Dr. Pletser’s experience includes 30 years of working with the European Space Agency as a Senior Physicist/Engineer and coordinating their parabolic flight campaigns, and he is the Guinness World Record holder for the most number of aircraft flown (12) in parabolas, personally logging more than 7,300 parabolas.
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Seeing the 5,000th book published makes us at the same time proud, happy, humble, and grateful. This is a great opportunity to stop and celebrate what we have done so far, but is also an opportunity to engage even more, grow, and succeed. It wouldn't be possible to get here without the synergy of team members’ hard work and authors and editors who devote time and their expertise into Open Access book publishing with us.
\\n\\n
Over these years, we have gone from pioneering the scientific Open Access book publishing field to being the world’s largest Open Access book publisher. Nonetheless, our vision has remained the same: to meet the challenges of making relevant knowledge available to the worldwide community under the Open Access model.
\\n\\n
We are excited about the present, and we look forward to sharing many more successes in the future.
\\n\\n
Thank you all for being part of the journey. 5,000 times thank you!
\\n\\n
Now with 5,000 titles available Open Access, which one will you read next?
Preparation of Space Experiments edited by international leading expert Dr. Vladimir Pletser, Director of Space Training Operations at Blue Abyss is the 5,000th Open Access book published by IntechOpen and our milestone publication!
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"This book presents some of the current trends in space microgravity research. The eleven chapters introduce various facets of space research in physical sciences, human physiology and technology developed using the microgravity environment not only to improve our fundamental understanding in these domains but also to adapt this new knowledge for application on earth." says the editor. Listen what else Dr. Pletser has to say...
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Dr. Pletser’s experience includes 30 years of working with the European Space Agency as a Senior Physicist/Engineer and coordinating their parabolic flight campaigns, and he is the Guinness World Record holder for the most number of aircraft flown (12) in parabolas, personally logging more than 7,300 parabolas.
\n\n
Seeing the 5,000th book published makes us at the same time proud, happy, humble, and grateful. This is a great opportunity to stop and celebrate what we have done so far, but is also an opportunity to engage even more, grow, and succeed. It wouldn't be possible to get here without the synergy of team members’ hard work and authors and editors who devote time and their expertise into Open Access book publishing with us.
\n\n
Over these years, we have gone from pioneering the scientific Open Access book publishing field to being the world’s largest Open Access book publisher. Nonetheless, our vision has remained the same: to meet the challenges of making relevant knowledge available to the worldwide community under the Open Access model.
\n\n
We are excited about the present, and we look forward to sharing many more successes in the future.
\n\n
Thank you all for being part of the journey. 5,000 times thank you!
\n\n
Now with 5,000 titles available Open Access, which one will you read next?
\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:"7728",leadTitle:null,fullTitle:"Synthetic Biology - New Interdisciplinary Science",title:"Synthetic Biology",subtitle:"New Interdisciplinary Science",reviewType:"peer-reviewed",abstract:"Synthetic biology gives us a new hope because it combines various disciplines, such as genetics, chemistry, biology, molecular sciences, and other disciplines, and gives rise to a novel interdisciplinary science. We can foresee the creation of the new world of vegetation, animals, and humans with the interdisciplinary system of biological sciences. These articles are contributed by renowned experts in their fields. The field of synthetic biology is growing exponentially and opening up new avenues in multidisciplinary approaches by bringing together theoretical and applied aspects of science.",isbn:"978-1-78984-090-2",printIsbn:"978-1-78984-089-6",pdfIsbn:"978-1-78985-329-2",doi:"10.5772/intechopen.77541",price:119,priceEur:129,priceUsd:155,slug:"synthetic-biology-new-interdisciplinary-science",numberOfPages:206,isOpenForSubmission:!1,isInWos:1,isInBkci:!1,hash:"cc50b31cb749d94a5aa38999a712ae2f",bookSignature:"Madan