa | Precession | Recall | F1 | AUC | Specificity |
---|---|---|---|---|---|---|---|
LR | 78.52 (77.39, 79.61) | 0.5559 | 81.23 | 82.39 | 81.81 | 86.57 | 73.03 |
RF | 77.57 (76.43, 78.68) | 0.5288 | 78.32 | 85.35 | 81.69 | 84.07 | 66.53 |
NB | 76.56 (75.40, 77.69) | 0.4995 | 75.73 | 88.32 | 81.54 | 84.17 | 59.90 |
LASSO | 79.08 (77.96, 80.16) | 0.5601 | 79.39 | 86.85 | 82.96 | 86.59 | 68.06 |
CT | 78.57 (77.45, 79.67) | 0.5464 | 78.16 | 88.06 | 82.81 | 85.59 | 65.13 |
AdaBoost | 78.50 (77.37, 79.59) | 0.5523 | 80.20 | 84.08 | 82.10 | 86.15 | 70.59 |
NN | 79.34 (78.23, 80.42) | 0.5626 | 78.71 | 88.76 | 83.44 | 86.90 | 65.99 |
Performance evaluation for seven ML algorithms (test data set).
Area under curve of all seven machine learning classifiers.
Table 5 shows that the logistic regression classifier has an accuracy of 78.52%. The precision and recall of the fitted model were 81.23% and 82.39%, respectively, while the F1 score was 81.81%. The area under the curve (AUC) was calculated to be 86.57%. The prediction performance result of a random forest was displayed with an accuracy of 77.57%. Here, the precision, recall, and F1 score of the random forest classifier were 73.82%, 85.35%, and 81.99%, respectively. The AUC, in this case, was 84.07%. The final accuracy of the naïve Bayes classifier was 76.56%, with a precision of 75.73% and a recall of 88.32%. The F1 score and the AUC value, in this case, were 81.54% and 84.17%, respectively. Using Least Absolute Shrinkage and Selection Operator (LASSO) analysis, the accuracy in the test data set was seen as 79.08% with precession and recall of 79.39% and 86.85% respectively, and the F1 score was 82.96%. According to the test observation results, the classification tree method showed 78.57% accuracy in predicting contraceptive practice among married women, with a precession of 78.16%, a recall of 88.06%, an F1 score of 82.81%, and an AUC value of 85.59%. For AdaBoost, these values are 78.05% (accuracy), 80.20% (precession), 84.88% (recall), 82.10% (F1 score) and 86.15% (AUC). Finally, we used an artificial neural network and obtained an accuracy of 79.34%. Here, other parameters such as precession, recall, F1 score, and AUC are 78.71%, 88.76%, 83.44%, and 86.90% respectively. Among the seven classifiers, we obtained the best performance from NN in terms of both accuracy and AUC. Cohen’s kappa value is 0.5626.
This violin plot shows the relationship of seven classifiers to accuracy. The shaded areas detail the distribution of the data in each classifier. Figure 4 shows that NN provided the highest mean accuracy, followed by LASSO and AdaBoost. Unlike the boxplot, the entire distribution of the 10-fold accuracy can be visualized in this violin plot (Figure 4).
Violin plots of the 10-fold cross-validation.
This is the very first study that uses a hierarchical logistic classifier in a machine learning approach. Then the predictive performance of the hierarchical logistic classifier was compared with the other six machine learning algorithms’ predictive power. In this study, the use of contraception among ever-married women in Bangladesh has been predicted using sociodemographic factors. This study can provide policymakers and academics with a starting point to examine key outlines in a larger framework and raise noteworthy interventions.
The study found that the prevalence of contraception was almost 59% in Bangladesh. The prevalence rate of contraceptives in India is 54%, while the rates were 47%, 34%, and 65%, respectively, for Nepal, Pakistan, and Sri Lanka [37, 38]. As the government of Bangladesh is committed to the London Summit on Family Planning to improve contraceptive access and use among impoverished people in both urban and rural areas [39], the findings of this study will provide grounding direction for the increase in the prevalence of contraception.
