Indications and contraindications to guide patient selection during the learning curve.
\r\n\tThe protection of biodiversity is a major target of the European Union Marine Strategy Framework Directive, requiring an assessment of the status of biodiversity on the level of species, habitats, and ecosystems including genetic diversity and the role of biodiversity in food web structure and functioning. The restoration of marine ecosystems can support the productivity and reliability of goods and services that the ocean provides to humankind, to maintain ecosystem integrity and stability. Some of the goods produced by the marine ecosystem services are fish harvests, wild plant and animal resources, water, some of the services provided recreation, tourism, breeding and nursery habitats, water transport, carbon sequestration, erosion control, and habitat provision.
",isbn:"978-1-83968-460-9",printIsbn:"978-1-83968-459-3",pdfIsbn:"978-1-83968-544-6",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"727e7eb3d4ba529ec5eb4f150e078523",bookSignature:"Dr. Ana M.M. Marta Gonçalves",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10845.jpg",keywords:"Non-indigenous Species, Dynamics, Ecosystem Maturation, Ecological Succession, Water Quality, Recovery, Biodiversity, Environmental Status, Ecosystem Services, Goods Production, Carbohydrates, Carrageenan",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 14th 2022",dateEndSecondStepPublish:"June 22nd 2022",dateEndThirdStepPublish:"August 21st 2022",dateEndFourthStepPublish:"November 9th 2022",dateEndFifthStepPublish:"January 8th 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"2 months",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Dr. Ana Marta Gonçalves (h-index 19) holds a Ph.D. in Biology, from the University of Coimbra, Portugal, in collaboration with Ghent University, in 2011. During her research career obtained several grants is highly international competitive calls, including the MARS award for young scientists funded by The Royal Netherlands Institute for Sea Research (NIOZ) and the Foundation for Science and Technology (FCT, Portugal) grants.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"320124",title:"Dr.",name:"Ana M.M.",middleName:"Marta",surname:"Gonçalves",slug:"ana-m.m.-goncalves",fullName:"Ana M.M. Gonçalves",profilePictureURL:"https://mts.intechopen.com/storage/users/320124/images/system/320124.jpg",biography:"Ana Marta Gonçalves obtained a Ph.D. in Biology with a specialization in Ecology from the University of Coimbra, Portugal, in collaboration with Ghent University, Belgium, in 2011. Currently, she is an auxiliary researcher at the Marine and Environmental Sciences Center (MARE), Portugal, where she is also a member of the Directive Board. Since 2016, she has been a member of the Scientific Council of the Institute for Interdisciplinary Research, University of Coimbra (IIIUC). Dr. Gonçalves holds various administrative and management positions in international networks, societies (e.g., Society of Environmental Toxicology and Chemistry, AIL), and associations (e.g., PROAQUA). She is an editorial board member and reviewer for several indexed journals. She has published more than 70 journal articles, 50 book chapters, and 165 communications in international scientific events. She participated as a member and/or coordinator in more than twenty-five national and international projects and is currently the coordinator of four research projects. She has supervised more than ninety-five national and international undergraduate and graduate students. She has experience as a teacher of university courses and in accredited training sessions for teachers. Additionally, she has coordinated several ocean literacy and environmental education activities for kindergarten and school students. During her research career, Dr. Gonçalves obtained several grants and a MARS award for young scientists funded by The Royal Netherlands Institute for Sea Research (NIOZ).\n\nShe has expertise in biosafety, biochemical pathways, and impacts of stressors in aquatic species. Her research focus is on the valorization of marine resources and their applications in the industrial sector, such as the food and pharmaceutical industries. 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It manifests as localised joint pain, stiffness and occasionally swelling. Osteoarthritis can be secondary to pre-existing joint damage - commonly inflammatory arthropathy or previous injury - or primary with no known pre-existing damage. Risk factors for primary OA include old age, female sex and family history and obesity.
The disease can be restricted to a particular joint or generalised, affecting multiple joints. In severe cases, it can be progressive eventually leading to loss of function and deformity.
Treatment has mainly focused on symptomatic relief from pain, physical approaches such as rehabilitation and physiotherapy, disease modifying treatment (such as hydroxychloroquine) and surgery. Pain relief with systemic drugs has drawbacks. In particular the use of non-steroidal anti-inflammatories (NSAIDs) has been associated with significant adverse events including gastritis and increased risk of cardiovascular disease. In view of this, there has been increased interest in localised treatments for OA.- i.e. therapies that are administered to the joint itself, or in the region of the joint. These can be divided into topical treatment, such as anti-inflammatory gels and creams and thermotherapy, and more invasive local treatment including joint aspiration, and intra-articular joint injection with corticosteroid and hyaluronans.
Thermotherapy refers to the application of either heat or cold (cryotherapy) to affected joints in an attempt to improve pain, stiffness and swelling.
Ice massage and ice packs application have both been studied in knee osteoarthritis [5-10]. In one review [7], cryotherapy was found to reduce pain, stiffness and oedema. Regular ice massage, given 5 times a week, was found to have a clinically significant effect on all three symptoms as well as function (11% improvement relative difference), strength (29% improvement) and range of movement (8% relative difference) over a short period of time [8]. However, these improvements were not replicated with less frequent applications (3 times per week) [9] and there are no data to indicate a more long term effect of cold therapy on osteoarthritis as these studies looked at short term results. It is likely that most of the effects of cryotherapy are related to the induction of local vasoconstriction and the reduction of local blood flow resulting in reduced swelling.
Common methods of superficial heat administration are electrical heating pads, application of hot packs, towels or wax, or immersion in warm water or wax baths. In some early trials, heat application was not found to improve function or symptoms [8,9]. In recent years, however, there has been an explosion of studies looking at different modalities of local heat therapy[10-13]. These include the application of heat packs [12], ultrasound [13\n\t\t\t\t\t11] and diathermy. The application of local heat packs has been found to provide short-lived benefit in terms of pain relief [12, 14]; and in particular, wet heat has been found to be better than dry heat [15] for symptomatic improvement. In one study [12] 18 patients were treated with either steam generating heat sheets for 6 hours daily or with quadriceps strengthening exercises only for a total of 12 weeks. At the end of the study, patients in the heat treated group reported statistically significant improvements in symptoms as well as the Timed Up and Go time (a measure of function). The mechanism of heat therapy in osteoarthritis is unclear, although
On the whole, the data suggest that thermotherapy maybe useful as an adjunct in the treatment of osteoarthritis although long-term benefits have not been established.
The role of ultrasound (US) in diagnosis of musculoskeletal problems has been well established. Its popularity in large part due to the low cost and non-invasive nature of the modality. In recent years, there has been growing interest in its application for therapeutic purposes [13,18-20]. In theory direct treatment with US leads to local heating of the tissue at depths not achieved by applying heat packs. There are two methods for doing this: continuous US which leads to a rise in temperature of the treated tissues; and pulsed wave treatment which harnesses other properties of US.
Laser beam therapy directs intense light to treated tissue. Two types of laser therapy have been trialled in osteoarthritis: low-level and high intensity. Low- level laser therapy uses red and infra-red light whilst high intensity laser therapy uses higher wavelengths of radiation for deeper tissue penetration. Low level laser therapy has been found to reduce pain, possibly by modulating the local inflammatory process In a rat model of osteoarthritis, laser therapy caused a reduction in neutrophil migration, oxidative stress, altered levels of cyclo-oxygenase-2 and other pro-inflammatory mediators) [21]. Other than providing symptomatic relief, there is also some evidence that laser promotes fibroblast proliferation, collagen synthesis and bone regeneration [22-26]. In a rabbit model of osteoarthritis, six weeks of treatment with laser therapy not only resulted in improved pain but also histological evidence of reduced inflammation as well as a reduction in cartilage damage [27]. This suggests that laser therapy could have disease-modifying as well as symptomatic benefits.
So far, the results of early clinical trials have been mixed [28]. More recent studies have tended to be more positive with those treated with laser therapy and exercise doing better than those treated with exercise alone on pain measurements as well as function [29, 30]. These studies suggest that laser in combination with standard physiotherapy could have advantages over standard therapy. We have little evidence regarding long term effect and whether the cellular effects noted results in halting disease progression. The use of low-level laser therapy has now been approved by the US Food and Drug Agency (FDA) and so we are likely to see an expansion in its use in the coming years.
Non-steroidal anti-inflammatory drugs (NSAIDS) work by blocking the action of cyclo-oxygenases responsible for prostaglandin synthesis, the latter being known mediators of inflammation [31]. Locally this reduces pain, swelling and heat. NSAIDs also have central analgesic actions, possibly by reducing brain prostaglandin synthesis although alternative mechanisms include the induction of endogenous opioid peptides and blockade of serotonin release. From this, it can be seen why systemic NSAIDs have long been used for osteoarthritis. However, significant side effects including gastritis, renal impairment and increased risk of cardiovascular disease has meant that their long-term use has been limited. It is on this background that topical NSAID use has been promoted, theoretically providing analgesic and anti-inflammatory benefits without systemic adverse effects.
