Glasgow Coma Scale.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"5781",leadTitle:null,fullTitle:"Phytohormones - Signaling Mechanisms and Crosstalk in Plant Development and Stress Responses",title:"Phytohormones",subtitle:"Signaling Mechanisms and Crosstalk in Plant Development and Stress Responses",reviewType:"peer-reviewed",abstract:"Phytohormones are regulatory compounds that play crucial roles in plants. This book brings together recent work and progress that has recently been made in the dynamic field of phytohormone regulation in plant development and stress responses. It also provides new insights and sheds new light regarding the exciting hormonal cross talk phenomenon in plants. This book will provoke interest in many readers and scientists, who can find this information useful for the advancement of their research works.",isbn:"978-953-51-3412-1",printIsbn:"978-953-51-3411-4",pdfIsbn:"978-953-51-4710-7",doi:"10.5772/65234",price:119,priceEur:129,priceUsd:155,slug:"phytohormones-signaling-mechanisms-and-crosstalk-in-plant-development-and-stress-responses",numberOfPages:170,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"054eaa85c13ebe3d04fb8852005d2bad",bookSignature:"Mohamed El-Esawi",publishedDate:"August 16th 2017",coverURL:"https://cdn.intechopen.com/books/images_new/5781.jpg",numberOfDownloads:15339,numberOfWosCitations:47,numberOfCrossrefCitations:39,numberOfCrossrefCitationsByBook:1,numberOfDimensionsCitations:77,numberOfDimensionsCitationsByBook:1,hasAltmetrics:0,numberOfTotalCitations:163,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 22nd 2016",dateEndSecondStepPublish:"November 17th 2016",dateEndThirdStepPublish:"February 9th 2017",dateEndFourthStepPublish:"April 9th 2017",dateEndFifthStepPublish:"June 9th 2017",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"191770",title:"Dr.",name:"Mohamed A.",middleName:null,surname:"El-Esawi",slug:"mohamed-a.-el-esawi",fullName:"Mohamed A. El-Esawi",profilePictureURL:"https://mts.intechopen.com/storage/users/191770/images/system/191770.jpeg",biography:"Dr. Mohamed A. El-Esawi is a visiting research fellow at the University of Cambridge, United Kingdom, and Associate Professor of Molecular Genetics, Botany Department, Faculty of Science, Tanta University, Egypt. Dr. El-Esawi received his BSc and MSc from Tanta University, and his Ph.D. degree in Plant Genetics and Molecular Biology from Dublin Institute of Technology, Technological University Dublin, Ireland. After obtaining his Ph.D., Dr. El-Esawi joined the University of Warwick, United Kingdom; University of Sorbonne, France; and University of Leuven (KU Leuven), Belgium as a visiting research fellow. His research focuses on plant genetics, genomics, molecular biology, molecular physiology, developmental biology, plant-microbe interaction, and bioinformatics. He has authored several international peer-reviewed articles, book chapters, and books, and has participated in more than sixty conferences and workshops worldwide. Dr. El-Esawi is currently involved in several biological science research projects.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"8",totalChapterViews:"0",totalEditedBooks:"9",institution:{name:"Tanta University",institutionURL:null,country:{name:"Egypt"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"328",title:"Food Technology",slug:"agricultural-and-biological-sciences-bromatology-food-technology"}],chapters:[{id:"56091",title:"Introductory Chapter: Hormonal Regulation in Plant Development and Stress Tolerance",doi:"10.5772/intechopen.69806",slug:"introductory-chapter-hormonal-regulation-in-plant-development-and-stress-tolerance",totalDownloads:2363,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:null,signatures:"Mohamed A. El‐Esawi",downloadPdfUrl:"/chapter/pdf-download/56091",previewPdfUrl:"/chapter/pdf-preview/56091",authors:[{id:"191770",title:"Dr.",name:"Mohamed A.",surname:"El-Esawi",slug:"mohamed-a.-el-esawi",fullName:"Mohamed A. El-Esawi"}],corrections:null},{id:"55145",title:"Recent Developments in a Radio-labeling of Brassinosteroids",doi:"10.5772/intechopen.68584",slug:"recent-developments-in-a-radio-labeling-of-brassinosteroids",totalDownloads:1730,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The chapter provides a comprehensive overview on methodologies used for radio-labeling of brassinosteroids as one of the newest class of phytohormones. Discussed labeling strategies are lined up in terms of reached specific activities (SA) of brassinosteroids (BRs) as a key parameter for further utilization of such labeled drugs. The chapter is focused on two key natural radio-isotopes (tritium and carbon-14) used for drug tracing in pharmaceutical research.",signatures:"Aleš Marek",downloadPdfUrl:"/chapter/pdf-download/55145",previewPdfUrl:"/chapter/pdf-preview/55145",authors:[{id:"201705",title:"Dr.",name:"Ales",surname:"Marek",slug:"ales-marek",fullName:"Ales Marek"}],corrections:null},{id:"54932",title:"Salicylic Acid: An All-Rounder in Regulating Abiotic Stress Responses in Plants",doi:"10.5772/intechopen.68213",slug:"salicylic-acid-an-all-rounder-in-regulating-abiotic-stress-responses-in-plants",totalDownloads:2778,totalCrossrefCites:13,totalDimensionsCites:29,hasAltmetrics:0,abstract:"Salicylic acid (SA) is an endogenous growth regulator of phenolic nature and also a signaling molecule, which participates in the regulation of physiological processes in plants such as growth, photosynthesis, and other metabolic processes. Several studies support a major role of SA in modulating the plant response to various abiotic stresses. It is a well-founded fact that SA potentially generates a wide array of metabolic responses in plants and also affects plant-water relations. This molecule also found to be very active in mitigating oxidative stress under adverse environmental conditions. Since abiotic stress remained the greatest constraints for crop production worldwide, finding effective approaches is an important task for plant biologists. Hence, understanding the physiological role of SA would help in developing abiotic stress tolerance in plants. In this chapter, we will shed light on the recent progress on the regulatory role of SA in mitigating abiotic stress.",signatures:"Mirza Hasanuzzaman, Kamrun Nahar, Tasnim Farha Bhuiyan,\nTaufika Islam Anee, Masashi Inafuku, Hirosuke Oku and Masayuki\nFujita",downloadPdfUrl:"/chapter/pdf-download/54932",previewPdfUrl:"/chapter/pdf-preview/54932",authors:[{id:"47687",title:"Prof.",name:"Masayuki",surname:"Fujita",slug:"masayuki-fujita",fullName:"Masayuki Fujita"},{id:"76477",title:"Prof.",name:"Mirza",surname:"Hasanuzzaman",slug:"mirza-hasanuzzaman",fullName:"Mirza Hasanuzzaman"},{id:"166818",title:"MSc.",name:"Kamrun",surname:"Nahar",slug:"kamrun-nahar",fullName:"Kamrun Nahar"},{id:"198602",title:"Dr.",name:"Hirosuke",surname:"Oku",slug:"hirosuke-oku",fullName:"Hirosuke Oku"},{id:"198603",title:"Dr.",name:"Taufika Islam",surname:"Anee",slug:"taufika-islam-anee",fullName:"Taufika Islam Anee"},{id:"198604",title:"Ms.",name:"Tasnim Farha",surname:"Bhuiyan",slug:"tasnim-farha-bhuiyan",fullName:"Tasnim Farha Bhuiyan"},{id:"205411",title:"Dr.",name:"Masashi",surname:"Inafuku",slug:"masashi-inafuku",fullName:"Masashi Inafuku"}],corrections:null},{id:"55903",title:"Seed Dormancy: The Complex Process Regulated by Abscisic Acid, Gibberellins, and Other Phytohormones that Makes Seed Germination Work",doi:"10.5772/intechopen.68735",slug:"seed-dormancy-the-complex-process-regulated-by-abscisic-acid-gibberellins-and-other-phytohormones-th",totalDownloads:2758,totalCrossrefCites:9,totalDimensionsCites:20,hasAltmetrics:0,abstract:"Seed dormancy is one of the most important adaptive mechanisms in plants, which protects seeds from precocious germination in the presence of the inappropriate conditions for growth continuation. Numerous environmental and molecular signals regulate seed dormancy. Maintenance or release of seed dormancy is dependent on light, temperature, and water availability. Precise response of seeds to environmental factors is mediated by different phytohormonal pathways. ABA is considered as a main phytohormone regulating seed dormancy induction and maintenance. ABA‐ and GA‐responsive components, ensure crosstalk between the GA and ABA pathways and enable seed response adequate to the environment. Phytohormonal regulation mechanism of seed dormancy is similar in dicot and monocot plants. Recently, it is suggested that other phytohormones, such as auxin, jasmonates, brassinosteroids, and ethylene, also take part in seed dormancy regulation. Auxin regulators, enhance ABA action and positively influence seed dormancy. However, jasmonates, brassinosteroids, and ethylene reduce seed dormancy level. Here, we describe recent advances in understanding the complex process of seed dormancy regulated by many phytohormonal pathways and their components. Seed dormancy studies can help obtain crop varieties producing seeds with the most desirable timing of germination.",signatures:"Anna Skubacz and Agata Daszkowska‐Golec",downloadPdfUrl:"/chapter/pdf-download/55903",previewPdfUrl:"/chapter/pdf-preview/55903",authors:[{id:"156791",title:"Dr.",name:"Agata",surname:"Daszkowska-Golec",slug:"agata-daszkowska-golec",fullName:"Agata Daszkowska-Golec"},{id:"197990",title:"MSc.",name:"Anna",surname:"Skubacz",slug:"anna-skubacz",fullName:"Anna Skubacz"}],corrections:null},{id:"55005",title:"Strigolactone Signaling in Plants",doi:"10.5772/intechopen.68497",slug:"strigolactone-signaling-in-plants",totalDownloads:1748,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Strigolactones (SLs) are a new group of recently described phytohormones. They were found to be involved in the communication between plant roots and symbiotic bacteria or fungi, but also in the interactions between roots of host plants and germinating seeds of parasitic plants. Over the years, however, it has become clear that SLs play a regulatory role in many aspects of plant growth and development. Extensive studies on plant model species Arabidopsis thaliana L. and Oryza sativa L. have uncovered the molecular mechanisms of SL biosynthesis and signaling. In some aspects, the SL perception and signaling correspond to the already known mechanisms described for other phytohormones, but in other points, they seem to be unique in the plant kingdom. This chapter summarizes the recent discoveries in the signal transduction pathway of SLs and describes the model of SL perception and signaling.",signatures:"Marek Marzec",downloadPdfUrl:"/chapter/pdf-download/55005",previewPdfUrl:"/chapter/pdf-preview/55005",authors:[{id:"198115",title:"Dr.",name:"Marek",surname:"Marzec",slug:"marek-marzec",fullName:"Marek Marzec"}],corrections:null},{id:"56185",title:"Cross Talk between Nitric Oxide and Phytohormones Regulate Plant Development during Abiotic Stresses",doi:"10.5772/intechopen.69812",slug:"cross-talk-between-nitric-oxide-and-phytohormones-regulate-plant-development-during-abiotic-stresses",totalDownloads:2016,totalCrossrefCites:12,totalDimensionsCites:22,hasAltmetrics:0,abstract:"Plants, being sessile, are concurrently exposed to various biotic and abiotic stresses. The perception of stress signals in plants involves a wide spectrum of signal transduction pathways that interact to induce tolerance against adverse environmental conditions. This functional overlapping among various stress signaling cascades also leads to the expression of genes that regulate biosynthesis or action of other hormones. Phytohormonal signals, activated by both developmental and environmental responses, play a crucial role to develop stress tolerance in plants. Nitric oxide (NO) is one of the major players in plant signaling networks. Emerging evidence supports that NO interplays with signaling pathways of auxins, gibberellins, abscisic acid, ethylene, jasmonic acid, brassinosteroids, and other plant hormones to control metabolism, growth, and development in plants. This chapter focuses on the current state of knowledge of cross talk between signaling pathways of NO and phytohormones in plants