Role of insulin on various vessels and mechanism.
\r\n\t
",isbn:"978-1-80356-951-2",printIsbn:"978-1-80356-950-5",pdfIsbn:"978-1-80356-952-9",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"bb6fc82b35ad2c63618a9bc15aeb61ce",bookSignature:"Dr. Kim Ho Yeap and Dr. Magdalene Goh Wan Ching",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11948.jpg",keywords:"MOSFET, CMOS, OFET, JFET, FinFET, Integrated Circuit (IC), Oxidation, Metallization, Semiconductor, Silicon (Si), Gallium Arsenide (GaAs), Silicon Carbide (SiC)",numberOfDownloads:13,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 7th 2022",dateEndSecondStepPublish:"June 16th 2022",dateEndThirdStepPublish:"August 15th 2022",dateEndFourthStepPublish:"November 3rd 2022",dateEndFifthStepPublish:"January 2nd 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"2 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"A researcher in the fields of microelectronics and electromagnetics. Member of IEEE, IET, IEM.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"24699",title:"Dr.",name:"Kim Ho",middleName:null,surname:"Yeap",slug:"kim-ho-yeap",fullName:"Kim Ho Yeap",profilePictureURL:"https://mts.intechopen.com/storage/users/24699/images/system/24699.jpg",biography:"Kim Ho Yeap is an Associate Professor at Universiti Tunku Abdul Rahman, Malaysia. He is an IEEE senior member, a Professional Engineer registered with the Board of Engineers, Malaysia,a Chartered Engineer registered with the UK Engineering Council, and an ASEAN Chartered Professional Engineer (ACPE). He received his BEng (Hons) Electrical and Electronics Engineering from Universiti Teknologi Petronas in 2004, his MSc in microelectronics from Universiti Kebangsaan Malaysia in 2005, and his PhD from Universiti Tunku Abdul Rahman in 2011. In 2008 and 2015, respectively, Dr. Yeap underwent research attachment at the University of Oxford (UK) and Nippon Institute of Technology (Japan). Dr. Yeap is the external examiner and external course assessor of Wawasan Open University. He is also the Editor in Chief of the i-manager’s Journal on Digital Signal Processing. He has also been a guest editor for the Journal of Applied Environmental and Biological Sciences and Journal of Fundamental and Applied Sciences. Dr. Yeap has been given the university teaching excellence award, and 22 research grants. He has published more than 100 research articles (including refereed journal papers, conference proceedings, books, and book chapters). Prior to joining the academic industry, Dr. Yeap worked in Intel corporation in the pre-silicon validation group. He was awarded 4 Kudos awards by Intel for his contributions in the design and verification of the microchip’s design for testability (DFT) features.",institutionString:"Universiti Tunku Abdul Rahman",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"Universiti Tunku Abdul Rahman",institutionURL:null,country:{name:"Malaysia"}}}],coeditorOne:{id:"454196",title:"Dr.",name:"Magdalene",middleName:null,surname:"Goh Wan Ching",slug:"magdalene-goh-wan-ching",fullName:"Magdalene Goh Wan Ching",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:"Dr Magdalene Goh Wan Ching\r\nDesignation: Senior lecturer\r\nQualifications: Diploma in Electrical & Electronics Engineering (Inti College), BEng in Electrical\r\nEngineering & Electronics (University of Liverpool, UK), PhD in Solid State\r\nDevice Physics & RF Transistors Design (University of Liverpool, UK)\r\n\r\nProfessional Body\r\nMemberships:\r\n\r\nInaugural Senior Member, International Engineering & Technology Institute\r\n(IETI), Hong Kong\r\n\r\nBiodata: Dr. Magdalene Goh obtained her Diploma in Electrical & Electronics Engineering\r\nfrom Inti College before leaving for the UK to pursue her BEng in Electrical\r\nEngineering & Electronics and later on, her PhD. Prior to joining the academia,\r\nshe has worked for a few years in the industry in the areas of semiconductor\r\nprocess technology, silicon wafer characterizations, mask layout design,\r\nanalogue circuits design and design for testability (DFT). While in the academic,\r\nshe had served as a judge for Innovate Malaysia undergraduate final year\r\nprojects competition from 2012 - 2015. She had served as an external examiner\r\nfor a PhD candidate from VIT University, India in 2013, and an external examiner\r\nfor SEGi College Penang from 2014 – 2018. She has been actively involved with\r\nthe Penang Science Cluster in their radio telescope team since 2014, where she\r\nworks with a team of volunteers (from both academia and the industry in\r\nPenang) to create curricula in radio astronomy, for the purpose of introducing the\r\nconcepts of radio astronomy and radio telescopes to both school pupils and\r\ncollege students. She has been a member of the Astronomical Society of\r\nPenang since 2016.\r\n\r\nCourse Development\r\nExperience:\r\n\r\nSince joining WOU, Dr. Goh has developed eight courses, namely Control\r\nSystems, Microprocessors, Digital Communications, Microelectronics, VLSI\r\nDesign, Process Control & Instrumentation, Power Electronics & Drives and\r\nElectrical Power & Drives.