Computed elements of the CPT functions for G03, R01, E01, C06 satellites by
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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{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"}]},book:{item:{type:"book",id:"10904",leadTitle:null,fullTitle:"Fusarium - An Overview of the Genus",title:"Fusarium",subtitle:"An Overview of the Genus",reviewType:"peer-reviewed",abstract:"Fusarium is a large cosmopolitan genus of ascomycete fungi that are among the most important toxigenic plant pathogens causing seed and soil-borne diseases in a wide variety of agricultural crops worldwide. Fusarium species are broadly distributed in soil, root and plant tissues, and other organic substrates. Almost all species are able to generate mycotoxins, as secondary metabolites, that cause different physiological responses in plants. This book provides an overview of recent research on Fusarium species in the fields of metabolites, pathogenicity, plant-pathogen interactions, and management strategies in agricultural practices.",isbn:"978-1-83968-736-5",printIsbn:"978-1-83968-735-8",pdfIsbn:"978-1-83968-737-2",doi:"10.5772/intechopen.95213",price:119,priceEur:129,priceUsd:155,slug:"fusarium-an-overview-of-the-genus",numberOfPages:110,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"49d9063e43f94bd1517d65fbc58b93c3",bookSignature:"Seyed Mahyar Mirmajlessi",publishedDate:"May 18th 2022",coverURL:"https://cdn.intechopen.com/books/images_new/10904.jpg",numberOfDownloads:717,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:0,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"June 8th 2021",dateEndSecondStepPublish:"July 6th 2021",dateEndThirdStepPublish:"September 4th 2021",dateEndFourthStepPublish:"November 23rd 2021",dateEndFifthStepPublish:"January 22nd 2022",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"100573",title:"Dr.",name:"Seyed Mahyar",middleName:null,surname:"Mirmajlessi",slug:"seyed-mahyar-mirmajlessi",fullName:"Seyed Mahyar Mirmajlessi",profilePictureURL:"https://mts.intechopen.com/storage/users/100573/images/system/100573.png",biography:"Dr. Seyed Mahyar Mirmajlessi is a highly experienced plant pathologist with expertise in disease management, plant-pathogen interactions, and biological control. He received an MSc in Plant Pathology with a specialization in the genetic diversity of plant-pathogenic fungi. He earned a Ph.D. in Molecular Plant Pathology from the Estonian University of Life Sciences. He continued as a postdoctoral researcher in plant protection at Ghent University (UGent), Belgium. Dr. Mirmajlessi has been contributing as a reviewer and editorial board member for a number of scientific journals. He has also published several research articles in various international peer-reviewed journals. Currently, he is a senior research associate at the Department of Plants and Crops, Faculty of Bioscience Engineering, UGent, Belgium.",institutionString:"Ghent University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Ghent University",institutionURL:null,country:{name:"Belgium"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"151",title:"Pure Microbiology",slug:"pure-microbiology"}],chapters:[{id:"79683",title:"Fusarium Wilt: A Destructive Disease of Banana and Their Sustainable Management",doi:"10.5772/intechopen.101496",slug:"fusarium-wilt-a-destructive-disease-of-banana-and-their-sustainable-management",totalDownloads:86,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Banana is one of the most important fruit crops. The major losses in banana mainly due to the fungal wilt disease which is caused by Fusarium oxysporum f. sp. cubense. The pathogen is mainly soil bone and saprotrophic in nature that’s why its management is very difficult. The yearly losses of banana by this disease in the world is ranging from 60 to 90% and in India 30–40%. Sustainable management of panama wilt is must to overcome these losses occur in banana. The management strategies for longer duration through crop rotation, organic amendment, application of micronutrient like silicon (Si), borax, host-pathogen interaction, hormonal induction of defence response, biological control, transgenic approach, disease resistance developed by somaclonal variation. These approaches are mainly emphasized for long term management of the panama wilt disease.",signatures:"Ram Niwas, Gireesh Chand and Ramesh Nath Gupta",downloadPdfUrl:"/chapter/pdf-download/79683",previewPdfUrl:"/chapter/pdf-preview/79683",authors:[{id:"423044",title:"Ph.D. Student",name:"Ram",surname:"Niwas",slug:"ram-niwas",fullName:"Ram Niwas"},{id:"424857",title:"Dr.",name:"Gireesh",surname:"Chand",slug:"gireesh-chand",fullName:"Gireesh Chand"},{id:"424858",title:"Dr.",name:"Ramesh Nath",surname:"Gupta",slug:"ramesh-nath-gupta",fullName:"Ramesh Nath Gupta"}],corrections:null},{id:"79480",title:"Potato Dry Rot Caused by Fusarium spp. and Mycotoxins Accumulation and Management",doi:"10.5772/intechopen.100651",slug:"potato-dry-rot-caused-by-em-fusarium-em-spp-and-mycotoxins-accumulation-and-management",totalDownloads:85,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Dry rot of potato (Solanum tuberosum L.) is an important postharvest disease during storage. The decay can be caused by several different species of Fusarium spp., such as, F. sambucinum, F. coeruleum, F. oxysporum, F. avenaceum, F. culmorum. The pathogen of Fusarum spp. causing dry rot of potato is considerable different in different countries and regions. The typical symptom of potato dry rot is sunken and wrinkled brown to black tissue patch on tuber with less dry matter and shriveled flesh. Fusarium spp. only invades host through wound or natural orifice during pre-harvest, storage and transportation period. Some Fusarium species infection associated with mycotoxins accumulation, which has phytotoxicity and mycotoxicoses in humans and animals. Synthetic fungicide is the main strategy to control the dry rot of potato, however, there are series of problem, such as environmental pollution, pathogen resistance. An integrated approach to manage the disease includes the introduction of resistant cultivar, appropriate cultural practices, and storage conditions combined with the application of synthetic fungicides pre-harvest or post-harvest. Moreover, some chemical fungicides and microbial antagonists have been integrated into potato dry rot management.",signatures:"Huali Xue and Zhimin Yang",downloadPdfUrl:"/chapter/pdf-download/79480",previewPdfUrl:"/chapter/pdf-preview/79480",authors:[{id:"425420",title:"Prof.",name:"Huali",surname:"Xue",slug:"huali-xue",fullName:"Huali Xue"},{id:"429049",title:"Ms.",name:"Zhimin",surname:"Yang",slug:"zhimin-yang",fullName:"Zhimin Yang"}],corrections:null},{id:"79069",title:"Fusarium Soilborne Pathogen",doi:"10.5772/intechopen.100597",slug:"fusarium-soilborne-pathogen",totalDownloads:100,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Fusarium species are among the most persistent species of soilborne fungal pathogens. They cause severe economic damage in different agricultural production (potato, wheat, rice, etc.) due to the mycelia and chlamydospores that play a role during the infection of host plants. Our review has explored various studies on Fusarium species. The mechanisms involved in enhancing the protective ability of the Fusarium strain have been discussed. Furthermore, the current chemical and biological control methods to minimize Fusarium species’ impact on crops were highlighted. Future directions in the attempt to improve the control of Fusarium soilborne pathogens have been discussed.",signatures:"Leonce Dusengemungu",downloadPdfUrl:"/chapter/pdf-download/79069",previewPdfUrl:"/chapter/pdf-preview/79069",authors:[{id:"423031",title:"Ph.D. Student",name:"Leonce",surname:"Dusengemungu",slug:"leonce-dusengemungu",fullName:"Leonce Dusengemungu"}],corrections:null},{id:"79176",title:"Current Status of Fusarium and Their Management Strategies",doi:"10.5772/intechopen.100608",slug:"current-status-of-em-fusarium-em-and-their-management-strategies",totalDownloads:207,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Fusarium spp. is one of the most economically important plant pathogens causing a wide range of plant diseases with significant crop losses globally. Fusarium wilt is a major problem all over the world. Fusarium oxysporum, Fusarium solani, Fusarium fujikuroi are economic importance species in worldwide. Fusarium solani causing disease in many agriculturally crops and favored by high temperatures and warm moist soils. The fungus produces three types of asexual spores; microconidia, macroconidia and chlamydospores serve as propagules in infecting host plants and found endophytes and saprophytes. The color of the colony, length and shape of the macroconidia, the number shape of microconidia and the presence or absence of chlamydospores are key features for the differentiation of Fusarium species. Pathogens, forms over 100 formae speciales cause disease in dicot and monocot plant species and infecting a variety of hosts. Vegetative compatibility Groups (VCG) is used to differentiate their races. Resistant cultivars and bio-control agents (Trichoderma spp., and Psedomonas spp.) have been used to manage the disease.",signatures:"Amar Bahadur",downloadPdfUrl:"/chapter/pdf-download/79176",previewPdfUrl:"/chapter/pdf-preview/79176",authors:[{id:"422984",title:"Assistant Prof.",name:"Amar",surname:"Bahadur",slug:"amar-bahadur",fullName:"Amar Bahadur"}],corrections:null},{id:"79705",title:"Fusarium Disease of Maize and Its Management through Sustainable Approach",doi:"10.5772/intechopen.100575",slug:"fusarium-disease-of-maize-and-its-management-through-sustainable-approach",totalDownloads:127,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Fusarium causing disease in maize is probably the one of the most serious diseases among the crop plants all over the world. It not only damages the maize plant, reduces its potential yield and its nutritional values but imposes threatening to the human life through the induction of mycotoxin development. F. graminearum and F. moniliforme syn. Fusarium verticillioides are two important maize pathogens that cause substantial damage to its ear, stalk and foliage, causing contamination of grains with mycotoxins. Since conventional methods of controlling the diseases including the chemical methods proved not enough for total control of the disease with creating situation even worse for our surroundings, the application of PGPR and PGPF can play significant role to control the damage caused by Fusarium.",signatures:"Zerald Tiru, Parimal Mandal, Arka Pratim Chakraborty, Ayon Pal and Sanjoy Sadhukhan",downloadPdfUrl:"/chapter/pdf-download/79705",previewPdfUrl:"/chapter/pdf-preview/79705",authors:[{id:"424199",title:"Assistant Prof.",name:"Zerald",surname:"Tiru",slug:"zerald-tiru",fullName:"Zerald Tiru"},{id:"435431",title:"Dr.",name:"Arka Pratim",surname:"Chakraborty",slug:"arka-pratim-chakraborty",fullName:"Arka Pratim Chakraborty"},{id:"436686",title:"Dr.",name:"Parimal",surname:"Mandal",slug:"parimal-mandal",fullName:"Parimal Mandal"},{id:"436688",title:"Dr.",name:"Ayon",surname:"Pal",slug:"ayon-pal",fullName:"Ayon Pal"},{id:"436689",title:"Dr.",name:"Sanjoy",surname:"Sadhukhan",slug:"sanjoy-sadhukhan",fullName:"Sanjoy Sadhukhan"}],corrections:null},{id:"79720",title:"Importance of the Natural Incidence of the Fusarium Genus in Food Crops Established in Northern México",doi:"10.5772/intechopen.100595",slug:"importance-of-the-natural-incidence-of-the-em-fusarium-em-genus-in-food-crops-established-in-norther",totalDownloads:112,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The incidence of the Fusarium genus causing root rot is reviewed in crops showing high importance for food supply and to obtain regular income by farmers in the highlands of Northern México. Pathogen incidence was evaluated under field conditions in multiple sampling locations for common beans (Phaseolus vulgaris L.) and several chili peppers (Capsicum annuum) local cultivars (landraces and bred cultivars). Five commercial plots for registered and certified seed were also evaluated in common beans to be used in the ‘seed refreshing program’ implemented for the cultivar Pinto Saltillo, considered as the main variety sown in the highlands of México. High Fusarium genus incidence and its interactions with other fungi species, such as Rhizoctonia solani and Pythium spp., cause high losses in plant population, commercial yield and seed quality in food crops grown in Northern México. The natural incidence of plant disease caused by the Fusarium genus and its negative effect on crop survival and the reduction of commercial yield and seed quality is fully reviewed. Plant disease resistance, crop breeding and the influence of the environmental conditions were also considered.",signatures:"Julio César Ríos Saucedo, María Gabriela Ramírez-Valadez, Saúl Santana Espinoza, Maihualy Martínez-Fernández and Rigoberto Rosales-Serna",downloadPdfUrl:"/chapter/pdf-download/79720",previewPdfUrl:"/chapter/pdf-preview/79720",authors:[{id:"226125",title:"Dr.",name:"Rigoberto",surname:"Rosales-Serna",slug:"rigoberto-rosales-serna",fullName:"Rigoberto