exposed to various abiotic stresses.",signatures:"Fahim Nawaz, Rana Nauman Shabbir, Muhammad Shahbaz, Sadia\nMajeed, Muhammad Raheel, Waseem Hassan and Muhammad\nAmir Sohail",downloadPdfUrl:"/chapter/pdf-download/56185",previewPdfUrl:"/chapter/pdf-preview/56185",authors:[{id:"198267",title:"Dr.",name:"Fahim",surname:"Nawaz",slug:"fahim-nawaz",fullName:"Fahim Nawaz"},{id:"206899",title:"Dr.",name:"Rana Nauman",surname:"Shabbir",slug:"rana-nauman-shabbir",fullName:"Rana Nauman Shabbir"},{id:"206905",title:"Dr.",name:"Muhammad",surname:"Shahbaz",slug:"muhammad-shahbaz",fullName:"Muhammad Shahbaz"},{id:"206906",title:"Ms.",name:"Sadia",surname:"Majeed",slug:"sadia-majeed",fullName:"Sadia Majeed"},{id:"206907",title:"Dr.",name:"Muhammad",surname:"Raheel",slug:"muhammad-raheel",fullName:"Muhammad Raheel"},{id:"206908",title:"Dr.",name:"Waseem",surname:"Hassan",slug:"waseem-hassan",fullName:"Waseem Hassan"},{id:"206909",title:"Mr.",name:"Muhammad",surname:"Sohail",slug:"muhammad-sohail",fullName:"Muhammad Sohail"}],corrections:null},{id:"55013",title:"Phytohormonal Control over the Grapevine Berry Development",doi:"10.5772/intechopen.68453",slug:"phytohormonal-control-over-the-grapevine-berry-development",totalDownloads:1946,totalCrossrefCites:2,totalDimensionsCites:3,hasAltmetrics:0,abstract:"Grapevine (Vitis vinifera) is one of the most important commercial plants since its berries are used for wine production or consumed as fresh fruit or dry fruit. Many studies have focused on berry development and have pointed out the hormonal regulation on the three phases, from early development to maturity. Grapevine fruit has been classified as non-climacteric based on the low levels of ethylene present around véraison, although recent evidence has suggested a role for this hormone during grape berry ripening. The control of different physiological processes depends on a complex integration between environmental cues and endogenous factors, which is mediated by a phytohormone crosstalk. In this chapter, we will focus on phytohormones, their signaling pathways, and their association to berry development in V. vinifera; in particular, we will refer to auxins, abscisic acid, brassinosteroids, ethylene, gibberellins, and cytokinins.",signatures:"Francisca Parada, Carmen Espinoza and Patricio Arce-Johnson",downloadPdfUrl:"/chapter/pdf-download/55013",previewPdfUrl:"/chapter/pdf-preview/55013",authors:[{id:"181474",title:"Dr.",name:"Patricio",surname:"Arce-Johnson",slug:"patricio-arce-johnson",fullName:"Patricio Arce-Johnson"},{id:"182102",title:"Dr.",name:"Carmen",surname:"Espinoza",slug:"carmen-espinoza",fullName:"Carmen Espinoza"},{id:"198306",title:"Ph.D. Student",name:"Francisca",surname:"Parada",slug:"francisca-parada",fullName:"Francisca Parada"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"6627",title:"Brassica Germplasm",subtitle:"Characterization, Breeding and Utilization",isOpenForSubmission:!1,hash:"f11a68d95e239f899f787ef2ecd31466",slug:"brassica-germplasm-characterization-breeding-and-utilization",bookSignature:"Mohamed Ahmed El-Esawi",coverURL:"https://cdn.intechopen.com/books/images_new/6627.jpg",editedByType:"Edited by",editors:[{id:"191770",title:"Dr.",name:"Mohamed A.",surname:"El-Esawi",slug:"mohamed-a.-el-esawi",fullName:"Mohamed A. 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The management of fractures of the maxillofacial complex remains a challenge for the oral maxillofacial surgeon, demanding both skill and expertise [2]. The success of treatment and implementation of preventive measures are more specifically dependent on epidemiologic assessments [3].Midfacial fractures can occur in isolation or in combination with other serious injuries, including mandibular, ophthalmologic, cranial, spinal, thoracic, and abdominal trauma, as well as upper and lower orthopedic injuries [4].The epidemiology of facial fractures varies in type, severity, and cause depending on the population studied. Differences among populations in the causes of maxillofacial fractures may be the result of differences in risk and cultural factors among countries, but are more likely to be influenced by the severity of injury [1,5]. The causes of maxillofacial fractures have changed over the past three decades, and they continue to do so. The main causes worldwide are traffic accidents, assaults, falls, sport-related injuries, and warfare [6-8]. Many articles pertaining to the incidence and causes of maxillofacial injuries have been published [1,4,7-10]. In 2003, Motamedi [7] reported the distribution of facial fractures as 72.9% mandibular, 13.9% maxillary, 13.5% zygomatic, 24.0% zygomatico-orbital, 2.1% cranial, 2.1% nasal, and 1.6% frontal injuries [Figure 1].
Fracture sites are shown for 237 maxillofacial trauma patients according to Motamedi
Causes of these maxillofacial injuries were automobile (30.8%) and motorcycle (23.2%) accidents, altercations (9.7%), sport (6.3%), and warfare (9.7%) [Figure 2].
The causes of fracture for Motamedi’s assessment of maxillofacial trauma patients
The distribution of maxillary fractures was 54.6% Le Fort II, 24.2% Le Fort I, 12.1% Le Fort III, and 9.1% alveolar [7] [Figure 3].
Distribution of maxillary fractures in Motamedi’s assessment of maxillofacial trauma patients
According to Cook and Rowe [4], midfacial injuries occur most frequently in individuals aged 21–30 years (43%). The 11–20-year and 31–40-year age groups each account for 20% of these fractures. Most (83.1%) midfacial fractures occur in males, with the remainder (16.9%) occurring in females [4] [Figure 4].
Age distribution of midfacial fracture patients according to Cook and Rowe.
Thoren [9] noted that injuries are associated with 25.2% of midfacial fractures. These injuries most commonly affect a limb (13.5%), followed by the brain (11.0%), chest (5.5%), spine (2.7%), and abdomen (0.8%) [9].
The anatomy of the head is complex; the physical properties of the skin, bone, and brain differ markedly and the facial skeletal components articulate and interdigitate in a complex fashion, with the consequence that a given facial bone is rarely fractured without disrupting its neighbor [10]. The severity and pattern of a fracture depend on the magnitude of the causative force, impact duration, the acceleration imparted by impact to the affected part of the body, and the rate of acceleration change. The surface area of the impact site is also relevant [11,12]. The middle third of the facial skeleton is defined as an area bounded superiorly by a line drawn across the skull from the zygomaticofrontal suture, across the frontonasal and frontomaxillary sutures, to the zygomaticofrontal suture on the opposite side; and inferiorly by the occlusal plane of the maxillary teeth, or, in an edentulous patient, by the maxillary alveolar ridge. It extends posteriorly to the frontal bone in the superior region and the body of the sphenoid in the inferior region, and the pterygoid plates of the sphenoid are usually involved in any severe fracture [13].
The middle third of the facial skeleton comprises the following bones [14] [Figure 5]:
Two maxillae
Two zygomatic bones
Two zygomatic processes of the temporal bones
Two palatine bones
Two nasal bones
Two lacrimal bones
The vomer
The ethmoid and attached conchae
Two inferior conchae
The pterygoid plates of the sphenoid
Bones of the middle third of the facial skeleton
The frontal bone and the sphenoid body and greater and lesser wings are not usually fractured. In fact, they are protected to a considerable extent by the cushioning effect achieved as the fracturing force crushes the comparatively weak bones comprising the middle third of the facial skeleton [13].
The initial assessment and management of a patient’s injuries must be completed in an accurate and systematic manner to quickly establish the extent of any damage to vital life-support systems. Patients are assessed and treatment priorities are established based on patients’ injuries and the stability of their vital signs. Injuries can be divided into three general categories: severe, urgent, and non-urgent. Severe injuries are immediately life threatening and interfere with vital physiologic functions; examples are compromised airway, inadequate breathing, hemorrhage, and circulatory system damage or shock. These injuries constitute approximately 5% of patient injuries but represent more than 50% of injuries associated with all trauma deaths. Urgent injuries make up approximately 10–15% of all injuries and present no immediate threat to life. Patients with this type of injury may present with damage to the abdomen, orofacial structures, chest, or extremities that requires surgical intervention or repair, but their vital signs are stable. Non-urgent injuries account for approximately 80% of all injuries and are not immediately life threatening. Patients with this type of trauma eventually require surgical or medical management, although the exact nature of the injury may not become apparent until significant evaluation and observation are performed. The goal of initial emergency care is to provide life-saving and support measures until definitive care can be initiated. Any trauma victim with altered consciousness must be considered to have a brain injury. The level of consciousness is assessed by serial Glasgow Coma Scale evaluations [15] [Table 1].
\n\n | \n\n \n\n | \n\n
Eye Opening Spontaneous To speech To pain None Motor Response Obeys Localises pain Withdraws from pain Flexion to pain Extension to pain None Verbal Response Oriented Confused Inappropriate Incomprehensible None | \n\n 4 3 2 1 \n\n\t\t\t\t 6 5 4 3 2 1 \n\n\t\t\t\t 5 4 3 2 1 | \n\n
Glasgow Coma Scale.
Adapted from Teasdale and Jennett [15]. A patient’s score determines the category of neurologic impairment: 15 = normal, 13 or 14 = mild injury, 9–12 = moderate injury, and 3–8 = severe injury.
Other signs of brain damage include restlessness, convulsions, and cranial nerve dysfunction (
During the primary survey, life-threatening conditions are identified and reversed quickly. This period calls for quick and efficient evaluation of the patient’s injuries and almost simultaneous life-saving intervention. The primary survey progresses in a logical manner based on the ABC pneumonic: airway maintenance with cervical spine control, breathing and adequate ventilation, and circulation with control of hemorrhage. The letters D and E have also been added: a brief neurologic examination to establish the degree of consciousness, and exposure of the patient
The physical examination should begin with an evaluation of soft-tissue injuries. Lacerations should be debrided and examined for disruption of vital structures, such as the facial nerve or parotid duct. The eyelids should be elevated to allow evaluation of the eyes for neurologic and ocular damage. The face should be symmetric, without discolouration or swelling suggestive of bony or soft-tissue injury. The bony landmarks should be palpated, beginning with the supraorbital and lateral orbital rims and followed by the infraorbital rims, malar eminences, zygomatic arches, and nasal bones. Any steps or irregularities along the bony margin are suggestive of a fracture. Numbness over the area of distribution of the trigeminal nerve is usually noted with fractures of the facial skeleton. The oral cavity should be inspected and evaluated for lost teeth, lacerations, and occlusal alterations. Any tooth lost at the time of injury must be accounted for because it may have been aspirated or swallowed. The neck should also be examined for injury. Subcutaneous air may be visualised if massive injury is present; if subtle, it may be detected only by palpation. The presence of air in the soft tissue may be the result of tracheal damage. Any externally expanding edema or hematoma of the neck must be observed closely for continued expansion and airway compromise. Carotid pulses should be assessed. Palpation should be performed to detect abnormalities in the contour of the thyroid cartilage and to confirm the midline position of the trachea in the suprasternal notch.