\r\n\r\nResearch Interest: Dr. Goh’s research interests are in the areas of semiconductor physics and\r\nelectromagnetics. She also has strong interest in the field of astronomy and is\r\nworking with a group of volunteers to promote astronomy education in the\r\nsecondary schools in Penang. She had also worked with some interns on the\r\nradio telescope project at the Penang Science Cluster.\r\n\r\nResearch Projects and\r\nConsultancy Work:\r\nSelected Publications: Design of Radio Frequency Metal-Insulator-Metal (MIM) Capacitors. \r\n\r\nExperimental Investigation on Thermoelectric Generator for Battery - Charger\r\nBased Oven.\r\nAnalyzing the Physics of Radio Telescopes and Radio Astronomy (book\r\nchapters).\r\n\r\nConferences,\r\nSeminars and\r\nWorkshops:\r\n\r\nDr. Goh was appointed as one of the Technical Committee Member for the\r\nVirtual Conference on Electronics and Communication: Loading Intelligence on\r\nFuture Electronics (October 2020).\r\n\r\nHonorary\r\nAppointments and\r\nAwards:\r\n\r\nDr. Goh is a reviewer of the following journals:-\r\n1. Microwave and Optical Technology Letters.\r\n2. Journal of Electrical Engineering.\r\n3. Journal on Digital Signal Processing.\r\n\r\nOfficial\r\n\r\nDr. Magdalene Goh Wan Ching\r\nSenior Lecturer & Programme Coordinator of Bachelor of Technology in\r\n\r\nCorrespondence\r\nAddress:\r\n\r\nElectronics,\r\nSchool of Science & Technology\r\nWawasan Open University\r\n54, Jalan Sultan Ahmad Shah,\r\n10050 Penang\r\n\r\nEmail Address: magdalenegoh@wou.edu.my\r\nPersonal Homepage\r\n(optional):\r\n\r\nBTEL facebook page:\r\nhttps://www.facebook.com/groups/238200129533176/",institutionString:"Technology Wawasan Open University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Wawasan Open University",institutionURL:null,country:{name:"Malaysia"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"11",title:"Engineering",slug:"engineering"}],chapters:[{id:"82415",title:"Power Consumption in CMOS Circuits",slug:"power-consumption-in-cmos-circuits",totalDownloads:15,totalCrossrefCites:0,authors:[null]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"444312",firstName:"Sara",lastName:"Tikel",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/444312/images/20015_n.jpg",email:"sara.t@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"9309",title:"Integrated Circuits/Microchips",subtitle:null,isOpenForSubmission:!1,hash:"3c7ff3f191842303cc95e466e28b5e33",slug:"integrated-circuits-microchips",bookSignature:"Kim Ho Yeap and Jonathan Javier Sayago Hoyos",coverURL:"https://cdn.intechopen.com/books/images_new/9309.jpg",editedByType:"Edited by",editors:[{id:"24699",title:"Dr.",name:"Kim Ho",surname:"Yeap",slug:"kim-ho-yeap",fullName:"Kim Ho Yeap"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6511",title:"Complementary Metal Oxide Semiconductor",subtitle:null,isOpenForSubmission:!1,hash:"96b2d63df3822f48468050aa7a44a44c",slug:"complementary-metal-oxide-semiconductor",bookSignature:"Kim Ho Yeap and Humaira Nisar",coverURL:"https://cdn.intechopen.com/books/images_new/6511.jpg",editedByType:"Edited by",editors:[{id:"24699",title:"Dr.",name:"Kim Ho",surname:"Yeap",slug:"kim-ho-yeap",fullName:"Kim Ho Yeap"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5799",title:"Very-Large-Scale Integration",subtitle:null,isOpenForSubmission:!1,hash:"5df47859b1341d2834dd041646592231",slug:"very-large-scale-integration",bookSignature:"Kim Ho Yeap and Humaira Nisar",coverURL:"https://cdn.intechopen.com/books/images_new/5799.jpg",editedByType:"Edited by",editors:[{id:"24699",title:"Dr.",name:"Kim Ho",surname:"Yeap",slug:"kim-ho-yeap",fullName:"Kim Ho Yeap"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10198",title:"Response Surface Methodology in Engineering Science",subtitle:null,isOpenForSubmission:!1,hash:"1942bec30d40572f519327ca7a6d7aae",slug:"response-surface-methodology-in-engineering-science",bookSignature:"Palanikumar Kayaroganam",coverURL:"https://cdn.intechopen.com/books/images_new/10198.jpg",editedByType:"Edited by",editors:[{id:"321730",title:"Prof.",name:"Palanikumar",surname:"Kayaroganam",slug:"palanikumar-kayaroganam",fullName:"Palanikumar Kayaroganam"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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\nThe cellular changes resulting from exercise in overweight or obese population are not fully documented. However, the incidence of overweight and obese population who are insulin resistant is gradually increasing. There seems to be an intimate relationship between fat hypertrophy, fat inflammation, and vascular supply in metabolic syndrome states such as prediabetes. The vasculature and endothelium in metabolic syndrome or subjects with prediabetes and insulin resistance are prone to ROS accumulation and inflammation. Exercise appears to improve endothelial dysfunction in insulin resistant cohort though cell-based data is lacking. The favorable impact of exercise on cardio-metabolic health depends in part on the concomitant exercise-induced reduction of adiposity and fat-based inflammation and insulin resistance.