There are many types of topical NSAID. There are preparations containing diclofenac, ibuprofen, piroxicam, ketoprofen or felbinac as the active ingredient. Some include a penetration enhancer such as menthol or dimethylsulfoxide (DMSO). Gels and sprays tend to be more penetrative than cream preparations. Once applied, a topical NSAID must be absorbed by the underlying tissue or enter the local blood stream. Studies have shown that the absorption of NSAIDs into the underlying tissue gives rise to therapeutic local concentrations of the drug without significant systemic absorption [32,33]. An estimated 3-7% of the applied dose is thought to be absorbed systemically [33] with plasma concentrations being approximately 5% of those achieved with oral administration [33].
The skin seems to act as a reservoir from which the drug disseminates to the deeper tissue. Peak concentrations in the skin are achieved 2 hours after application with a further spike at about 19 hours later, likely secondary to systemic absorption. Further proof of their local action is the absence of analgesic effect at joints distant to the point of application [34].
There have been many studies looking into the effectiveness of topical NSAIDs in treating osteoarthritis [35-41]. These on the whole have found that topical NSAIDs were superior to placebo in the treatment of chronic pain. Most of the initial studies found no benefit beyond two weeks of treatment [35-41] but larger randomised controlled trials found long term benefit for up to 3 months when compared to placebo [42-43].
When compared to oral NSAID use, the results have been variable. A meta-analysis in 2004 [41] found that topical NSAIDs were less effective than systemic NSAIDs. Since then, however, there have been several studies showing comparable effectiveness. Two studies comparing oral diclofenac with a topical preparation of the drug [44,45] found that there was no difference in pain scores or physical function. They also found that those in the topical treatment arm had a much lower incidence of severe gastrointestinal side effects, deranged liver function tests and abnormal creatinine clearance [44,45]. These results were replicated in another study comparing oral and topical treatment with ibuprofen for knee osteoarthritis, which also found no difference in pain and function scores between the two arms [43].
On the whole, topical NSAID use is associated with fewer systemic adverse events [35, 39, 44, 45] as compared to oral preparations. The main adverse event associated with topical NSAID use is local skin irritation, which has been reported in up to 39.3% of patients [46]. However, these skin reactions occur with placebo gel application with equal frequency indicating that it may not be related to the drug itself [39]. Other studies also suggest that skin reactions may be more common with solutions containing DMSO than DSG [37]. There is some contradictory evidence regarding their safety in older patients as some studies have found the rate of GI side effects in the over 50s to be as high as 15% [46].
Overall the data suggest that topical NSAIDs may be considered as first line therapy for osteoarthritis as they appear to be efficacious and associated with fewer adverse events. There should be caution about their long term use in the elderly as these patients may be more prone to adverse events.
Topical capsaicin cream has been used to treat a multitude of different painful conditions including osteoarthritis, inflammatory arthritis and neuropathic pain. Derived from chilli peppers, capsaicin is a lipophilic alkaloid that acts as a local irritant. It activates local pain receptors (c-nociceptors) leading to the release of substance P [47]. This in turn causes local irritation in the initial phase of treatment. With repeated use, however, levels of substance P are depleted, leading to desensitisation of the pain fibres and hypoalgesia [48]. In clinical practice, capsaicin is better than placebo for the treatment of chronic pain but compares less favourably with other treatments. In a meta-analysis comparing capsaicin with plaster, capsaicin was found to be only marginally effective [49]. Other drawbacks include the need to apply the cream four times a day for maximum benefit, as well as local irritation and intense burning sensation (occurring in uto 40% of patients) [50]. These problems lead 10% of patients to discontinue treatment [49]. In view of this, topical capsaicin should be used in conjunction with more traditional treatments.
Other topical treatments include the use of salicylate or nicotine esters, which acts as a local counter-irritant or rubefacient. These cause localised vasodilatation and reddening of the skin. This results in a local sensation of warmth, which often palliates pain. Theories of mechanisms of action include irritation of the sensory nerve endings in underlying muscle and tissue [51] as well as activation of the transient receptor ion channels involved in relaying thermal and pain sensation [52,53]. Clinical studies have shown modest benefits with regular use [54,55]. Compared to placebo, 16% achieved ≥50% improvement in pain scores at 2 weeks [54]. However, when compared to topical NSAIDs, counter-irritants performed poorly [55]. On the whole, counter-irritants are well tolerated and may be useful as adjuvants to standard therapy or patients in whom standard analgesics are contra-indicated [55]. There are no data to support their long term use and they are not recommended as continuing therapy.
Intra-articular (IA) corticosteroid injections are frequently used to treat osteoarthritis. In common practice, they are diluted in local anaesthetic to provide immediate relief, ensure accurate drug delivery and allow even dispersal of the drug within the joint due to the larger volume [57]. Commonly used corticosteroids in IA injections include hydrocortisone acetate (HCA), methylprednisolone acetate (MPA) and triamcinolone acetonide (TCA). These vary in solubility with the former being more soluble than the latter. Less soluble preparations are longer acting and theoretically provide more long term relief. In one randomised control trial comparing MPA (more soluble and shorter acting) and TCA in knee osteoarthritis, greater improvement in pain scores was found in the TCA group at 3 weeks compared to MPA [56]. Interestingly, there was no difference between the 2 groups at 8 weeks despite TCA being longer acting. There was also no significant difference in functional scores [56].
Several studies have looked into whether intra-articular steroid injections have symptomatic or functional benefit in knee osteoarthritis [58-61]. These have shown short term (lasting between 1-4 weeks) improvement in pain but not function in these patients following injections when compared to placebo. Follow up beyond 4 weeks did not show longer lasting benefits as compared to placebo. These results were further corroborated in a Cochrane systematic review [62]. This suggests that IA steroid injections should be used as a short term bridging treatment to resolve acute painful flares pending further intervention such as surgery or physiotherapy. Trials looking IA injections in the hip echo the results of the studies done in the knee: patients gained rapid and short lived pain relief following injection but that these benefits were not maintained beyond 1 month [63,64].
Other studies, looking at 1st carpo-metacarpal joint (CMC) injections found more mixed results in terms of long term relief. In one study of 40 patients, no benefit was observed between steroid injection when compared to placebo [65]. Patients less likely to have sustained long term benefits were those with worse radiographic appearances (increased number of osteophytes and more advanced joint space narrowing) [66]. In patients with less advanced disease, IA 1st CMC joint injection could provide symptomatic relief up to 18 months following injection and splinting [66].
IA steroid injections work locally via anti-inflammatory effects, inhibiting the inflammatory cascade at multiple points. Local injection avoids the systemic problems associated with steroid use and allows delivery of high doses to the affected tissue. Response to IA injection, however, does not appear to be dependent on inflammation in the affected joint itself [61]. Further studies looking at whether inflammation detected on ultrasound predicted clinical response found that those without inflammatory change fared better in response to IA injection than those with evidence of inflammation. The presence of synovial thickening, synovial fluid volume and white cell count did not predict better response to IA injection [60, 61]. In knee OA, joint aspiration prior to IA injection appears to provide greater symptomatic benefit [60]. This is partly due to confirmation of correct position by prior aspiration and more concentrated drug delivery due to a lower volume [67].
Although IA injections avoid the toxic side effects of systemic steroids, they are not without risks themselves. All patients undergoing IA injection should be consented for the risk of infection, although this is a rare event (incidence reported between 1 in 3,000 to 1 in 50,000) [68] and may be clinically difficult to differentiate from an injection-induced crystal arthritis which can occur in 2-6% of patients [58, 60]. In general, septic arthritis following IA injection occurs 3 to 4 days post procedure. There is a risk of lipoatrophy at the site of injection (estimated 0.6% of patients) [69]. The risk of this is reduced by using shorter-acting preparations and doing imaging-guided injections where possible. Other serious local adverse events include tendon rupture, muscle wasting and local depigmentation. The risk of these can also be minimised by using guided injections where possible.
Systemic adverse events are rare with local corticosteroid injections. The most common is flushing (up to 40%) [69]. There have been reported incidents of unstable diabetic glycaemic control post injection but this tends to be minor and usually settles [70]. There is evidence for systemic absorption of intra-articular steroids [71]. Studies looking at the endocrine axis in patients who had received intra-articular steroid injections found that serum cortisol dipped 24-48 hours after IA injection and took up to 4 weeks to return to baseline [71]. Major complications, such as steroid induced osteoporosis, have not been observed however [72].