In this study, we used hierarchical LR, RF, NB, LASSO, CT, AdaBoost, and NN machine learning techniques to predict contraceptive practice among ever-married women in Bangladesh. The current analysis was to evaluate which performed better based on the accurate prediction rate of contraceptive use for 2014, BDHS data sets. Moreover, there was no evidence of scientific study that used a hierarchical logistic classifier and several supervised learning. In this study, 70% of the respondents were used for model tuning purposes, and the remaining 30% were used to check model performance, for the model tuning was performed using 10-fold cross-validation on the training dataset. The researcher observed that cross-validation is most commonly used to evaluate model performance [40]. The prediction of contraceptive use was measured by performance parameters (such as accuracy, precision, recall, F1, and AUC value) compared to the performance of seven different machine learning classifiers in this analysis. Cohen’s kappa, the proportion of predicted to actual classification in the dataset, is used to assimilate model perfection. Among the used models, the Neural Network outperformed other models with an accuracy of 79.34%. Additionally, in terms of Cohen kappa, the result of this analysis also highlighted that the Neural Network provides the best predictive performance (Cohen’s
In this paper, we investigate the hierarchical logistic regression classifier in machine learning approaches to identify potential risk factors related to contraceptive practices of women in Bangladesh. In summary, we conclude that all of the selected covariates were significant determinants for contraceptive practice except FP Mass media exposure and wealth status according to the hierarchical logistic regression classifier in machine learning approaches based on the Delong test. Here, we compared seven supervised machine learning algorithms to predict contraceptive practice among ever-married women aged between 15 and 49 years in Bangladesh. The NN model has exhibited the best results based on the performance parameters, having demonstrated an accuracy of 79.34%, a precision of 78.71%, a recall of 88.76%, an F1 score of 83.44%, and an AUC value of 86.90. Among the seven algorithms, the NN model performs the best in terms of accuracy, Cohen’s kappa statistic, and area under the curve (AUC). This study recommends the use of the NN model and policymakers should pay attention to continuing this study in the future.
A special thank goes to the Demographic Health Surveys for enabling us to use Bangladesh Demographic Health Survey data for our study from https://dhsprogram.com/data/.
The authors declare that they are not competing of interest.
This study did not receive funding.
This study was analyzed using secondary data, which were available at “https://dhsprogram.com/data/”.
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Due to rapid depletion of agricultural areas and soil quality by means of ever-increasing population and an excessive addition of chemical fertilizers, a rehabilitated attention is a need of the hour to maintain sustainable approaches in agricultural crop production. Biochar is the solid, carbon-rich material obtained by pyrolysis using different biomasses. It has been widely documented in previous studies that, the crop growth and yield can be increased by using biochar. This chapter exclusively summarizes the properties of biochar, its interaction with soil microflora, and its role in plant growth promotion when added to the soil.",book:{id:"7305",slug:"biochar-an-imperative-amendment-for-soil-and-the-environment",title:"Biochar",fullTitle:"Biochar - An Imperative Amendment for Soil and the Environment"},signatures:"Jyoti Rawat, Jyoti Saxena and Pankaj Sanwal",authors:null},{id:"46355",doi:"10.5772/57469",title:"Phytoremediation of Soils Contaminated with Metals and Metalloids at Mining Areas: Potential of Native Flora",slug:"phytoremediation-of-soils-contaminated-with-metals-and-metalloids-at-mining-areas-potential-of-nativ",totalDownloads:8550,totalCrossrefCites:14,totalDimensionsCites:86,abstract:null,book:{id:"3854",slug:"environmental-risk-assessment-of-soil-contamination",title:"Environmental Risk Assessment of Soil Contamination",fullTitle:"Environmental Risk Assessment of Soil Contamination"},signatures:"Paulo J.C. Favas, João Pratas, Mayank Varun, Rohan D’Souza and\nManoj S. Paul",authors:[{id:"169746",title:"Dr.",name:"Paulo",middleName:null,surname:"Favas",slug:"paulo-favas",fullName:"Paulo Favas"},{id:"169747",title:"Dr.",name:"Manoj",middleName:"Stephen",surname:"Paul",slug:"manoj-paul",fullName:"Manoj Paul"},{id:"169952",title:"Dr.",name:"Joao",middleName:null,surname:"Pratas",slug:"joao-pratas",fullName:"Joao Pratas"},{id:"169953",title:"Dr.",name:"Mayank",middleName:null,surname:"Varun",slug:"mayank-varun",fullName:"Mayank Varun"},{id:"169954",title:"Dr.",name:"Rohan",middleName:null,surname:"D'Souza",slug:"rohan-d'souza",fullName:"Rohan