\nInsulin acts as a vascular hormone, mediating its action by several mechanisms including its effect on cardiac output, endothelium, type and location of vessel, and skeletal muscle [1].
\n
\n
\n
The conduit arteries are large arteries which regulate arterial compliance in response to the ejection volume and stretch in order to maintain blood pressure. Insulin increases compliance by vasodilation of these vessels in response to NO release. In human studies with insulin infusion, the responsiveness of the femoral artery to methacholine-induced vasodilation is increased [4].
The resistance arterioles regulate blood pressure and total blood flow to tissues. They determine vascular resistance as a change in the size of the vessel (lumen size) can significantly increase or decrease resistance and thus the amount of blood supply to the tissues. Insulin via NO production causes dilation of these vessels, decreases resistance, and increases blood flow.
The microvasculature including the terminal arterioles, capillary networks and venules regulate insulin delivery to muscle tissues. Insulin action here promotes glucose uptake, recruitment of muscle vasculature and its own trans-endothelial transport [4]. This allows for exchange of nutrients, oxygen, and hormones to the muscle with removal of metabolic waste.
\n
Pathway of insulin-mediated release of nitric oxide (NO) and endothelin-1 (ET-1), two peptides that influence vasomotor tone and risk of atherosclerosis. Insulin directly affects the vascular endothelium by binding to receptors present on the endothelium which expresses not only insulin receptors but also insulin-like growth factor I (IGF-I) receptors and hybrid insulin/IGF-I receptors. These hybrid receptors are expressed 5- to 10-fold higher concentration than insulin receptors. Potentially, an over-abundance of IGF-1 receptor may result in vascular insulin resistance by promoting hybrid receptor formation which does not respond to physiological insulin concentrations while decreasing insulin receptor availability. As described in the text, insulin initiates an intracellular cascade of steps resulting in NO or ET-1. GLUT-4 transports glucose across the cellular membrane following insulin activation or muscle contraction via a complex of intermediary substrates. The former is initiated by the PI3K pathway, while muscle contraction by a PI3K independent pathway.
Vessel | \nRole | \nInsulin action | \nMechanism | \n
---|---|---|---|
Conduit arteries | \nRegulate arterial compliance, blood pressure | \nIncreases relaxation, increases compliance | \nLikely NO | \n
Resistance arterioles | \nDetermines vascular resistance | \nDilation, decrease vascular resistance | \nNO | \n
Terminal arterioles, capillaries | \nRegulate insulin delivery to muscle. Also exchange nutrients, oxygen and hormones with muscle | \nMuscle glucose uptake, recruit muscle microvasculature | \nInsulin, muscle contraction, angiotensin GLP1, adiponectin | \n
Skeletal muscle | \nMuscle contraction | \nIncrease blood flow, increase glucose uptake | \nNO, translocation of GLUT4 receptors | \n
Role of insulin on various vessels and mechanism.
Insulin resistance is characterized by a state of compensatory hyperinsulinemia due to changes in insulin secretion and/or insulin clearance [6] leading to mild forms of glucose intolerance, dyslipidemia (high triglycerides, low HDL, small dense LDL), and hypertension termed the “insulin resistance syndrome”. As discussed, during physiological conditions, insulin binding to endothelial receptors leads to phosphorylation of downstream substrates including activation of the IRS-1, PI3K pathway and subsequent recruitment of GLUT4 to mediate glucose transport into muscle and other tissues [7]. However, In the IR state, the IRS-1-PI3K-Akt-NO pathway is muted while the MAPK pathway remains intact [8]. The unopposed action of ET-1 leads to a shift towards vasoconstriction, increased arterial stiffness, hypertension, and tissue hypoxia. In addition to this decrease in NO bioavailability, increases in oxidative stress, inflammatory markers, and pro-thrombotic mediators (i.e., increased plasma von Willebrand factor, decreased lipoprotein lipase activity) are seen. More direct evidence for endothelial IR was shown in freshly isolated arterial endothelial cells where the insulin-induced eNOS-phosphorylation was negatively associated with oxidative stress markers [9].
\nDuring states of IR each vascular site becomes affected and contributes to an increase in atherosclerosis. At the level of the conduit arteries, IR causes decreased compliance with a concomitant increase in vessel stiffness, which is a predictor of coronary artery disease and stroke [10]. The impaired vasodilatory action of insulin on the resistance arterioles leads to decrease in blood flow to the tissues it supplies. For example, Baron et al. demonstrated that the inhibition of NO production (similar to states of IR) causes a decrease in blood flow and glucose uptake in the leg. The terminal arterioles in patients with IR showed a blunted response to mixed meal in brachial blood flow and forearm microvascular recruitment compared to lean subjects [3].