Studies in animals have suggested that intra-articular steroids can induce chondrocyte degeneration [73] but prospective clinical trials where patients were receiving regular IA injections have failed to demonstrate increased rate of cartilage loss [74]. There are also limited data to support significant increased risk of osteonecrosis in injected joints. Repeated IA injections offer no long-term benefit [67] and should generally be avoided but short-term use may provide rapid pain relief and can be used as a bridging treatment pending further intervention.
Hyaluronic acid is a large glycosamino-glycan molecule found in synovial and cartilage extra cellular matrix (ECM). It is produced by synoviovytes, chondrocytes and fibroblasts and functions as both lubricant as well as a means to maintain hydration within the joint [75]. Studies have shown that osteoarthritic joints have decreased hyaluronan content in the synovial fluid [76] and therefore IA injection with a synthetic analogue was developed to restore the function in degenerative joints.
Synthetic preparations of hyaluronic acid closely mimic endogenous molecules. Later preparations contain cross linked hyaluronin in order to achieve greater elasticity and viscosity. In theory this confers greater intra-articular durability of the solution. Preparations with a higher molecular weight also seem to be more beneficial than those with a lower weight [78]. This may be related to the difference in volume required for injection as well as the number of injections required and the intra-articular durability of the solution.
Multiple studies have been conducted into the effectiveness of IA injections of hyaluronans in osteoarthritis, mostly of the knee. These have found mixed evidence to recommend their use. In general, hyaluronans appear to be better than placebo in improving pain scores, function and patient global assessment when used in knee osteoarthritis [77]. The greatest clinical benefit is achieved at week 5-13 after a course of treatment of several injections. Part of the problem with interpreting the data is wide variability in trial design, frequency of injections and molecular weight of the synthetic product being used. In hip OA, hyaluronan injections were not superior to placebo nor corticosteroid injections in reducing pain or improving function [79]. These results were echoed in studies looking at its use in hand OA [80].
These injections are relatively safe and tend to provide longer term relief than corticosteroid injections. Its use, however, is restricted by the relatively high cost of the treatment [75]. IA hyaluronan injection is generally reserved for knee osteoarthritis and is offered either as a holding measure until more definitive treatment can be undertaken (e.g. surgery), or in patients for whom such treatment is inappropriate.
Trigger points are localised areas of tenderness and thickening in the soft tissues. They are typically found proximal to an inflamed or painful joint such as the rectus femoris in patients with knee OA and paraspinal regions in the cervical and lumbar spine [81]. They have also been described as interstitial fibrositis, myofasciitis and myofascial trigger points [82-84]. The aetiology and pathogenesis of these trigger points is unknown.
Trigger point injection has been used as a way of alleviating pain and discomfort associated with these areas of thickening. This can be direct injection of a substance (e.g. local anaesthetic or corticosteroid) into the point or indirect needling of the soft tissue in that area. The trigger point is identified as the maximal area of tenderness in the muscle and the point is then isolated by the thumb and forefinger to prevent movement in the underlying muscle. A small sterile needle is then introduced into the area and the substance injected directly into it (or alternatively it can be dry needled). If the injection is performed correctly, there is usually an acute worsening of pain associated with muscle spasm [85].
A systematic review of trigger point injection in the management of chronic musculoskeletal pain found an improvement in symptoms when used exclusively [86]. This was irrespective of the injectant used [86]. The addition of a local anaesthetic, however, has been found to reduce the pain and irritation of the caused by the procedure [84].
There are limited data on the efficacy of trigger point injection in the treatment of osteoarthritis. One study found that trigger point injection in conjunction with IA corticosteroid was more effective than IA injection alone in both pain and functional scores [87]. Other studies have looked at trigger point injections as sole treatment and this does not reflect clinical practice. Overall, trigger point injections are safe and can be used as additional therapy in OA.
Drugs used for trigger point injections have included local anaesthetic, corticosteroids, anti-inflammatories such as acetylsalicylate and ketorolac as well as saline and water [84, 88-92]. There have also been several studies looking at the use of subcutaneous salicylate therapy for OA. In one trial 40 patients with OA of the 1st CMC joint [93] were randomised into either sham injection or subcutaneous injection with salicylate into trigger points. Patients were assessed blind at 3, 7 and 13 weeks. Pain scores and tenderness were significantly lower in those treated with salicylate compared to sham injections [93].
The mechanism of action of subcutaneous salicylate injections is unclear, particularly as the site of injection is distant from the affected joint. One theory is that salicylate may alter central sensitisation and this is supported by the immediate relief patients report following injection. An alternative model would be that the local effect of salicylate modifies the neurogenic control of inflammation, which may be abnormal in diseases that affect musculoskeletal structures [94, 95]. Changes in the expression and transport of neurogenic peptides might be induced by the local irritant effect of salicylate [96]. Systemic anti-inflammatory effects are unlikely, since the benefits are not observed in distant sites [93].
There is, however, a degree of overlap with acupuncture in that the injection sites are standard acupuncture locations. Acupuncture involves the insertion of fine filiform needles at or near the painful site, or sometimes at distant acupuncture “points”. In a variation of this, the needles are sometimes stimulated electronically or with heat. Patients typically receive six or more sessions for a complete course of treatment. A systematic review of 393 patients with osteoarthritis found that acupuncture significantly improved pain but not function when compared to sham acupuncture [97-104]. In addition, it was not better than standard treatment with physiotherapy or being on a waiting list to receive acupuncture [97,100]. There was also no additional benefit of including acupuncture to standard therapy with exercise and advice [103]. Moreover, there is little evidence for long term benefit following treatment with improvements in symptoms lasting up to 12 weeks only [97,100]. Acupuncture is relatively safe, however, with minimal risks of serious side effects [101-104].
Osteoarthritic joints may be helped by various forms of external support. Benefit can be obtained by adjusting alignment, modifying stress or load, providing shock absorption, or simply resting the joint. Orthoses (including braces, splints and elasticated sleeves) are frequently used in OA of the hand and knee and hand.. For hand OA they include thumb and wrist splints; for the knee they include rest orthoses, knee sleeves and unloading braces. Medial patellar strapping may be specifically helpful for patellar maltracking [105]. Shoe insoles may be particularly helpful for OA affecting the ankle and knee, and can sometimes alleviate symptoms from OA of the hip: they include cushioned or neutral insoles, which act as a shock absorbers; and wedged insoles, which also modulate mechanical stress.
For OA of the knee and ankle the main purpose of orthoses and insoles is to support joint that is unstable, and to help correct alignment [106]. They can modify load bearing and contribute to pain reduction, and they often improve physical function. There is also evidence that they can improve proprioception [107] and that they may slow disease progression [108]. They are especially useful for mild or moderate uni-compartmental knee OA [109-110, 42] where there may be varying degrees of instability and mal-alignment. Unloading knee braces are designed to reduce the load transmitted to the diseased compartment by applying an external valgus or varus force. Symptomatic relief is achieved by stabilizing the joint, increased joint opening and reduced local muscle contraction [108]. One study [111] demonstrated that patients treated with unloading knee braces had better functional and symptomatic outcomes at 6 months with medial compartment knee OA. These results were not replicated in other studies [112] although there is evidence that they can improve quadriceps strength and gait symmetry [113]. The main disadvantage of these braces is poor tolerability due to the weight and heat of the device. In one study, 41% of patients complained of skin irritation [114] and up to 20% of patients discontinue use within 6 months [115].
Splinting of the thumb carpometacarpal (CMC) joint has also been found to be helpful in improving function and pain [116]. CMC joint OA contributes more to pain and disability than inter-phalangeal joint OA [117] and thus splinting of the CMC joint makes sense. In a systematic review in 2010, CMC splinting was found to improve function and grip strength [116]. Further RCT data has corroborated this finding and showed sustained benefit at 12 months [118]. However, these splints are inevitably somewhat cumbersome to wear, and inhibit many day-today functions of the hand.
In general, splinting might be useful for symptomatic relief and may even improve function with prolonged use in appropriately selected patients.
There are a number of different local treatments for osteoarthritis which focus on symptomatic relief. Choice of treatment should, therefore, be guided by patient response and personal preference. Most local therapies are safe, avoiding any major systemic side effects. In general, these therapies should be used as adjuncts to physiotherapy and systemic analgesia. Although some of these treatments are well established and have been used in clinical practice for many years (e.g. intra-articular injections and orthoses), newer approaches are being developed such as local laser therapy and subcutaneous sodium salicylate injections. There is limited data to show any benefit for long term outcome for any of these local therapies and further studies are required to establish this.