Rosales-Serna"},{id:"423632",title:"MSc.",name:"María Gabriela",surname:"Ramírez-Valadez",slug:"maria-gabriela-ramirez-valadez",fullName:"María Gabriela Ramírez-Valadez"},{id:"423633",title:"MSc.",name:"Maihualy",surname:"Martínez-Fernández",slug:"maihualy-martinez-fernandez",fullName:"Maihualy Martínez-Fernández"},{id:"423634",title:"MSc.",name:"Saúl",surname:"Santana-Espinoza",slug:"saul-santana-espinoza",fullName:"Saúl Santana-Espinoza"},{id:"435231",title:"Dr.",name:"Julio César",surname:"Ríos-Saucedo",slug:"julio-cesar-rios-saucedo",fullName:"Julio César Ríos-Saucedo"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"8954",title:"Biostimulants in Plant Science",subtitle:null,isOpenForSubmission:!1,hash:"ac0eb3328820cca42cb7d6cdbfca4ec2",slug:"biostimulants-in-plant-science",bookSignature:"Seyed Mahyar Mirmajlessi and Ramalingam Radhakrishnan",coverURL:"https://cdn.intechopen.com/books/images_new/8954.jpg",editedByType:"Edited by",editors:[{id:"100573",title:"Dr.",name:"Seyed Mahyar",surname:"Mirmajlessi",slug:"seyed-mahyar-mirmajlessi",fullName:"Seyed Mahyar Mirmajlessi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8997",title:"Microorganisms",subtitle:null,isOpenForSubmission:!1,hash:"d4bb9c77b89f8baf2716d1fb84c5bd9f",slug:"microorganisms",bookSignature:"Miroslav Blumenberg, Mona Shaaban, Abdelaziz Elgaml",coverURL:"https://cdn.intechopen.com/books/images_new/8997.jpg",editedByType:"Edited by",editors:[{id:"31610",title:"Dr.",name:"Miroslav",surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10906",title:"Fungal Reproduction and Growth",subtitle:null,isOpenForSubmission:!1,hash:"f84de0280d54f3b52e3e4585cff24ac1",slug:"fungal-reproduction-and-growth",bookSignature:"Sadia Sultan and Gurmeet Kaur Surindar Singh",coverURL:"https://cdn.intechopen.com/books/images_new/10906.jpg",editedByType:"Edited by",editors:[{id:"176737",title:"Dr.",name:"Sadia",surname:"Sultan",slug:"sadia-sultan",fullName:"Sadia Sultan"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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Nowadays, it is clear that the identification and rehabilitation of hearing impairment, when possible, have to be adequately and promptly managed because hearing loss can seriously interfere with psychosocial development, family dynamics, and social interactions. This book has been edited with a strong educational perspective (all chapters include an extensive introduction to their corresponding topic and an extensive glossary of terms). This book contains various materials suitable for graduate students in audiology, ENT, hearing science, and neurosciences.",isbn:"978-1-78923-213-4",printIsbn:"978-1-78923-212-7",pdfIsbn:"978-1-83881-431-1",doi:"10.5772/intechopen.69828",price:119,priceEur:129,priceUsd:155,slug:"an-excursus-into-hearing-loss",numberOfPages:206,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"a38726fa9ccb2ba12a90ef3f02843770",bookSignature:"Stavros Hatzopoulos and Andrea Ciorba",publishedDate:"May 30th 2018",coverURL:"https://cdn.intechopen.com/books/images_new/6364.jpg",keywords:null,numberOfDownloads:11949,numberOfWosCitations:6,numberOfCrossrefCitations:13,numberOfDimensionsCitations:17,numberOfTotalCitations:36,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 25th 2017",dateEndSecondStepPublish:"June 15th 2017",dateEndThirdStepPublish:"September 11th 2017",dateEndFourthStepPublish:"December 10th 2017",dateEndFifthStepPublish:"February 8th 2018",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"5 years",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:"Edited by",kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"174266",title:"Prof.",name:"Stavros",middleName:null,surname:"Hatzopoulos",slug:"stavros-hatzopoulos",fullName:"Stavros Hatzopoulos",profilePictureURL:"https://mts.intechopen.com/storage/users/174266/images/system/174266.jpg",biography:"Dr. Stavros Hatzopoulos is a faculty member of the Audiology and ENT clinic, University of Ferrara, Italy, since 1994. His background is in biomedical engineering, audiological engineering, and hearing science (BS, from the University of Southern California; MSc from Texas A&M University; PhD from Worcester Polytechnic Institute in Massachusetts). He received his habilitation as an associate professor in 2014. He is the author of more than 175 book chapters, peer-review papers, and congress presentations. He has participated in numerous European Concerted Action Projects in the areas of otoacoustic emissions, genetics, and nanotechnologies. 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There are two main computing classes, these are hard and soft computing. Scientists and engineers generally prefer the first-class computing because they can easily establish an explicit mathematical relationship between the model parameters and their data (observations), not in the second class. The relationships between the parameters and data can be linear or nonlinear. If the relations are nonlinear, they should be linearized via Taylor expansion [1, 2, 3, 4, 5, 6, 7]. Therefore, the linear models can be solved by linear algebra [8, 9, 10, 11, 12, 13, 14, 15].
To overcome complicated real-life problems whose mathematical models are not known, the soft computing techniques have been developed in the last decades. We can count well-known techniques, some as artificial neural network (ANN), artificial intelligence (AI), machine learning (ML), deep learning (DP), fuzzy logic (FL) and genetic algorithms (GA) [16, 17, 18]. The techniques inspired by the human intelligence and learning processes can be very time-consuming according to the data given in run due to their processing based on the trial-and-error method. If these techniques are roughly defined, data (experimental outcomes and observations) are separated into two parts in them, learning (or training) data and test data. Mathematical (functional and/or stochastic) relations between data and model parameters are learned from the learning data. The handled model is tested by means of the test data. After that, the trained and developed model, if meets expectations, is used to estimate for producing unobserved data for the scientific (or engineering) problems [16, 17, 18].
In the soft computing techniques, the linear algebra is also a very effective tool to solve the problem as in the hard computing ones. For this reason, we should take a short overview on linear algebra used in science and engineering [16, 17, 18].
Linear algebra has two basic problems. A solution of linear equations system is one of them; the other is the eigendecomposition. In this chapter, we will use both of them upon a linear equation system as a combined form (Eqs. (8)–(11)) in which we will solve the linear equations system by means of the singular value decomposition related with the eigendecomposition (or the matrix diagonalization) [8, 9, 13, 14].
Suppose an estimated unknown vector
Start with a linear or nonlinear functions vector
Mathematical model between data and unknowns can be established by Taylor expansion for any model. However, if
where
Most of science and engineering problems can be modeled as
A generalization for objective functions is
The second-degree objective function is
The last-degree objective function is
While a rank is a number that indicates a linear independent column, the number of the coefficient matrix of unknowns in a linear equation system, a rank deficiency represents a linear dependent column number (if it is smaller than the row number) of the coefficient matrix. Inconsistency in the solution stage of a linear equation system results from the (rank) deficiencies. Defining the rank of
Denoting the rank defect
Objective functions are used to remove the surjectivity defect
The defects lead to the failure of any given problem to be solved properly. Since the unknown coefficient matrix cannot be inverted by
Since
Linearizing from nonlinear functions to their linear form by means of Taylor expansion, a linear equation system is to be handled as Eq. (1). To avoid complicated proofs in the solution of an equation system, the simplified mathematical model can be written in the following (statically rotation invariant [1]) numerical computation form.
Meet two states to solve Eq. (8),
And then
In the state (
Solution to the second state
End the solution if the condition ensured is
Relationships between nonlinearity and LS in a multidimensional surface have been shown by Teunissen et al. [1, 2]. The authors argued the relation on some simple examples and gave some analytical solutions for them. But, they highlighted that those types of analytical solutions have not been given for every problem and emphasized that suitable Taylor expansions have been useful to the solution not being transformed into the analytical ones.
These type functions can be used in defining the orbits of artificial satellites (and celestial bodies). Also, the numerical example part of this chapter, to estimate those type functions, will be inspected and applied on a real example. To foresee a model for any problem we should interpret the model parameter and comprehend the geometry of the model (Figure 1).
The geometry of a first-degree and first-order combination of polynomial and trigonometric (CPT) function.
With respect to independent variable time
where
In this chapter, the functions
Earth (GR) and space-fixed (Υ) coordinates for an artificial satellite.
For this propose, an easy transformation into any epoch (e.g., it can be taken as the first epoch
where
A solution of nonlinear Eq. (12) is realized in the following order. Linearizing Eq. (12) by Taylor expansion and omitting the terms greater than or equal to quadratic ones, the linear equation system as given by Eq. (8) is obtained. The explicit form of the Eq. (8) with respect to the approximate values of unknowns for a CPT is:
We can use a recursive solution for Eq. (14) instead of the batch solution as Eq. (11) because of its solution velocity.
Continuation of the solution of Eq. (15) can be performed according to Eq. (11). The model given by Eq. (12) is a simple model to determine the satellite orbit motions. For more complicated models, the readers can utilize [19, 20, 21, 22, 23, 24, 25] resources.
For a nonlinear estimation of CPT functions, some numerical examples are chosen from GNSS {Global navigation satellite systems = GPS (USA) + GLONASS (RU), GALILEO (EU), COMPASS (CHN)} artificial satellite orbits whose coordinates are downloaded from the internet address ftp://ftp.glonass-iac.ru/MCC/PRODUCTS/17091/final/Sta19426.sp3 [26].
For this purpose, two estimation software have been developed in 64Bit Python (in accordance with the 2.7 and 3.6 version) and 32Bit C++ (Code::Blocks) environments to see the convergence rate of the mathematical model given in Eq. (12) [27, 28]. The computed elements of CPT functions for the selected four satellites R01 (GLONASS), G03 (GPS), E01 (GALILEO) and C06 (COMPASS) are summarized in Table 1 in which they are ordered from the nearest satellite to the farthest one.
The motions of the CPT functions estimated satellites (in Table 1) with respect to earth- (left column of Figure 3) and space-fixed (right column of Figure 3) coordinate systems are demonstrated in Figure 3. Moreover, coherence between the estimated CPT function (black solid line) of the C06 satellite and its data points given (colorful circles) is represented in detail in Figure 4.
Earth (left) and space (right) fixed orbital traces (see the appendix) with time tags of R01, G03, E02, C06 satellites and the motion of X-coordinate axis shown as GR (XGR(t0) position on the intersection Greenwich meridian and equator) symbol at
Temporal changing of space fixed coordinates of C06. The circles and solid lines represent the data points and estimated functions under LS respectively for X (red), Y (green), Z (blue), S (cyan).
We know that accuracy of precise SP3 file coordinates is about
Comparing the solution velocities (from the iteration numbers with respect to
If we chose the threshold as 51e-13, we can see the distinctions of solution convergences between 64Bit and 32Bit running on the estimations of C06 satellite from 1000 (X), 8 (Y), 7 (Z), 1000 (S) in 32Bit C++ and 10 (X), 8 (Y), 6 (Z), 28 (S) in 64Bit Python in Windows. In here, 1000 is the maximum iteration number. If the mathematical model would be more complicated and its data number would be bigger than the number used in the example part, we would see the state more prominently.
Approximated values and the loop element for the unknowns are computed following the order in all solutions of the satellites when running in 32Bit C++ and 64Bit Python platforms for the estimations in Table 1.
Maximum iteration number and threshold loop elements are
Taking the approximated values as
Since the estimated standard deviations
The added terms represent an amplitude
we can choose the approximate values of the new parameters as
from
The approximate values are substituted in the following linearized model as initial values for the loop in LS estimation.