D'Souza"}]},{id:"61845",doi:"10.5772/intechopen.77987",title:"Montmorillonite: An Introduction to Properties and Utilization",slug:"montmorillonite-an-introduction-to-properties-and-utilization",totalDownloads:5469,totalCrossrefCites:43,totalDimensionsCites:76,abstract:"Clay mineral is an important material available in nature. With an increasing understanding of clay structure, montmorillonite is realized viable for an enhanced performance in a variety of materials and products in the areas of catalysis, food additive, antibacterial function, polymer, sorbent, etc. Significant development in the use and application of montmorillonite is seen in recent time. This chapter provides an overview of montmorillonite, structure, and properties and particularly discusses its recent utilization in important materials. Montmorillonite is introduced in terms of its natural sources, chemical structure, physical and chemical properties, and functional utilization. The important physical and chemical properties are summarized as particle and layered structure, molecular structure and cation exchange effect, barrier property, and water sorption. This is followed by the important functional utilizations of montmorillonite based on the effects of its chemical structure. The important functional utilization of montmorillonite includes food additive for health and stamina, for antibacterial activity against tooth and gum decay, as sorbent for nonionic, anionic, and cationic dyes, and the use as catalyst in organic synthesis. The environment concerns, to date, do not indicate the adversity for particles used as additive. Studies will be useful which are clearly based on any montmorillonite structure to describe environmental effects.",book:{id:"6561",slug:"current-topics-in-the-utilization-of-clay-in-industrial-and-medical-applications",title:"Current Topics in the Utilization of Clay in Industrial and Medical Applications",fullTitle:"Current Topics in the Utilization of Clay in Industrial and Medical Applications"},signatures:"Faheem Uddin",authors:[{id:"228107",title:"Prof.",name:"Faheem",middleName:null,surname:"Uddin",slug:"faheem-uddin",fullName:"Faheem Uddin"}]}],mostDownloadedChaptersLast30Days:[{id:"46032",title:"Soil Contamination, Risk Assessment and Remediation",slug:"soil-contamination-risk-assessment-and-remediation",totalDownloads:13896,totalCrossrefCites:22,totalDimensionsCites:60,abstract:null,book:{id:"3854",slug:"environmental-risk-assessment-of-soil-contamination",title:"Environmental Risk Assessment of Soil Contamination",fullTitle:"Environmental Risk Assessment of Soil Contamination"},signatures:"Muhammad Aqeel Ashraf, Mohd. Jamil Maah and Ismail Yusoff",authors:[{id:"25185",title:"Dr.",name:"Muhammad Aqeel",middleName:null,surname:"Ashraf",slug:"muhammad-aqeel-ashraf",fullName:"Muhammad Aqeel Ashraf"},{id:"101988",title:"Dr.",name:"Ismail",middleName:null,surname:"Yusoff",slug:"ismail-yusoff",fullName:"Ismail Yusoff"},{id:"169931",title:"Prof.",name:"Mohd Jamil",middleName:null,surname:"Maah",slug:"mohd-jamil-maah",fullName:"Mohd Jamil Maah"},{id:"169932",title:"Dr.",name:"Ng Tham",middleName:null,surname:"Fatt",slug:"ng-tham-fatt",fullName:"Ng Tham Fatt"}]},{id:"71931",title:"Open Pit Mining",slug:"open-pit-mining",totalDownloads:1625,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Open pit mining method is one of the surface mining methods that has a traditional cone-shaped excavation and is usually employed to exploit a near-surface, nonselective and low-grade zones deposits. It often results in high productivity and requires large capital investments, low operating costs, and good safety conditions. The main topics that will be discussed in this chapter will include an introduction into the general features of open pit mining, ore body characteristics and configurations, stripping ratios and stripping overburden methods, mine elements and parameters, open pit operation cycle, pit slope angle, stability of mine slopes, types of highwall failures, mine closure and reclamation, and different variants of surface mining methods including opencast mining, mountainous mining, and artisan mining.",book:{id:"8620",slug:"mining-techniques-past-present-and-future",title:"Mining Techniques",fullTitle:"Mining Techniques - Past, Present and Future"},signatures:"Awwad H. Altiti, Rami O. Alrawashdeh and Hani M. Alnawafleh",authors:[{id:"313182",title:"Prof.",name:"Rami",middleName:null,surname:"Alrawashdeh",slug:"rami-alrawashdeh",fullName:"Rami Alrawashdeh"},{id:"313522",title:"Dr.",name:"Awwad",middleName:null,surname:"Altiti",slug:"awwad-altiti",fullName:"Awwad Altiti"},{id:"313523",title:"Prof.",name:"Hani",middleName:null,surname:"Alnawafleh",slug:"hani-alnawafleh",fullName:"Hani Alnawafleh"}]},{id:"64027",title:"Stages of a Integrated Geothermal Project",slug:"stages-of-a-integrated-geothermal-project",totalDownloads:4341,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"A geothermal project constitutes two big