Total Hip Arthroplasty (THA) is one of the most commonly performed orthopaedic procedures for the treatment of end-stage hip degeneration. With a robust track record of effectiveness and safety, THA has become a widely accepted method for providing pain relief, restoring function, and reestablishing a patient’s quality of life [1]. Sir John Charnley pioneered one of the first low friction arthroplasties in the 1950s, laying the groundwork for future advancement in the field [2]. Since then, advents in technology in the arena of biomaterials, implant design, and surgical technique have contributed to THA’s widespread acceptance [1]. An estimated 370,770 hip replacements were performed in 2014, with this number expected to reach 635,000 in 2030; this represents a projected 71% increase [3]. A rapidly aging population, widening surgical indications, as well as an increased prevalence of obesity and associated osteoarthritis have fueled this increase in demand [4].
Total hip arthroplasty can be performed through several surgical exposures, including the posterior, posterolateral, direct lateral, anterolateral, and direct anterior approaches [2]. The direct anterior approach (DAA), in particular, has exhibited a tremendous amount of enthusiasm in recent years. German surgeon Carl Hueter first characterized the anterior approach for accessing the hip joint in 1881, describing an inter-nervous and inter-muscular plane between the tensor fasciae latae and sartorius muscles – known today as the Hueter Interval [5]. However, American surgeon Marius Nygaard Smith-Petersen is credited with popularizing this surgical approach. Although this surgical approach was first adopted as a means of reducing congenital hip dislocations, Smith-Petersen also used it to perform mold arthroplasties in 1949 [2, 5].
There is a growing body of literature substantiating the benefits of the DAA. This surgical approach is considered less invasive, exhibits greater stability compared to other approaches, and results in less overall tissue damage [6, 7]. A randomized clinical study comparing the DAA and the posterior approach demonstrated lower pain scores and better function during the early stages of recovery with the DAA [8]. Additional studies have reported lower pain scores, less blood loss, and increased walking speed compared to the direct lateral approach [9]. In the immediate post-operative period, the DAA patients were discharged from the hospital earlier and with greater mobility [10]. However, other studies have shown that differences in post-operative recovery may not be clinically significant as they equalize by 6 weeks, and maintain in the longer term [6] Regardless of surgical approach, clinical success in THA is predicated on adequate surgical exposure, correct component position, and proper soft-tissue balancing [11].
Patient demand, as well as marketing by industry and orthopaedic practices has contributed to the rise in popularity of the DAA [11]. In an effort to meet demand, surgeons may choose to switch from an alternative surgical approach, but, the steep learning curve has always been a major barrier, especially if the transition occurs once already in practice and dedicated time to pursue formal fellowship training is not practical. The DAA is typically performed with the patient in a supine position, requiring different sets of retractors, and often use of a specialized operative table [12]. Some studies suggest that surgeons should perform at least 100 such operations in order to become adequately proficient in the technique [12].
Adult reconstruction fellowships and orthopaedic residency training programs have taken notice of this enthusiasm for the DAA, and have addressed this demand through formal didactics, surgical videos, hands-on training, cadaveric workshops, and educational simulation platforms [13]. For surgeons that do not have the luxury of formally training, a systematic, dedicated methodology must be employed when transitioning to the DAA in order to minimize complications, achieve favorable clinical outcomes, and recognize the benefits associated with the surgical approach.
The first step in learning the DAA is understanding the anatomy, and more particularly the anterior structures of the hip. The important landmarks include the anterior superior iliac spine (ASIS) and the greater trochanter (GT). Proper equipment and positioning are paramount for successful procedure. A specialized surgical table is often used to allow for controlled manipulation of the extremity; however, many surgeons successfully perform this procedure using a regular table. The Hana table is commonly described for this purpose as it allows the surgeon to apply traction, rotate, and abduct/adduct the extremity as needed. The principal author of this paper utilizes a Medacta table extension which can be readily attached to a regular surgical table. The patient is positioned supine with a triangular bump under the hip to assist with hip extension. The bump should be placed proximal 1/3 and middle 1/3 of the femur making sure that a hand can be freely moved over the bump.
The surgical incision is marked out 2 cm distal and 3 cm lateral to the ASIS (Figure 1); the top of the incision is typically at the midpoint between the ASIS and the tip of the GT. The superficial dissection is performed down to the level of the TFL fascia which can be identified based on the blue tint of the muscle belly deep to the fascia (Figure 2). Using electrocautery or a scalpel, the TFL fascia is incised in-line with the muscle fibers and carefully separated from the muscle belly. It is important to stay parallel with the muscle fibers to ensure minimal bleeding and muscle damage. Retracting the released TFL laterally completes the superficial dissection and should expose the fascial floor of the TFL. The TFL is a digastric muscle, therefore, it is critical to make sure that both muscle bellies are retracted laterally.
Incision placement for the direct anterior approach. The trajectory of the incision follows the muscle belly of the tensor fascia latae (TFL) (Right hip).
Following the superficial dissection, the rectus femoris is visible. The deep layer of the dissection beneath the rectus is accessed by making a facial incision at the red-yellow junction (dotted white line) and retracting the rectus muscle belly medially (Right hip).
After retracting both the TFL and the rectus femoris muscle belly, the reflected head of the rectus (pars reflecta) can be seen inserting proximally on the anterior acetabulum (Figure 3). There is typically a fat pad with a small vessel at the insertion site. In cases where the pars reflecta is going to be released to allow the rectus femoris to relax and enhance surgical exposure, the fat pad needs to be resected and the vessel cauterized.
The yellow circle denotes the pars reflects tendon as it originates from the anterior lip of the acetabulum (Right hip).
The lateral circumflex vessels are typically visible just proximal to the vastus lateralis and course proximal lateral to distal medial. The artery typically courses with two accompanying venae comitantes (Right hip).
After appropriately addressing the circumflex vessels, the peri-capsular fat is removed and the anterior hip capsule is exposed. While most surgeons are familiar with posterior capsular exposure, the anterior capsule creates a bare triangle between the iliocapsularis muscle medially, the gluteus medius laterally and the vastus lateralus distally. At this point, the option is to perform a capsulotomy (author’s preferred technique) or a capsulectomy (Figure 5).
The bare area in the anterior hip capsule is bordered by these muscles. This image shows the femoral head and neck after a triangular anterior capsulotomy has been performed (Right hip).
In addition to strong foundation of anatomy and surgical technique the use of retractors with appropriate placement is paramount for exposure and safety during the procedure. During acetabular exposure and preparation, the principal author utilizes two, 45 degree, pointed homan retractors for capsular exposure, placing one retractor inferior femoral neck space between the capsule and the muscle and the other retractor over the superior femoral neck protecting the gluteus medius muscle. Both retractors should be extracapsular; following capsulotomy, the retractors should be repositioned intracapsular. Additionally, a charnley retractor is used for hands free acetabular exposure. For right sided procedure, the anterior blade should be placed in the 1 o’clock position and the posterior blade in the 7 o’clock position. For femoral exposure, the use of a dark and stormy retractor placed over the posterior femoral neck, distal to the obturator externus muscle to elevate the femur for broaching.
The decision to transition from an alternative surgical approach is not one to take lightly. A surgeon must acknowledge that although they may have significant experience with performing a THA from an alternate surgical approach, the DAA THA is an entirely different procedure, especially if transitioning from a posterior approach – the anterior approach is oriented 90 degrees from your normal surgical view. Several reports highlight the dangers of inadequate preparation/planning for surgeons starting to perform the DAA leading to significantly increased surgical times and higher intra/post-operative complications [14]. Therefore, any surgeon deciding to take this step should create a comprehensive and thorough plan involving self-learning, mentorship, and cadaver sessions.
Once the decision to transition to the DAA has been made, and familiarization with the anatomy and surgical steps has been completed, the focus should be on proper surgical indications, common pitfalls, and understanding why you may struggle with portions of the procedure. E-learning (technique guides, digital modeling, online tutorials, surgical videos) has emerged as a powerful tool with many diverse teaching modalities, 24/7 access, and real-time measures progress through testing [15].
Surgical mentorship has been a pivotal aspect of training, emphasized by the Halstedian model of educating new surgeons [16]. Identifying a mentor is critical and it should be someone that is equally invested in you [17]. Observation of the surgical technique should be accompanied by creating a detailed, annotated surgical technique guide. This is the most critical part of making the transition and decreasing the learning curve. Similar to the sequence of surgical steps, the process of creating this surgical technique guide requires patience, diligence, and attention to detail. Additionally, this document should be used to acquaint the surgical team with the procedure, so they too can participate in minimizing the learning curve.