L. Nagpal, Oana-Maria Boldura, Cornel Baltă and Shymaa Enany",publishedDate:"February 12th 2020",coverURL:"https://cdn.intechopen.com/books/images_new/7728.jpg",numberOfDownloads:21114,numberOfWosCitations:7,numberOfCrossrefCitations:10,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:26,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:43,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 12th 2018",dateEndSecondStepPublish:"March 15th 2019",dateEndThirdStepPublish:"May 14th 2019",dateEndFourthStepPublish:"August 2nd 2019",dateEndFifthStepPublish:"October 1st 2019",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"182681",title:"Dr.",name:"Madan L.",middleName:null,surname:"Nagpal",slug:"madan-l.-nagpal",fullName:"Madan L. Nagpal",profilePictureURL:"https://mts.intechopen.com/storage/users/182681/images/system/182681.png",biography:"Research Associate Professor at the Department of Microbiology and Immunology, University of South Carolina, Columbia, SC, and Research Chemist at the Dorn Veterans Medical Center, Columbia, SC, USA for 10 plus years. He has published 40 research articles, 38 Abstracts and Presentations, a Book Chapter and edited a book. He was awarded Research & Productive Scholarship 1990 by the Univ. South Carolina. He was funded by the grants as Co-Investigator by National Institutes of Health (NIH) and the VA Merit Review grants. His contributions include gene regulation in steroid hormone biosynthesis and the characterization of Bacillus species. He is a member of American Society of Cell Biology, American Association of Advancement of Science, The Endocrine Society, Fellow Linnean Society of London, American Association for Laboratory Animal Science, International Who’s Who Professionals, and Marquis Who’s Who in America.",institutionString:"University of South Carolina",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"University of South Carolina",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"189429",title:"Prof.",name:"Oana-Maria",middleName:null,surname:"Boldura",slug:"oana-maria-boldura",fullName:"Oana-Maria Boldura",profilePictureURL:"https://mts.intechopen.com/storage/users/189429/images/system/189429.jpg",biography:"Oana-Maria Boldura is licensed in Genetic Engineering with specialization in Molecular Biology (2005), Master\\'s Degree in Genetic Manipulation (2007) and Pharmacy (2014), and PhD in Biotechnology field (2010). From 2015 she has been an Assistant Professor at Banat University of Agricultural Sciences and Veterinary Medicine 'King Michael I of Romania” Timisoara, Faculty of Veterinary Medicine, Department of Chemistry, Biochemistry and Molecular Biology and researcher at ,,Horia Cernescu” Research Unit. Her main scientific competences are in the field of Molecular Biology, Biotechnology, Genomics and Biosecurity with technical aptitudes in manipulation and experimentation with nucleic acid and proteins (purification, sequencing, gene expression studies, SDS-PAGE analysis of proteins fractions, ,,Lab-on-chip” electrophoresis, Immunological Testing). Her areas of interest are Molecular Forensic Methods and Apoptotic Process Pathways.",institutionString:"Banat’s University of Agricultural Sciences and Veterinary Medicine",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Banat University of Agricultural Sciences and Veterinary Medicine",institutionURL:null,country:{name:"Romania"}}},coeditorTwo:{id:"222863",title:"Dr.",name:"Cornel",middleName:null,surname:"Balta",slug:"cornel-balta",fullName:"Cornel Balta",profilePictureURL:"https://mts.intechopen.com/storage/users/222863/images/system/222863.jpg",biography:"Dr. Cornel Baltă, MD, DVM, is a licensed veterinarian with both\na PhD and MD in Veterinary Medicine. He is a researcher at the\nInstitute of Life Sciences, at “Vasile Goldis” Western University\nArad, Romania. Dr. Baltă’s main scientific competences are in\nthe fields of laboratory animals, molecular biology, physiology,\nhistology, and clinical Laboratory. He has technical aptitudes in\nnucleic acid examination by electrophoresis techniques, PCR and\nqPCR, and qualitative and quantitative determination of proteins by Western Blot\nand microelectrophoresis. His areas of interest include molecular mechanisms involved in the evolution of liver and gastrointestinal diseases, and bone regeneration\nand remodeling using different types of polymers.",institutionString:'"Vasile Goldis" Western University of Arad',position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Vasile Goldis Western University of