Patients with midfacial trauma often pose the greatest airway challenges to the anaesthesiologist. Preoperative airway evaluation must be detailed and thorough. Particular attention should be focused on jaw opening, mask fit, neck mobility, maxillary protrusion, macroglossia, dental pathology, nasal patency, and the existence of any intraoral lesion or debris. If any forewarning sign of problems with mask ventilation or endotracheal intubation is observed, the airway should be secured prior to anaesthesia induction. This process may involve fibre-optic nasal or oral intubation or tracheostomy. Nasal intubation with a preformed or straight tube with a flexible angle connector is usually preferred in dental or oral surgery. The endotracheal tube can then be directed cephalically and connected to breathing tubes passing over the patient’s head.
Reconstructive surgery can be associated with substantial blood loss. Strategies to minimise bleeding include a slight head-up position, controlled hypotension, and local infiltration with epinephrine solutions. Because the patient’s arms are typically tucked along the sides of the body, at least two intravenous lines should be established prior to surgery. This step is especially important if one line is used for the delivery of an anaesthetic or hypotensive agent. An arterial line can be helpful in cases of marked blood loss, as a surgeon leaning against the patient’s arm may interfere with non-invasive blood pressure cuff readings. An oropharyngeal pack is often placed to minimize the amount of blood and other debris reaching the larynx and trachea. Due to the proximity of the airway to the surgical field, the anaesthesiologist’s location is more remote than usual. This situation increases the likelihood of serious intraoperative airway problems, such as endotracheal tube kinking, disconnection, or perforation by a surgical instrument. Airway monitoring of end-tidal CO2, peak inspiratory pressures, and esophageal stethoscope breath sounds assumes increased importance in such cases. At the end of the surgery, the oropharyngeal pack must be removed and the pharynx suctioned. Although the presence of some bloody debris during initial suctioning is not unusual, repeated efforts should be less productive. If there is a chance of postoperative edema involving structures that could potentially obstruct the airway (e.g. the tongue), the patient should be left intubated. Otherwise, extubation can be attempted once the patient is fully awake and shows no sign of continued bleeding. Appropriate cutting tools should be placed at the bedside of a patient with intermaxillary fixation (
Fracture of the alveolar process is a common injury, comprising 2–8% of all craniofacial injuries. Nearby soft tissues and teeth are often damaged, increasing the severity of the situation [16]. The most common causes of such fractures are falls, motor vehicle accidents, sporting injuries, altercations, child abuse, and playground accidents. Direct or indirect force on a tooth, the latter transmitted most commonly through overlying soft tissues, may cause dentoalveolar injury [17].
The practitioner should first ask when, where, and how the injury occurred and whether any treatment has been provided since that time. Answers to these simple questions could provide important clues. The patient’s general health status should be known and his or her current situation examined when any nausea, vomiting, unconsciousness, amnesia, headache, or visual disturbance has occurred after injury. The examination of a patient’s dentoalveolar injuries should assess the condition of the extraoral and intraoral soft tissues, jaws, and alveolar bone; establish the presence of any tooth displacement or mobility; and include tooth percussion and pulp testing [18]. Lacerations, abrasions, and contusions are very common in dentoalveolar injuries. Any vital structure crossing the line of laceration should be noted. The removal of blood clots, saline irrigation, and cleaning of the oral cavity facilitate inspection. Any foreign body within surrounding tissues should be examined carefully because bone or tooth fragments might have penetrated these areas, depending on the mechanism of injury. All fractured or missing teeth and restorations should be assumed to have been swallowed, aspirated, or lodged in adjacent structures. Alveolar segment fractures can be detected readily by visual examination and palpation. However, examination may be difficult because of post-injury pain. Sublingual ecchymosis on the mouth floor is pathognomonic for an underlying mandibular fracture. Step defects, crepitation, malocclusion, and gingival lacerations should raise the suspicion of possible underlying bony defects. The presence of fractured teeth should be noted. The depth of the fracture is very important. Complete mobility of the crown may indicate crown–root fracture. Post-injury occlusion should be checked and any displacement, intrusion, or luxation should be examined carefully. Percussion tests to determine sensitivity and pulp vitality should be performed to rule out periodontal ligament injury and many types of tooth fracture.
Radiographic studies should be performed before intraoral manipulation. Radiography should determine the presence of root or jaw fracture, degree of extrusion or intrusion and its relationship to possible existing tooth germs, extent of root development, and presence of tooth fragments and foreign bodies lodged in soft tissues. The combination of periapical, occlusal, and panoramic radiographs is used most frequently for the detection of damage to underlying tissues. Periapical radiographs provide the most detailed information about root fractures and tooth dislocation. Occlusal radiographs, however, provide larger fields of view and nearly the same level of detail as periapical radiographs; they are also very useful for the detection of foreign bodies. Panoramic radiographs provide useful screening views and visualize fractures of the mandible, maxilla, alveolar ridges, and teeth. Computed tomography (CT) offers insufficient resolution for the diagnosis of dental trauma, but cone-beam CT technology provides sufficient resolution to serve as a valuable tool in the diagnosis of various dental injuries [17,19,20].
The most commonly used simple and comprehensive classification of dentoalveolar injuries was developed by Andreasen [21] [Figure 6].
Diagram of Andreasen’s classification
Dental tissues and pulp
Simple crown infraction (crack in the tooth without loss of tooth substance)
Uncomplicated crown fracture (confined to enamel, or enamel and dentine, with no root exposure)
Complicated crown fracture (pulp exposure)
Uncomplicated crown–root fracture (involving the enamel, dentine, and cementum without pulp exposure)
Complicated crown–root fracture (involving the enamel, dentine, and cementum with pulp exposure)
Root fracture (involving the dentine and cementum with pulp exposure)
Injuries to periodontal tissues
Concussion: injury to the periodontium producing sensitivity to percussion without tooth loosening or displacement
Subluxation: the tooth is loosened but not displaced
Extrusive luxation, lateral luxation, intrusive luxation
Avulsion: tooth displacement without accompanying comminution or fracture of the alveolar socket
Injuries to the supporting bone
Comminution of the alveolar housing, often with intrusive or lateral luxation
Fracture of a single wall of an alveolus
Fracture of the alveolar process
Fracture involving the main body of the mandible or maxilla
The aim of dentoalveolar fracture treatment is to re-establish the normal form and function of the masticatory system. The involvement of pulp tissue makes a great difference in the treatment protocol.
Simple crown infractions do not require treatment. Multiple cracks can be sealed with restorative materials to prevent staining. For uncomplicated crown fractures affecting only the enamel, grinding of the sharp edges is one possible solution. In cases of extensive enamel loss, a composite restoration may be used for recontouring. If a considerable amount of dentine is exposed, it should be covered with glass ionomer as an emergency treatment, and permanent composite restoration with bonding agents can be performed immediately or at a later stage. If the missing fragment is found, bonding to the tooth can be attempted with dentine bonding agents. Periodic follow-up visits should be scheduled to monitor pulp vitality. The management of complicated crown fractures is more challenging. If the exposed pulp tissue is vital, pulp capping or pulpotomy should be performed in cases without extensive crown loss. In cases of severe loss of crown substance or a lengthy interval between injury and treatment, pulp extirpation should be performed
Concussed teeth present only tenderness to percussion in the horizontal and vertical directions. Removing the tooth from occlusion is the only accepted treatment option in such cases. Subluxated teeth show no clinical or radiographic displacement, but damage to the periodontal ligament tissue is present. Periodontal tissue rupture can cause bleeding from the gingival margin crevice. Treatment in these cases is the same as described for concussion, and follow-up monitoring of pulp vitality is necessary. Extrusive luxation is characterized by neurovascular and periodontal ligament rupture with mobility and bleeding from the gingival margin. Pulp necrosis and external root resorption may be seen in later stages. The tooth should be positioned properly and splinted to uninjured adjacent teeth with an acid-etch/resin splint for 3 weeks. Other methods of splinting used routinely in oral and maxillofacial surgery are not recommended. If pulp necrosis occurs, endodontic therapy should be performed. Lateral extrusions often involve the alveolar bone, and may be characterized by complex gingival lacerations and step deformities. The goal of treatment is to properly reposition the alveolar bone and tooth, which can be accomplished with the application of an acid-etch/resin splint for 4–8 weeks. Intrusive luxation is characterized by obvious tooth displacement and comminution and fracture of the alveolus. The risks of pulpal necrosis and inflammatory root resorption are higher in such cases than in other dentoalveolar injuries. Affected teeth with complete root development and closed apices should be repositioned and stabilized with a non-rigid splint. Endodontic therapy within 10–14 days after injury, including canal filling with Ca(OH)2, is recommended to retard or inhibit the inflammatory or replacement resorption process. Intrusion of an incompletely developed tooth is discussed in the ‘Midfacial Fractures in Children’ section below. The fate of an avulsed tooth depends on the cellular viability of the periodontal fibres that remain attached to the root surface prior to reimplantation. Important factors determining the success of treatment measures are the length of time that the tooth has been out of the socket, the state of the tooth and periodontal tissues, and the manner in which the tooth has been preserved before replantation. Avulsed teeth should be stored temporarily in milk, saliva, saline, or Hank’s solution. More than 15 min of extraoral exposure of a periodontal ligament will deplete most cell metabolites in the dental tissue. Teeth in poor hygienic condition and those with moderate to severe periodontal disease, gross caries involving the pulp, apical abscess, infection at the replanting site, and bony defects and/or alveolar injuries involving the loss of supporting bone are generally not replanted. For individuals with avulsed teeth with mature or closed apices who present within 2 h after injury, the tooth is placed in Hank’s solution for about 30 min, then in doxycycline (1 mg/20 mL saline) to inhibit bacterial growth and aid pulpal revascularization; replantation and splinting with an acid-etch/resin splint for 7–10 days are then performed. Endodontic cleansing and shaping of the canal should be performed, and Ca(OH)2 filling should be applied immediately prior to splint removal. The use of final gutta-percha obturation 6–12 months later is contingent on the resolution of canal and/or root pathology. To optimise the success of treatment, avulsed teeth should be replanted and stabilized within 2 h, before periodontal ligament cells become irreversibly necrotic. Teeth with apical openings >1 mm in diameter have a much better prognosis than do those with more mature or closed apices; however, when the extraoral period exceeds 2 h, apical root morphology has little effect on the treatment success rate.