After the evaluation, the improved solution for the C06 satellite is represented in Table 2. We can readily see the improvements upon the downs of the standard deviations from
Sat. | ||||||
---|---|---|---|---|---|---|
5 5 | 4 4 | 4 5 | — — | 10 9 | ||
R01 (RU) | −11.860 0.028 25,474.503 −60°54′04.37″ 31°57′53.92″ 11h05’44.37” | 2.420 0.003 11,178.453 −23°03′56.93″ −31°57′44.92″ 11h15’47.54” | 2.771 0.052 22,965.361 −30°31′00.32″ −31°57′56.31″ 11h15’43.53” | km km/h km deg deg/h h | 0.001 8.127 42°41′35.87″ −31°58′13.55″ 11h15’37.46” | |
2.902 | 1.266 | 2.653 | km | 0.211 | ||
6 6 | 4 4 | 4 4 | — — | 30 34 | ||
G03 (USA) | −17.545 −0.132 24,800.602 66°34′39.73” 30°04′56.03” 11h58’01.91” | 7.332 −0.045 17,959.166 −48°06′43.68” 30°04′52.50” 11h58’3.31” | −1.824 −0.085 21,757.547 −7°51′47.16” 30°05′00.02” 11h58’00.32” | km km/h km deg. deg./h h | −0.003 14.211 −72°24′19.52” −30°08′11.17” 11h56’44.42” | |
4.898 | 3.648 | 3.961 | km | 0.183 | ||
4 5 | 5 5 | 4 4 | — — | 32 93 | ||
E01 (EU) | 1.866 0.052 21,349.011 −35°22′15.46″ −25°34′13.06” 14h04’43.81” | 1.358 −0.048 26,031.918 85°57′22.67” −25°34′14.87” 14h04’42.81” | −4.673 0.004 24,878.432 −16°23′29.47” 25°34′18.57” 14h04’40.78” | km km/h km deg. deg./h h | −0.000 3.720 8°29′58.23” −25°42′10.68” 14h00’22.19” | |
1.796 | 1.428 | 1.058 | km | 0.236 | ||
7 10 | 6 7 | 6 7 | — — | 28 29 | ||
C06 (CHN) | −407.495 61.945 41,716.806 −24°21′36.29” −15°07′02.75” 23h48’48.86” | 228.037 −6.376 24,832.649 59°24′50.73″ −15°02′16.41” 23h56’22.30” | 266.178 −7.892 34,235.695 67°36′9.42″ −15°02′36.74” 23h55’49.94” | km km/h km deg. deg./h h | −0.358 227.599 18°32′27.85” −14°57′17.11” 24h04’21.41” | |
56.552 | 38.018 | 51.901 | km | 0.491 |
Computed elements of the CPT functions for G03, R01, E01, C06 satellites by
Sat. | ||||||
---|---|---|---|---|---|---|
27 | 158 | 53 | — | 19 | ||
C06 (CHN) | 223.514 1.515 42,064.675 −25°07′54.78″ −15°02′24.75” 110.710 5°08′57.82” 30°10′58.43” | 149.296 0.224 66.183 11°15′24.23″ 30°04′30.44″ 24,808.034 30°28′55.61″ 15°02′17.24” | 182.012 0.060 91.527 3°15′58.76″ 30°04′02.09″ 34,217.994 −22°21′14.60″ −15°02′19.27” | km km/h km deg deg/h km deg. deg./h | 42,169.956 0.055 225.161 19°47′37.54″ −15°02′43.26″ 0.838 8°56′45.50″ −29°40′58.52” | |
0.178 | 0.137 | 0.191 | km | 0.003 |
The results by the expanded model for the C06 satellite in Python 3.6 in windows.
As another example, the expanded model has been trained on the coordinate components of R01 GLONASS satellite by means of Python 3.6 software on Windows. We can also see the improvements upon the downs of the standard deviations (
Condition numbers computed from a rate of maximum and minimum eigenvalues or a rate of singular values under LS are very effective tools for determining the consistency as well. Therefore, a larger condition number can cause larger iteration number (related to convergence rate), We can see those states from the CPT estimations of the C06 satellite with the iteration (
In this chapter, the least squares (LS) estimations of the artificial satellite orbital movements by a combination of polynomial and trigonometric (CPT) functions have been given after a general overview has been made on the hard and soft computations. In practice, the orbital motions are modeled on Keplerian orbital elements. In contrary to this, the coordinate components have been selected for this chapter due to the nonlinear relations of the components and the unknowns which are the elements of CPT functions. The relations cause inconsistencies in the LS solutions. The inconsistencies result from the two injectivity defects,
For the sake of simplicity for readers, a simple CPT function has been chosen at first. After the initial estimation of the function, the estimated errors vector has been found. We have seen that the errors have had a periodic characteristic in time. So, a new wave defining the error characteristic and been able to carry by the first wave has been planned for expanding the CPTs. It is shown that we can expand a CPT function until ensuring statically equivalency between a priory and a posteriori variances. For instance, one may secure the equivalency of the variances if one would expand more by a new wave in the last estimated model in the same manner.
The convergence rates (upon the iteration numbers) of the LS estimation have been inspected according to the threshold (
We can use the Soft Computing Methods (SCM) if not an exact mathematical relationship between the data and unknowns. The mathematical model is established by the trial-and-error method in training part of SCM by means of arbitrary weights and activation functions depending on SCM expert forecasts. For the solution of the SCM model during the training, we can use least absolute residuals (LAR) and minmax absolute residuals (MAR) objective functions by the linear programming or the LS estimation as in hard computing method (HCM). In the state, the inconsistency problem can erase whatever the solution method (LAR, MAR or LS) is. The inconstancy can be removed by means of experiences gained from HCMs.
Prior information is very important to select a suitable mathematical model for a scientific problem. For example, comparing a priori variance with a posteriori variance at the end of the estimation is a useful warning to the user to determine the correct mathematical model as seen from the expanded model in the example section of the chapter.
In numerical computation, there are two main phenomena which are the mathematical model (as a combination of functional and stochastic models) and objective function. The solution strategy is of no importance if the same mathematical model and objective function are preferred in the same problem of hard computing. All solution strategies always give same results, only their solution time spans can be distinct from each other (Table 3).
I wish to thank
0 | 0.00 | −17531.307506 | 21541.792054 | 31834.209680 | 691.175390 |
1 | 0.25 | −19992.147900 | 20678.913485 | 30924.464057 | 691.487182 |
2 | 0.50 | −22367.333395 | 19727.437365 | 29882.214843 | 691.798804 |
3 | 0.75 | −24646.589754 | 18691.353300 | 28711.797065 | 692.110527 |
4 | 1.00 | −26820.032098 | 17575.021170 | 27418.102912 | 692.422088 |
5 | 1.25 | −28878.208475 | 16383.154007 | 26006.563346 | 692.733923 |
6 | 1.50 | −30812.142166 | 15120.799311 | 24483.127129 | 693.045689 |
7 | 1.75 | −32613.372313 | 13793.318783 | 22854.237453 | 693.357416 |
8 | 2.00 | −34273.992670 | 12406.366506 | 21126.806228 | 693.668853 |
9 | 2.25 | −35786.688260 | 10965.865676 | 19308.186097 | 693.980453 |
10 | 2.50 | −37144.769753 | 9477.983947 | 17406.140275 | 694.291853 |
11 | 2.75 | −38342.205344 | 7949.107471 | 15428.810302 | 694.603337 |
12 | 3.00 | −39373.649964 | 6385.813755 | 13384.681845 | 694.914789 |
13 | 3.25 | −40234.471624 | 4794.843425 | 11282.548651 | 695.226157 |
14 | 3.50 | −40920.774721 | 3183.071022 | 9131.474825 | 695.537828 |
15 | 3.75 | −41429.420160 | 1557.474971 | 6940.755568 | 695.849062 |
16 | 4.00 | −41758.042128 | −74.893170 | 4719.876568 | 696.160359 |
17 | 4.25 | −41905.061383 | −1706.940006 | 2478.472204 | 696.471627 |
18 | 4.50 | −41869.694990 | −3331.562017 | 226.282782 | 696.782836 |
19 | 4.75 | −41651.962330 | −4941.677516 | −2026.889008 | 697.094239 |
20 | 5.00 | −41252.687387 | −6530.258698 | −4271.222183 | 697.405373 |
21 | 5.25 | −40673.497209 | −8090.363611 | −6496.921900 | 697.716659 |
22 | 5.50 | −39916.816531 | −9615.167884 | −8694.263981 | 698.028206 |
23 | 5.75 | −38985.858544 | −11097.996030 | −10853.639319 | 698.339619 |
24 | 6.00 | −37884.611845 | −12532.352178 | −12965.597898 | 698.651055 |
25 | 6.25 | −36617.823589 | −13911.950035 | −15020.892223 | 698.962566 |
26 | 6.50 | −35190.978917 | −15230.741942 | −17010.519896 | 699.273893 |
27 | 6.75 | −33610.276761 | −16482.946839 | −18925.765115 | 699.585363 |
28 | 7.00 | −31882.602129 | −17663.077000 | −20758.238873 | 699.896674 |
29 | 7.25 | −30015.495009 | −18765.963379 | −22499.917620 | 700.208082 |
30 | 7.50 | −28017.116067 | −19786.779434 | −24143.180195 | 700.519378 |
31 | 7.75 | −25896.209299 | −20721.063292 | −25680.842806 | 700.830889 |
32 | 8.00 | −23662.061860 | −21564.738140 | −27106.191889 | 701.142117 |
33 | 8.25 | −21324.461276 | −22314.130731 | −28413.014646 | 701.453707 |
34 | 8.50 | −18893.650283 | −22965.987908 | −29595.627135 | 701.764972 |
35 | 8.75 | −16380.279535 | −23517.491071 | −30648.899728 | 702.076478 |
36 | 9.00 | −13795.358449 | −23966.268499 | −31568.279851 | 702.387737 |
37 | 9.25 | −11150.204459 | −24310.405495 | −32349.811865 | 702.699185 |
38 | 9.50 | −8456.390949 | −24548.452300 | −32990.154024 | 703.010540 |
39 | 9.75 | −5725.694161 | −24679.429736 | −33486.592421 | 703.321863 |
40 | 10.00 | −2970.039352 | −24702.832610 | −33837.051887 | 703.633117 |
41 | 10.25 | −201.446497 | −24618.630817 | −34040.103800 | 703.944417 |
42 | 10.50 | 2568.024186 | −24427.268222 | −34094.970801 | 704.255873 |
43 | 10.75 | 5326.326597 | −24129.659289 | −34001.528424 | 704.567076 |
44 | 11.00 | 8061.482740 | −23727.183555 | −33760.303648 | 704.878433 |
45 | 11.25 | 10761.636054 | −23221.677952 | −33372.470443 | 705.189684 |
46 | 11.50 | 13415.103835 | −22615.427078 | −32839.842340 | 705.501070 |
47 | 11.75 | 16010.428511 | −21911.151470 | −32164.862120 | 705.812547 |
48 | 12.00 | 18536.427516 | −21111.993965 | −31350.588697 | 706.124190 |
49 | 12.25 | 20982.241560 | −20221.504257 | −30400.681303 | 706.435990 |
50 | 12.50 | 23337.381077 | −19243.621724 | −29319.381091 | 706.747258 |
51 | 12.75 | 25591.770667 | −18182.656653 | −28111.490271 | 707.058650 |
52 | 13.00 | 27735.791345 | −17043.269964 | −26782.348927 | 707.370038 |
53 | 13.25 | 29760.320445 | −15830.451549 | −25337.809640 | 707.681516 |
54 | 13.50 | 31656.769034 | −14549.497344 | −23784.210083 | 707.992915 |
55 | 13.75 | 33417.116707 | −13205.985271 | −22128.343727 | 708.304435 |
56 | 14.00 | 35033.943650 | −11805.750146 | −20377.428827 | 708.615955 |
57 | 14.25 | 36500.459878 | −10354.857705 | −18539.075847 | 708.927258 |
58 | 14.50 | 37810.531573 | −8859.577863 | −16621.253481 | 709.238773 |
59 | 14.75 | 38958.704447 | −7326.357314 | −14632.253449 | 709.549980 |
60 | 15.00 | 39940.224086 | −5761.791632 | −12580.654219 | 709.861492 |
61 | 15.25 | 40751.053248 | −4172.596961 | −10475.283826 | 710.172943 |
62 | 15.50 | 41387.886081 | −2565.581420 | −8325.181952 | 710.484439 |
63 | 15.75 | 41848.159196 | −947.616367 | −6139.561422 | 710.796071 |
64 | 16.00 | 42130.059795 | 674.392412 | −3927.769279 | 711.107495 |
65 | 16.25 | 42232.530676 | 2293.533436 | −1699.247596 | 711.419275 |
66 | 16.50 | 42155.272132 | 3902.918094 | 536.505839 | 711.730566 |
67 | 16.75 | 41898.740894 | 5495.708947 | 2769.976807 | 712.042086 |
68 | 17.00 | 41464.146141 | 7065.147654 | 4991.673762 | 712.353663 |
69 | 17.25 | 40853.442432 | 8604.582424 | 7192.166646 | 712.665021 |
70 | 17.50 | 40069.319938 | 10107.494927 | 9362.125250 | 712.976412 |
71 | 17.75 | 39115.191840 | 11567.526548 | 11492.356997 | 713.287987 |
72 | 18.00 | 37995.179006 | 12978.503915 | 13573.844046 | 713.599417 |
73 | 18.25 | 36714.092016 | 14334.463621 | 15597.779572 | 713.910828 |
74 | 18.50 | 35277.410608 | 15629.676058 | 17555.603122 | 714.221952 |
75 | 18.75 | 33691.260665 | 16858.668299 | 19439.034930 | 714.533584 |
76 | 19.00 | 31962.388796 | 18016.245942 | 21240.109087 | 714.845281 |
77 | 19.25 | 30098.134631 | 19097.513875 | 22951.205467 | 715.156764 |
78 | 19.50 | 28106.400907 | 20097.895874 | 24565.080300 | 715.468390 |
79 | 19.75 | 25995.621474 | 21013.152993 | 26074.895308 | 715.779824 |
80 | 20.00 | 23774.727299 | 21839.400671 | 27474.245306 | 716.091334 |
81 | 20.25 | 21453.110591 | 22573.124521 | 28757.184187 | 716.402951 |
82 | 20.50 | 19040.587166 | 23211.194732 | 29918.249189 | 716.714457 |
83 | 20.75 | 16547.357150 | 23750.879046 | 30952.483389 | 717.026029 |
84 | 21.00 | 13983.964160 | 24189.854253 | 31855.456321 | 717.337474 |
85 | 21.25 | 11361.253075 | 24526.216175 | 32623.282652 | 717.649172 |
86 | 21.50 | 8690.326544 | 24758.488074 | 33252.638847 | 717.960633 |
87 | 21.75 | 5982.500334 | 24885.627475 | 33740.777748 | 718.272113 |
88 | 22.00 | 3249.257698 | 24907.031342 | 34085.541002 | 718.583548 |
89 | 22.25 | 502.202871 | 24822.539587 | 34285.369282 | 718.895203 |
90 | 22.50 | −2246.986126 | 24632.436884 | 34339.310236 | 719.206528 |
91 | 22.75 | −4986.605239 | 24337.452758 | 34247.024111 | 719.518326 |
92 | 23.00 | −7704.972522 | 23938.759921 | 34008.787012 | 719.830016 |
93 | 23.25 | −10390.476491 | 23437.970866 | 33625.491749 | 720.141620 |
94 | 23.50 | −13031.624539 | 22837.132665 | 33098.646226 | 720.452998 |
95 | 23.75 | −15617.091194 | 22138.719998 | 32430.369356 | 720.764247 |
Space Fixed Coordinates of C06 inclined geostationary earth orbit in COMPASS (which is Chinese Global Positioning Satellite System) are transformed with respect to
There are a number of factors that influence patient outcome in trauma and orthopedic surgery in relation to hemorrhage. These can include patient factors, for example anticoagulant and antiplatelet medications, coagulopathies and other conditions, as well as surgical factors such as bony bleeding, large surgical incisions, diffuse venous bleeding and unseen sources of bleeding [1, 2].