Arad",institutionURL:null,country:{name:"Romania"}}},coeditorThree:{id:"81926",title:"Dr.",name:"Shymaa",middleName:null,surname:"Enany",slug:"shymaa-enany",fullName:"Shymaa Enany",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRqB9QAK/Profile_Picture_1626163237970",biography:"Dr. Shymaa Enany is an associate professor of Microbiology at Suez Canal University, Egypt. She received her PhD from School of Medical Sciences, Niigata University, Japan, and spent her postdoc in USA and Japan. She was the first Arab scientist applying bacterial proteomic techniques helping in revealing good markers for microbes spreading in community. She received many awards for her scientific contributions. Recently, she awarded the most prestigious award in Egypt: the state encouragement prize for women in the field of health and pharmaceutical sciences, 2019. Also, she was awarded The World Academy of Sciences (TWAS) Young Arab Scientist Prize 2018 for Scientific Achievement in Medical Sciences. She was selected as a member of Egyptian Young Academy of Science, an evaluator on Academy of Scientific Research and Technology, a reviewer in International Exhibition of Innovation, and an affiliate of The World Academy of Sciences. Dr. Shymaa is also a part of the scientific committee of World Forum for Women in Science, a selected young leader in STS and WSF, a member in the global Open Science Group, and a collaborator in Global Burden of Disease. On Microbiology National Committee, she is working for achieving sustainable development goals for a better future. She was appointed an Egyptian ambassador in Next Einstein Forum (NEF), which showcases the global contribution and potential of scientists from Africa, enabling Africa to get onto the global scientific stage, and she is a selected member in COVID-19 Diagnostics group in Africa, as well as the co-chair of the COVID-19 Clinical Research Coalition platform (Immunology, Virology and Diagnostics Working Group) in low- and middle-income countries. Latterly, she is selected as an African science leadership program fellow.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"5",institution:{name:"Suez Canal University",institutionURL:null,country:{name:"Egypt"}}},coeditorFour:null,coeditorFive:null,topics:[{id:"694",title:"Genetic Engineering",slug:"engineering-biomedical-engineering-genetic-engineering"}],chapters:[{id:"70481",title:"Introductory Chapter: The Role of Genetic Engineering Technology in the Manipulation of Genetics of Organisms and Synthetic Biology",doi:"10.5772/intechopen.90549",slug:"introductory-chapter-the-role-of-genetic-engineering-technology-in-the-manipulation-of-genetics-of-o",totalDownloads:628,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Madan L. Nagpal",downloadPdfUrl:"/chapter/pdf-download/70481",previewPdfUrl:"/chapter/pdf-preview/70481",authors:[{id:"182681",title:"Dr.",name:"Madan L.",surname:"Nagpal",slug:"madan-l.-nagpal",fullName:"Madan L. Nagpal"}],corrections:null},{id:"65149",title:"Synthetic Biology, Artificial Intelligence, and Quantum Computing",doi:"10.5772/intechopen.83434",slug:"synthetic-biology-artificial-intelligence-and-quantum-computing",totalDownloads:2061,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:1,abstract:"We envisage a world where genetic engineering, artificial intelligence (AI), and quantum computing (QC) will coalesce to bring about a forced speciation of the Homo sapiens. A forced speciation will drastically reduce the emergence time for a new species to a few years compared to Nature’s hundreds of millennia. In this chapter, we explain the basic concepts that would allow a forced speciation of the Homo sapiens to occur and its consequences on life on Earth thereafter. Accelerating speciation mediated by Homo sapiens via domestication, gene splicing, and gene drive mechanisms is now scientifically well understood. Synthetic biology can advance speciation far more rapidly using a combination of clustered regularly interspaced short palindromic repeats (CRISPR) technology, advanced computing technologies, and knowledge creation using AI. The day is perhaps not far off when Homo sapiens itself will initiate its own speciation once it advances synthetic biology to a level where it can safely modify the brain to temper emotion and enhance rational thinking as a means of competing against AI-embedded machines guided by quantum algorithms.",signatures:"Rajendra K. Bera",downloadPdfUrl:"/chapter/pdf-download/65149",previewPdfUrl:"/chapter/pdf-preview/65149",authors:[{id:"77013",title:"Prof.",name:"Rajendra",surname:"Bera",slug:"rajendra-bera",fullName:"Rajendra