Most alveolar fractures occur in the premolar and incisor regions. The treatment of these fractures involves proper reduction and rapid stabilization. Manipulation by pressure and rigid stabilization of the fragments are accepted closed-reduction techniques. Major displacement or difficulty with closed reduction may necessitate open reduction. Alignment of the involved teeth, edema of the segments, restoration of proper occlusion, and edema of the teeth in the fractured segment are important. The removal of teeth with no bony support may be considered, but should not be performed before the fractured bony segments have healed, even if the teeth are considered to be unsalvageable. Segment edema can be performed with acrylic or metal cap splints, orthodontic bands, fibreglass splints, transosseous wires, small or mini cortical plates, or transgingival lag screws; these materials should be applied for at least 4 weeks.
Pulp canal obliteration is characterized by the deposition of hard tissue within the root canal space and dark-yellow discolouration of the clinical crown. This complication is seen most frequently after tooth luxation or horizontal root fracture. A tooth with pulpal canal obliteration does not require treatment unless the pulp tissue becomes necrotic and develops periradicular radiolucency. Pulp necrosis is the most likely complication of dentoalveolar injury. Its incidence depends on the type and severity of injury and the extent of root development; teeth with fully formed roots are affected more often. If pulp necrosis is detected, root canal therapy should be initiated immediately to prevent inflammatory root resorption. Internal root resorption can be an issue after most dentoalveolar injuries. This process is usually detected radiographically; if it is identified at an early stage, root canal therapy has an excellent prognosis. The risk of tooth fracture after endodontic therapy is increased in cases of large defects. Follow-up radiography is useful for the detection of internal root resorption. If necrotic pulp is not removed, inflammation of the root surface may occur and the tooth root will be resorbed. Inflammatory root resorption can be detected radiographically and treated by Ca(OH)2 dressing after canal debridement. Ankylosis can occur following damage to large areas of the periodontal membrane, as a primary result of trauma, or as a result of inflammatory root resorption. Osseous replacement proceeds slowly in adults; the tooth may serve for several years, but will loosen eventually.
Rene Le Fort famously characterized the types of midfacial fracture caused by anteriorly directed forces [22-24] [Figure7-9]. Most Le Fort fractures are caused by motor vehicle accidents, and this type of trauma is often associated with other facial fractures and orthopaedic and neurologic injuries.
In Le Fort I fractures, a horizontal fracture line separates the inferior portion of the maxilla, the horizontal plates of the palatal bones, and the inferior one-third of the sphenoid pterygoid processes from the superior two-thirds of the face, which remain associated with the skull. The entire maxillary dental arch may be mobile or wedged in a pathologic position. The patient may have an anterior open bite. Step deformities can be palpated intraorally if edema allows. Hematomas in the upper vestibule (Guerin’s sign) and epistaxis may occur. Le Fort I fractures can be detected readily by orthopantomography, and CT provides a superior level of detail. [Figure 7].
Le Fort I Fracture (Figure adapted from www.radiologytutorials.com)
In Le Fort II fractures, the pyramidal mid-face is separated from the rest of the facial skeleton and skull base. The fracture begins inferior to the nasofrontal suture and extends across the nasal bones and along the maxilla to the zygomaticomaxillary suture, including the inferomedial third of the orbit. The fracture then continues along the zygomaticomaxillary suture to and through the pterygoid plates. [Figure 8].
Le Fort II Fracture (Figure adapted from www.radiologytutorials.com)
In Le Fort III fractures, the face is essentially separated along the base of the skull due to force directed at the level of the orbit. The fracture line runs from the nasofrontal region along the medial orbit, through the superior and inferior orbital fissures, and then along the lateral orbital wall through the frontozygomatic suture. It then extends through the zygomaticotemporal suture and inferiorly through the sphenoid and the pterygomaxillary suture. In the past, Water’s and lateral views were used to identify Le Fort fractures. CT and three-dimensional CT are now used most frequently, and axial and coronal scans are most useful for identifying midfacial fractures. Pterygoid plate fractures are found in all types of Le Fort fracture. Le Fort I fractures can be seen through the lateral aspect of the piriform aperture. Fractures of the infraorbital rim and zygomaticomaxillary buttress are unique to Le Fort II fractures. Only Le Fort III fractures involve the lateral orbital wall and zygomatic arch, and cerebrospinal fluid leakage can be a matter of concern. [Figure 9].
Le Fort III Fracture (Figure adapted from www.radiologytutorials.com)
The basic principle employed in the treatment of Le Fort fractures is fixation of the maxilla to the next highest stable structure, which differs with Le Fort fracture level. At the Le Fort I level, fixation is performed along the vertical buttresses of the maxilla at the piriform and zygomatic buttress. At higher Le Fort levels, fixation to the nasal bones, orbital rims, or zygomaticofrontal sutures may be necessary. The restoration of proper occlusion is a main goal of treatment. Reconstruction and fixation of the paranasal and zygomaticoalveolar buttresses are often sufficient to re-establish the proper position of the maxilla in Le Fort I fractures. Fractures with minimal or no displacement can heal spontaneously. Bleeding from the nasal wall or septal cracks is common and can be managed by various types of nasal packing. Tamponades can be used at other bleeding sites, such as those with lacerations or abrasions. Intermaxillary fixation with arch bars should be performed after reduction of the maxilla, followed by internal fixation of the maxillary vertical buttresses with plates and screws. Le Fort I fractures can generally be approached
Rowe disimpaction forceps
Hayton Williams forceps
Incomplete fractures may make maxillary mobilisation difficult; in such cases, completion of the fracture with osteotomies can facilitate reduction. In cases of severe comminution, inadequate dentition, periodontal disease, or edentulous arches (Gunning splints), fabricated occlusal or palatal splints can be applied to establish intermaxillary fixation.
Le Fort II fractures can be reduced with Rowe impaction forceps and intermaxillary fixation. A maxillary buccal vestibule incision and any of various approaches to the orbital rim can be used if open reduction is necessary. Bilateral Lynch incisions are to expose the nasofrontal suture [Figure 12].
Lynch incision line
Le Fort III fractures rarely occur in isolation and are usually components of panfacial fractures. Bicoronal incisions can be used to expose the naso-orbito-ethmoidal region, frontozygomatic sutures, and lateral orbital rims. Pre-auricular, lower lid, and maxillary vestibular incisions can be performed when necessary.
Patients who have undergone intermaxillary fixation may experience breathing problems, which can be resolved by opening the nasopharyngeal airways. Hemorrhage of the posterior superior alveolar artery should be suspected when perfuse bleeding occurs following any fracture of the posterior alveolar wall. Rapid decreases in blood pressure, hemoglobin, and hematocrit are other signs of fatal hemorrhage. If the artery cannot be ligated, embolization is indicated after the identification of the bleeding source
Zygomatic bone fracture is the second most common midfacial injury, following nasal fracture. A zygomatic complex fracture is characterized by separation of the zygoma from its four articulations (frontal, sphenoidal, temporal, and maxillary). An independent fracture of the zygomatic arch is termed an isolated zygomatic arch fracture [Figure 13,14].
Zygomatic complex fracture
Isolated Zygomatic Arch fracture
The face is inspected and palpated to identify asymmetry caused by displaced fragments of the facial skeleton. Pain, ecchymosis, and periorbital edema with subconjunctival hemorrhage are the earliest clinical signs of a non-displaced zygomatic bone injury. Displaced fractures generally cause depression of the malar eminence and infraorbital rim. Damage to the zygomaticotemporal and infraorbital nerves may cause paraesthesia or anaesthesia in the cheek, lateral nose, upper lip, and maxillary anterior teeth. Epistaxis and diplopia are common in zygomatic bone fractures. Limitation of motion in the extraocular muscles and enophthalmos or exophthalmos should be noted, as they can be signs of fracture of the orbital floor or medial or lateral orbital walls. In such cases, ophthalmologic consultation should be considered before surgical intervention. An isolated zygomatic arch fracture typically has an M-shaped pattern, with two fragments collapsed medially and often impinging on the masseter muscle or even the muscular process of the mandible. Medial displacement of the zygomatic arch may cause mandibular trismus as a result of masseter muscle spasm or mechanical impingement of the coronoid process against the displaced segments. Direct lateral force causes an isolated zygomatic arch fracture or an inferomedially displaced zygomatic complex fracture; frontal force usually produces an inferoposteriorly displaced fragment. Extraoral step deformities of the zygomatic arch and inferior and superolateral orbital margins, as well as intraoral step deformities of the zygomaticomaxillary buttress, may be palpable if the region is free of edema. Axial and coronal CT images inhibit visualisation of the buttress of the midfacial skeleton. Three-dimensional images may be used to obtain additional information about the relationships of displaced and rotated fractured segments to surrounding bony structures. Plain radiography employing Waters’ and Caldwell’s views can also be used to detect zygomatic complex fractures. The submentovertex view is very helpful for the evaluation of the zygomatic arch and malar projection.
The management of zygomatic bone fractures depends on the degree of displacement and the resultant aesthetic and functional deficits. Surgery can be delayed until the majority of facial edema is gone. Isolated zygomatic arch and zygomatic complex fractures with minimal or no displacement are not managed surgically. A soft diet restriction can help to avoid secondary fracture displacement. When displacement and minimal comminution are present, the Gillies technique is the standard reduction treatment for isolated zygomatic arch fractures [Figure 15]. In the Gillies approach, a 2-cm-long temporal incision is made behind the hairline, and the subcutaneous and superficial temporal fascia are dissected to the level of the temporalis muscle to reach the underlying temporal surface of the zygomatic bone; a zygomatic elevator is then used to reduce the arch fracture [25]. The use of a J-shaped hook elevator through a periauricular incision made anterior to the articular eminence and inferior to the zygomatic arch is an alternative approach for reducing zygomatic arch fractures. This approach is faster than the Gillies approach, but it can easily cause damage to the frontal branches of the facial nerve. Fixation of zygomatic arch fractures can be performed by packing the temporal fossa or using transcutaneous circumzygomatic arch wires while providing support with metal or aluminium finger splints. Open reduction is rarely performed in highly comminuted zygomatic arch fractures because it requires a time-consuming coronal incision.
Gillies approach to zygomatic arch (Figure adapted from www.aofoundation.org)
Displaced zygomatic complex fractures require open reduction and internal fixation. Miniplates and microplates provide the best results with minimal complications. A useful option for displaced zygomatic fractures is the application of a transcutaneous Carroll–Girard screw in the malar region [Figure 16].
Useof Carroll-Girard screw (Figure adapted from www.aofoundation.org)
This technique enables excellent manipulation of the fractured segment for reduction. Reduction of the frontozygomatic suture, zygomaticomaxillary buttress, and inferior orbital rim should be the main goal of the treatment protocol. The perfect reduction of these three points of reference allows proper positioning of the fractured segment. The location and number of fixation sites depend on the fracture pattern, location, direction of displacement, and degree of instability. In more severe fractures, perfect reduction can be achieved with the use of the zygomatic arch as a fourth reference point. The zygomaticomaxillary buttress should be reduced first
Lateral eyebrow incision line
Transconjuctival incision line
Subciliary incision line
In complex and highly comminuted fractures, the zygomatic arch should be reconstructed first; a coronal flap is usually used to gain access to this structure.
Restoration of the natural contour of the zygoma is the key to restoring facial projection in patients with displaced and comminuted fractures. Inadequate flattening the zygomatic arch and failure to achieve optimal rotation of the zygomaticomaxillary complex result in malar eminence flattening, asymmetry, and widening of the face. Inadequate reduction or edema of segments may cause malunion.