\n\n
It is well established that exercise augments insulin signaling independent of PI3K, while the combination of skeletal muscle contraction and insulin additively enhances glucose transport via GLUT4 translocation. A plethora of studies have reported that regular physical activity is effective in patients with IR, such as type 2 diabetes, prediabetes and metabolic syndrome, in improving glucose tolerance, insulin sensitivity, glycosylated hemoglobin levels (HbA1c) and morbidity and mortality [12]. For instance, adults with IR were found to have improvements in hepatic and peripheral insulin sensitivity after 12 weeks of aerobic exercise. Shorter term studies (i.e., 7 days) have also demonstrated similar improvements in insulin sensitivity in obese patients [13]. Lifestyle interventions such as diet modifications added to 12 weeks exercise training showed further enhancements in addition to insulin sensitivity including fatty acid oxidation, post-prandial hyperinsulinemia and systolic resting blood pressure [14].
\n\n
\n
Endothelial cells constitute the innermost layer of blood vessel and promote vascular homeostasis and angiogenesis. Endothelial cells can secrete several mediators that can alternatively mediate vasoconstrictors, such as endothelin-1 and thromboxane A2, or vasodilators, such as NO, prostacyclin, and endothelium-derived hyperpolarizing factor. Since hyperglycemia and IR can negatively impact NO secretion from the endothelium, with vasoconstriction, vessel wall stiffness, platelet aggregation and diminished angiogenesis, there is a counter-regulatory reparatory cellular response by circulating endothelial progenitor cells (EPCs). These are immature bone marrow derived cells that can differentiate into mature endothelial cells. These cells home in on areas that experience vascular injury or ischemia by way of circulating growth factors and cytokines to initiate repair of the endothelial surface and stimulate neovascularization and angiogenesis. In conditions such as diabetes with vascular damage, the presence of diminished circulating EPCs constitute cellular biomarkers of compromised cardiovascular health [19]. In subjects with IR such as metabolic syndrome, decreased EPC number and impaired functionality prognosticates increased cardiovascular risk [20]. Interestingly, exercise promotes the production and numbers of EPCs [19, 21] putatively related to the anti-apoptotic effect of NO [22]. EPCs are also stimulated by exercise in aging studies. Moreover, the migratory function of EPCs is improved by exercise in subjects with IR [19, 23]. The degree of exercise dose appears to influence the overall EPC response [23]. In presence of insulin resistance but not overt diabetes, CPAP therapy improves endothelial health and EPC parameters [24].
\nExercise, endothelium and fat derived mesenchymal stromal cells (MSCs): clinical trials are necessary to investigate the possible cellular and molecular pathways that may impact endothelium and fat metabolism. Identification of the pathways that influence crosstalk between endothelium and fat, and thereby improve cardio-metabolic health in the elderly and young subjects is important to identify. The process will help to identify genes and cell differentiation pathways that may change fat derived stem cell differentiation, following exercise training in the elderly and the young subject cohorts, which will subsequently influence the mesenchymal structures of our body. Our study [25] appears to indicate that exercise promotes osteogenic differentiation but not myogenic differentiation in the middle-aged veteran population with mean age of 51 years. However, whether osteogenic differentiation of adipose tissue derived mesenchymal stromal cells (MSCs) also occurs in young and the elderly is unknown. Myogenic differentiation in response to exercise is well documented [26], and different types of exercise appear to influence the differentiation depending on plasma-based differentiation factors [26]. However, the exact mechanism of how exercise modifies mesenchymal stromal cell (MSC) differentiation in the body needs further investigation. Prior to our recent studies, we would have hypothesized that exercise will promote myogenic differentiation in all age groups, however the differentiation of stem cells may be dependent upon the need of the body to regenerate a particular tissue lineage at a particular age. For example, exercise promotes myogenic differentiation in the young [26] whereas endothelial function improvement and bone regeneration may be more important in the elderly [27, 28].
\nExercise is an important modifiable risk factor that significantly attenuates cardiovascular morbidity and mortality. Physical activity is associated with enhanced cardiorespiratory fitness which significantly attenuates IR, and some of these effects are mediated by augmented endothelial action of insulin. These vascular effects of exercise include an increase in endothelium-dependent vasodilation through increased NO bioavailability, suppression of ET-1, increased capillary density, and reduction in ROS.
\nFinally, exercise appears to rejuvenate endothelial function by recruitment of exercise responsive EPCs and influences MSC differentiation.
\nNone.
\nEnterococci as the name implies are gram positive cocci that dwell in the human intestine. They are a genus comprising of spherical to oval diplococcic that typically form an angle to each other upon division. Most of the species are non-motile and the early classification was based on their ability to survive in 10% bile solution unlike the other streptococci. This chapter will focus on the evolution of their nomenclature, the important species and emerging trends of infection in the present scenario.
The first mention of the word “Enterococci” came up in 1899, when Thiercelin and Jouhad discovered a diplococcus from the human intestine and named it as “enterococque” to describe its habitat. However, he was overruled by Andrews and Horder in 1906 who included enterococci in the genus streptococci based on their gram reaction, shape and ability to form chains in some circumstances. This continued till 1968, when Kalina questioned the inclusion. Kalina looked at the position of the Group D antigen and found it to be located inside the cell wall unlike the Group A antigen of streptococci. He found that culture is more diffuse in broth and spreading on solid media, chain formation occurred only in adverse physiological conditions and the natural arrangement was in pairs in broth culture. It did not display many of the virulence factors common to streptococci, like hyaluronidase. They called for changing the type species to
In 1984, Schliefer and Kilpper-Balz came out with the full justification for a separate genus for Enterococci. They showed that
In April 1984, the same researchers came up with a proposal to include “
At present there are 18 species pathogenic to human beings, under the genus
Enterococcal species pathogenic to man.