Trauma still remains a leading worldwide cause of morbidity and mortality [3] and despite various developments over the years, hemorrhagic shock from trauma continues to form one part of the terrible triad contributing to mortality in both the military and civilian settings [4].
Effective hemostasis during surgery is advantageous to the surgeon as it prevents diffuse bleeding from capillaries and venules obscuring the surgical field and adding to operation time and infection risk [5, 6].
Significant blood loss has been associated with increased need for allogeneic and autologous blood transfusion [2, 7, 8]. These are associated with attendant risks including nosocomial infections [9], transfusion-related injury and fluid overload [10, 11]. In fact blood transfusion is an independent risk factor for infection, respiratory complications and the need for critical care support in traumatic injuries and resulted in a twofold increase in complications and critical care admissions, with more than two units of blood transfusion [7]. The risk of major perioperative complications is also increased with high intraoperative blood loss [2, 12, 13]. Therefore, patient outcome is optimal when the balance between bleeding and clotting is maintained during surgery such that tissue perfusion is adequate without excessive blood loss [5, 6].
Hemostasis in regard to trauma and surgery is a highly regulated process, maintaining flow through vessels at the same time as the thrombotic response to tissue damage is occurring [14], thereby ensuring tissue perfusion and limiting blood loss. The process is a complex interaction between vascular endothelium, platelets, the coagulation and fibrinolytic systems [15, 16].
Following injury, a temporary vascular smooth muscle contraction occurs in an attempt to stem blood flow. Endothelial disruption exposes the subendothelial layer and circulating Von Willebrand factor attaches to the site of injury. Surface glycoproteins also adhere to platelet surfaces. The subendothelial collagen activates adhering platelets and their surface receptors then bind circulating fibrinogen, forming a soft platelet plug comprising aggregated platelets and fibrinogen [14]. The adhering platelets secrete humoral factors including serotonin, prostaglandins and thromboxane that maintain a reduced blood flow, creating an environment that is conducive to clot formation at the site of bleeding. At the same time, circulating coagulating factors produced by the liver are activated in a series of precisely controlled sequential and dependant reactions [14, 17].
The final common pathway is the activation of thrombin that leads to conversion of soluble plasma fibrinogen to insoluble fibrin. The complex of activated factor XIII and fibrin results in cross-linking of fibrin monomers to form a stable clot [17].
Broadly speaking, there are mechanical, thermal, pharmacological and topical methods of hemorrhage control [2, 6, 8, 17, 18, 19, 20].
Mechanical methods include direct pressure, ligating clips and staples, sutures, fabric pads and gauze while hemostatic scalpels and lasers also reduce bleeding during surgery [6, 7, 17]. However, these methods have their drawbacks with respect to certain situations. The location of bleeding is particularly important with respect to orthopedics and in particular trauma. Bony surface bleeding and bleeding from the intramedullary canals are almost impossible to control with mechanical methods. Inflamed or friable tissues may contain a dense network of friable capillaries may prove a challenge [1, 2, 7]. Junctional bleeding in trauma may be potentially catastrophic and its control may not be amenable to the above methods.
The use of pharmacological methods can be a useful adjunct to other methods in these circumstances [7]. These may include epinephrine, desmopressin, tranexamic acid, vitamin K, aminocaproic acid and others.
In some situations though, even the above methods are ineffective or impractical [15] and hence the development of topical hemostatic agents. These are a diverse group of agents of varying composition and mechanisms of action. They can be versatile in the sense that when blood loss is minimal, they can be used sparingly and when there is severe blood loss then more liberal application could be an option [2]. They may be applied directly to the bleeding site and prevent or reduce continuous and unrelenting bleeding intraoperatively and postoperatively [2] and their topical nature broadly avoids the systemic adverse effects associated with systemic hemostatic medications including thrombosis [8].
Topical hemostasis is defined as a process that acts locally to stop bleeding from damaged vessels [21]. Recent and continuing developments have focused on agents that can be used as adjuncts to control bleeding during surgical procedures and control residual problematic bleeding if conventional methods fail. Broadly speaking, topical hemostats can be divided into three types [17, 20].
Passive—where the mechanism of action is to provide a physical scaffold around which platelets can aggregate. These act through contact activation and promote platelet aggregation so a clot can form. Examples include collagen, cellulose and gelatins.
Active—these have biological activity and their mechanism of action is actively influencing the clotting cascade to promote clot formation [17, 20]. These usually contain thrombin in one form or another [14].
Combined—combination of passive product with thrombin.
Contact activation occurs between receptors on platelets and collagen, promoting platelet aggregation [15, 17]. Preparation includes collagen sponges, pastes and powders [15, 17] and is obtained mainly from bovine sources [15], making it potentially immunogenic. In fact a 2–4% allergy in the total population to bovine collagen has been reported in the literature [22] (Table 1).
Hemostatic agent | Examples | Manufacturer |
---|---|---|
Collagen-based products | Avitene | Davol/BD BARD |
Helistat/Helitene | Integra Lifesciences | |
Instat/Ultrafoam | Ethicon, Johnson & Johnson | |
Oxidized cellulose | Surgicel Fibrillar | Ethicon, Johnson & Johnson |
Surgicel Nu-Knit | Ethicon, Johnson & Johnson | |
Gelatin-based products | Gelfoam | Pharmacia Corp, Pfizer |
Surgifoam | Johnson & Johnson | |
Polysaccharide spheres | Arista AH | BD BARD |
Passive hemostats.
The active ingredient in this product is oxidized regenerated cellulose (ORC). Its exact mechanism of action is poorly understood but contact activation is thought to play a part [15]. Often at reoperation, previously used ORC is visible, indicating reduced absorption and poor biodegradability, although this may be related to the amount used and the site of implantation [8]. For this reason, only the minimum possible amount to be used is indicated and it is recommended that the product be removed once hemostasis is achieved and before definitive closure [6, 8].
Their mechanism of action involves swelling while in contact with blood, providing a tamponade effect in confined spaces and restoring blood flow, and thereby producing a stable scaffold around which clots can form [17]. This does make it suitable for irregular wounds [6] and confined spaces [17]. However, it tends to stick to instruments when soaked with blood, making it difficult to handle and does not form a tight bond with the bleeding surface and can hence easily be dislodged [17].
Active agents have biological activity and actively participate in the coagulation cascade to induce clot formation at the site of bleeding [20]. They include thrombin, which comes into play in the last stages of the clotting cascade, converting circulating fibrinogen to a fibrin clot [17, 23]. Hence a significant advantage of thrombin is that its action is less susceptible to coagulopathies caused by clotting factor or platelet dysfunction [17]. Its activity constitutes the final steps in the clotting cascade and therefore it bypasses the initial steps in the cascade. Therefore, other aspects of the clotting cascade can be dysfunctional without significantly impairing the local hemostatic activity of thrombin [20].
Thrombin-based products are therefore excellent adjuncts in the presence of congenital and acquired coagulation and platelet disorders and in the presence of pharmacological and antiplatelet agents that are increasingly being used in the general population [5, 17]. Circulating fibrinogen is necessary for hemostasis to occur by active agents as thrombin converts it into insoluble fibrin that forms part of the clot. Therefore in rare cases of fibrinogen deficiency, clotting by thrombin-based products is impaired [17, 23].
These accomplish their action by bypassing the coagulation cascade to the final steps and converting fibrinogen to fibrin [24]. A fibrin precursor and thrombin stored in two separate adjacent syringes (dual syringe kit) with a single lumen enables delivery and mixing of these agents in the lumen and onto the surgical site, causing thrombin to cleave the fibrin precursor, resulting in fibrin monomers that polymerize at the site into a soluble mesh stabilized into a stable clot by factor XIII at the tissue surface [25]. Previously, bovine thrombin was used, which has recently been replaced by human thrombin [26] and more recently autologous human thrombin. Autologous fibrin sealants overcome the risk of allogeneic blood products, for example one is a patient-derived fibrin sealant utilizing the patient’s own blood as a source of fibrinogen and prothrombin and mixing it with an alkaline buffer solution to lower the pH, activating endogenous prothrombin [24] (Table 2).
Biosurgical | Examples | Manufacturer |
---|---|---|
Liquid fibrin adhesives | Tiseel | Baxter |
Evicel | Ethicon, Johnson & Johnson | |
Crosseal | Ethicon, Johnson & Johnson | |
Floseal | Baxter | |
Fibrin patches | Tachosil | Takeda |
Platelet gels | Vitagel | Orthovita |
Glutaraldehyde cross-linked albumin | BioGlue | Cryolife |
Sealants and adhesives.
These are a combination of thrombin, calcium and platelet-rich plasma, usually obtained from autologous sources using centrifugation systems that produce platelet-rich plasma. Platelets provide growth factors to stimulate wound healing and contribute to the strength of the clot [27].
These systems however rely on an intact coagulation system and may not be as effective in patients on antiplatelet or anticoagulant medications [27]. Also the extraction systems are expensive and there is a risk of contamination.
In addition to not requiring normal clotting mechanisms to work as mentioned before, active hemostats may offer other advantages. With many passive hemostatic agents, degeneration and reabsorption are a problem. This necessitates their removal from the surgical site prior to closure. With thrombin, this is not the case as degeneration and resorption of the resulting fibrin clot is achieved as part of wound healing [1, 8]. Thrombin and combination products also have a rapid onset of action with hemostasis being achieved within 10 min in most patients [7, 17, 28, 29]. Studies have shown that combining an active hemostat within a hemostatic product accelerates clotting. In a comparison of collagen-based products at different bleeding sites after surgical tumor resection, the combination of a collagen-thrombin product (n = 23) achieved complete hemostasis three times faster than the collagen sponge alone (n = 30). The median time to hemostasis was 78 seconds versus 243 seconds respectively (p < 0.001) [30]. Furthermore, approximately 80% achieved complete hemostasis within 2 min with an active topical hemostatic agent compared with only one-third of patients receiving a passive topical hemostatic agent [31]. Active hemostats are also very versatile and can come in various forms. These include sprays that can be advantageous in covering large bleeding surfaces quickly without the need for tamponade [31], and the concentration of thrombin in the formulation can also be varied depending on the severity and type of bleeding. Surgeons can use them in multiple ways during a single procedure due to their flexibility and range of delivery options [20]. Although bovine sources of thrombin may induce antibodies in hosts, this has not manifest itself as a major problem in the clinical setting [1, 32].
It has been shown that the terrible triad of hypothermia, coagulopathy and acidosis are associated with increased mortality in multiple trauma patients and that infection and multiple organ failure are other potential complications arising from severe blood loss [33, 34]. About a quarter of patients presenting to trauma centers have an established coagulopathy secondary to hemorrhage [35] with attendant risks of significant complications. Multiple defects in hemostasis can occur in combat injuries and as such, conventional methods of hemostasis may not be possible. Time is of the essence in these situations and non-transfusional approaches to hemostasis and the use of biosurgicals may be indicated [36, 37, 38, 39].