Poor or excessive reconstruction of the orbital rim should be avoided because an increase in orbital volume can cause enophthalmos and a decrease can cause exophthalmos. Diplopia can be caused by edema, hematoma, injury to cranial nerves 3, 4, or 6, and damage to extraocular muscles, and may heal spontaneously except in the latter case.
Although damage to the zygomaticomaxillary and zygomaticofacial nerves is less common, zygomaticomaxillary complex fractures often cause damage to the infraorbital foramen. Anaesthesia of the lower eyelid and malar and upper lip areas is common in infraorbital nerve injuries. Proper reduction of the fractured segments usually minimizes the risk of permanent symptoms. Blindness immediately after surgery may indicate impingement of the orbital apex contents by a bony fragment. Retrobulbar hematomas rarely develop, but compression of the central retinal artery causing disruption of the retinal circulation may lead to irreversible ischaemia of the optic nerve and permanent blindness.
Patients with zygomatic fractures may suffer from trismus, which may be caused by impingement of the zygomatic bone on the coronoid process of the mandible or ankylosis of the coronoid process to the zygomatic arch. If a previous zygomatic bone or arch fracture has been reduced improperly, the zygomatic bone should be repositioned
Isolated orbital fracture is not a common type of midfacial fracture, but the incidence of midfacial fractures involving the orbit is high because all Le Fort II and III fractures and those of the naso-orbito-ethmoidal and zygomaticomaxillary complexes involve orbital injury. Orbital fractures may affect the internal and/or external orbital frame. Thus, fractures of the orbital region can be discussed in the context of zygomaticomaxillary complex, naso-orbito-ethmoidal complex, and isolated orbital fractures.
As discussed above, zygomaticomaxillary complex fracture is the most common fracture type with orbital involvement. Like naso-orbito-ethmoidal fractures (discussed below), zygomaticomaxillary complex fractures are caused by blunt force applied directly to the bone. Isolated fractures of the orbit often occur as a result of direct force to the globe of the eye. A sudden increase in intraorbital pressure creates an outward force that causes fracture of the weakest bony structures in internal orbital walls. Isolated orbital fractures can be classified as ‘blow-out’ or ‘blow-in’. Most blow-out fractures affect the anteroinferomedial aspect of the orbital cavity and displace the orbital globe posteromedially and inferiorly. A significant increase in the volume of the orbital cavity results in enophthalmos of the globe. Herniation of the orbital roof and globe to the maxillary sinus occurs in such fractures. When an isolated fracture is caused by low-energy force, linear fracture of the orbit may be detected. Linear fractures retain periosteal attachments and do not cause orbital globe herniation to the maxillary sinus or complete perforation of the maxillary sinus roof. More severe trauma causes a complex fracture involving two or more orbital walls. In complex internal orbital fractures, the globe is often displaced posteriorly and the optic canal may be involved. Blow-in fractures affect the orbital roof and may be diagnosed after severe injury of the anterior skull base. Rupture of the orbital roof reduces the orbital volume and often causes anteroinferior globe displacement.
The affected region should be inspected carefully to identify the presence of edema, chemosis, ecchymosis, lacerations, ptosis, asymmetric lid drape, canalicular injury, and/or canthal tendon disruption. Any step deformity or mobility around the orbital rim should be palpated before edema develops in surrounding tissues. Neurosensation of the infraorbital and supraorbital nerves should be tested. Ophthalmologic consultation is very important and necessary. Limitation of ocular movements can be caused by mechanical entrapment or neurologic injury. Three-dimensional CT and magnetic resonance imaging are preferred for the evaluation of orbital fractures. Waters’ projection is the most useful plain radiographic modality because it enables visualisation of the orbital floor and roof. Ophthalmic ultrasonography and color Doppler imaging can provide additional information.
Subciliary and transconjunctival incisions are the most aesthetically acceptable approaches to the orbital floor. Linear injuries of the orbital floor require no intervention unless they show signs of soft-tissue entrapment in fractured but self-reduced sites. In patients with blow-out or blow-in fractures, soft- and hard-tissue reduction and reconstruction are necessary. Grafting of the injured site with autografts, allografts, or alloplastic materials may be necessary to achieve proper anatomic reduction and stability and to prevent soft-tissue contraction. The iliac crest and nasal septal cartilage are the best donor sites for autografts, and the use of alloplastic titanium mesh can be successful in cases requiring extra support.
Most internal orbital fractures cause volumetric contraction or expansion of the orbital cavity, which may lead to diplopia, enophthalmos, exophthalmos, proptosis, and/or extraocular muscle imbalance. Extraocular muscle imbalance and diplopia can be the result of extraocular muscle entrapment or neuropathy of the 3rd to 5th cranial nerves. An increase in orbital volume causes enophthalmos, which may occur weeks or months after injury.
For some challenging fractures of the orbital floor, the transconjunctival approach may be safer than other methods. The placement of a transconjunctival incision at the conjunctival fornix appears to minimize the risk of eyelid malposition. A transantral endoscopic approach is an alternative method that avoids potential damage caused by lower-lid incisions.
Naso-orbito-ethmoidal facture can occur either in isolation or in association with other midfacial fractures. Most associated injuries affect the cervical spine and ocular and intracranial regions. This fracture type is caused by focused high-energy transfer to the intercanthal area. Because the naso-orbito-ethmoidal area contains several types of tissue (bone, cartilage, tendons, ocular tissue) restoration is challenging.
Naso-orbito-ethmoidal fractures are characterized by three major post-injury symptoms: increased intercanthal distance, diminished nasal projection, and impaired nasofrontal and lacrimal drainage.
Markowitz
Type I: the medial canthal tendon is attached to a single, large central fragment
Type II: the medial canthal tendon is attached to a comminuted but manageable central fragment; the canthal tendon remains attached to a fragment that is sufficiently large to allow osteosynthesis
Type III: the medial canthal tendon is attached to a comminuted and unmanageable central fragment; the fragments are either too small to allow osteosynthesis or completely detached.
Classification of Nasoorbitoethmoidal fractures
Periorbital ecchymosis, subconjunctival hemorrhage, and pain are the most common signs and symptoms of naso-orbito-ethmoidal fractures. Other signs and symptoms include skin and mucosal lacerations, epistaxis, nasal obstruction, edema, telecanthus, and increased canthal angles. Depression of the bony segment causes internal and external nasal cosmetic deformities. Edema may obscure such depression for up to 5 days, and most surgeons recommend the postponement of surgery until the edema has resolved. The impaction of bony segments to the orbit may cause exophthalmos, proptosis, or ptosis. Fractures of cribriform plate and posterior wall of the frontal sinus may cause cerebrospinal fluid leakage. Nasal bone mobility, traumatic telecanthus, crepitus, and depressibility of the area are the clinical digital-examination findings for naso-orbito-ethmoidal fractures.
Increased intercanthal distance, termed telecanthus, is a key deformity resulting from naso-orbito-ethmoidal injury. Normal intercanthal distances are 29–36 mm in males and 29–34 mm in females; a distance exceeding 40 mm is classified as telecanthus and may indicate that surgical treatment is required.The medial canthal tendon is a very important anatomic factor in naso-orbito-ethmoidal injuries resulting in telecanthus. The pretarsal portions of the orbicularis oculi muscle in the upper and lower lids unite at the canthus to form the medial canthal tendon. The superficial portion of this tendon provides support to the eyelids and maintains the integrity of the palpebral fissure. Restoration of this component after canthal detachment is critical for maintaining proper eyelid appearance. The deeper portion, also called Horner’s muscle, attaches to the posterior lacrimal crest and assists in the movement of fluid through the lacrimal system. Disruption of the medial canthal tendon causes contraction of the orbicularis oculi muscle, increasing the intercanthal distance and laterally displacing the rounded contour of the medial palpebral fissure. The ‘bowstring test’ is a useful method of assessing the status of the medial canthal tendon’s attachment to the bone. This test involves lateral pulling of the lid while palpating the tendon area to detect movement of fracture segments [27] [Figure 21].
Bowstring test
Two- and three-dimensional CT using axial and coronal views are the most valuable imaging methods for the diagnosis of naso-orbito-ethmoidal fractures. The use of conventional imaging techniques is not recommended because these modalities do not provide adequate information.
The goals of naso-orbito-ethmoidal fracture treatment are the resolution of the three major issues described above: Establishment of proper nasal projection, narrowing of the intercanthal distance, and establishment of the nasofrontal and lacrimal fluid route. The surgeon should seek to achieve satisfactory results in a single surgery because corrective secondary surgery may cause scarring and fibrosis. For this reason, most authors have advocated the postponement of surgery for 3–7 days to allow for the recession of edema. For naso-orbito-ethmoidal fractures involving a single fragment (type I), treatment can be attempted with closed reduction and the provision of intranasal packing support. If the fragment cannot be reduced satisfactorily by closed reduction, the operation should be converted immediately to an open reduction to avoid the need for secondary surgery. In most cases, a transoral approach is sufficient to reach the injured area without an additional incision.
Proper restoration of types II and III naso-orbito-ethmoidal fractures usually require wide access, which can be provided only by a coronal flap. Wide exposure of the nasal bones and medial orbital walls can be achieved readily. When necessary, a transoral approach can be used to access the paranasal areas and a transconjunctival approach can be used to expose the inferior orbital rim or inferomedial wall. Existing lacerations can also be used to access the injured area. Transcutaneous approaches are not considered to be acceptable because they cause facial scarring.
In severe naso-orbito-ethmoidal injuries, nasal dorsal strut grafting is often required to re-establish support for the entire nose. This graft is cantilevered from the stable frontal bone and placed in the subcutaneous plane, extending inferiorly to the nasal tip.
When the medial canthal tendon is detached completely or attached to an unusable bone fragment, its proper position must be secured immediately using medial canthopexy. The medial canthal tendon should be reduced into a position slightly posterosuperior to the posterior lacrimal crest. The tendon is then sutured with a wire passing transnasally to a cantilevered miniplate on the opposing (undamaged) side. The canthopexy should be positioned sufficiently deep in the orbit to achieve the proper shape of the palpebral fissure and lower lid, as the superficial portion of the medial canthal tendon secures the position of the lower lid and contour of the palpebral fissure. Proper positioning of the medial canthal tendon will achieve correct lacrimal fluid drainage, which is aided by the deep portion of the tendon. When nasofrontal obstruction is a concern, endoscopic frontal sinus surgery can be indicated to re-establish nasofrontal drainage. The medial canthal tendon should be slightly over-reduced in canthopexy procedures to compensate for remodelling of related tissues.
Cosmetic deformities are foreseeable after nasal and naso-orbito-ethmoidal injuries. Postoperative septal hematoma, septal abscess, and/or destructive fracture of the septal cartilage/bone are the postoperative causes of nasal deformity. Massive comminution of the naso-orbito-ethmoidal complex is classically associated with saddle nose deformity. Bone grafting is required in most patients to establish proper nasal projection, symmetry, and contour. However, even bone grafts can be associated with potential resorption problems in the long term. Depending on the fracture level, cartilage or bone grafts and nasal implants can be used to improve the appearance of these deformities.
Septal deviation due to inadequate closed reduction often results in external nasal asymmetry. Direct septal visualisation
After naso-orbito-ethmoidal injury, scar contracture results in cosmetic and functional deformities. Thus, secondary surgery should be avoided because it may result in scarring.