Bera"}],corrections:null},{id:"68797",title:"Construction and Analysis of Metagenome Library from Bacterial Community Associated with Toxic Dinoflagellate Alexandrium tamiyavanichii",doi:"10.5772/intechopen.88751",slug:"construction-and-analysis-of-metagenome-library-from-bacterial-community-associated-with-toxic-dinof",totalDownloads:665,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Previous studies have suggested that a specific community of bacteria coexists within the phycosphere of marine dinoflagellates. In order to better understand the dinoflagellate-bacteria relationships, a fosmid clone library was constructed from the metagenome DNA and analyzed. Some of the fosmid clones were end-sequenced. A total of 1501 fosmid clones with insert sizes of 30–40 Kbp were produced. End sequencing of 238 clones showed that 55% of the genes had known functions, 11% were of putative function and 34% were genes of unknown function or had no match in Genbank. There were approximately 14% sequences with no classification and could potentially represent novel genes. Analysis of these partial sequences also revealed some promising enzymes that possess various potential industrial applications such as chitinases, kinases, agarases and oxygenases. The results also showed that the bacterial flora of the Alexandrium tamiyavanichii culture was dominated by the Alpha-proteobacteria, followed by Bacteroidetes and Gamma-proteobacteria. The findings in this study suggested that the bacterial community may play various role in the association with dinoflagellate. This study had also shown that dinoflagellate-associated bacterial community is a valuable source for discovery of novel genes and gene products.",signatures:"Muhd Danish-Daniel, Mohd Ezhar Mohd Noor, Yik Sung Yeong, Tan Min Pau and Gires Usup",downloadPdfUrl:"/chapter/pdf-download/68797",previewPdfUrl:"/chapter/pdf-preview/68797",authors:[{id:"253550",title:"Associate Prof.",name:"Muhd",surname:"Danish-Daniel",slug:"muhd-danish-daniel",fullName:"Muhd Danish-Daniel"},{id:"309693",title:"MSc.",name:"Mohd Ezhar",surname:"Mohd Noor",slug:"mohd-ezhar-mohd-noor",fullName:"Mohd Ezhar Mohd Noor"},{id:"309694",title:"Prof.",name:"Yik Sung",surname:"Yeong",slug:"yik-sung-yeong",fullName:"Yik Sung Yeong"},{id:"309695",title:"Dr.",name:"Tan",surname:"Min Pau",slug:"tan-min-pau",fullName:"Tan Min Pau"},{id:"309696",title:"Prof.",name:"Gires",surname:"Usup",slug:"gires-usup",fullName:"Gires Usup"}],corrections:null},{id:"68217",title:"Applied Molecular Cloning: Present and Future for Aquaculture",doi:"10.5772/intechopen.88197",slug:"applied-molecular-cloning-present-and-future-for-aquaculture",totalDownloads:1020,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"With the grim picture of millions of people living in poverty and hunger, there is also an international alarm over future world food supply. This global concern of food scarcity has established the need to not only increase the production of traditional staples but also fisheries and aquaculture. Genetically, physiologically and phenotypically, fish are the most diverse group of livings. Similar to mammals, molecular biology is being extensively used in aquaculture, be it in disease management, or growth and reproduction enhancement. In this chapter we aim to discuss the molecular methodologies applied to uplift and attain sustainability in aqua farming.",signatures:"Tapas Chakraborty, Sipra Mohapatra, Chimwar Wanglar and Dipak Pandey",downloadPdfUrl:"/chapter/pdf-download/68217",previewPdfUrl:"/chapter/pdf-preview/68217",authors:[{id:"295354",title:"Dr.",name:"Tapas",surname:"Chakraborty",slug:"tapas-chakraborty",fullName:"Tapas Chakraborty"},{id:"301450",title:"Dr.",name:"Sipra",surname:"Mohapatra",slug:"sipra-mohapatra",fullName:"Sipra Mohapatra"},{id:"301567",title:"Dr.",name:"Dipak",surname:"Pandey",slug:"dipak-pandey",fullName:"Dipak Pandey"},{id:"301568",title:"Dr.",name:"Chimwar",surname:"Wanglar",slug:"chimwar-wanglar",fullName:"Chimwar Wanglar"}],corrections:null},{id:"67662",title:"Molecular Cloning of Genic Male-Sterility Genes and Their Applications for Plant Heterosis via Biotechnology-based Male-sterility Systems",doi:"10.5772/intechopen.86976",slug:"molecular-cloning-of-genic-male-sterility-genes-and-their-applications-for-plant-heterosis-via-biote",totalDownloads:1039,totalCrossrefCites:1,totalDimensionsCites:4,hasAltmetrics:0,abstract:"In this chapter, we summarize the strategies about molecular cloning and functional confirmation of plant genic male-sterility (GMS) genes and