Standard textbooks of Bacteriology suggest identification of enterococci by the following characteristics.
Gram positive catalase negative diplococci with growth on MacConkey bile salt lactose agar to distinguish from Streptococci, fermentation of Aesculin on nutrient agar with 4% bile, production of acetoin (Voges-Proskauer test) and the pyrrolidonyl peptidase positive test (PYR) to distinguish from other Group D streptococci, known as non-enterococcal Group D streptococci (Group B streptococci grow on Mac Conkey agar unlike other streptococci and Group A streptococci are also PYR test positive, while all other streptococci are negative) [5].
Enterococci are also hardier than streptococci, the main differences being:
Survives in 6.5% NaCl solution
Has a wide temperature range from 10 to 45°C
Resistant to 10% bile
They can grow at a pH of 9.6
Survive heating at 60°C for 30 min.
Above tests are done only after Lancefield grouping for Group D.
However,
The 16S rRNA typing studied by Gilmore et al. 2013 gave rise to a phylogenetic tree. In 2017, further advances in genetic analysis led to genomic sequence mapping [7, 8]. This study was very interesting in that it traced the origin of enterococci from the pre-historical age and shows their relation to the modern evolved strains isolated from hospital associated infections, including Vancomycin resistant
Pulsed field gel electrophoresis: Using restriction enzymes (restriction fragment length polymorphism) the genome is cut into smaller pieces and for identical strains these fragments are of the same length. These are run on a pulsed field for comparison. As for all other bacteria this is a popular method for tracing clusters of infections due to enterococci within a geographic area or inside a hospital.
Multi locus sequence typing (MLST) has been found to be useful in describing the genomic characteristics and thereby the phenotypic diversity of Enterococci. MLST is a sequencing-based classification scheme that has answered questions regarding evolution of the genome due to antibiotic pressure and whether nosocomial strains differ in their virulence from community acquired strains. MLST has been done mostly on
Whole genome sequencing (WGS) is the latest answer to all genotyping problems. This is based on average nucleotide identity (ANI). This correlates very well with DNA-DNA hybridisation. In a study done in Uppsala, Sweden, a total of 60
Alterations in the Penicillin binding proteins (Pbp, notable Pbp5) are responsible for the resistance seen against, Ampicillin and the Cephalosporins. In addition, some enterococci also express the beta lactamase enzyme.
They are also inherently resistant to Clindamycin, due to modifying enzymes.
Co-trimoxazole is ineffective due to the ability of enterococci to utilise extracellular folate. Hence it may look susceptible in vitro by disc diffusion.
Aminoglycoside resistance is due to poor uptake or covalent modification by intracellular enzymes which prevent binding to the ribosome. Poor uptake is overcome by combination with a beta lactam antibiotic like Ampicillin or cell wall acting antibiotic like Vancomycin. However, high-level aminoglycoside resistance (HLAR) mediated by aminoglycoside destroying enzymes cannot be overcome by combinations.
Mobile element acquisition is a major contributor to acquired resistance in enterococci. Multi-drug resistant strains possess larger genomes.
The gene that encodes resistance to Vancomycin and Teicoplanin in enterococci is known as the
CLSI 31st Edition (2021) of performance standards for antimicrobial susceptibility testing, sets down the following procedure for reporting of Enterococcal susceptibility testing [14].
Penicillin can act as a surrogate for Ampicillin, Amoxycillin and all the Beta-lactam-lactamase combinations as long as beta lactamase is not produced by the strain, however, Ampicillin cannot be a surrogate for Penicillin.
For serious infections like endocarditis,
Ampicillin has to be combined with an aminoglycoside to which there is no high level resistance (HLAR- as per procedure spelt out in CLSI M100).
If Ampicillin MIC is >16 μg/ml and less than 64 μg/ml and the strain is susceptible to Gentamicin (noHLAR), this combination will still be effective, if Ampicillin is given in high dose.
Combination is not effective if strain is resistant to either Ampicillin or Gentamicin.
HLAR test has to be done for Gentamicin and Streptomycin separately. Gentamicin is surrogate for all the other aminoglycosides.
For Ampicillin resistant isolates, Vancomycin can be substituted and combination with Aminoglycoside is recommended here also.
Vancomycin susceptibility can be done using the Vancomycin screen agar (BHI agar with 6 μg/ml Vancomycin), but it has to be confirmed by any test that gives the MIC.
If MIC is greater than 8 μg/ml, confirm identification as
It is not recommended to report susceptibility for Cephalosporins, Clindamycin and Trimethoprim-sulfamethoxazole, even if susceptible in vitro.
Most number of virulence factors are present in human pathogenic enterococci followed by animal pathogenic enterococci.