After an extensive observership and creating of a technique guide, hands-on cadaveric training is the next step in the sequence. The senior author assisted his mentor in the lab during a cadaveric demonstration of the procedure. Following the demonstration, the senior author performed a DAA THA on the contralateral hip with the assistance of his mentor. This cadaveric workshop helped to translate what was seen in the operating room during observation into the tangible ability of performing the procedure prior to going live on an actual patient.
After selectively identifying patients that should be considered candidates for a DAA THA (Table 1), reverse surgical observation by the mentor was arranged. The first two DAA THAs were observed by the mentor with real-time feedback and guidance provided during the operation. This portion of the training significantly decreased the anxiety associated with performing a DAA for the first time. The mentor should help with identifying your tendencies and anticipating difficulties (e.g. improper retractor placement or limb positioning) before they arise.
Indications | Contraindications |
---|---|
Non-muscular patients | Muscular patients |
Thin patients | Obese patients |
Patients with normal bone quality | Patients with osteoporosis |
Long valgus femoral necks | Short varus femoral necks |
Narrow iliac flares | Wide iliac flares |
Dorr Type B femoral canal | Dorr Type A femoral canal |
Retained hardware | |
Severe dysplasia | |
Proximal femoral deformity |
Indications and contraindications to guide patient selection during the learning curve.
All team members should be a part of the learning process. This is not limited to the surgical team performing the procedure (surgeon, Fellow/Resident, advanced practice provider) but should include the scrub technician, circulating nurse, radiology technician, and the anesthesia team. A pre-operative planning session with the entire team can be very helpful early on in the learning curve. More importantly, a post-operative debrief after every case should be conducted with the team to determine what went well, what didn’t go well, what did we learn, and what should we should do differently for the next case. This process allows for iterative improvements with performing the DAA safely and reproducibly.
Creating a schedule that allows for continued learning is imperative. The senior author re-visited his mentor after case #30; the surgical team was included as a part of this visitation. After 60 cases, the senior author arranged for repeat reverse visitation by the mentor to observe and identify any additional tweaks in the technique that should be incorporated. Lastly, data collection is helpful to monitor your tendencies and refine the technique to recognize additional efficiencies.
It is important to stress that although you may be a skilled arthroplasty surgeon and experienced in other THA approaches, learning the DAA approach is like starting from scratch. Creating a comprehensive, and methodological, training plan is crucial to achieving clinical success while maintain the safety of your patients. Embracing the significance of self-learning and critique, active mentorship, and substantial hands-on training will maximize your time spent re-training. It is important to understand that once the training period is complete, the learning period continues. Finally, it is imperative to incorporate every member of the operative team as each member plays a critical role in executing the procedure and thus achieving a favorable clinical outcome. In conclusion, transitioning to the direct anterior approach is not a spectator sport – this approach requires dedication, diligence, attention to detail, and patience!
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His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. He has contributed in stochastic estimation of control area especially, in the Multiple Target Tracking and Interactive Multiple Model (IMM) research, Ball & Beam Control Problem, Robotics, Levitation Control. He has contributed in developing Algorithms for Fingerprint Matching, Computer Vision and Face Recognition. He has been supervising Pattern Recognition, Formal Languages and Distributed Processing projects for several years. He has reviewed many books on Management, Computer Science. Currently, he is an active and permanent reviewer for many international conferences and symposia and the program committee member for many international conferences.\nIn teaching he has taught the core computer science subjects like, Digital Design, Real Time Embedded System Programming, Operating Systems, Software Engineering, Data Structures, Databases, Compiler Construction. 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Ranz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5163",title:"Beekeeping and Bee Conservation",subtitle:"Advances in Research",isOpenForSubmission:!1,hash:"fc469ff4d2cf6651cfdbf3c5cf90a469",slug:"beekeeping-and-bee-conservation-advances-in-research",bookSignature:"Emerson Dechechi Chambo",coverURL:"https://cdn.intechopen.com/books/images_new/5163.jpg",editedByType:"Edited by",editors:[{id:"94059",title:"Dr.",name:"Emerson",middleName:"Dechechi",surname:"Dechechi Chambó",slug:"emerson-dechechi-chambo",fullName:"Emerson Dechechi Chambó"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:3,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"50073",doi:"10.5772/62487",title:"Impacts of Pesticides on Honey Bees",slug:"impacts-of-pesticides-on-honey-bees",totalDownloads:3411,totalCrossrefCites:19,totalDimensionsCites:39,abstract:"This chapter focuses on the detrimental effects that pesticides have on managed honey bee colonies and their productivity. We examine first the routes of exposure of bees to agrochemicals used for crop protection and their application to crops, fate and contamination of water and plants around the fields. Most of the time, the exposure of bees to pesticides is through ingestion of residues found in the pollen and nectar of plants and in water. Honey bees are also exposed to pesticides used for the treatment of Varroa and other parasites. The basic concepts about the toxicity of the different kinds of pesticides are explained next. Various degrees of toxicity are found among agrochemicals, and emphasis is given to the classic tenet of toxicology, “the dose makes the poison,” and its modern version “the dose and the time of exposure makes the poison.” These two factors, dose and time, help us understand the severity of the impacts that pesticides may have on bees and their risk, which are analysed in the third section. Sublethal effects are also considered. The final section is devoted to some practical advice for avoiding adverse impacts of pesticides in beekeeping.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Francisco Sanchez-Bayo and Koichi Goka",authors:[{id:"74970",title:"Dr.",name:"Francisco",middleName:null,surname:"Sánchez-Bayo",slug:"francisco-sanchez-bayo",fullName:"Francisco Sánchez-Bayo"},{id:"192045",title:"Dr.",name:"Koichi",middleName:null,surname:"Goka",slug:"koichi-goka",fullName:"Koichi Goka"}]},{id:"50307",doi:"10.5772/62654",title:"From Extraction to Meliponiculture: A Case Study of the Management of Stingless Bees in the West-Central Region of Mexico",slug:"from-extraction-to-meliponiculture-a-case-study-of-the-management-of-stingless-bees-in-the-west-cent",totalDownloads:2743,totalCrossrefCites:5,totalDimensionsCites:9,abstract:"Currently, stingless bees' populations are declining due to environmental degradation. In this context, the authors have developed a research project in the central-western region of Mexico with the goal to generate strategies for conservation and sustainable management of stingless bees. The chapter aims to present the process of this investigation and its main results in terms of a) local knowledge and management strategies of stingless bees, and b) the social process of technological appropriation of meliponiculture by beekeepers. We recognized specific knowledge on the biology and ecology of stingless bees that result in a system for identifying species and management strategies of wild populations of these bees based on the extraction of nests. The implementation of an innovative productive activity based on the principles of meliponiculture and current techniques has been well received by producers, which has led to the formation of the Meliponicultores Michoacanos del Balsas Association, which grows five species of stingless bees. The research suggests that conservation associated with the use of bees (integral meliponiculture) can be enhanced in the region. Faced with the loss of biodiversity and environmental crisis, it is essential to maintain and enhance local knowledge of stingless bees and management practices. This represents an alternative to develop management schemes that allow the raising and breeding of these bees, while its products are obtained.