their applications for hybrid breeding and seed production via biotechnology-based male-sterility (BMS) systems in crop plants. The main content includes four sections: (1) GMS gene cloning strategies, including forward genetic approaches (e.g., map-based cloning, T-DNA or transposon tagging, and MutMap method) and reverse genetic approaches (e.g., homology-based cloning, anther-specific expression gene screening, and other reverse genetic methods); (2) functional confirmation methods of GMS genes, including transgenic complementation, targeted mutagenesis, allelic mutant test and sequencing, anther spatiotemporal expression analysis, and cytological observation; (3) application value assessment of GMS genes and mutants, such as genetic stability analysis of male sterility controlled by GMS genes under different genetic backgrounds and multiple environments, and genetic effects driven by GMS genes on plant heterosis and analysis of potential linkage with bad traits; (4) development and application of BMS systems based on GMS genes and/or their mutants, including transgenic construct-driven non-transgenic seed systems (e.g., seed production technology (SPT) and multi-control sterility (MCS)), and transgenic male-sterility systems (e.g., roundup hybridization systems (RHS1 and RHS2) and Barnase/Barstar system). Finally, we summarize and provide our perspectives on the studies of GMS genes and development of cost-effective and environment-friendly BMS systems in crop plants.",signatures:"Xiangyuan Wan and Suowei Wu",downloadPdfUrl:"/chapter/pdf-download/67662",previewPdfUrl:"/chapter/pdf-preview/67662",authors:[{id:"299083",title:"Prof.",name:"Xiangyuan",surname:"Wan",slug:"xiangyuan-wan",fullName:"Xiangyuan Wan"},{id:"299450",title:"Dr.",name:"Suowei",surname:"Wu",slug:"suowei-wu",fullName:"Suowei Wu"}],corrections:null},{id:"68741",title:"Silencing of Peroxiredoxin-4 in Anticancer Activity of Gamma-Tocotrienol",doi:"10.5772/intechopen.88813",slug:"silencing-of-peroxiredoxin-4-in-anticancer-activity-of-gamma-tocotrienol",totalDownloads:669,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Peroxiredoxin-4 (PRDX4) is known to have a role in protecting cells from oxidative stress. It has been previously reported to increase in HepG2 liver cancer cells treated with gamma-tocotrienol (GTT). As GTT treatment potentially kills the cancer cell by regulating multiple signaling pathways, this study aims to determine the involvement of PRDX4 in GTT anticancer activity by silencing the PRDX4 gene. The efficiency of PRDX4 silencing is achieved by optimizing HepG2 cell density, effect of serum presence in transduction media, incubation time of the cells with lentivirus, polybrene concentration, puromycin dose, functional titer, and multiplicity of infection (MOI) of the lentivirus. Silenced HepG2-PRDX4 cells (HepG2-shRNA-PRDX4) were treated with 70 μM of GTT for 48 h. GTT treatment significantly decreased the HepG2-shRNA-PRDX4 cell viability, increased apoptosis rate, and reduced free radical production compared to untreated HepG2-shRNA-PRDX4 cells. These findings are further supported by proteomic analysis, which showed that pro-apoptotic and DNA damage proteins were upregulated, and proteins involved in cell cycle arrest, carcinogenesis, and anti-apoptotic signaling pathways were downregulated in HepG2-shRNA-PRDX4 cells treated with GTT compared to control. In conclusion, PRDX4 plays a role in GTT anticancer activity by increasing free radical production and oxidative damage to induce apoptosis in HepG2 cell.",signatures:"Afiah Nasuha Aznan and Zakiah Jubri",downloadPdfUrl:"/chapter/pdf-download/68741",previewPdfUrl:"/chapter/pdf-preview/68741",authors:[{id:"296821",title:"Associate Prof.",name:"Zakiah",surname:"Jubri",slug:"zakiah-jubri",fullName:"Zakiah Jubri"},{id:"296847",title:"BSc.",name:"Afiah Nasuha",surname:"Aznan",slug:"afiah-nasuha-aznan",fullName:"Afiah Nasuha Aznan"}],corrections:null},{id:"67615",title:"A Noninvasive, Orally Stable, Mucosa-Penetrating Polyvalent Vaccine Platform Based on Hepatitis E Virus Nanoparticle",doi:"10.5772/intechopen.86830",slug:"a-noninvasive-orally-stable-mucosa-penetrating-polyvalent-vaccine-platform-based-on-hepatitis-e-viru",totalDownloads:750,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Hepatitis E virus nanoparticle (HEVNP) is an orally stable, mucosa-penetrating delivery platform for noninvasive, targeted delivery of therapeutic and diagnostic agents. HEVNP does not carry HEV genomic RNA and is incapable of replication. The key characteristics that make HEVNP an ideal and