Variable factors: Production of bacteriocins or enterocins, is one process that depends on the environment. When there is a harsh environment and there is competition for survival, enterococci are seen to produce enterocins that are capable of killing
Antibiotic resistance is another factor that is dependent on the environment. In a hospital environment with antibiotic pressure, enterococci rapidly acquire and activate genetic elements like plasmids with transposons. They are capable of conjugation based on a pheromone induced system that does not depend on pili. Pheromones released by plasmid free cells are taken up by those with plasmids, leading to upregulation of synthesis of specific aggregatory proteins that help these bacteria to attach to each other for transfer of genetic material. The plasmid transferred contains not only conjugatory genes, but also genes responsible for antibiotic resistance and virulence factor production. One such plasmid induced by pheromones and extensively studied is pAD1. It carries the Tn917 transposon and the Tn916 transposons that are integrated into the recipient cell after conjugation. Tn916 is known to code for Tetracycline resistance in addition to be actively involved in conjugation [15].
Constant virulence factors:
Cell bound:
Ace: Adhesion of collagen of enterococci, seen in
Esp: Extra cellular surface protein which plays a role in biofilm formation and evasion of the immune system. It is seen both in
Pili: Enterococcal pili help in adhesion and play a role in biofilm formation.
Secreted virulence factors:
Cytolysin or hemolysin which is bactericidal for other bacteria and is haemolytic.
Hyaluronidase breaks down the mucopolysaccharide in connective tissue helping spread of enterococci, a feature shared with other streptococci.
Gelatinase and serine protease break down proteins and have a role in biofilm formation also. They are produced when the quorum sensing system is activated and involves the faecal streptococci regulator (
It was in 1899, that the first report of infective endocarditis due to enterococci was published. The authors were MacCallum and Hastings who provided a detailed report of a case of acute endocarditis in a 37-year-old patient, caused by an organism they called Micrococcus zymogenes, probably the present
If we start with the risk factors for enterococcal infective endocarditis, only a few studies have addressed this. One study done in Denmark found that men were more prone, with prosthetic valve being a significant risk factor and most were community acquired and not related to hospital infection. They went on to say that for all cases of enterococcal bacteremia, it would be worthwhile to do echocardiography to rule out IE, especially in the presence of valve abnormality [16]. Another risk factor commonly encountered in cases of enterococcal IE in patients with valve abnormality is history of colorectal or urogenital disease or surgery [17]. A few case reports have been published describing enterococcal IE after colonoscopy and proctosigmoidoscopy [18]. In women, the ovaries may be a significant source. In a study done in our centre, we encountered a case of recurrent enterococcal endocarditis in a woman that could be resolved only after removal of an ovarian cyst. We also found that 12% of the valvular endocarditis was due to enterococci. Other than
The close proximity of the gut flora to the urethra make
Enterococci cause a minority of community acquired UTI, 15–30% of catheter associated UTI and is the third common cause of hospital acquired UTI. Enterococci are seen to colonise the cells in the kidney and do not persist in the bladder. They have a tendency to persist inside macrophages in the kidney. Urothelial cells are also seen to have intracellular enterococci. All the above-mentioned constant cell bound virulence factors like Ace and Esp are important in the pathogenesis and persistence of enterococci in the urinary tract. In case of CA-UTI, enterococci can persist in the catheter forming a biofilm. However, CA-UTI due to gram positive bacteria including enterococci cause less inflammatory reaction as seen in a wet film of the urine. This may be the effect of immune evasion due to the biofilm formation.
Enterococci are also encountered in asymptomatic bacteriuria (ABU), like enterococci isolated during routine screening of urine in asymptomatic antenatals, at a healthcare facility. A review article on this subject found that such enterococci are actually protective against symptomatic bacteriuria in the future [23]. Treatment of ABU is recommended only in pregnancy and as part of pre-operative evaluation and decolonisation. ABU treatment is associated with higher incidence of multi drug resistant UTI [24].
Treatment: Ampicillin is the treatment of choice for strains that are sensitive. Ampicillin concentrates in the bladder and patients with strains that are resistant too can be treated with Ampicillin, as demonstrated in a study by Shah et al. Here they showed that Ampicillin can be used for treatment even if Vancomycin resistant strain is isolated. In their study 87.5% of patients on catheter with VRE responded to treatment with Ampicillin alone [25]. Another agent that holds hope in the face of VRE is Nitrofurantoin [26].
Enterococcus species are ubiquitous among the SSTIs due to trauma, surgical site infections (SSI), vascular ulcers and device associated infections. NHSN has released the SSI rates pathogen wise for the years 2015–2017 (Figure 1) [27].
Among SSTIs that are admitted in hospitals, a study from New Delhi, India, reports that out of 11,524 pus and tissue samples, 86
In most studies, Vancomycin resistance is reported to be increasing and associated with hospitalisation, though one study reported community acquired Vancomycin resistant strains too [29, 30]. This increase has been variously attributed to prior antibiotic treatment and nosocomial spread due to poor hand hygiene and environmental cleaning practices.
Enterococci that were once part of the genus Streptococci, moved out to form a new genus and the genus expanded to include species present in a wide variety of animals. With the advent of Cephalosporins, they gained access to hospitals and now are acquiring new resistance genes at a rapid pace.