stages: the exploration and the exploitation. Each one has a single task whose results allow defining the feasibility of a geothermal project, until achieving the construction and operation stage of the power generation plant. The first stage contains the area recognition, its limitation to the target, and elimination of external factors until defining a geothermal zone with characteristics to be commercially exploited. The main studies and analysis that can be applied during the exploration stage are listed, and the major indicator to continue with the project or suspend is the prefeasibility report. The major risks in the exploration stage are due to studies that are carried out on the surface; at this stage, the costs can be considered low. The main results of the exploration are the selection of sites to drill three or four initial wells. Each well provides a direct overview of the reservoir: depth, production thicknesses, thermodynamic parameters, and production characteristics. The drilling of three to four exploratory wells is recommended, as far as there is certainty of the feasibility of the project, and the development of the field begins with drilling of sufficient wells to feed the plant. In this stage, the cost increases, but the risks decrease.",book:{id:"7504",slug:"renewable-geothermal-energy-explorations",title:"Renewable Geothermal Energy Explorations",fullTitle:"Renewable Geothermal Energy Explorations"},signatures:"Alfonso Aragón-Aguilar, Georgina Izquierdo-Montalvo,\nDaniel Octavio Aragón-Gaspar and Denise N. Barreto-Rivera",authors:[{id:"258358",title:"Dr.",name:"Alfonso",middleName:null,surname:"Aragón-Aguilar",slug:"alfonso-aragon-aguilar",fullName:"Alfonso Aragón-Aguilar"}]},{id:"65070",title:"Biochar: A Sustainable Approach for Improving Plant Growth and Soil Properties",slug:"biochar-a-sustainable-approach-for-improving-plant-growth-and-soil-properties",totalDownloads:6893,totalCrossrefCites:55,totalDimensionsCites:92,abstract:"Soil is the most important source and an abode for many nutrients and microflora. Due to rapid depletion of agricultural areas and soil quality by means of ever-increasing population and an excessive addition of chemical fertilizers, a rehabilitated attention is a need of the hour to maintain sustainable approaches in agricultural crop production. Biochar is the solid, carbon-rich material obtained by pyrolysis using different biomasses. It has been widely documented in previous studies that, the crop growth and yield can be increased by using biochar. This chapter exclusively summarizes the properties of biochar, its interaction with soil microflora, and its role in plant growth promotion when added to the soil.",book:{id:"7305",slug:"biochar-an-imperative-amendment-for-soil-and-the-environment",title:"Biochar",fullTitle:"Biochar - An Imperative Amendment for Soil and the Environment"},signatures:"Jyoti Rawat, Jyoti Saxena and Pankaj Sanwal",authors:null},{id:"39170",title:"Study of Impacts of Global Warming on Climate Change: Rise in Sea Level and Disaster Frequency",slug:"study-of-impacts-of-global-warming-on-climate-change-rise-in-sea-level-and-disaster-frequency",totalDownloads:6659,totalCrossrefCites:14,totalDimensionsCites:32,abstract:null,book:{id:"2206",slug:"global-warming-impacts-and-future-perspective",title:"Global Warming",fullTitle:"Global Warming - Impacts and Future Perspective"},signatures:"Bharat Raj Singh and Onkar Singh",authors:[{id:"26093",title:"Dr.",name:"Bharat Raj",middleName:null,surname:"Singh",slug:"bharat-raj-singh",fullName:"Bharat Raj Singh"},{id:"118426",title:"Prof.",name:"Onkar",middleName:null,surname:"Singh",slug:"onkar-singh",fullName:"Onkar Singh"}]}],onlineFirstChaptersFilter:{topicId:"10",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82311",title:"Remediation of Soil Impacted by Heavy Metal Using Farm Yard Manure, Vermicompost, Biochar and Poultry Manure",slug:"remediation-of-soil-impacted-by-heavy-metal-using-farm-yard-manure-vermicompost-biochar-and-poultry-",totalDownloads:1,totalDimensionsCites:0,doi:"10.5772/intechopen.105536",abstract:"Soil contamination by organic and inorganic compounds is a universal concern nowadays. One such contamination is heavy metal exposure to the soil from different sources. The discharge of effluents from various factories in Punjab like tanning industries, leather industries, and electroplating industries generate a large volume of industrial effluents. These industrial units discharge their effluents directly or through the sewer into a water tributary (Buddha Nallah) and this water is being used for irrigating the crops. The heavy metals enter into the food chain thus contaminating all resources i.e. air, soil, food, and water. Preventive and remedial measures should be taken to reduce the effects of heavy metals from soil and plants. Organic soil amendments like FYM, Vermicomposting, Biochar, and poultry manure have been used to deactivate heavy metals by changing their forms from highly