The combat setting has proved a challenging environment in many different ways in terms of management of hemorrhage. The tissue available for controlling life-threatening hemorrhage may be limited, the wound severity and the possibility of multiple injuries make the situation uniquely challenging [40]. Most combat injuries are penetrating in nature and a large proportion are limb wounds. Mortality from hemorrhage from these kinds of wounds is potentially preventable [36, 41, 42].
In the combat setting, the three principal sites of lethal hemorrhage are truncal (67%), junctional (19%) and extremity (14%). A report from the National Trauma Database suggests that the mortality from isolated lower limb extremity trauma with arterial injury is 2.8% with a 6.6% amputation rate [38]. Tourniquets can be used for these isolated injuries and their use in the military and civilian setting is supported by the Hartford consensus [39] and by the American College of Surgeons Committee on Trauma [38].
Junctional injuries (neck, axilla, groin and perineum) form a significant proportion of trauma in a combat setting and may damage the large vascular structures. These types of injuries are difficult to compress and are not amenable to tourniquet control [43, 44]. Topical hemostatic agents that have been developed in the last two decades [36, 45] can play a vital role in controlling severe bleeding in these situations and increase survival [33, 46] and have thus been listed as optional basic equipment for ambulances [39]. In addition, in a combat setting, more complex types of wound patterns are encountered than in a civilian setting, including blast injuries, which may be more amenable to topical hemostasis.
In 2003, USAIR [47] introduced guidelines of what should constitute the perfect hemostatic agent for use in the prehospital and battlefield settings [33, 41, 47, 48, 49] that included the following: being able to stop large vessel and arterial bleeding within 2 min of application, ability to be delivered through a pool of blood when applied, ready to use with no need for on-site preparation, simple enough to use by the wounded victim or a paramedic with minimal training, light weight and durable with a minimum 2-year shelf life in extreme environmental conditions, safe to use with no risk of injury to tissues or transmission of infection and inexpensive [41, 45, 50, 51]. In addition, hemostatic dressings need to be conformable and flexible enough due to the irregular shape, depth and wound configurations caused by modern explosive devices [40, 48].
These include gelatin [52], oxidized cellulose [53] and collagen and plant-derived polysaccharide spheres [54]. These agents are not biologically active and rely on the patients’ endogenous fibrin production for hemostasis. They provide a scaffold for platelet activation and aggregation, absorbing fluid several times their own weight to form a matrix at the site of hemorrhage, activating the extrinsic coagulation pathway and allowing clotting to occur. This makes them suitable only for patients in whom the coagulation system is intact [55, 56]. In fact in the absence of some coagulation factors, these agents may not be effective [53, 56]. They can be used as first line due to their ready availability and favorable cost-effectiveness, mostly as adjuncts with direct pressure at bleeding sites to control minimal residual hemorrhage [56].
These agents act by forming a physical matrix that stimulates platelet aggregation and degranulation to release factors that encourage clot formation [55].
Cellulose is a homopolysaccharide made by polymerization of glucopyranose molecules through glucosidic bonds. Surgical oxidized cellulose is either regenerated where organized fibers are formed prior to oxidation (regenerated ORC), or non-regenerated, with unorganized fibers prior to oxidation [55]. ORC conforms more rapidly to the surrounding environment. Surgical oxidized cellulose offers several favorable properties in hemostasis including bactericidal activity, good biocompatibility and ease of use [55]. It is usually resorbed but can take anywhere between 2 and 6 weeks depending on the amount used, the degree of saturation with blood and the tissue bed. The excess material may also cause foreign body reactions and granuloma formation without biodegradation and complicate radiological and clinical diagnoses of abscess, residual or recurrent tumor and granuloma [55, 57, 58]. For this reason, the minimal effective amount should be used and excess material removed prior to definitive closure. In addition, these products should not be used or left in place close to nerves, ureters, intestinal and vascular structures due to the risk of local inflammatory reactions and ischemia [55].
These can be used in combination with active agents such as thrombin in adhesives, or in a stand-alone manner. They are usually of bovine or porcine origin and act at the terminal stages of clotting to facilitate fibrin clot formation and are highly absorptive, forming a mechanical matrix for the clot to adhere to [55, 59]. They are quite versatile and available as sponges, powders or granules and are usually completely resorbed in 4–6 weeks [59]. It is important to use the minimum amount necessary to achieve hemostasis and to remove excess because part of the mechanism of action is swelling to cause a tamponade effect and this could potentially cause compression and necrosis in surrounding tissues if packed in tight spaces. This is particularly important around neural tissue and in bony spaces [59]. They are also useful in irregular wounds and surgical cavities as they can expand and fill these irregular spaces.
Mucoporous polysaccharide hemispheres are among a relatively new class of hemostatic agents derived from plant starch. Their mechanism of action includes absorbing water and the low-molecular weight components of blood, hence concentrating platelets and clotting factors in the vicinity, thereby enhancing local clotting processes [58, 60]. They have been used safely in cardiothoracic and neurospinal surgery.
These are active formulations containing mostly two agents—human purified fibrinogen and thrombin. They may also have added other compounds such as factor XIII, fibronectin and antifibrinolytics such as aprotinin used previously and tranexamic acid currently [61]. However, formulations without tranexamic acid or aprotinin are available to avoid hypersensitivity associated with aprotinin and neurotoxicity associated with tranexamic acid [62, 63] (Table 2).
These products are available in liquid or low-viscosity forms (fibrin glues) or as part of stiff collagen fleece (fibrin patches) [55]. Once applied, their mechanism of action is cleavage of fibrinogen to fibrin monomers by thrombin, which also activates factor XIII and the complex fibrin matrix forms the clot [55]. Calcium is required in both these steps and then the clot is eventually resorbed via the fibrinolytic pathway [25]. Generally, they connect atraumatically to tissues and form a barrier to leakage and bleeding through covalent polymerization between themselves and adjacent tissue [55]. Chiara et al. set out the properties of an sealant as being strong, rapid to adhere, flexible, sterile, without toxicity, biologically inert, biocompatible and able to be used in relatively wet environments with low thrombogenicity [55].
True sealants are of two types: synthetic (PEG-based or cyanoacrylates) [53, 60, 64, 65, 66, 67] or semisynthetic glutaraldehyde [68] (Table 2).
True sealants are cross-linking sealants that polymerize through nonenzymatic reactions, free of the need for the presence of blood or coagulation factors although some do have some coagulation factors within them. Both can be used to control residual ooze [53, 67].
PEG sealants are composed of polyethylene glycol and come in both flowing form as well as pads or fleeces. They should be avoided in kidney disease due to the renal clearance of polyethylene glycol and may contain allergenic components such as human albumin that can also lead to the theoretical risk of disease transmission [55].
Cyanoacrylates are products generally used for skin closure or lacerations in areas of low skin tension, for example scalp wounds. They are synthetic sealants that rapidly polymerize with water acting as the catalyst. There are two formulations: octyl-2-cyanocrylate and N-Butyl-2-cyanoacrylate. In a systematic review looking at octyl-2-cyanoacrylate, there were no differences in infections, wound dehiscence or cosmetic appearance when compared with other methods of closure [65]. Polymerization generates heat and therefore the amount used should be just enough and should certainly be avoided in delicate areas such as the spinal canal and neural tissue [55, 65]. Below the skin, a foreign body reaction may occur [65] and intravascular use is contraindicated due to the risk of systemic embolization [55].
Semisynthetic sealants otherwise known as bioglues are compounds of semisynthetic glutaraldehyde—bovine albumin-based sealant. Proteins on the surface of bleeding human tissue link with those of bovine albumin in the bioglue, causing a sealant effect [55]. Within synthetic graft materials, bioglue permeates interstices within the graft matrix [69], making it suitable for sealing anastomotic sites and decreasing postop bleeding [70].
These can be used as an adjunct to surgical hemostasis to improve residual moderate bleeding [55]. They are usually applied by double syringe systems. Each component is located in a separate section of the syringe, which then combine in a single lumen. They subsequently are applied using a blunt needle or spray tips in cases of large bleeding surface areas to the bleeding surgical site [25, 61]. Since the components bypass the initial steps in the extrinsic coagulation pathway, they can be used in achieving hemostasis in patients with congenital or acquired bleeding disorders such as hemophilia and patients on anticoagulants or antiplatelet medications [25, 62, 71] (Table 2).
They do have some drawbacks including the risk of thrombosis if injected intravascularly, hypotension and death and the risk of air embolization with the use of gas-driven sprayers [55]. In addition, the cost of sealants is significant and hence they are not recommended for use except in particular situations where indicated, for example in those with coagulation disorders [61]. One cost-effectiveness analysis done in the United Kingdom in patients undergoing total knee replacement on Quixil, one of the commercial brands, in addition to conventional hemostatic agents estimated that the use of a 5-ml dose of Quixil in addition to conventional hemostatic methods was cost saving in comparison to conventional methods alone. But the use of a 10-ml dose increased the cost substantially and they recommended that liquid fibrin adhesives only be used in selected cases [25]. They have however been found to be effective. Echave et al. [59] carried out a systematic review of 27 studies on the effectiveness of human gelatin-thrombin matrix sealant in different surgical fields including orthopedics. All 27 studies demonstrated that this sealant was associated with a significantly higher rate of successful hemostasis, and a shorter time to achieve it (p < 0.001) in comparison to other alternatives when conventional methods failed.
These products are also available as patches, for example Tachosil. They may have slightly different components but all of them have essentially the same mechanism of action, offering mechanical support with either collagen, oxidized cellulose/polyglactin 910 matrix, binding coagulation factors, allowing better adherence to bleeding tissue even in the presence of brisk bleeding, preventing the so-called “streaming effect” observed with fluid adhesives [72, 73, 74]. Tachosil is a ready-to-use fixed combination of equine collagen patch on one side and coated with coagulation factors, human fibrinogen and human thrombin on the other side [55]. Fibrin-pad and PGA-felt are absorbable hemostats composed of polyglactin 910, oxidized regenerated cellulose, thrombin and fibrinogen shown to be effective in a variety of tissue types [25, 72] and can rapidly achieve hemostasis in brisk bleeding in the retroperitoneum and pelvis, compared with the standard of care [72, 73] (Table 2).
Junctional hemorrhage is a significant problem in major trauma especially on the battlefield and often conventional methods such as tourniquets are ineffective [55]. In this respect, science has led to the development of products that are effective options in these circumstances and they can be divided into factor concentrators [75], procoagulants [76] and mucoadhesives [77] (Table 3).
Biosurgical | Examples | Manufacturer |
---|---|---|
Zeolite dressings | QuikClot & QuikClot ACS | Z-Medica |
Smectite dressings | WoundStat | TraumaCure Inc. |
Kaolin dressings | QuikClot Combat Gauze | Z-Medica |
Rapid Deployment Hemostat | Marine Polymer Technologies | |
Celox | Med Trade Products, UK | |
Trauma Stat | OreMedix | |
Fibrin dressings | Dry fibrin sealant dressing (DFSD) | American Red Cross |
Hemostatic dressings.
These are compounds of either zeolite (microporous crystalline aluminum silicate) or smectite (a nonmetallic clay mineral sodium, calcium and aluminum silicate). Examples include QuikClot (Z-Medica LLC, CT,USA) and QuikClot ACS (advanced clotting sponge), Traumadex (Medafor Inc., MN, USA) and self-expanding hemostatic polymer (SEHP) [35]. As the group name suggests these agents rapidly absorb the fluid content of blood. The resulting effect is an increase in relative concentration of its cellular and protein content and therefore clot formation. Water molecules are held in its pores by hydrogen bonds and this results in a relative local increase in concentration of platelets and clotting factors [35]. The first generation of QuikClot was designed as granules that were poured onto the bleeding wound. A high efficiency rate of 92% was demonstrated in a series of 103 patients in the military and civilian setting. There were eight patients in which hemorrhage was not effectively controlled with QC in coagulopathic patients where it was used as a last resort [75]. There were also some side effects of QC including intense exothermic reaction and scar formation from foreign body reaction [75]. Animal and early human studies on QC revealed thermal injury, poor biodegradability and foreign body reactions as the main drawbacks of QC [78, 79, 80]. In fact temperature generated by QuikClot in contact with aqueous components of blood at bleeding wounds has been measured to reach and average of 61°C with a potential rise to 76°C [78].
QuikClot has been compared to other hemostatic agents including HemCon (HemCon Medical Technologies Inc., OR, USA) in a military setting in multiple patients injured after explosions and gunshot wounds [81]. In this study, QC was effective but thermal injury was an issue. This has also been investigated in other studies by McMannus et al. [82] in the combat setting and evidence suggests that the greater the amount of blood and the more the QC applied, the greater is the risk of thermal injury. Thus currently it is only recommended for external use and the minimum amount required to achieve effective hemostasis is recommended.