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All published Book Chapters are licensed under a Creative Commons Attribution 3.0 Unported License. Monographs are licensed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license granted to all others. Our Copyright Policy aims to guarantee that original material is published while at the same time giving significant freedom to our Authors. IntechOpen upholds a flexible Copyright Policy meaning that there is no copyright transfer to the publisher and Authors hold exclusive copyright to their work.
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\n\nAll scientific works are subject to Peer Review prior to publishing. IntechOpen is a member of the Committee on Publication Ethics (COPE) and all participating referees and Academic Editors are expected to review submitted scientific works in line with the COPE Ethical Guidelines for Peer Reviewers where applicable.
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Naughton M.",authors:null},{id:"63898",doi:"10.5772/intechopen.81478",title:"Indoor Air Quality Monitoring for Enhanced Healthy Buildings",slug:"indoor-air-quality-monitoring-for-enhanced-healthy-buildings",totalDownloads:1637,totalCrossrefCites:8,totalDimensionsCites:12,abstract:"Since most people spend 90% of their time indoors, the indoor environment has a determining influence on human health. In many instances, the air quality parameters are very different from those defined as healthy values. Using real-time monitoring, occupants or the building manager can decide and control behaviors and interventions to improve indoor air quality. The historical database is also useful for assisting doctors to support the medical diagnosis. The continuous technological advancements notably, as regards, networking, sensors, and embedded devices have made it possible to monitor and provide assistance to people in their homes. Smart objects with great capabilities for sensing and connecting could revolutionize the way we are monitoring our environment. This chapter consists of a general overview of several real-time monitoring systems developed and published by the authors. In this chapter, the authors present several new open-source and cost-effective systems that had been developed for monitoring environmental parameters, always with the aim of improving indoor air quality for enhanced healthy buildings.",book:{id:"7473",slug:"indoor-environmental-quality",title:"Indoor Environmental Quality",fullTitle:"Indoor Environmental Quality"},signatures:"Gonçalo Marques and Rui Pitarma",authors:[{id:"202912",title:"Prof.",name:"Rui",middleName:null,surname:"Pitarma",slug:"rui-pitarma",fullName:"Rui Pitarma"},{id:"250831",title:"Dr.",name:"Gonçalo",middleName:"Miguel Santos",surname:"Marques",slug:"goncalo-marques",fullName:"Gonçalo Marques"}]},{id:"66693",doi:"10.5772/intechopen.85808",title:"Lumber-Based Mass Timber Products in Construction",slug:"lumber-based-mass-timber-products-in-construction",totalDownloads:1870,totalCrossrefCites:8,totalDimensionsCites:12,abstract:"This chapter provides information related to commonly used wood construction methods (i.e., light-frame, post-and-beam, and mass timber) and mass timber products. It briefly discusses the manufacturing of four major lumber-based mass timber products (i.e., glue-laminated timber, nail-laminated timber, dowel-laminated timber, and cross-laminated timber), and their available dimensions and typical applications. The discussion also addresses primary lumber products, such as dimension lumber, machine stress-rated lumber, and finger-joined lumber, which are the building blocks from which mass timber products are manufactured. Advantages of using wood in construction are illustrated by examples largely from North American practices. The life cycle assessment concept is also introduced.",book:{id:"8299",slug:"timber-buildings-and-sustainability",title:"Timber Buildings and Sustainability",fullTitle:"Timber Buildings and Sustainability"},signatures:"Meng Gong",authors:[{id:"274242",title:"Dr.",name:"Meng",middleName:null,surname:"Gong",slug:"meng-gong",fullName:"Meng Gong"}]},{id:"9627",doi:"10.5772/8410",title:"Aging in Place: Self-Care in Smart Home Environments",slug:"aging-in-place-self-care-in-smart-home-environments",totalDownloads:3408,totalCrossrefCites:9,totalDimensionsCites:10,abstract:null,book:{id:"3631",slug:"smart-home-systems",title:"Smart Home Systems",fullTitle:"Smart Home Systems"},signatures:"Blanson Henkemans, Olivier A., Alpay, Laurence, L., and Dumay Adrie, C.M.",authors:null},{id:"62021",doi:"10.5772/intechopen.78576",title:"Urbanization and Meeting the Need for Affordable Housing in Nigeria",slug:"urbanization-and-meeting-the-need-for-affordable-housing-in-nigeria",totalDownloads:2681,totalCrossrefCites:5,totalDimensionsCites:10,abstract:"Urbanization is an ongoing trend in developed and developing countries. With particular reference to Nigeria, studies have shown that many urban centres have been experiencing rapid and continuous growth over the years, as people tend to migrate from rural areas to urban centres in order to better their living conditions. However, there has been an inadequacy of the necessary infrastructures to meet the needs of the increasing urban populace. Empirical studies have also shown that about 75% of the urban settlers live in slums and improper housing, which is antithetical to human dignity. Therefore, this study aims at exploring the causes, advantages, and disadvantages of urban slum dwelling in Nigeria, and similarly proper possible solutions to the prevailing urbanization challenges in the country. The authors agree that the policy can bring about an effective provision of affordable housing, thereby meeting the needs of housing and helping to solve most of the problems of urbanization in