Open reduction and internal fixation procedures often damage the medial canthal tendon or nasolacrimal apparatus. As a result, epiphora related to nasolacrimal duct obstruction can be an issue. Intubation or stenting of the lacrimal duct may be necessary in such cases.
Midfacial fractures are not common in children; they account for only 1–8% of pediatric fractures [28-31] and usually affect the mandible. This low incidence is related to the protection provided by the mandible and cranium, which absorb most of the traumatic impact, and to the elastic nature of midfacial bones and flexibility of osseous suture lines [32]. Children form a distinct patient group in maxillofacial surgery due to significant differences between the facial skeletons of children and adults. Depending on the patient’s age, these differences include small bone size, small paranasal sinus volume, growth potential, the presence of tooth germs in alveoli during primary and mixed dentition stages, a more rapid healing process compared with adults, and difficulty with cooperation resulting in the need for general anaesthesia in more cases than in adults [33]. The proportion of children in whom midfacial fractures are identified has increased over time, probably due to the increased use of adequate imaging modalities [34]. CT has largely supplanted standard radiography as the preferred imaging method for pediatric facial trauma.
The presence of tooth germs in alveoli potentially creates zones of weakness in the jaws and limits the placement of certain plate and screw types, given the need to avoid damage to the developing dentition. The treatment of pediatric patients with midfacial fractures using intermaxillary fixation is also quite difficult, and erupting or exfoliating teeth can be an issue. On the other hand, the on-going processes of tooth eruption and exfoliation may compensate for minor inaccuracies in reduction and fixation. Recognition of the differences between children and their adult counterparts is important in facial rehabilitation.
Several aspects of dentoalveolar trauma management in children differ from that in adults. Developing roots have open apices, and the preservation of pulp vitality is important. In complicated crown and crown–root fractures, pulpotomy can be performed 1–2 mm below the exposed pulp tissue and Ca(OH)2 or mineral trioxide aggregate can be applied. The second step in such cases is composite restoration or bonding of the crown fragment to the tooth. If the pulp is necrotic, apexification with intracanal application of Ca(OH)2 must be used instead of pulpotomy. In pediatric cases of intrusion, spontaneous re-eruption may occur. Orthodontic repositioning can be a second treatment plan unless movement is observed within about 3 weeks. In the pediatric dentition, osseous replacement in ankylosis occurs much faster than in adults; dentoalveolar ankylosis usually interferes with alveolar process growth, and the tooth might be malpositioned.
Fractures in the maxillary region tend to be less comminuted in children than in adults because children’s paranasal sinuses are not fully developed. Open reduction and internal fixation are the preferred treatment methods, but intermaxillary fixation may be necessary in some cases. Avoiding damage to permanent tooth germs is a mandatory indication for closed reduction. Intermaxillary fixation with arch bars presents some difficulties in patients with mixed dentition, but the fixation period can be shorter than in adults. Teeth may be avulsed by the force of arch bars, and the fixation of arch bars to the teeth may not provide adequate retention because of weak and undeveloped roots. For this reason, the fabrication and use of Gunning splints to provide retention from the zygomatic arches, piriform apertures, and mandible
Paediatric orbital fractures resulting in herniation and extraocular muscle entrapment require immediate intervention and even orbital exploration. Fractures of the orbital floor or wall in children heal rapidly, increasing the risks of scar cicatrisation and related ischemic necrosis of entrapped tissues.
Because the development of the nasal septum is a very important factor in facial growth, post-traumatic septal hematoma, which may cause septal necrosis and resorption, should not be ignored because it may result in saddle nose deformity.
The demand for switching converters has been steadily increasing. The desired converters should be small and have high power density, high efficiency, good responsiveness, and good robustness. High responsiveness and high robustness are required for the control systems of switching converters. Voltage mode control (VMC) is the most basic control system of switching converters [1, 2]. Since the voltage mode control uses only one voltage sensor, it can be constructed at very low cost. However, since the stability of the control system is low, current mode control (CMC) is used for a general switching converter [3, 4]. Some studies suggest that responsiveness and robustness can be significantly improved using the current mode control (CMC) approach [1, 2, 3, 4]. However, it is difficult to improve the performance of boost-type DC-DC converters significantly using only this technology. Although buck-type DC-DC converters can be regarded as approximately linear circuits (regardless of the time-varying circuit), this is not so for boost-type DC-DC converters. This is because in boost-type DC-DC converters, the ON and OFF circuit states are different. As a result, the transfer function of any boost-type DC-DC converter includes an unstable zero (right half plane zero (
On the other hand, control of switching converter using sliding mode control (SMC) has been studied [5, 6, 7, 8, 9]. Sliding mode control has high robustness and is resistant to influences by plant fluctuations. However, the control system has a problem that it is very complicated compared with VMC and CMC.
In this research, we developed power balance mode control (PBMC), which is a new control method that incorporates SMC concept into CMC [10]. In the PBMC approach, the input voltage and the output current are incorporated into the control system as in the conventional control method, and new control items are added by calculation. As a result, the performance of the control system can be greatly improved, when compared with the conventional control method. Furthermore, since the added control items are constituted by four arithmetic operations, implementation is also very easy.
In this study, a single-phase boost-type DC-DC converter was used as a plant. Figure 1 shows the circuit diagram of the plant. To obtain the transfer function of this plant, a modeling method called the state-space averaging method was used. In this section, various transfer functions used for designing the control system of the DC-DC converter are described.
Single-phase boost-type DC-DC converter.
The switching converter is a time-varying circuit in which the state of the circuit can be set to either ON or OFF. Therefore, the state-space averaging method [11, 12, 13], which averages the circuit by a duty ratio, was used. The derivation for obtaining the transfer function of the switching converter using the state-space averaging method is shown below.
For circuit averaging, it is necessary to determine the circuit’s ON/OFF states. When mathematically modeling the state of a circuit, the state equation and the following output equation are used:
where
With respect to the circuit shown in Figure 2, the state equation and the output equation are expressed using the following equations:
Equivalent circuits for the ON and OFF states. (a) Switch Q1: ON; (b) switch Q1: OFF.
In Eq. (2), the inductor current and capacitor voltage comprise the state vector, while the input voltage and the output current comprise the input vector. Figure 2 shows the equivalent circuit for the ON and OFF states of the switch Q1.
When the state of a circuit is averaged over one switching period using the duty ratio, the state equation and the output equation are given as follows:
Here
where
Because the switching converter is controlled by the pulse width modulation (PWM) signal corresponding to the duty ratio, it is necessary to modulate the control signal from the compensator to the PWM signal. Figure 3 shows the correspondence between the control signal and the PWM signal. In an analog circuit, a comparator is used for comparing the control signal
PWM modulation
From Eq. (5), when the amplitude of the sawtooth wave is
When current and voltage are used for feedback directly, the sensor gain can be neglected. However, when the voltage is high, it is necessary to lower it to the voltage value that can be provided to the controller. In addition, when inputting the current value to the controller, it is necessary to convert it into voltage. Therefore, when designing a control system, it is necessary to consider various sensor gains. In this chapter, the voltage gain is denoted by
In this section, voltage mode control (VMC) and current mode control (CMC) are compared to the power balance mode control (PBMC).
Figure 4 shows the block diagram of the VMC. As shown, the control loop is configured to maintain a constant output voltage. The loop transfer function
Voltage mode control.
However, there is a long phase lag due to the second-order lag system 1/
In addition, there is a gain peak owing to the LC resonance. As a result, large overshoots or undershoots can occur in the inductor current and the output voltage following sudden changes such as load changes. In particular, the peak inductor current is remarkable, and when the overcurrent protection (OCP) operates, the DC-DC converter halts. For these reasons, VMC is typically not used in DC-DC converters.
Figure 5 shows the block diagram of the CMC. In the CMC, a control loop is added to the voltage control loop. The loop transfer function
Current mode control.
From Eq. (7), the second-order lag system 1/
In this section, the sliding mode control (SMC) of the buck-type DC-DC converter and the power balance mode control (PBMC) applied to the boost-type DC-DC converter are explained.
The SMC in the buck-type DC-DC converter, which is the foundation of the PBMC, is described here. Figure 6 shows the block diagram of the SMC. One of the SMCs in the buck-type DC-DC converter is the feedforward input of the charge/discharge current of the output capacitor to the output signal of the voltage compensator. For this reason, the voltage compensator adjusts the duty ratio and finely adjusts it with the charge/discharge current of the output capacitor.
Buck-type DC-DC converter using sliding mode control.
In the steady state, the amounts of charge and discharge are equivalent, and the feedforward input can be neglected. In the transient state, the amounts of charge and discharge are different, and the feedforward input directly adjusts the duty ratio.
Because the CMC also feeds back the inductor current, the duty ratio is finely adjusted. However, in the transient state, the inductor suppresses sudden changes in the current, and the system’s responsiveness worsens.
On the other hand, when the charge/discharge current of the output capacitor is used as the feedforward input, the charge/discharge current in the transient state rapidly changes depending on the capacitor. As a result, the duty ratio can be changed faster than for the CMC. Furthermore, when shifting from the transient state to the steady state, the average charge/discharge current becomes zero, and the influence of the feedforward input automatically decreases. Therefore, the feedforward input gain automatically becomes minimal during the transient and in the steady state.
In addition, by appropriately designing the various sensor gains and compensators of this control system, it is possible to set an operation state called the sliding mode. It is known that the control system operating in this sliding mode is not affected by disturbances or plant fluctuations. Therefore, responsiveness and robustness can be improved by operating in sliding mode.
Although this output capacitor current can be detected directly, equivalent series resistance (ESR) and equivalent series inductance (ESL) increase owing to the addition of a shunt resistance and a current transformer, which affects the control system and output voltage. In addition, in digital control systems, analog-to-digital conversion cannot be performed precisely owing to an increase in the noise associated with charging/discharging. On the other hand, it is possible to derive the charge/discharge current of the output capacitor without directly detecting it, by appropriately detecting the output current and the inductor current and performing the calculation. However, as the inductor current of the boost-type DC-DC converter flows only to the output side during the OFF period, the output current differs from the inductor current.
Therefore, it is necessary to consider the control system corresponding to the step-up-type DC-DC converter considering output capacitor current detection and digital control. In the next section, we describe the PBMC with improved responsiveness and robustness for boost-type DC-DC converters.
Figure 7 shows the block diagram of the PBMC. First, various blocks are described.
Power balance mode control.
In addition,
As a result, all output signals of the correction coefficients’ block can be considered as the values for the power stage.
First, when the detected output voltage and output current are fed into the multiplier, the output is expressed by Eq. (9).
Thus, the output power can be calculated. Next, when the calculated output power and the detected input voltage are provided to the divider, the output is expressed by Eq. (10).
Thus, the input current can be calculated. Because the input current of the boost-type DC-DC converter is equivalent to the inductor current, it is denoted by
The flowchart of the control methods.
In this mode, the calculated inductor current
As a result, the signal to be added to the output signal of the voltage compensator becomes positive and the duty ratio increases.
In this mode, the calculated inductor current
As a result, the signal to be added to the output signal of the voltage compensator becomes negative and the duty ratio decreases.
In this mode, the calculated inductor current is equal to the detected inductor current. This corresponds to a steady state, and because the input and output powers are ideally equal, the following relation holds:
As a result, as the signal to be added to the output signal of the voltage compensator becomes zero, the duty ratio does not fluctuate.