QuikClot ACS is a newer generation of product made by larger zeolite beads packaged into mesh bags. This makes it easier to pack into cavities and irregular wounds often found on the battlefield and at junctional sites of hemorrhage and in cavities [55] and is claimed to produce much less of an exothermic reaction [75, 78] although there is a lack of studies with sufficient numbers to confirm this unequivocally [41].
Self-expanding hemostatic polymer (SEHP) is a dual action factor concentrator. Its mechanism of action results from its extremely potent absorptive capacity following absorption of the fluid component of blood and its ability to expand to conform to large irregular cavities and spaces, exerting a tamponade effect [35]. The other action is the effect of the polymer absorbing the liquid phase of blood into its matrix, thereby leading to a relative increase in concentration of platelets and coagulation factors at the site of bleeding, thereby promoting clotting [83, 84].
Woundstat is a compound of smectite granules that come in granular form. Its mechanism of action is absorption of the aqueous phase of blood, forming a clay substance that adheres to bleeding tissue and acts as a sealant and also concentrates clotting factors and blood cells locally, contributing to hemostasis. Granules are negatively charged and activate the intrinsic pathway as well [85, 86, 87].
These are products where the basic component is chitosan, which is a polymer derived from crustacean chitin. It is a complex biodegradable carbohydrate [55]. The mechanism of action appears to be related to highly positively charged chitosan interacting electronically with negatively charged cell membranes of erythrocytes. The product adheres strongly to tissues and seals bleeding wounds [77, 88, 89]. Examples include HemCon (HemCon Med Tech, Portland, OR) and Celox (Med. Trade Products, UK).
Celox is a chitosan-based adhesive, which is biodegradable and causes absorption of the aqueous phase and the advancement of red blood cell bonding. The positively charged Celox binds negatively charged red blood cells independently of the body’s clotting system, resulting in clot formation without the exothermic reaction associated with certain factor concentrators like QuikClot [35]. Its action is independent of the body’s clotting system, a property that makes it useful in patients requiring antiplatelet or anticoagulant medications or in the presence of coagulopathy and its local action means that it is not associated with distant clot formation. It is also reported to be very versatile, being available in granular and bandage forms and easy to remove from the wound after its clot formation activity is complete [49, 90, 91, 92]. HemCon, however, does have a hard consistency and is made in a square shape. Therefore, it works best on flat bleeding surfaces rather than deep irregular wounds [79, 83]. Wedmore et al. [77] looked at a series of patients with prehospital combative injuries where chitosan-based products had been used externally in chest, groin, buttock and abdominal wounds in 25 patients, 35 extremity wounds and neck and facial wounds in 4 cases. In about two-thirds of cases, the chitosan dressings were used following failure of hemostasis using only gauze with 100% success. In 97% of cases, bleeding stopped or hemostasis was improved, with failure only occurring in two cases attributed to blind stuffing of bandages into large cavitational injuries [77].
Trauma Stat is another chitosan-based derivative that was developed in collaboration with the United States Army, in which the mechanism of action involves positive charges in the amine groups on the chitosan molecule interacting with negative charges on the red blood cell membranes and in addition the adsorption of chitosan for fibrinogen and plasma proteins [79, 93].
Te Grotenhuis carried out a study of 66 patients in which conventional treatment with gauze and compression failed to control excessive bleeding or where conventional treatment was unlikely to achieve hemostasis. Complete cessation of hemorrhage including arterial hemorrhage occurred in 70% using the HemCon ChitoGauze, and reduction in hemorrhage occurred in 20% of patients despite 21 patients being on anticoagulants or having a clotting disorder and no adverse events occurred [88].
Due to the fact that chitosan is derived from crustaceans, there is a theoretical risk of allergenic reactions in patients allergic to shellfish. However in a study of 19 patients who had a positive IgE test to shellfish, none of the patients demonstrated a positive skin prick test to chitosan powder or expressed a reaction to HemCon bandage during serial bandage challenges, indicating favorable but not completely risk-free use of these products [94].
Chitosan-based dressings are also easy to remove after hemostasis has been achieved [41] and are known to have some antimicrobial properties [41, 95].
Their mechanism of action is mainly to deliver factors that promote coagulation into the bleeding wound. Examples are dry fibrin sealant dressing (DFSD) and QuikClot Combat Gauze (QCG) [70, 96, 97]. QCG is a surgical gauze coated with kaolin. On contact with injured endothelium, kaolin activates the extrinsic pathway, enhancing coagulation and promoting hemostasis. It is not degradable and needs to be removed from the wound following achievement of hemostasis [76].
Kaolin-based products have been used in a military setting and have demonstrated good results in both junctional and non-junctional hemorrhage [76]. In the above study, Shina et al. retrospectively reviewed 133 kaolin-based dressings applied to 122 military patients. 27% were for junctional hemorrhage with a success rate of 88% while the rest were extremity trauma where the success rate was 92%.
In addition to problems specific to certain types of hemostatic agents, there are also general drawbacks.
The hemostats that contain biological agents, usually the active hemostats, can be associated with the risk of disease transmission. For example, DFSD has the theoretical risk of viral disease transmission and hence has not achieved FDA approval.
Some agents have handling characteristics that are beneficial in certain situations. For example agents that have a granular nature can be used for complex irregular wounds with multiple bleeding points. However, the handling characteristics are difficult and they are difficult to apply in combat situations [89]. In addition, many agents are nonabsorbable and need to be removed after hemostasis is achieved. This may be difficult with some agents and require multiple washouts. Granular agents also have the potential to enter the vascular system and occlude the distal parts of vessels, causing endothelial injury and intravascular coagulation [41]. This has been demonstrated by Kheirabadi et al. [89] in their study, and for these reasons a bandage/gauze form of hemostatic agent is preferable as being safer for hemorrhage control, avoiding intravascular complications [38].
Any chapter on hemostasis in trauma and orthopedics is incomplete without the mention of tranexamic acid. This drug has been shown to be effective in reducing mortality due to bleeding in both the military and civilian setting.
The CRASH-2 (Clinical Randomization of an Antibrinolytic in Severe Hemorrhage-2) trial was a multicenter trial involving 40 centers looking at 20,211 adult trauma patients with significant bleeding who were randomized to two arms. One arm received TA within the first 3 hours of trauma and the other received placebo. The study demonstrated a reduction in mortality risk due to any cause from 14.5% compared with 16% in the placebo group (p < 0.001), with no increase in vasoocclusive events such as pulmonary embolism or myocardial infarction (0.3% versus 0.5% p-0.096) [98].
The MATTER (Military Application of Tranexamic Acid in Trauma) study looked at 896 patients with severe combat injuries and demonstrated a 6.5% absolute risk reduction in mortality in these patients with the use of tranexamic acid [99].
Both these studies have recommended incorporation of intravenous tranexamic acid into clinical practice [24].
Joint replacements are major procedures in elective orthopedics and can be associated with significant blood loss and increased transfusion requirements if appropriate steps are not taken to mitigate against this. In addition to the conventional methods of blood management including preoperative optimization, tourniquets if appropriate, intraoperative techniques such as cell saver and cauterization, topical and pharmacological hemostats and biosurgicals may offer some excellent solutions to reduce the transfusion requirements and achieve hemostasis.
A few studies have looked at human-derived fibrin sealants in total knee replacement [100, 101, 102]. A multicenter randomized control trial looking at 58 patients who underwent total knee replacement demonstrated a reduced postoperative blood loss, reduced postoperative decrease in hemoglobin and calculated blood loss in patients in whom fibrin sealant was used compared with that in the standard group (20% compared with the standard 83% p = 0.004) [100]. Another study that showed benefit was done by Dhillon et al. [25]. Results from other studies have been equivocal and have not demonstrated any clear difference.
In total hip arthroplasty, the use of fibrin sealants has been associated with reducing blood loss but inconsistent results have been demonstrated with regard to reduction in postoperative transfusion requirements [24, 103, 104, 105].
Multiple studies have looked at platelet gels in arthroplasty surgery. The evidence has been inconsistent in many. One randomized control trial looking at 100 total knee replacements did demonstrate significantly lower transfusion requirements in patients in whom platelet gels were used [106].
Desmopressin is a synthetic analog of anti-diuretic hormone. Its mechanism of action is to increase the levels of factor VIII and Von Willebrand factor, thereby enhancing primary hemostasis and platelet aggregation and adherence. This makes it suitable as a blood management strategy in patients with platelet dysfunction or other clotting disorders such as Von Willebrand’s disease and hemophilia A [107, 108]. It has also been used in healthy individuals for reducing postoperative bleeding in total hip and knee replacement surgery [109]. Six randomized placebo-controlled trials addressing the use of desmopressin in total hip and knee arthroplasty have been undertaken [110, 111, 112, 113, 114, 115]; however, evidence suggests that desmopressin is not significantly effective in reducing blood loss or transfusion requirements in these patients [24].
There are a number of good-quality randomized control trials that support the use of tranexamic acid in reducing blood loss and transfusion requirements in both knee and hip arthroplasty surgery [24]. There is however considerable amount of heterogeneity between the trials with regard to methods of delivery including single intravenous bolus dose, repeated boluses, prolonged infusion or intraarticular injection [116], and also differing dosing regimes [117]. In total knee arthroplasty, it has been shown that one intraoperative dose is sufficiently effective in reducing transfusion requirements and postoperative bleeding [118]. With the theoretical risk of intravascular thrombosis, intraarticular injection of tranexamic acid was investigated and compared to placebo and the studies showed reduction in blood loss but no reduction in transfusion rates [101, 119, 120]. Only one RCT by Seo et al. [121] showed a reduction in transfusion requirements with intraarticular (20%) rather than intravenous (34%) or placebo (94%). The evidence in total hip replacement with regard to intraarticular tranexamic acid is less convincing than in knee arthroplasty and more studies are needed.
With regard to aminocaproic acid, three RCTs did demonstrate benefit in hip and knee replacement surgery in terms of reducing blood loss in comparison with placebo. However, with regard to reducing transfusion requirements the evidence is much less convincing [24, 122, 123, 124].
Spine surgery presents a few unique challenges that limit the products that can be used for hemostasis in these situations. One of them is the friability of neural tissue and secondly the fact that the spinal cord and nerve roots are enclosed in rigid bony spaces that limit the kinds of hemostats that can be used due to the potential of swelling and compression of neural tissue in a rigid space. In addition, there is the potential for neurotoxicity with certain agents.
Cerebrospinal fluid leaks are a common source of postoperative morbidity in patients who have undergone spinal surgery. The morbidity burden includes severe postural headaches, vomiting, dizziness, photophobia, tinnitus, pseudomeningoceles and the risk of meningitis. It is therefore important that when dural tears occur or when an iatrogenic durotomy is created a water tight repair is essential. PEG hydrogel sealant has been found to be a safe effective way to augment dural closure and prevent these complications. A prospective study by Kim et al. [66] demonstrated that augmentation of standard dural closure techniques with this sealant in patients had significantly higher rates of watertight closure than with controls (100% and 64.3% respectively), without statistical differences in cerebrospinal fluid leaks, infections or wound healing. Complications due to swelling of polyethylene glycol and nerve compression were not demonstrated in this study but this remains a possibility. This led to the development of low-swell PEG hydrogel sealant (Duraseal) [55] and has been found to be safe and effective in a 3-to-1 randomized single-blind multicenter trial in which 100% of patients who had this low-swell formulation achieved watertight dural closure. Another study has also shown that BioGlue (semisynthetic glutaraldehyde-bovine albumin sealant) is safe and cost-effective in proximity to neurological structures despite previous concerns. Miscusi et al. [125] demonstrated a watertight dural closure in 23 patients requiring dural repair, with no incidence of neurological or infection related complications.
Collagen and gelatin-based products can be used to achieve hemostasis in spinal surgery. Xu et al. [64] carried out a study on 92 patients undergoing spinal fusion surgery and concluded that collagen-based products are superior to gelatin-based products in achieving hemostasis in spine surgery, with lower blood loss and postoperative drain volume.
Oxidized regenerated cellulose has been used for hemostasis in spine surgery. However when used around or in foramina with rigid bony walls, the swelling of small portions of the cellulose material may lead to significant mass effect and neural compression 1 day after surgery as demonstrated by Menovsky et al. [126] and may lead to rapid neurological deterioration. Therefore this material should be removed after hemostasis has been achieved prior to closure.
As mentioned before, liquid fibrin sealants can be used in spine surgery for hemostasis, but those containing tranexamic acid may be associated with neurotoxicity and should not be used if CSF leak or dural tear is present [55].