bioavailable forms to the much less bioavailable forms associated with organic matter (OM), metal oxides, or carbonates. These amendments have significant immobilizing effects on heavy metals because of the presence of humic acids which bind with a wide variety of metal(loid)s including Cd, Cr, Cu, and Pb.",book:{id:"10952",title:"Soil Science - Emerging Technologies, Global Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10952.jpg"},signatures:"Neeraj Rani and Mohkam-Singh"},{id:"82451",title:"An Emerging Global Understanding of Arsenic in Rice (Oryza sativa) and Agronomic Practices Supportive of Reducing Arsenic Accumulation",slug:"an-emerging-global-understanding-of-arsenic-in-rice-oryza-sativa-and-agronomic-practices-supportive-",totalDownloads:0,totalDimensionsCites:0,doi:"10.5772/intechopen.105500",abstract:"Arsenic uptake in rice (Oryza sativa) is recognized as a global health emergency, requiring the development of agronomic protocols to reduce human exposure to rice having elevated arsenic concentrations. Recent rice-arsenic investigations have centered around numerous agronomic approaches, including: (i) rice breeding and cultivar selection, (ii) altering irrigation water applications to reduce arsenic soil availability, (iii) application of soil amendments which either support arsenic adsorption on iron-plaque or provide antagonistic competition for root uptake, and (iv) phytoremediation. Given that rice cultivars vary in their arsenic accumulation capacity, this manuscript review concentrates on the influences of water management, soil amendments, and phytoremediation approaches on arsenic accumulation. Water management, whether alternating wetting and drying or furrow irrigation, provides the greatest potential to alleviate arsenic uptake in rice. Phytoremediation has great promise in the extraction of soil arsenic; however, the likelihood of multiple years of cultivating hyperaccumulating plants and their proper disposal is a serious limitation. Soil amendments have been soil applied to alter the soil chemistry to sequester arsenic or provide competitive antagonism towards arsenic root uptake; however, existing research efforts must be further field-evaluated and documented as producer-friendly protocols. The usage of soil amendments will require the development of agribusiness supply chains and educated extension personnel before farm-gate acceptance.",book:{id:"10952",title:"Soil Science - Emerging Technologies, Global Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10952.jpg"},signatures:"Michael Aide and Indi Braden"},{id:"82332",title:"Introductory Chapter: Access to Space, Access to the Moon: Two Sides of the Same Coin?",slug:"introductory-chapter-access-to-space-access-to-the-moon-two-sides-of-the-same-coin",totalDownloads:9,totalDimensionsCites:0,doi:"10.5772/intechopen.105175",abstract:null,book:{id:"10955",title:"Lunar Science - Habitat and Humans",coverURL:"https://cdn.intechopen.com/books/images_new/10955.jpg"},signatures:"Yann-Henri Chemin"},{id:"82329",title:"Bifacial Photovoltaic Technology: Recent Advancements, Simulation and Performance Measurement",slug:"bifacial-photovoltaic-technology-recent-advancements-simulation-and-performance-measurement",totalDownloads:10,totalDimensionsCites:0,doi:"10.5772/intechopen.105152",abstract:"In this chapter, we introduce the physic principle and applications of bifacial PV technology. We present different bifacial PV cell and module technologies as well as investigate the advantages of using bifacial PV technology in the field. We describe the measurement and modeling of Albedo, which is one of the important factors for the energy yield of bifacial PV technology. For an accurate assessment of the performance ratio of bifacial PV strings, it is necessary to measure the albedo irradiance using an albedometer or the front- and rear-side plane of array (POA) irradiance. We also discuss the advanced techniques for the characterization of bifacial PV modules. By means of simulation, we give insight into what boundary conditions result in new bifacial technology gains and the influence of the mounting position of irradiance sensors. We executed several simulations by varying the sensor positions on the rear side of the PV modules, different places, different albedo numbers, mounting heights, different geographical locations with various tilts, seasons, and weather types. To validate the simulation results, we performed various experiments in the field under different conditions. The results prove that the bifacial gain is highly dependent on the mounting heights of PV modules, tilt angles, weather conditions, latitude, and location.",book:{id:"9862",title:"Solar Radiation - Measurements, Modeling and Forecasting for Photovoltaic Solar Energy Applications",coverURL:"https://cdn.intechopen.com/books/images_new/9862.jpg"},signatures:"Mohammadreza Aghaei, Marc Korevaar, Pavel Babal and Hesan Ziar"},{id:"79973",title:"Impacts of Drought on Homestead Plant Diversity