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Alejandro Reyes-González, Andrés Camou-Guerrero and Salvador\nGómez-Arreola",authors:[{id:"179951",title:"Dr.",name:"Andres",middleName:null,surname:"Camou-Guerrero",slug:"andres-camou-guerrero",fullName:"Andres Camou-Guerrero"},{id:"185413",title:"MSc.",name:"Alejandro",middleName:null,surname:"Reyes-González",slug:"alejandro-reyes-gonzalez",fullName:"Alejandro Reyes-González"},{id:"192049",title:"Dr.",name:"Salvador",middleName:null,surname:"Gómez-Arreola",slug:"salvador-gomez-arreola",fullName:"Salvador Gómez-Arreola"}]},{id:"50170",doi:"10.5772/62395",title:"A Comprehensive Characterization of the Honeybees in Siberia (Russia)",slug:"a-comprehensive-characterization-of-the-honeybees-in-siberia-russia-",totalDownloads:2296,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"A comprehensive study of some populations of honeybee (332 colonies) in Siberia (Tomsk region, Krasnoyarsk Krai (Yenisei population), Altai) using morphometric and molecular genetic methods was conducted. Infestation of bees (132 colonies) by Nosema has also been studied. Three variants of the COI-COII mtDNA locus were registered: PQQ, PQQQ (typical for Apis m. mellifera), and Q (specific for southern races). It was established that 64% of bee colonies from the Tomsk region and all colonies studied from the Krasnoyarsk and the Altai territories originate from Apis m. mellifera on the maternal line. According to the morphometric study, the majority of bee colonies of the Tomsk region are hybrids; in some colonies the mismatch of morphometric and mtDNA data was observed. Moreover, the majority of bee colonies infected by Nosema were hybrids. Yenisei population may be considered as a unique Apis m. mellifera population. Microsatellite analysis (loci А008, Ap049, AC117, AC216, Ap243, H110, A024, A113) showed the specific distribution of genotypes and alleles for some loci in the bees, which differ by geographical location. Loci A024 and Ap049 are of considerable interest for further study as candidate markers for differentiation of subspecies; locus A008 can be considered informative for determining of different ecotypes of Apis m. mellifera.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Nadezhda V. Ostroverkhova, Olga L. Konusova, Aksana N. Kucher\nand Igor V. Sharakhov",authors:[{id:"180112",title:"Ph.D.",name:"Nadezhda",middleName:null,surname:"Ostroverkhova",slug:"nadezhda-ostroverkhova",fullName:"Nadezhda Ostroverkhova"},{id:"180249",title:"Ms.",name:"Olga",middleName:null,surname:"Konusova",slug:"olga-konusova",fullName:"Olga Konusova"},{id:"180342",title:"Prof.",name:"Aksana",middleName:null,surname:"Kucher",slug:"aksana-kucher",fullName:"Aksana Kucher"},{id:"180343",title:"Prof.",name:"Igor",middleName:null,surname:"Sharakhov",slug:"igor-sharakhov",fullName:"Igor Sharakhov"}]},{id:"50683",doi:"10.5772/63145",title:"Advances in Pharmacological Activities and Chemical Composition of Propolis Produced in Americas",slug:"advances-in-pharmacological-activities-and-chemical-composition-of-propolis-produced-in-americas",totalDownloads:2578,totalCrossrefCites:2,totalDimensionsCites:8,abstract:"Propolis is a resinous material produced by bees from the selective collection of plant exudates that are subsequently mixed with beeswax and salivary bee secretions. Propolis has been used in folk medicine, and certainly, several studies have validated its biological properties. The chemical composition and pharmacological activities of propolis collected through North (including Central America and Caribbean) and South America have been studied in the last years, and several papers have reported differences and similarities among the analysed geographical samples. Propolis has been classified according to its aspect and plant source; however, the ecological diversity present along the Americas provides a plethora of botanical resins. Herein, we summarize and discuss most of the studies performed at present on this profitable product for apiculture, attempting to compare the bioactivity, phytochemical diversity and botanical sources of honeybee propolis produced in Americas.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Efrain Alday, Moisés Navarro-Navarro, Adriana Garibay-Escobar,\nRamón Robles-Zepeda, Javier Hernandez and Carlos Velazquez",authors:[{id:"96966",title:"MSc.",name:"Moises",middleName:null,surname:"Navarro-Navarro",slug:"moises-navarro-navarro",fullName:"Moises Navarro-Navarro"},{id:"180409",title:"Dr.",name:"Carlos",middleName:null,surname:"Velazquez",slug:"carlos-velazquez",fullName:"Carlos Velazquez"},{id:"186351",title:"Dr.",name:"Ramón",middleName:null,surname:"Robles-Zepeda",slug:"ramon-robles-zepeda",fullName:"Ramón Robles-Zepeda"},{id:"186352",title:"MSc.",name:"Efrain",middleName:null,surname:"Alday",slug:"efrain-alday",fullName:"Efrain Alday"},{id:"186353",title:"Dr.",name:"Javier",middleName:null,surname:"Hernandez",slug:"javier-hernandez",fullName:"Javier Hernandez"},{id:"189161",title:"Dr.",name:"Adriana",middleName:null,surname:"Garibay-Escobar",slug:"adriana-garibay-escobar",fullName:"Adriana Garibay-Escobar"}]},{id:"71161",doi:"10.5772/intechopen.91196",title:"Detailed Review on Pesticidal Toxicity to Honey Bees and Its Management",slug:"detailed-review-on-pesticidal-toxicity-to-honey-bees-and-its-management",totalDownloads:1053,totalCrossrefCites:1,totalDimensionsCites:6,abstract:"This chapter deals with the effects of different pesticides used in agro-ecosystem on honey bees and other pollinators and probable measures to manage this escalating problem of global decline of managed as well as the wild insect pollinators. This chapter describes different routes from which pollinators, especially honey bees get exposed to the different toxicants, followed by poisoning symptoms in honey bees. Further, this chapter focuses on the classification of different toxicants in different classes as per their nature. Finally, the management of these different toxicants and their toxicity to avoid bee poisoning has been considered in the later portion of the chapter.",book:{id:"8929",slug:"modern-beekeeping-bases-for-sustainable-production",title:"Modern Beekeeping",fullTitle:"Modern Beekeeping - Bases for Sustainable Production"},signatures:"Gaurava Kumar, Swoyam Singh and Rukesh Pramod Kodigenahalli Nagarajaiah",authors:[{id:"305621",title:"Ph.D. Student",name:"Gaurava",middleName:null,surname:"Kumar",slug:"gaurava-kumar",fullName:"Gaurava Kumar"},{id:"315507",title:"Dr.",name:"Swoyam",middleName:null,surname:"Singh",slug:"swoyam-singh",fullName:"Swoyam Singh"},{id:"315508",title:"Dr.",name:"Rukesh",middleName:null,surname:"Pramod K.N.",slug:"rukesh-pramod-k.n.",fullName:"Rukesh Pramod K.N."}]}],mostDownloadedChaptersLast30Days:[{id:"50170",title:"A Comprehensive Characterization of the Honeybees in Siberia (Russia)",slug:"a-comprehensive-characterization-of-the-honeybees-in-siberia-russia-",totalDownloads:2302,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"A comprehensive study of some populations of honeybee (332 colonies) in Siberia (Tomsk region, Krasnoyarsk Krai (Yenisei population), Altai) using morphometric and molecular genetic methods was conducted. Infestation of bees (132 colonies) by Nosema has also been studied. Three variants of the COI-COII mtDNA locus were registered: PQQ, PQQQ (typical for Apis m. mellifera), and Q (specific for southern races). It was established that 64% of bee colonies from the Tomsk region and all colonies studied from the Krasnoyarsk and the Altai territories originate from Apis m. mellifera on the maternal line. According to the morphometric study, the majority of bee colonies of the Tomsk region are hybrids; in some colonies the mismatch of morphometric and mtDNA data was observed. Moreover, the majority of bee colonies infected by Nosema were hybrids. Yenisei population may be considered as a unique Apis m. mellifera population. Microsatellite analysis (loci А008, Ap049, AC117, AC216, Ap243, H110, A024, A113) showed the specific distribution of genotypes and alleles for some loci in the bees, which differ by geographical location. Loci A024 and Ap049 are of considerable interest for further study as candidate markers for differentiation of subspecies; locus A008 can be considered informative for determining of different ecotypes of Apis m. mellifera.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Nadezhda V. Ostroverkhova, Olga L. Konusova, Aksana N. Kucher\nand Igor V. Sharakhov",authors:[{id:"180112",title:"Ph.D.",name:"Nadezhda",middleName:null,surname:"Ostroverkhova",slug:"nadezhda-ostroverkhova",fullName:"Nadezhda Ostroverkhova"},{id:"180249",title:"Ms.",name:"Olga",middleName:null,surname:"Konusova",slug:"olga-konusova",fullName:"Olga Konusova"},{id:"180342",title:"Prof.",name:"Aksana",middleName:null,surname:"Kucher",slug:"aksana-kucher",fullName:"Aksana Kucher"},{id:"180343",title:"Prof.",name:"Igor",middleName:null,surname:"Sharakhov",slug:"igor-sharakhov",fullName:"Igor Sharakhov"}]},{id:"70501",title:"Southeast Asian Meliponiculture for Sustainable Livelihood",slug:"southeast-asian-meliponiculture-for-sustainable-livelihood",totalDownloads:1262,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"Stingless bees (Apidae: Meliponini) are one of the most important pollinators of native plants and economic crops in tropical and subtropical parts of the world. They not only establish large perennial colonies with complex social organization but also have a diverse nesting biology. The economic utilization of a total of 60 stingless bee species in Asia has been reported. The current status of meliponiculture in Southeast Asia is mainly focused on pollination utilization and honey and propolis production. This chapter shows that small-scale beekeeping of stingless bees, which is suitable for the flowering pattern in the tropics, is one of the best potential alternative opportunities. The cost-effectiveness analysis based on production yield, investment cost, and profit-return rate is reviewed. Finally, a sustainable utilization of stingless bees is considered to be an enhancer of pollination services both in an agricultural crop and natural ecosystem.",book:{id:"8929",slug:"modern-beekeeping-bases-for-sustainable-production",title:"Modern Beekeeping",fullTitle:"Modern Beekeeping - Bases for Sustainable Production"},signatures:"Atsalek Rattanawannee and Orawan Duangphakdee",authors:[{id:"283087",title:"Ph.D.",name:"Atsalek",middleName:null,surname:"Rattanawannee",slug:"atsalek-rattanawannee",fullName:"Atsalek Rattanawannee"},{id:"306411",title:"Dr.",name:"Orawan",middleName:null,surname:"Duangphakdee",slug:"orawan-duangphakdee",fullName:"Orawan Duangphakdee"}]},{id:"50073",title:"Impacts of Pesticides on Honey Bees",slug:"impacts-of-pesticides-on-honey-bees",totalDownloads:3419,totalCrossrefCites:20,totalDimensionsCites:41,abstract:"This chapter focuses on the detrimental effects that pesticides have on managed honey bee colonies and their productivity. We examine first the routes of exposure of bees to agrochemicals used for crop protection and their application to crops, fate and contamination of water and plants around the fields. Most of the time, the exposure of bees to pesticides is through ingestion of residues found in the pollen and nectar of plants and in water. Honey bees are also exposed to pesticides used for the treatment of Varroa and other parasites. The basic concepts about the toxicity of the different kinds of pesticides are explained next. Various degrees of toxicity are found among agrochemicals, and emphasis is given to the classic tenet of toxicology, “the dose makes the poison,” and its modern version “the dose and the time of exposure makes the poison.” These two factors, dose and time, help us understand the severity of the impacts that pesticides may have on bees and their risk, which are analysed in the third section. Sublethal effects are also considered. The final section is devoted to some practical advice for avoiding adverse impacts of pesticides in beekeeping.