Topical hemostats and biosurgicals are a diverse group of compounds that have been developed and can be used in different situations as part of a comprehensive blood management program to limit the amount of blood loss. Trauma and orthopedics as a specialty also presents some unique challenges, with operations having significant blood loss and in trauma, junctional injuries on the battlefield with hemorrhage that is hard to control by conventional means. In addition, patients may be complex and frequently have platelet or coagulation disorders that preclude the use of certain classes of hemostatic agents. As mentioned before, these compounds are diverse, with different mechanisms of actions and indications, both in an elective and an emergency trauma setting. A comprehensive knowledge of these products is essential in modern-day trauma and orthopedic practice.
Despite recent developments, the perfect hemostatic or biosurgical agent still remains elusive and each of these products has their own drawbacks, side effects and unique indications and future research will hopefully continue to improve on these.
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Gulrez, Saphwan Al-Assaf and Glyn O Phillips",authors:[{id:"58120",title:"Prof.",name:"Saphwan",middleName:null,surname:"Al-Assaf",slug:"saphwan-al-assaf",fullName:"Saphwan Al-Assaf"}]},{id:"13254",doi:"10.5772/13474",title:"Insight Into Adsorption Thermodynamics",slug:"insight-into-adsorption-thermodynamics",totalDownloads:7156,totalCrossrefCites:90,totalDimensionsCites:267,abstract:null,book:{id:"25",slug:"thermodynamics",title:"Thermodynamics",fullTitle:"Thermodynamics"},signatures:"Papita Saha and Shamik Chowdhury",authors:[{id:"13943",title:"Dr.",name:"Papita",middleName:null,surname:"Saha",slug:"papita-saha",fullName:"Papita Saha"},{id:"24184",title:"Mr.",name:"Shamik",middleName:null,surname:"Chowdhury",slug:"shamik-chowdhury",fullName:"Shamik Chowdhury"}]},{id:"35261",doi:"10.5772/34233",title:"Anisotropic Mechanical Properties of ABS Parts Fabricated by Fused Deposition Modelling",slug:"anisotropic-mechanical-properties-of-abs-parts-fabricated-by-fused-deposition-modeling-",totalDownloads:7283,totalCrossrefCites:116,totalDimensionsCites:246,abstract:null,book:{id:"1982",slug:"mechanical-engineering",title:"Mechanical Engineering",fullTitle:"Mechanical Engineering"},signatures:"Constance Ziemian, Mala Sharma and Sophia Ziemian",authors:[{id:"89554",title:"Dr.",name:"Mala",middleName:null,surname:"Sharma",slug:"mala-sharma",fullName:"Mala Sharma"},{id:"98759",title:"Dr.",name:"Constance",middleName:null,surname:"Ziemian",slug:"constance-ziemian",fullName:"Constance Ziemian"},{id:"137165",title:"Ms.",name:"Sophia",middleName:null,surname:"Ziemian",slug:"sophia-ziemian",fullName:"Sophia Ziemian"}]},{id:"8446",doi:"10.5772/39538",title:"2 µm Laser Sources and Their Possible Applications",slug:"2-m-laser-sources-and-their-possible-applications",totalDownloads:12087,totalCrossrefCites:139,totalDimensionsCites:227,abstract:null,book:{id:"3161",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",title:"Frontiers in Guided Wave Optics and Optoelectronics",fullTitle:"Frontiers in Guided Wave Optics and Optoelectronics"},signatures:"Karsten Scholle, Samir Lamrini, Philipp Koopmann and Peter Fuhrberg",authors:[{id:"4951",title:"Dr.",name:"Karsten",middleName:null,surname:"Scholle",slug:"karsten-scholle",fullName:"Karsten Scholle"},{id:"133366",title:"Prof.",name:"Samir",middleName:null,surname:"Lamrini",slug:"samir-lamrini",fullName:"Samir Lamrini"},{id:"133370",title:"Prof.",name:"Philipp",middleName:null,surname:"Koopmann",slug:"philipp-koopmann",fullName:"Philipp Koopmann"},{id:"133371",title:"Mr.",name:"Peter",middleName:null,surname:"Fuhrberg",slug:"peter-fuhrberg",fullName:"Peter Fuhrberg"}]},{id:"27163",doi:"10.5772/31200",title:"Synergisms between Compost and Biochar for Sustainable Soil Amelioration",slug:"synergism-between-biochar-and-compost-for-sustainable-soil-amelioration",totalDownloads:6069,totalCrossrefCites:66,totalDimensionsCites:170,abstract:null,book:{id:"873",slug:"management-of-organic-waste",title:"Management of Organic Waste",fullTitle:"Management of Organic Waste"},signatures:"Daniel Fischer and Bruno Glaser",authors:[{id:"84418",title:"Prof.",name:"Bruno",middleName:null,surname:"Glaser",slug:"bruno-glaser",fullName:"Bruno Glaser"},{id:"96141",title:"Mr.",name:"Daniel",middleName:null,surname:"Fischer",slug:"daniel-fischer",fullName:"Daniel Fischer"}]}],mostDownloadedChaptersLast30Days:[{id:"35255",title:"Mechanical Transmissions Parameter Modelling",slug:"mechanical-transmissions-parameter-modelling",totalDownloads:7414,totalCrossrefCites:1,totalDimensionsCites:2,abstract:null,book:{id:"1982",slug:"mechanical-engineering",title:"Mechanical Engineering",fullTitle:"Mechanical Engineering"},signatures:"Isad Saric, Nedzad Repcic and Adil Muminovic",authors:[{id:"101313",title:"Prof.",name:"Isad",middleName:null,surname:"Saric",slug:"isad-saric",fullName:"Isad Saric"}]},{id:"67558",title:"Polymerase Chain Reaction (PCR): Principle and Applications",slug:"polymerase-chain-reaction-pcr-principle-and-applications",totalDownloads:10632,totalCrossrefCites:8,totalDimensionsCites:18,abstract:"The characterization of the diversity of species living within ecosystems is of major scientific interest to understand the functioning of these ecosystems. It is also becoming a societal issue since it is necessary to implement the conservation or even the restoration of biodiversity. Historically, species have been described and characterized on the basis of morphological criteria, which are closely linked by environmental conditions or which find their limits especially in groups where they are difficult to access, as is the case for many species of microorganisms. The need to understand the molecular mechanisms in species has made the PCR an indispensable tool for understanding the functioning of these biological systems. A number of markers are now available to detect nuclear DNA polymorphisms. In genetic diversity studies, the most frequently used markers are microsatellites. The study of biological complexity is a new frontier that requires high-throughput molecular technology, high speed computer memory, new approaches to data analysis, and the integration of interdisciplinary skills.",book:{id:"7728",slug:"synthetic-biology-new-interdisciplinary-science",title:"Synthetic Biology",fullTitle:"Synthetic Biology - New Interdisciplinary Science"},signatures:"Karim Kadri",authors:[{id:"290766",title:"Dr.",name:"Kadri",middleName:null,surname:"Karim",slug:"kadri-karim",fullName:"Kadri Karim"}]},{id:"62059",title:"Types of HVAC Systems",slug:"types-of-hvac-systems",totalDownloads:12391,totalCrossrefCites:8,totalDimensionsCites:14,abstract:"HVAC systems are milestones of building mechanical systems that provide thermal comfort for occupants accompanied with indoor air quality. HVAC systems can be classified into central and local systems according to multiple zones, location, and distribution. Primary HVAC equipment includes heating equipment, ventilation equipment, and cooling or air-conditioning equipment. Central HVAC systems locate away from buildings in a central equipment room and deliver the conditioned air by a delivery ductwork system. Central HVAC systems contain all-air, air-water, all-water systems. Two systems should be considered as central such as heating and cooling panels and water-source heat pumps. Local HVAC systems can be located inside a conditioned zone or adjacent to it and no requirement for ductwork. 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Many critical affairs must be properly treated to obtain the improved operating characteristics. This chapter presents the basic and key technologies of switched-reluctance machine in motor and generator operations. The contents in this chapter include: (1) structures and governing equations of SRM; (2) some commonly used SRM converters; (3) estimation of key parameters and performance evaluation of SRM drive; (4) commutation scheme, current control scheme, and speed control scheme of SRM drive; (5) some commonly used front-end converters and their operation controls for SRM drive; (6) reversible and regenerative braking operation controls for SRM drive; (7) some tuning issues for SRM drive; (8) operation control and some tuning issues of switched-reluctance generators; and (9) experimental application exploration for SRM systems—(a) wind generator and microgrid and (b) EV SRM drive.",book:{id:"8899",slug:"modelling-and-control-of-switched-reluctance-machines",title:"Modelling and Control of Switched Reluctance Machines",fullTitle:"Modelling and Control of Switched Reluctance Machines"},signatures:"Chang-Ming Liaw, Min-Ze Lu, Ping-Hong Jhou and Kuan-Yu Chou",authors:[{id:"37616",title:"Prof.",name:"Chang-Ming",middleName:null,surname:"Liaw",slug:"chang-ming-liaw",fullName:"Chang-Ming Liaw"},{id:"306461",title:"Mr.",name:"Min-Ze",middleName:null,surname:"Lu",slug:"min-ze-lu",fullName:"Min-Ze Lu"},{id:"306463",title:"Mr.",name:"Ping-Hong",middleName:null,surname:"Jhou",slug:"ping-hong-jhou",fullName:"Ping-Hong Jhou"},{id:"306464",title:"Mr.",name:"Kuan-Yu",middleName:null,surname:"Chou",slug:"kuan-yu-chou",fullName:"Kuan-Yu Chou"}]},{id:"70874",title:"Social, Economic, and Environmental Impacts of Renewable Energy Resources",slug:"social-economic-and-environmental-impacts-of-renewable-energy-resources",totalDownloads:4969,totalCrossrefCites:27,totalDimensionsCites:53,abstract:"Conventional energy source based on coal, gas, and oil are very much helpful for the improvement in the economy of a country, but on the other hand, some bad impacts of these resources in the environment have bound us to use these resources within some limit and turned our thinking toward the renewable energy resources. The social, environmental, and economical problems can be omitted by use of renewable energy sources, because these resources are considered as environment-friendly, having no or little emission of exhaust and poisonous gases like carbon dioxide, carbon monooxide, sulfur dioxide, etc. Renewable energy is going to be an important source for power generation in near future, because we can use these resources again and again to produce useful energy. Wind power generation is considered as having lowest water consumption, lowest relative greenhouse gas emission, and most favorable social impacts. It is considered as one of the most sustainable renewable energy sources, followed by hydropower, photovoltaic, and then geothermal. As these resources are considered as clean energy resources, they can be helpful for the mitigation of greenhouse effect and global warming effect. Local employment, better health, job opportunities, job creation, consumer choice, improvement of life standard, social bonds creation, income development, demographic impacts, social bonds creation, and community development can be achieved by the proper usage of renewable energy system. Along with the outstanding advantages of these resources, some shortcomings also exist such as the variation of output due to seasonal change, which is the common thing for wind and hydroelectric power plant; hence, special design and consideration are required, which are fulfilled by the hardware and software due to the improvement in computer technology.",book:{id:"7636",slug:"wind-solar-hybrid-renewable-energy-system",title:"Wind Solar Hybrid Renewable Energy System",fullTitle:"Wind Solar Hybrid Renewable Energy System"},signatures:"Mahesh Kumar",authors:[{id:"309842",title:"Mr.",name:"Kamlesh",middleName:null,surname:"Kumar",slug:"kamlesh-kumar",fullName:"Kamlesh Kumar"}]}],onlineFirstChaptersFilter:{topicId:"11",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"83003",title:"Rheology of Heavy Oils",slug:"rheology-of-heavy-oils",totalDownloads:0,totalDimensionsCites:null,doi:"10.5772/intechopen.105666",abstract:"The problems of heavy oil rheology, accompanied by physical phenomena of the formation and destruction of coagulation disordered structures and aggregates as a result of the hydrodynamic interaction of particles (asphaltenes, paraffins, resins, and solid-phase particles) contained in the oil, which significantly affect its properties and flow, are considered and analyzed. Rheological models of viscous-plastic heavy oils are considered and developed, consistent with a variety of experimental data. New rheological models for viscous-plastic heavy oils are proposed, which make it possible to generalize many existing models. It is noted that the variety of rheological models for heavy oils is determined by the conditions for the formation of disordered structures in the bulk of the oil flow. For heavy oils, a nonlinear equation for filtration in porous media is proposed, depending on the shear stress, pressure gradient, effective viscosity of the oil, and a number of other parameters. An analytical solution to this equation is proposed, which is consistent with the experimental data. Models for the settling rate and drag coefficient of particles in heavy oils are proposed. Applied problems of rheology aimed at improving the rheological properties of heavy oil during their processing as a result of creating a recirculation scheme at an operating oil refining unit are considered.",book:{id:"11542",title:"Crude Oil - Emerging Downstream Processing Technologies",coverURL:"https://cdn.intechopen.com/books/images_new/11542.jpg"},signatures:"Gudret Isfandiyar Kelbaliyev, Dilgam Babir Tagiyev and Manaf Rizvan Manafov"},{id:"82986",title:"Interferometric Gravitational Wave Detectors",slug:"interferometric-gravitational-wave-detectors",totalDownloads:0,totalDimensionsCites:0,doi:"10.5772/intechopen.106417",abstract:"The existence of gravitational waves is an important proof of Einstein’s theory of general relativity and took 100 years to be achieved using optical interferometry. This work describes how such a detector works and how it can change the way of seeing the Universe. Kilometers size laser interferometers