These conditions are summarized in Eq. (14).
To sum up, the PBMC is a control method that always compares the input power and the output power and compensates for the difference if there is one. In the next sections, operation verification studies for the different control methods are reported.
In this study, a comparative verification of the different control systems was performed using circuit simulations. Table 1 shows the circuit constants of the single-phase boost-type DC-DC converter, which is the analysis circuit. The control systems were constructed using these circuit parameters.
Description | Symbol | Value |
---|---|---|
Inductor current (100 W design) | 8.33 A | |
Output voltage | 48 V | |
Output power | 100/200 W | |
Switching frequency | 100 kHz | |
Inductance (100 W design) | 36 μH | |
Output capacitance (100 W design) | 500 μH | |
Equivalent series resistance (ESR) of | 58.5 mΩ | |
DC resistance of | 20 mΩ | |
Resistance of drain to source (ON) of Q1 | 58 mΩ | |
Forward resistance of Q1 (diode: D) | 130 mΩ |
Circuit parameters and specifications.
To provide a reference for the responses of these control systems, the gain crossover frequencies of the loop transfer functions for the different control methods were designed to be equal. In addition, the voltage compensator for the PBMC used the same 2-pole-1-zero (type-2) compensator as the current mode control.
The transfer function of the VMC includes second-order lag systems, as expressed by Eq. (4). In addition, the phase lags by 180° or more, owing to the RHP-zero. To improve the phase delay and to stabilize the operation of the control system, a 3-pole-2-zero (type-3) compensator was used. The transfer function of this 3-pole-2-zero compensator is given in Eq. (15).
A secondary delay system was included in both
where
In the PBMC, the difference between the calculated inductor current
Therefore, the voltage compensator used a 2-pole-1-zero compensator similar to the CMC. In our simulations, for simplicity, the values of the correction coefficients
Various parameters represented by capital letters on the right side of Eq. (17) are design values. As a result, the input/output voltage/current/power parameters were all 1 by design.
In this section, a comparative verification of each control system using circuit simulation is described. For the simulation, a circuit simulator PSIM manufactured by Powersim Corporation is used. Configure the configuration of the power stage and control stage using PSIM. The circuit constants of the power stage are shown in Table 1, and the parameters of the voltage compensator of the control stage are shown in Table 2 described later. In addition, each sensor gain and correction constants are as in Section 5.1.3.
Table 2 shows the compensators’ parameters for the different control methods. In addition, the gain crossover frequency of the loop transfer function was
Figure 9 shows the output voltage during load transient in each control method. Compared with CMC, over/undershoot of output voltage is small and settling time is short in PBMC. In particular, the settling time of the output voltage of the PBMC is very short compared with other control methods. Therefore, the PBMC can instantaneously respond to load fluctuations.
Output voltage responses for load transients. (a) Step-up load transient and (b) step-down load transient.
Figure 10 shows the inductor current during the load transient, for the different control methods. From Figure 10, the rise/fall time of the inductor current of the PBMC is very short compared with that of the other control methods. Because the rise/fall time of the inductor current of the PBMC is very short, the settling time of the output voltage becomes short. Although over/undershoots of the inductor current also appear in the PBMC, the outcome can be improved by appropriately setting the correction coefficient
Inductor current responses for load transients. (a) Step-up load transient and (b) step-down load transient.
Figure 11 shows the output voltage during the input voltage transient, for the different control methods. Compared with the other control methods, the over/undershoot of output voltage is smaller and the settling time is shorter for the PBMC method. Therefore, a system with PBMC can instantaneously respond to input voltage fluctuations.
Inductor current responses for input voltage transients. (a) Step-up input voltage transient and (b) step-down input voltage transient.
Figure 12 shows the inductor current during the input voltage transient, for the different control methods. From Figure 12, the rise/fall time of the inductor current for the PBMC method is much shorter compared with that of the other control methods. Because the rise/fall time of the inductor current for the PBMC method is very short, the settling time of the output voltage is short.
Inductor current responses for input voltage transients. (a) Step-up input voltage transient and (b) step-down input voltage transient.
The simulation results for the different control methods are compared below. Table 3 lists the simulation results for the load transient response, and Table 4 shows the simulation results for the input voltage transient response. The most efficient results are shown by *, while the least efficient ones are shown by **. From these tables, it is evident that the PBMC method yields the most efficient results in terms of almost all metrics, when compared with the other control systems. The effectiveness of the PBMC method is confirmed across all simulation results.
VMC | 35.3 | 1.86 × 103 | 1.86 × 103 | 4.00 × 104 | 3.42 × 104 |
CMC | 105.0 | 86.8 | – | 3.42 × 104 | – |
PBMC |
Compensator
Target value | Step-up transient | Step-down transient | ||
---|---|---|---|---|
Undershoot (mV) | Settling time (ms) | Overshoot (mV) | Settling time (ms) | |
VMC | 0.77 | 0.78 | ||
CMC | 735.2 | |||
PBMC | 667.1 |
Simulation results for the load transient response.
Target value | Step-up transient | Step-down transient | ||
---|---|---|---|---|
Overshoot (mV) | Settling time (ms) | Undershoot (mV) | Settling time (ms) | |
VMC | 3.86 | 3.96 | ||
CMC | 498.7 | 484.9 | ||
PBMC |
Simulation results for the input voltage transient response.
VMC method has only output components. Therefore, it is impossible to promptly respond to input fluctuations. Therefore, the overshoot and undershoot in the input voltage fluctuation are much larger than the other two control methods.
CMC method has input and output components one by one. However, even during transient, the settling time is long because it is always approximated to the first-order lag system.
PBMC method has all components of input and output. Therefore, it is thought that it be able to respond quickly to input/output fluctuations.
This chapter described fast-response and highly robust PBMC for boost-type DC-DC converters. PBMC uses control to compensate for the difference between input power and output power for the inner loop. Performances of the PBMC method and conventional control methods were compared and verified using circuit simulations. As a result, the PBMC method yielded the best results on all performance metrics. This confirms the effectiveness of PBMC.
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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. 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Modeling and implementing a new heuristic algorithm may be time‐consuming but has strong motivations: on the one hand, even a small improvement of the new solution may be worth the long time spent on the construction of a new method; on the other hand, there are problems for which good‐enough solutions are acceptable which could be achieved at a much lower computational cost. In the first case, specially designed heuristics or metaheuristics are needed, while the latter hyper‐heuristics can be proposed. The paper will describe both approaches in different domain problems.",book:{id:"5966",slug:"heuristics-and-hyper-heuristics-principles-and-applications",title:"Heuristics and Hyper-Heuristics",fullTitle:"Heuristics and Hyper-Heuristics - Principles and Applications"},signatures:"Aleksandra Swiercz",authors:[{id:"203032",title:"Ph.D.",name:"Aleksandra",middleName:null,surname:"Swiercz",slug:"aleksandra-swiercz",fullName:"Aleksandra Swiercz"}]},{id:"55594",title:"Multi‐Objective Hyper‐Heuristics",slug:"multi-objective-hyper-heuristics",totalDownloads:1470,totalCrossrefCites:1,totalDimensionsCites:0,abstract:"Multi‐objective hyper‐heuristics is a search method or learning mechanism that operates over a fixed set of low‐level heuristics to solve multi‐objective optimization problems by controlling and combining the strengths of those heuristics. Although numerous papers on hyper‐heuristics have been published and several studies are still underway, most research has focused on single‐objective optimization. Work on hyper‐heuristics for multi‐objective optimization remains limited. This chapter draws attention to this area of research to help researchers and PhD students understand and reuse these methods. It also provides the basic concepts of multi‐objective optimization and hyper‐heuristics to facilitate a better understanding of the related research areas, in addition to exploring hyper‐heuristic methodologies that address multi‐objective optimization. Some design issues related to the development of hyper‐heuristic framework for multi‐objective optimization are discussed. The chapter concludes with a case study of multi‐objective selection hyper‐heuristics and its application on a real‐world problem.",book:{id:"5966",slug:"heuristics-and-hyper-heuristics-principles-and-applications",title:"Heuristics and Hyper-Heuristics",fullTitle:"Heuristics and Hyper-Heuristics - Principles and Applications"},signatures:"Mashael Suliaman Maashi",authors:[{id:"201702",title:"Dr.",name:"Mashael",middleName:null,surname:"Maashi",slug:"mashael-maashi",fullName:"Mashael Maashi"}]},{id:"55968",title:"On the Use of Hybrid Heuristics for Providing Service to Select the Return Channel in an Interactive Digital TV Environment",slug:"on-the-use-of-hybrid-heuristics-for-providing-service-to-select-the-return-channel-in-an-interactive",totalDownloads:1303,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The technologies used to link the end-user to a telecommunication infrastructure, has been changing over time due to the consolidation of new access technologies. Moreover, the emergence of new tools for information dissemination, such as interactive digital TV, makes the selection of access technology, factor of fundamental importance. One of the greatest advantages of using digital TV as means to disseminate information is the installation of applications. In this chapter, a load characterization of a typical application embedded in a digital TV is performed to determine its behavior. However, it is important to note that applications send information through an access technology. Therefore, this chapter, based on the study on load characterization, developed a methodology combining Bayesian networks and technique for order preference by similarity to ideal solution (TOPSIS) analytical approach to provide support to service providers to opt for a technology (power line communication, PLC, wireless, wired, etc.) for the return channel.",book:{id:"5966",slug:"heuristics-and-hyper-heuristics-principles-and-applications",title:"Heuristics and Hyper-Heuristics",fullTitle:"Heuristics and Hyper-Heuristics - Principles and Applications"},signatures:"Marcos César da Rocha Seruffo, Ádamo Lima de Santana, Carlos\nRenato Lisboa Francês and Nandamudi Lankalapalli Vijaykumar",authors:[{id:"10493",title:"Dr.",name:"Adamo",middleName:null,surname:"Lima De Santana",slug:"adamo-lima-de-santana",fullName:"Adamo Lima De Santana"},{id:"202549",title:"Dr.",name:"Marcos",middleName:null,surname:"Seruffo",slug:"marcos-seruffo",fullName:"Marcos Seruffo"},{id:"202551",title:"Dr.",name:"Nadamundi",middleName:null,surname:"Vijaykumar",slug:"nadamundi-vijaykumar",fullName:"Nadamundi Vijaykumar"},{id:"202552",title:"Dr.",name:"Carlos Renato",middleName:null,surname:"Francês",slug:"carlos-renato-frances",fullName:"Carlos Renato Francês"}]},{id:"55704",title:"Advanced Particle Filter Methods",slug:"advanced-particle-filter-methods",totalDownloads:1565,totalCrossrefCites:2,totalDimensionsCites:6,abstract:"This chapter presents a set of algorithmic methods based on particle filter heuristics. We start with an introduction to particle filters, which covers the main motivation and related works. Then, the generic framework for particle filter algorithm is presented, followed by two important use cases regarding indoor positioning and multitarget tracking; for both problems, modified particle filter algorithms are presented followed by experimental results, implementation remarks, and a discussion. Finally, a short list of conclusion and future work are presented.",book:{id:"5966",slug:"heuristics-and-hyper-heuristics-principles-and-applications",title:"Heuristics and Hyper-Heuristics",fullTitle:"Heuristics and Hyper-Heuristics - Principles and Applications"},signatures:"Roi Yozevitch and Boaz Ben-Moshe",authors:[{id:"203049",title:"Prof.",name:"Boaz",middleName:null,surname:"Benmoshe",slug:"boaz-benmoshe",fullName:"Boaz Benmoshe"},{id:"203051",title:"Mr.",name:"Roi",middleName:null,surname:"Yozevitch",slug:"roi-yozevitch",fullName:"Roi Yozevitch"}]}],onlineFirstChaptersFilter:{topicId:"549",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:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:318,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:106,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:15,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"June 29th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:32,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"14",title:"Cell and Molecular Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",isOpenForSubmission:!0,editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",slug:"rosa-maria-martinez-espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",biography:"Dr. Rosa María Martínez-Espinosa has been a Spanish Full Professor since 2020 (Biochemistry and Molecular Biology) and is currently Vice-President of International Relations and Cooperation development and leader of the research group 'Applied Biochemistry” (University of Alicante, Spain). Other positions she has held at the university include Vice-Dean of Master Programs, Vice-Dean of the Degree in Biology and Vice-Dean for Mobility and Enterprise and Engagement at the Faculty of Science (University of Alicante). She received her Bachelor in Biology in 1998 (University of Alicante) and her PhD in 2003 (Biochemistry, University of Alicante). She undertook post-doctoral research at the University of East Anglia (Norwich, U.K. 2004-2005; 2007-2008).