Nigeria. It is recommended that each element of an effective housing policy, as entrenched in the National Housing Policy 2012, should be critically explored towards the delivery of affordable housing, which would in turn go a long way in solving urbanization problems in Nigeria.",book:{id:"7205",slug:"housing",title:"Housing",fullTitle:"Housing"},signatures:"Temi Oni-Jimoh and Champika Liyanage",authors:[{id:"245547",title:"Mrs.",name:"Temi",middleName:null,surname:"Oni-Jimoh",slug:"temi-oni-jimoh",fullName:"Temi Oni-Jimoh"},{id:"245550",title:"Dr.",name:"Champika",middleName:null,surname:"Liyanage",slug:"champika-liyanage",fullName:"Champika Liyanage"}]}],mostDownloadedChaptersLast30Days:[{id:"67068",title:"Structural Design of a Typical American Wood-Framed Single-Family Home",slug:"structural-design-of-a-typical-american-wood-framed-single-family-home",totalDownloads:2697,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Light-wood framing construction techniques have been traditionally used in America for the construction of single-family residences. Dimensional wood lumber is readily available and due to its convenient unit dimension can be packaged neatly and transported to work sites by either commercial transport or personal vehicle. The unit pieces of dimensional lumber are light and easily handled once on the work site. Design of light-framed single-family homes is typically conducted by an architect or construction contractor using prescriptive building codes. A structural engineer can assist, if needed, with design items not within the scope of the building code or if alternative design approaches are required. An owner may choose to involve the engineer to improve quality or economy of the home design. Engineers typically become involved with design items such as foundation design, steel framing design, or engineered product specification. In this chapter, the design of a typical light-framed home is discussed. The main structural assemblies are described and subsequently designed using a combination of prescriptive guidance and engineering design.",book:{id:"8299",slug:"timber-buildings-and-sustainability",title:"Timber Buildings and Sustainability",fullTitle:"Timber Buildings and Sustainability"},signatures:"Anthony C. Jellen and Ali M. Memari",authors:[{id:"252670",title:"Prof.",name:"Ali",middleName:null,surname:"M. Memari",slug:"ali-m.-memari",fullName:"Ali M. Memari"},{id:"276003",title:"Mr.",name:"Anthony",middleName:null,surname:"Jellen",slug:"anthony-jellen",fullName:"Anthony Jellen"}]},{id:"60236",title:"The Feasibility of Constructing Super-Long-Span Bridges with New Materials in 2050",slug:"the-feasibility-of-constructing-super-long-span-bridges-with-new-materials-in-2050",totalDownloads:1875,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"This chapter explores the possibility of designing and constructing a super-long-span bridge with new materials in 2050. The proposed bridge design has a total span of 4440 m with two 330-m end spans and a central span of 3780 m. The height of the two pylons is 702 m, and the deck width is 40 m. The features of this structure include the combination of a suspension bridge and cable-stayed bridge, application of carbon fibre materials, extension of deck width and pretension techniques. Linear static analysis, dynamic analysis and theoretical analysis are conducted under different loading cases. In linear static analysis, the stresses under critical load combinations are smaller than the ultimate strength of the materials. However, the maximum deflection under the dead and wind load combination exceeds the specified serviceability limit.",book:{id:"6395",slug:"bridge-engineering",title:"Bridge Engineering",fullTitle:"Bridge Engineering"},signatures:"Faham Tahmasebinia, Samad Mohammad Ebrahimzadeh\nSepasgozar, Hannah Blum, Kakarla Raghava Reddy, Fernando\nAlonso-Marroquin, Qile Gao, Yang Hu, Xu Wang and Zhongzheng\nWang",authors:[{id:"211659",title:"Dr.",name:"Faham",middleName:null,surname:"Tahmasebinia",slug:"faham-tahmasebinia",fullName:"Faham Tahmasebinia"},{id:"221172",title:"Dr.",name:"Samad M.E.",middleName:null,surname:"Sepasgozar",slug:"samad-m.e.-sepasgozar",fullName:"Samad M.E. 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Today, the social structure of mass housing estates becomes more heterogeneous, what puts new requirements on the design of open public spaces and, as well as, on the regeneration and design of children’s playgrounds, to serve the rising demands of the inhabitants and to enhance the livability of the housing estates. The study examines the current examples of the children’s playgrounds from Slovak mass housing estates, which show that nowadays the typified design of the standardized catalog type elements is used and preferred.",book:{id:"7205",slug:"housing",title:"Housing",fullTitle:"Housing"},signatures:"Katarína Kristiánová",authors:[{id:"224853",title:"Dr.",name:"Katarina",middleName:null,surname:"Kristianova",slug:"katarina-kristianova",fullName:"Katarina Kristianova"}]},{id:"62555",title:"Risk Management in Indonesia Construction Project: A Case Study of a Toll Road Project",slug:"risk-management-in-indonesia-construction-project-a-case-study-of-a-toll-road-project",totalDownloads:2917,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"While project risks are generally acknowledged merely from owner and contractor perspectives, other parties also play important roles in the project. 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Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. 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Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. 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Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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