are being built around the world in the way to make gravitational astronomy; detectors already built in the United States, Italy, and Japan will join efforts with detectors built in Japan and India and provide humanity with the means to see gravitational interactions of black holes and neutron star. Interactions, without these detectors, will be forever out of our sight.",book:{id:"11156",title:"Optical Interferometry - A Multidisciplinary Technique in Science and Engineering",coverURL:"https://cdn.intechopen.com/books/images_new/11156.jpg"},signatures:"Carlos Frajuca"},{id:"82985",title:"Motion Planning of UAV Swarm: Recent Challenges and Approaches",slug:"motion-planning-of-uav-swarm-recent-challenges-and-approaches",totalDownloads:0,totalDimensionsCites:0,doi:"10.5772/intechopen.106270",abstract:"The unmanned aerial vehicle (UAV) swarm is gaining massive interest for researchers as it has huge significance over a single UAV. Many studies focus only on a few challenges of this complex multidisciplinary group. Most of them have certain limitations. This paper aims to recognize and arrange relevant research for evaluating motion planning techniques and models for a swarm from the viewpoint of control, path planning, architecture, communication, monitoring and tracking, and safety issues. Then, a state-of-the-art understanding of the UAV swarm and an overview of swarm intelligence (SI) are provided in this research. Multiple challenges are considered, and some approaches are presented. Findings show that swarm intelligence is leading in this era and is the most significant approach for UAV swarm that offers distinct contributions in different environments. This integration of studies will serve as a basis for knowledge concerning swarm, create guidelines for motion planning issues, and strengthens support for existing methods. Moreover, this paper possesses the capacity to engender new strategies that can serve as the grounds for future work.",book:{id:"11522",title:"Aeronautics - New Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11522.jpg"},signatures:"Muhammad Mubashir Iqbal, Zain Anwar Ali, Rehan Khan and Muhammad Shafiq"},{id:"82950",title:"Flexible Demand for Optimzed Microgrid Design and Cost",slug:"flexible-demand-for-optimzed-microgrid-design-and-cost",totalDownloads:1,totalDimensionsCites:0,doi:"10.5772/intechopen.105490",abstract:"Although access to energy has been a major enabler for the development of our civilization, more than a billion people remain without access to electricity. Recent improvements in solar technology offer a unique opportunity to achieve global electrification. However, field studies have reported number of project failures. This chapter is dedicated to project developers, engineers, academicians and policymakers, who wish to contribute to rural development. In the first part, it recalls some important features of a well-thought rural electrification project, while proposing to involve students to liaise with local population. In a second part, it presents an original approach for achieving lowest cost solar microgrid design considering the random nature of solar energy and the users’ willingness to be flexible in their consumption. The inconvenience (loss of utility) for users has been modeled and the results suggest that rural users are likely to adapt their consumption to the availability of solar energy to reduce their electricity bill. Such a conclusion is likely to apply to interconnected power grid as renewable energy becomes more and more prominent in the energy mix and energy storage remains a costly challenge.",book:{id:"11534",title:"Renewable Energy - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11534.jpg"},signatures:"Fabien Chidanand Robert"},{id:"82959",title:"Coking",slug:"coking",totalDownloads:0,totalDimensionsCites:0,doi:"10.5772/intechopen.106190",abstract:"Currently, conventional oil is used as the main source for the petrochemical industry. However, conventional oil’s capacity is declining, and that source will probably be exhausted in the near future. Heavy oil and petroleum residues have become a suitable alternative source to meet global energy demand. However, heavy oil and oil residues require many upgrading processes before turning to be valuable products. Among the various upgrading processes, delayed coking, which is capable of processing any residue at a low investment cost, garnered tremendous importance. Petroleum coke is one of the coking products that is divided into three types: shot coke, sponge coke and needle coke, depending on the feed properties and operating conditions of the process. Needle coke is used as a valuable product in the production of graphite electrodes used in electric arc furnace (EAF) for melting scrap metal and producing steel.",book:{id:"11542",title:"Crude Oil - Emerging Downstream Processing Technologies",coverURL:"https://cdn.intechopen.com/books/images_new/11542.jpg"},signatures:"Jafar Ramezanzadeh and Hossein Moradi"},{id:"82664",title:"The Combined Method to Improve Heat Transfer Coefficient on Heat Exchanger",slug:"the-combined-method-to-improve-heat-transfer-coefficient-on-heat-exchanger",totalDownloads:3,totalDimensionsCites:0,doi:"10.5772/intechopen.105880",abstract:"The heat transfer process occurs all the time around us, from simple household appliances to equipment used in large industries. Energy efficiency in large-scale use in industry is necessary because it is related to company profits. One way to save energy use in heat exchangers is to change the thermal properties of the cooling fluid. The addition of particles of the nanometer size (nanofluids) in the working fluid will improve the performance of the heat exchanger, and the main goal is the highest efficiency. In addition, there is another method to increase the heat transfer rate, namely, by vibrating the cooling fluid. This chapter will discuss combining nanofluids and ultrasonic vibrations in heat transfer processes in heat exchangers. The application of these two methods simultaneously gives rise to several advantages to the heat transfer system, will promote higher heat transfer, and at the same time function as cleaning of scale/deposits that often appear on the surface of the heat exchanger.",book:{id:"11161",title:"Heat Transfer",coverURL:"https://cdn.intechopen.com/books/images_new/11161.jpg"},signatures:"Sudarmadji Sudarmadji, Sugeng Hadi Susilo and Asrori Asrori"}],onlineFirstChaptersTotal:280},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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\r\n\tEducation and Human Development is an interdisciplinary research area that aims to shed light on topics related to both learning and development. This Series is intended for researchers, practitioners, and students who are interested in understanding more about these fields and their applications.
",coverUrl:"https://cdn.intechopen.com/series/covers/23.jpg",latestPublicationDate:"August 1st, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:0,editor:{id:"280770",title:"Dr.",name:"Katherine K.M.",middleName:null,surname:"Stavropoulos",slug:"katherine-k.m.-stavropoulos",fullName:"Katherine K.M. Stavropoulos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRdFuQAK/Profile_Picture_2022-05-24T09:03:48.jpg",biography:"Katherine Stavropoulos received her BA in Psychology from Trinity College, in Connecticut, USA and her Ph.D. in Experimental Psychology from the University of California, San Diego. She completed her postdoctoral work at the Yale Child Study Center with Dr. James McPartland. Dr. Stavropoulos’ doctoral dissertation explored neural correlates of reward anticipation to social versus nonsocial stimuli in children with and without autism spectrum disorders (ASD). She has been a faculty member at the University of California, Riverside in the School of Education since 2016. Her research focuses on translational studies to explore the reward system in ASD, as well as how anxiety contributes to social challenges in ASD. She also investigates how behavioral interventions affect neural activity, behavior, and school performance in children with ASD. She is also involved in the diagnosis of children with ASD and is a licensed clinical psychologist in California. She is the Assistant Director of the SEARCH Center at UCR and is a faculty member in the Graduate Program in Neuroscience.",institutionString:null,institution:{name:"University of California, Riverside",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:2,paginationItems:[{id:"89",title:"Education",coverUrl:"https://cdn.intechopen.com/series_topics/covers/89.jpg",isOpenForSubmission:!1,annualVolume:null,editor:{id:"260066",title:"Associate Prof.",name:"Michail",middleName:null,surname:"Kalogiannakis",slug:"michail-kalogiannakis",fullName:"Michail Kalogiannakis",profilePictureURL:"https://mts.intechopen.com/storage/users/260066/images/system/260066.jpg",biography:"Michail Kalogiannakis is an Associate Professor of the Department of Preschool Education, University of Crete, and an Associate Tutor at School of Humanities at the Hellenic Open University. He graduated from the Physics Department of the University of Crete and continued his post-graduate studies at the University Paris 7-Denis Diderot (D.E.A. in Didactic of Physics), University Paris 5-René Descartes-Sorbonne (D.E.A. in Science Education) and received his Ph.D. degree at the University Paris 5-René Descartes-Sorbonne (PhD in Science Education). His research interests include science education in early childhood, science teaching and learning, e-learning, the use of ICT in science education, games simulations, and mobile learning. He has published over 120 articles in international conferences and journals and has served on the program committees of numerous international conferences.",institutionString:"University of Crete",institution:{name:"University of Crete",institutionURL:null,country:{name:"Greece"}}},editorTwo:{id:"422488",title:"Dr.",name:"Maria",middleName:null,surname:"Ampartzaki",slug:"maria-ampartzaki",fullName:"Maria Ampartzaki",profilePictureURL:"https://mts.intechopen.com/storage/users/422488/images/system/422488.jpg",biography:"Dr Maria Ampartzaki is an Assistant Professor in Early Childhood Education in the Department of Preschool Education at the University of Crete. Her research interests include ICT in education, science education in the early years, inquiry-based and art-based learning, teachers’ professional development, action research, and the Pedagogy of Multiliteracies, among others. 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Kasenga",hash:"91cde4582ead884cb0f355a19b67cd56",volumeInSeries:4,fullTitle:"Malaria",editors:[{id:"86725",title:"Dr.",name:"Fyson",middleName:"Hanania",surname:"Kasenga",slug:"fyson-kasenga",fullName:"Fyson Kasenga",profilePictureURL:"https://mts.intechopen.com/storage/users/86725/images/system/86725.jpg",institutionString:"Malawi Adventist University",institution:{name:"Malawi Adventist University",institutionURL:null,country:{name:"Malawi"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7123",title:"Current Topics in Neglected Tropical Diseases",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7123.jpg",slug:"current-topics-in-neglected-tropical-diseases",publishedDate:"December 4th 2019",editedByType:"Edited by",bookSignature:"Alfonso J. 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Saxena",hash:"d92a4085627bab25ddc7942fbf44cf05",volumeInSeries:2,fullTitle:"Current Perspectives in Human Papillomavirus",editors:[{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. 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:250,paginationItems:[{id:"274452",title:"Dr.",name:"Yousif",middleName:"Mohamed",surname:"Abdallah",slug:"yousif-abdallah",fullName:"Yousif Abdallah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274452/images/8324_n.jpg",biography:"I certainly enjoyed my experience in Radiotherapy and Nuclear Medicine, particularly it has been in different institutions and hospitals with different Medical Cultures and allocated resources. Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. RELACION DE PONENCIAS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGIA. 10/2014.",institutionString:null,institution:null},{id:"243698",title:"Dr.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. Dr. Wang was awarded two research project grants focused on multimodal optical coherence tomography imaging and deep learning in cataract and retinal disease, from the National Natural Science Foundation of China. He has published around 30 peer-reviewed journal papers and four book chapters and co-edited one book.",institutionString:null,institution:null},{id:"7227",title:"Dr.",name:"Hiroaki",middleName:null,surname:"Matsui",slug:"hiroaki-matsui",fullName:"Hiroaki Matsui",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Tokyo",country:{name:"Japan"}}},{id:"312999",title:"Dr.",name:"Bernard O.",middleName:null,surname:"Asimeng",slug:"bernard-o.-asimeng",fullName:"Bernard O. Asimeng",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Ghana",country:{name:"Ghana"}}},{id:"318905",title:"Prof.",name:"Elvis",middleName:"Kwason",surname:"Tiburu",slug:"elvis-tiburu",fullName:"Elvis Tiburu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Ghana",country:{name:"Ghana"}}},{id:"336193",title:"Dr.",name:"Abdullah",middleName:null,surname:"Alamoudi",slug:"abdullah-alamoudi",fullName:"Abdullah Alamoudi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"318657",title:"MSc.",name:"Isabell",middleName:null,surname:"Steuding",slug:"isabell-steuding",fullName:"Isabell Steuding",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}},{id:"318656",title:"BSc.",name:"Peter",middleName:null,surname:"Kußmann",slug:"peter-kussmann",fullName:"Peter Kußmann",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}}]}},subseries:{item:{id:"3",type:"subseries",title:"Bacterial Infectious Diseases",keywords:"Antibiotics, Biofilm, Antibiotic Resistance, Host-microbiota Relationship, Treatment, Diagnostic Tools",scope:"