\nHer multidisciplinary research focuses on investigating archaea and their potential applications in biotechnology. She has an H-index of 21. She has authored one patent and has published more than 70 indexed papers and around 60 book chapters.\nShe has contributed to more than 150 national and international meetings during the last 15 years. Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,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. Dr. Beydemir is also Rector of Bilecik Şeyh Edebali University, Turkey.",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",slug:"deniz-ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",biography:"Dr. Deniz Ekinci obtained a BSc in Chemistry in 2004, MSc in Biochemistry in 2006, and PhD in Biochemistry in 2009 from Atatürk University, Turkey. He studied at Stetson University, USA, in 2007-2008 and at the Max Planck Institute of Molecular Cell Biology and Genetics, Germany, in 2009-2010. Dr. Ekinci currently works as a Full Professor of Biochemistry in the Faculty of Agriculture and is the Head of the Enzyme and Microbial Biotechnology Division, Ondokuz Mayıs University, Turkey. He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. Dr. Ekinci serves as the Editor in Chief of four international books and is involved in the Editorial Board of several international journals.",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null},{id:"17",title:"Metabolism",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",isOpenForSubmission:!0,editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",slug:"yannis-karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",biography:"Yannis Karamanos, born in Greece in 1953, completed his pre-graduate studies at the Université Pierre et Marie Curie, Paris, then his Masters and Doctoral degree at the Université de Lille (1983). He was associate professor at the University of Limoges (1987) before becoming full professor of biochemistry at the Université d’Artois (1996). He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. His teaching areas are energy metabolism and regulation, integration and organ specialization and metabolic adaptation.",institutionString:null,institution:{name:"Artois University",institutionURL:null,country:{name:"France"}}},editorTwo:null,editorThree:null},{id:"18",title:"Proteomics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",isOpenForSubmission:!0,editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",slug:"paolo-iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",biography:"Paolo Iadarola graduated with a degree in Chemistry from the University of Pavia (Italy) in July 1972. He then worked as an Assistant Professor at the Faculty of Science of the same University until 1984. In 1985, Prof. Iadarola became Associate Professor at the Department of Biology and Biotechnologies of the University of Pavia and retired in October 2017. Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. In this context, he has developed and validated new methodologies (e.g., Capillary Electrophoresis coupled to Laser-Induced Fluorescence, CE-LIF) whose application enabled him to determine both the amounts of biochemical markers (Desmosines) in urine/serum of patients affected by Chronic Obstructive Pulmonary Disease (COPD) and the activity of proteolytic enzymes (Human Neutrophil Elastase, Cathepsin G, Pseudomonas aeruginosa elastase) in sputa of these patients. More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. He is a Consultant Reviewer for several journals, including the Journal of Chromatography A, Journal of Chromatography B, Plos ONE, Proteomes, International Journal of Molecular Science, Biotech, Electrophoresis, and others. He is also Associate Editor of Biotech.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",slug:"simona-viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",biography:"Simona Viglio is an Associate Professor of Biochemistry at the Department of Molecular Medicine at the University of Pavia. She has been working since 1995 on the determination of proteolytic enzymes involved in the degradation process of connective tissue matrix and on the identification of biological markers of lung diseases. She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. She is an author of about 90 publications (According to Scopus: H-Index: 23; According to WOS: H-Index: 20) on peer-reviewed journals, a member of the “Società Italiana di Biochimica e Biologia Molecolare,“ and a Consultant Reviewer for International Journal of Molecular Science, Journal of Chromatography A, COPD, Plos ONE and Nutritional Neuroscience.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null}]},overviewPageOFChapters:{paginationCount:36,paginationItems:[{id:"82195",title:"Endoplasmic Reticulum: A Hub in Lipid Homeostasis",doi:"10.5772/intechopen.105450",signatures:"Raúl Ventura and María Isabel Hernández-Alvarez",slug:"endoplasmic-reticulum-a-hub-in-lipid-homeostasis",totalDownloads:4,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}},{id:"82409",title:"Purinergic Signaling in Covid-19 Disease",doi:"10.5772/intechopen.105008",signatures:"Hailian Shen",slug:"purinergic-signaling-in-covid-19-disease",totalDownloads:5,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Purinergic System",coverURL:"https://cdn.intechopen.com/books/images_new/10801.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82374",title:"The Potential of the Purinergic System as a Therapeutic Target of Natural Compounds in Cutaneous Melanoma",doi:"10.5772/intechopen.105457",signatures:"Gilnei Bruno da Silva, Daiane Manica, Marcelo Moreno and Margarete Dulce Bagatini",slug:"the-potential-of-the-purinergic-system-as-a-therapeutic-target-of-natural-compounds-in-cutaneous-mel",totalDownloads:10,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Purinergic System",coverURL:"https://cdn.intechopen.com/books/images_new/10801.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82103",title:"The Role of Endoplasmic Reticulum Stress and Its Regulation in the Progression of Neurological and Infectious Diseases",doi:"10.5772/intechopen.105543",signatures:"Mary Dover, Michael Kishek, Miranda Eddins, Naneeta Desar, Ketema Paul and Milan Fiala",slug:"the-role-of-endoplasmic-reticulum-stress-and-its-regulation-in-the-progression-of-neurological-and-i",totalDownloads:6,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}}]},overviewPagePublishedBooks:{paginationCount:32,paginationItems:[{type:"book",id:"7006",title:"Biochemistry and Health Benefits of Fatty Acids",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7006.jpg",slug:"biochemistry-and-health-benefits-of-fatty-acids",publishedDate:"December 19th 2018",editedByType:"Edited by",bookSignature:"Viduranga Waisundara",hash:"c93a00abd68b5eba67e5e719f67fd20b",volumeInSeries:1,fullTitle:"Biochemistry and Health Benefits of Fatty Acids",editors:[{id:"194281",title:"Dr.",name:"Viduranga Y.",middleName:null,surname:"Waisundara",slug:"viduranga-y.-waisundara",fullName:"Viduranga Y. Waisundara",profilePictureURL:"https://mts.intechopen.com/storage/users/194281/images/system/194281.jpg",biography:"Dr. Viduranga Waisundara obtained her Ph.D. in Food Science\nand Technology from the Department of Chemistry, National\nUniversity of Singapore, in 2010. She was a lecturer at Temasek Polytechnic, Singapore from July 2009 to March 2013.\nShe relocated to her motherland of Sri Lanka and spearheaded the Functional Food Product Development Project at the\nNational Institute of Fundamental Studies from April 2013 to\nOctober 2016. She was a senior lecturer on a temporary basis at the Department of\nFood Technology, Faculty of Technology, Rajarata University of Sri Lanka. She is\ncurrently Deputy Principal of the Australian College of Business and Technology –\nKandy Campus, Sri Lanka. She is also the Global Harmonization Initiative (GHI)",institutionString:"Australian College of Business & Technology",institution:null}]},{type:"book",id:"6820",title:"Keratin",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/6820.jpg",slug:"keratin",publishedDate:"December 19th 2018",editedByType:"Edited by",bookSignature:"Miroslav Blumenberg",hash:"6def75cd4b6b5324a02b6dc0359896d0",volumeInSeries:2,fullTitle:"Keratin",editors:[{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. 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In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}},{id:"338856",title:"Mrs.",name:"Nur Alvira",middleName:null,surname:"Pascawati",slug:"nur-alvira-pascawati",fullName:"Nur Alvira Pascawati",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universitas Respati Yogyakarta",country:{name:"Indonesia"}}},{id:"441116",title:"Dr.",name:"Jovanka M.",middleName:null,surname:"Voyich",slug:"jovanka-m.-voyich",fullName:"Jovanka M. 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Animals need to receive a properly balanced diet. One of the new challenges we are now faced with is sustainable animal diets (STAND) that involve the 3 P’s (People, Planet, and Profitability). We must develop animal feed that does not compete with human food, use antibiotics, and explore new growth promoters options, such as plant extracts or compounds that promote feed efficiency (e.g., monensin, oils, enzymes, probiotics). These new feed options must also be environmentally friendly, reducing the Carbon footprint, CH4, N, and P emissions to the environment, with an adequate formulation of nutrients.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/20.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11416,editor:{id:"175967",title:"Dr.",name:"Manuel",middleName:null,surname:"Gonzalez Ronquillo",slug:"manuel-gonzalez-ronquillo",fullName:"Manuel Gonzalez Ronquillo",profilePictureURL:"https://mts.intechopen.com/storage/users/175967/images/system/175967.png",biography:"Dr. Manuel González Ronquillo obtained his doctorate degree from the University of Zaragoza, Spain, in 2001. He is a research professor at the Faculty of Veterinary Medicine and Animal Husbandry, Autonomous University of the State of Mexico. He is also a level-2 researcher. He received a Fulbright-Garcia Robles fellowship for a postdoctoral stay at the US Dairy Forage Research Center, Madison, Wisconsin, USA in 2008–2009. He received grants from Alianza del Pacifico for a stay at the University of Magallanes, Chile, in 2014, and from Consejo Nacional de Ciencia y Tecnología (CONACyT) to work in the Food and Agriculture Organization’s Animal Production and Health Division (AGA), Rome, Italy, in 2014–2015. He has collaborated with researchers from different countries and published ninety-eight journal articles. He teaches various degree courses in zootechnics, sheep production, and agricultural sciences and natural resources.\n\nDr. Ronquillo’s research focuses on the evaluation of sustainable animal diets (StAnD), using native resources of the region, decreasing carbon footprint, and applying meta-analysis and mathematical models for a better understanding of animal production.",institutionString:null,institution:{name:"Universidad Autónoma del Estado de México",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,series:{id:"13",title:"Veterinary Medicine and Science",doi:"10.5772/intechopen.73681",issn:"2632-0517"},editorialBoard:[{id:"175762",title:"Dr.",name:"Alfredo J.",middleName:null,surname:"Escribano",slug:"alfredo-j.-escribano",fullName:"Alfredo J. 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