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Francisco Sanchez-Bayo and Koichi Goka",authors:[{id:"74970",title:"Dr.",name:"Francisco",middleName:null,surname:"Sánchez-Bayo",slug:"francisco-sanchez-bayo",fullName:"Francisco Sánchez-Bayo"},{id:"192045",title:"Dr.",name:"Koichi",middleName:null,surname:"Goka",slug:"koichi-goka",fullName:"Koichi Goka"}]},{id:"50135",title:"Breeding Program Design Principles for Royal Jelly",slug:"breeding-program-design-principles-for-royal-jelly",totalDownloads:2780,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"This research was carried out to infer the genetic value to produce royal jelly in Africanized Apis mellifera L. honeybees with the compilation of data collected from 2006 to 2011. Genetic information of the selected and accessed colonies was obtained using the total DNA extraction techniques of nurse honeybees’ thorax with molecular markers for MRJP3 protein and characterized in Apis mellifera L. From the information on the colonies and genealogical structure were predicted genetic values of the colonies and queens for the larvae acceptance trait (%), royal jelly per colony (g), and royal jelly per cup (mg). Animal model with Bayesian Inference was used from Multiple Trait Gibbs Sampling software in Animal Models, Gibbs chains 58,500 cycles resulting from 650,000 cycles with intervals and disposal of 65,000 and 10 withdraw, respectively. From the predicted values, the colonies were classified into upper and lower. To compare the average of the genetic values according to the genotypes, the average multiple comparison tests were proceeded and implemented in routine PROC GENMOD from the Statistical Analysis System. Environmental effects were considered, time and hive type (standard Langstroth) as having flat distribution and collection as chi-square distribution. The studies presented an increase in the alleles C and D and the alleles D and E—referring to MRJPs—found in the highest genetic value for royal jelly production. Alleles D, E, and C are important when evaluating the parameters larvae acceptance, royal jelly per colony, and royal jelly per cup and, occasionally, it was the DE genotype that stood out royal jelly production. Genotypes DE, DC, and EC are those that should be kept in this evaluation system for royal jelly production, and the other genotypes should be discarded because they had the worst performance for the parameters evaluated.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Katia Ostrovski-Tomporoski, Patrícia Faquinello, Fabiana Martins\nCosta-Maia, Maria Claudia Ruvolo-Takasusuki, Pedro da Rosa\nSantos and Vagner Arnaut de Toledo",authors:[{id:"92329",title:"Dr.",name:"Vagner",middleName:"De Alencar",surname:"Arnaut De Toledo",slug:"vagner-arnaut-de-toledo",fullName:"Vagner Arnaut De Toledo"},{id:"119608",title:"Dr.",name:"Maria Claudia",middleName:"Colla",surname:"Ruvolo-Takasusuki",slug:"maria-claudia-ruvolo-takasusuki",fullName:"Maria Claudia Ruvolo-Takasusuki"},{id:"180234",title:"Dr.",name:"Patricia",middleName:null,surname:"Faquinello",slug:"patricia-faquinello",fullName:"Patricia Faquinello"},{id:"180235",title:"Prof.",name:"Fabiana",middleName:null,surname:"Costa-Maia",slug:"fabiana-costa-maia",fullName:"Fabiana Costa-Maia"},{id:"180368",title:"M.Sc.",name:"Katia",middleName:"Regina",surname:"Ostrovski-Tomporoski",slug:"katia-ostrovski-tomporoski",fullName:"Katia Ostrovski-Tomporoski"}]},{id:"50521",title:"Rearing Bumble Bees for Research and Profit: Practical and Ethical Considerations",slug:"rearing-bumble-bees-for-research-and-profit-practical-and-ethical-considerations",totalDownloads:2928,totalCrossrefCites:4,totalDimensionsCites:4,abstract:"The commercial production of bumble bee colonies is a multi-million dollar business worldwide. The pollination of greenhouse tomatoes is largely dependent on this industry. However, microparasites are prevalent in many of these colonies and can spread to wild populations of bumble bees. Academic researchers now commonly purchase colonies for their work. I believe that this raises some questions: (a) What is the danger of exacerbating the problem of spread of parasites and pathogens to wild population of bumble bees from field studies using purchased colonies? (b) How representative studies are done on only a few species, for example, B. terrestris, B. impatiens? (c) Does the purchase and use of these colonies give tacit approval to the industry, which may be having a detrimental effect on the native populations of bumble bees? This is an ethical issue. (d) Loss of “feeling for the organism” by researchers and particularly graduate students. These issues were discussed, and the classical method of bumble bee rearing which avoids these problems was described.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Robin E. Owen",authors:[{id:"101485",title:"Dr.",name:"Robin",middleName:"Edward",surname:"Owen",slug:"robin-owen",fullName:"Robin Owen"}]}],onlineFirstChaptersFilter:{topicId:"332",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters: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. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403",scope:"Artificial Intelligence (AI) is a rapidly developing multidisciplinary research area that aims to solve increasingly complex problems. In today's highly integrated world, AI promises to become a robust and powerful means for obtaining solutions to previously unsolvable problems. This Series is intended for researchers and students alike interested in this fascinating field and its many applications.",coverUrl:"https://cdn.intechopen.com/series/covers/14.jpg",latestPublicationDate:"July 5th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:9,editor:{id:"218714",title:"Prof.",name:"Andries",middleName:null,surname:"Engelbrecht",slug:"andries-engelbrecht",fullName:"Andries Engelbrecht",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNR8QAO/Profile_Picture_1622640468300",biography:"Andries Engelbrecht received the Masters and PhD degrees in Computer Science from the University of Stellenbosch, South Africa, in 1994 and 1999 respectively. He is currently appointed as the Voigt Chair in Data Science in the Department of Industrial Engineering, with a joint appointment as Professor in the Computer Science Division, Stellenbosch University. Prior to his appointment at Stellenbosch University, he has been at the University of Pretoria, Department of Computer Science (1998-2018), where he was appointed as South Africa Research Chair in Artifical Intelligence (2007-2018), the head of the Department of Computer Science (2008-2017), and Director of the Institute for Big Data and Data Science (2017-2018). In addition to a number of research articles, he has written two books, Computational Intelligence: An Introduction and Fundamentals of Computational Swarm Intelligence.",institutionString:null,institution:{name:"Stellenbosch University",institutionURL:null,country:{name:"South Africa"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:6,paginationItems:[{id:"22",title:"Applied Intelligence",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",isOpenForSubmission:!0,editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",slug:"carlos-travieso-gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",biography:"Carlos M. Travieso-González received his MSc degree in Telecommunication Engineering at Polytechnic University of Catalonia (UPC), Spain in 1997, and his Ph.D. degree in 2002 at the University of Las Palmas de Gran Canaria (ULPGC-Spain). He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. He won the “Catedra Telefonica” Awards in Modality of Knowledge Transfer, 2017, 2018, and 2019 editions, and awards in Modality of COVID Research in 2020.