in Barind Tract of Bangladesh",slug:"impacts-of-drought-on-homestead-plant-diversity-in-barind-tract-of-bangladesh",totalDownloads:2,totalDimensionsCites:0,doi:"10.5772/intechopen.101885",abstract:"Homestead is a great place for household food access, diet, and nutrition. Drought affects homestead plant diversity and reduces production, availability, and diversity that lead toward less supply and consumption. Drought detains moisture and degrades the soil that supports plant growth. Homestead provides regular bread and income in the rural areas with an effective means for both economic and environmental well-being. People are getting a good amount of subsidiary income without any extra care and effort. In managing homestead land and drought, the household needs necessary technical and managerial training. In reducing drought effects to the homestead, action research needs to be carried out on available knowledge, effective practices, water management, and the adoption of local varieties and knowledge to develop effective homestead integration. Government initiatives, community engagement and not harming the environment, and efficient uses of water could be great solutions for the adverse effects of drought on the homestead plant diversity.",book:{id:"11131",title:"Drought - Impacts and Management",coverURL:"https://cdn.intechopen.com/books/images_new/11131.jpg"},signatures:"Md. Shafiqul Islam"},{id:"81757",title:"Petroleum Geochemistry",slug:"petroleum-geochemistry",totalDownloads:18,totalDimensionsCites:0,doi:"10.5772/intechopen.104709",abstract:"Petroleum geochemistry has entered its second period of growth. The first period, largely associated with conventional oil and gas, occurred in the 70s and 80s when the classic works on source rock characterization, biomarkers, depositional systems, and petroleum generation, including kinetics and basin modeling were the focus. The second period began slightly after the turn of the century as a consequence of the “unconventional resource” revolution and the interest in distressed resources developed, the focus turned to non-hydrocarbon contaminants, new interest in hydrocarbon expulsion and retention, identification of tight rock pay zones, and the development of organic porosity. This chapter will discuss source rock characterization and formation, petroleum generation, expulsion, and retention, correlation among hydrocarbon accumulations and to their source rock(s), and organic porosity.",book:{id:"11139",title:"Geochemistry and Mineral Resources",coverURL:"https://cdn.intechopen.com/books/images_new/11139.jpg"},signatures:"Mei Mei and Barry Katz"}],onlineFirstChaptersTotal:150},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:318,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:106,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:15,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Bacterial Infectious Diseases",value:3,count:2},{group:"subseries",caption:"Parasitic Infectious Diseases",value:5,count:4},{group:"subseries",caption:"Viral Infectious Diseases",value:6,count:7}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:2},{group:"publicationYear",caption:"2021",value:2021,count:4},{group:"publicationYear",caption:"2020",value:2020,count:3},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:148,paginationItems:[{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:null},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:"Polytechnic University of Timişoara",institution:{name:"Polytechnic University of Timişoara",country:{name:"Romania"}}},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:null},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"414880",title:"Dr.",name:"Maryam",middleName:null,surname:"Vatankhah",slug:"maryam-vatankhah",fullName:"Maryam Vatankhah",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Borough of Manhattan Community College",country:{name:"United States of America"}}},{id:"414879",title:"Prof.",name:"Mohammad-Reza",middleName:null,surname:"Akbarzadeh-Totonchi",slug:"mohammad-reza-akbarzadeh-totonchi",fullName:"Mohammad-Reza Akbarzadeh-Totonchi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ferdowsi University of Mashhad",country:{name:"Iran"}}},{id:"414878",title:"Prof.",name:"Reza",middleName:null,surname:"Fazel-Rezai",slug:"reza-fazel-rezai",fullName:"Reza Fazel-Rezai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"American Public University System",country:{name:"United States of America"}}},{id:"302698",title:"Dr.",name:"Yao",middleName:null,surname:"Shan",slug:"yao-shan",fullName:"Yao Shan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Dalian University of Technology",country:{name:"China"}}},{id:"125911",title:"Prof.",name:"Jia-Ching",middleName:null,surname:"Wang",slug:"jia-ching-wang",fullName:"Jia-Ching Wang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Central University",country:{name:"Taiwan"}}},{id:"357085",title:"Mr.",name:"P. 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