\n\nPublic References:\nResearcher ID http://www.researcherid.com/rid/N-5967-2014\nORCID https://orcid.org/0000-0002-4621-2768 \nScopus Author ID https://www.scopus.com/authid/detail.uri?authorId=6602376272\nScholar Google https://scholar.google.es/citations?user=G1ks9nIAAAAJ&hl=en \nResearchGate https://www.researchgate.net/profile/Carlos_Travieso",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"23",title:"Computational Neuroscience",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",isOpenForSubmission:!0,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null},{id:"24",title:"Computer Vision",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",isOpenForSubmission:!0,editor:{id:"294154",title:"Prof.",name:"George",middleName:null,surname:"Papakostas",slug:"george-papakostas",fullName:"George Papakostas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hYaGbQAK/Profile_Picture_1624519712088",biography:"George A. Papakostas has received a diploma in Electrical and Computer Engineering in 1999 and the M.Sc. and Ph.D. degrees in Electrical and Computer Engineering in 2002 and 2007, respectively, from the Democritus University of Thrace (DUTH), Greece. Dr. Papakostas serves as a Tenured Full Professor at the Department of Computer Science, International Hellenic University, Greece. Dr. Papakostas has 10 years of experience in large-scale systems design as a senior software engineer and technical manager, and 20 years of research experience in the field of Artificial Intelligence. Currently, he is the Head of the “Visual Computing” division of HUman-MAchines INteraction Laboratory (HUMAIN-Lab) and the Director of the MPhil program “Advanced Technologies in Informatics and Computers” hosted by the Department of Computer Science, International Hellenic University. He has (co)authored more than 150 publications in indexed journals, international conferences and book chapters, 1 book (in Greek), 3 edited books, and 5 journal special issues. His publications have more than 2100 citations with h-index 27 (GoogleScholar). His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. Dr Ventura also holds the positions of Affiliated Professor at Virginia Commonwealth University (Richmond, USA) and Distinguished Adjunct Professor at King Abdulaziz University (Jeddah, Saudi Arabia). Additionally, he is deputy director of the Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI) and heads the Knowledge Discovery and Intelligent Systems Research Laboratory. He has published more than ten books and over 300 articles in journals and scientific conferences. Currently, his work has received over 18,000 citations according to Google Scholar, including more than 2200 citations in 2020. In the last five years, he has published more than 60 papers in international journals indexed in the JCR (around 70% of them belonging to first quartile journals) and he has edited some Springer books “Supervised Descriptive Pattern Mining” (2018), “Multiple Instance Learning - Foundations and Algorithms” (2016), and “Pattern Mining with Evolutionary Algorithms” (2016). He has also been involved in more than 20 research projects supported by the Spanish and Andalusian governments and the European Union. He currently belongs to the editorial board of PeerJ Computer Science, Information Fusion and Engineering Applications of Artificial Intelligence journals, being also associate editor of Applied Computational Intelligence and Soft Computing and IEEE Transactions on Cybernetics. Finally, he is editor-in-chief of Progress in Artificial Intelligence. He is a Senior Member of the IEEE Computer, the IEEE Computational Intelligence, and the IEEE Systems, Man, and Cybernetics Societies, and the Association of Computing Machinery (ACM). Finally, his main research interests include data science, computational intelligence, and their applications.",institutionString:null,institution:{name:"University of Córdoba",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"26",title:"Machine Learning and Data Mining",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",isOpenForSubmission:!0,editor:{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. His research interests include intelligent and embedded systems.",institutionString:"Universidad Autonoma de Queretaro",institution:{name:"Autonomous University of Queretaro",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null},{id:"27",title:"Multi-Agent Systems",coverUrl:"https://cdn.intechopen.com/series_topics/covers/27.jpg",isOpenForSubmission:!0,editor:{id:"148497",title:"Dr.",name:"Mehmet",middleName:"Emin",surname:"Aydin",slug:"mehmet-aydin",fullName:"Mehmet Aydin",profilePictureURL:"https://mts.intechopen.com/storage/users/148497/images/system/148497.jpg",biography:"Dr. Mehmet Emin Aydin is a Senior Lecturer with the Department of Computer Science and Creative Technology, the University of the West of England, Bristol, UK. His research interests include swarm intelligence, parallel and distributed metaheuristics, machine learning, intelligent agents and multi-agent systems, resource planning, scheduling and optimization, combinatorial optimization. Dr. Aydin is currently a Fellow of Higher Education Academy, UK, a member of EPSRC College, a senior member of IEEE and a senior member of ACM. In addition to being a member of advisory committees of many international conferences, he is an Editorial Board Member of various peer-reviewed international journals. He has served as guest editor for a number of special issues of peer-reviewed international journals.",institutionString:null,institution:{name:"University of the West of England",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null}]},overviewPageOFChapters:{paginationCount:20,paginationItems:[{id:"82526",title:"Deep Multiagent Reinforcement Learning Methods Addressing the Scalability Challenge",doi:"10.5772/intechopen.105627",signatures:"Theocharis Kravaris and George A. 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He worked as a Executive Research & Development @ Cadila Pharmaceuticals Ltd, Ahmedabad. He received DBT-postdoc fellow @ Molecular Biophysics Unit, Indian Institute of Science, Bangalore under the supervision of Prof. P. Balaram, later he moved to NIH-postdoc researcher at Drexel University College of Medicine, Philadelphia, USA, after his return from postdoc joined NITK-Surthakal as a Adhoc faculty at department of chemistry. Since from August 2013 working as a Associate Professor, and in 2016 promoted to Profeesor in the School of Basic Sciences: Department of Chemistry and having 20 years of teaching and research experiences.",institutionString:null,institution:{name:"Rani Channamma University, Belagavi",country:{name:"India"}}},{id:"158492",title:"Prof.",name:"Yusuf",middleName:null,surname:"Tutar",slug:"yusuf-tutar",fullName:"Yusuf Tutar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/158492/images/system/158492.jpeg",biography:"Prof. Dr. Yusuf Tutar conducts his research at the Hamidiye Faculty of Pharmacy, Department of Basic Pharmaceutical Sciences, Division of Biochemistry, University of Health Sciences, Turkey. He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. 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He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329248",title:"Dr.",name:"Md. Faheem",middleName:null,surname:"Haider",slug:"md.-faheem-haider",fullName:"Md. Faheem Haider",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329248/images/system/329248.jpg",biography:"Dr. Md. Faheem Haider completed his BPharm in 2012 at Integral University, Lucknow, India. In 2014, he completed his MPharm with specialization in Pharmaceutics at Babasaheb Bhimrao Ambedkar University, Lucknow, India. He received his Ph.D. degree from Jamia Hamdard University, New Delhi, India, in 2018. He was selected for the GPAT six times and his best All India Rank was 34. Currently, he is an assistant professor at Integral University. Previously he was an assistant professor at IIMT University, Meerut, India. He has experience teaching DPharm, Pharm.D, BPharm, and MPharm students. He has more than five publications in reputed journals to his credit. Dr. Faheem’s research area is the development and characterization of nanoformulation for the delivery of drugs to various organs.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/system/329795.png",biography:"Dr. Mohd Aftab Siddiqui is an assistant professor in the Faculty of Pharmacy, Integral University, Lucknow, India, where he obtained a Ph.D. in Pharmacology in 2020. He also obtained a BPharm and MPharm from the same university in 2013 and 2015, respectively. His area of research is the pharmacological screening of herbal drugs/natural products in liver cancer and cardiac diseases. He is a member of many professional bodies and has guided many MPharm and PharmD research projects. Dr. Siddiqui has many national and international publications and one German patent to his credit.",institutionString:"Integral University",institution:null}]}},subseries:{item:{id:"15",type:"subseries",title:"Chemical Biology",keywords:"Phenolic Compounds, Essential Oils, Modification of Biomolecules, Glycobiology, Combinatorial Chemistry, Therapeutic peptides, Enzyme Inhibitors",scope:"Chemical biology spans the fields of chemistry and biology involving the application of biological and chemical molecules and techniques. In recent years, the application of chemistry to biological molecules has gained significant interest in medicinal and pharmacological studies. This topic will be devoted to understanding the interplay between biomolecules and chemical compounds, their structure and function, and their potential applications in related fields. Being a part of the biochemistry discipline, the ideas and concepts that have emerged from Chemical Biology have affected other related areas. This topic will closely deal with all emerging trends in this discipline.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11411,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. He performed post-doctoral studies at Max-Planck Institute, Germany, and University of Florence, Italy in addition to making several scientific visits abroad. He currently works as a Full Professor of Biochemistry in the Faculty of Pharmacy, Anadolu University, Turkey. Dr. Beydemir has published over a hundred scientific papers spanning protein biochemistry, enzymology and medicinal chemistry, reviews, book chapters and presented several conferences to scientists worldwide. He has received numerous publication awards from various international scientific councils. He serves in the Editorial Board of several international journals. 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The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",fullName:"Reda R. Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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