unique vehicle for diagnostic and therapeutic delivery include surface plasticity, resistance to the harsh environment of the gastrointestinal (GI) tract, significant payload capacity, platform sustainability, and safety. Furthermore, HEVNP is easily produced using currently available expression/purification technologies; can be easily formulated as a liquid, powder, or solid; and can be distributed (and stored) without the need for a temperature-controlled supply chain.",signatures:"Shizuo G. Kamita, Mo A. Baikoghli, Luis M. de la Maza and R. Holland Cheng",downloadPdfUrl:"/chapter/pdf-download/67615",previewPdfUrl:"/chapter/pdf-preview/67615",authors:[{id:"242476",title:"Distinguished Prof.",name:"R. Holland",surname:"Cheng",slug:"r.-holland-cheng",fullName:"R. Holland Cheng"},{id:"258461",title:"Dr.",name:"Mo",surname:"Baikoghli",slug:"mo-baikoghli",fullName:"Mo Baikoghli"},{id:"304542",title:"Dr.",name:"Shizuo",surname:"Kamita",slug:"shizuo-kamita",fullName:"Shizuo Kamita"},{id:"304543",title:"Prof.",name:"Luis",surname:"De La Maza",slug:"luis-de-la-maza",fullName:"Luis De La Maza"}],corrections:null},{id:"66383",title:"PCR and Infectious Diseases",doi:"10.5772/intechopen.85630",slug:"pcr-and-infectious-diseases",totalDownloads:1609,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:1,abstract:"Since the 1950s, the medical community has been faced with infectious diseases, which have brought significant public health and financial challenges. Currently, routine testing for the laboratory diagnosis for infectious agents is based on cell culture, serological, and molecular methods. However, cell culture-based methods are used mainly in research laboratories and are less sensitive methods when compared with serological and molecular methods. The diagnosis of infectious diseases has been revolutionized by the development of molecular techniques, mainly with the applications of polymerase chain reaction (PCR). The high sensitivity, specificity, and ease with which the PCR can be used to detect genetic sequences known have led to your wide application in science. A great number of qualitative and quantitative molecular assays are mostly based on what have been described such as real-time PCR, multiplex PCR, LAMP-PCR, and digital PCR. These assays could identify active infection by detecting infectious agents and nucleic acid in various clinical conditions including arboviruses, sexually transmitted infections, and bacterial infections. Further advancement of molecular technology is needed to improve the capacity to detect infectious agents in order to control the spread of infectious diseases and lead to appropriate actions which help to benefit patients and health-care workers themselves.",signatures:"Danielle Alves Gomes Zauli",downloadPdfUrl:"/chapter/pdf-download/66383",previewPdfUrl:"/chapter/pdf-preview/66383",authors:[{id:"282969",title:"Ph.D.",name:"Danielle",surname:"Zauli",slug:"danielle-zauli",fullName:"Danielle Zauli"}],corrections:null},{id:"67558",title:"Polymerase Chain Reaction (PCR): Principle and Applications",doi:"10.5772/intechopen.86491",slug:"polymerase-chain-reaction-pcr-principle-and-applications",totalDownloads:10294,totalCrossrefCites:6,totalDimensionsCites:14,hasAltmetrics:1,abstract:"The characterization of the diversity of species living within ecosystems is of major scientific interest to understand the functioning of these ecosystems. It is also becoming a societal issue since it is necessary to implement the conservation or even the restoration of biodiversity. Historically, species have been described and characterized on the basis of morphological criteria, which are closely linked by environmental conditions or which find their limits especially in groups where they are difficult to access, as is the case for many species of microorganisms. The need to understand the molecular mechanisms in species has made the PCR an indispensable tool for understanding the functioning of these biological systems. A number of markers are now available to detect nuclear DNA polymorphisms. In genetic diversity studies, the most frequently used markers are microsatellites. The study of biological complexity is a new frontier that requires high-throughput molecular technology, high speed computer memory, new approaches to data analysis, and the integration of interdisciplinary skills.",signatures:"Karim Kadri",downloadPdfUrl:"/chapter/pdf-download/67558",previewPdfUrl:"/chapter/pdf-preview/67558",authors:[{id:"290766",title:"Dr.",name:"Kadri",surname:"Karim",slug:"kadri-karim",fullName:"Kadri Karim"}],corrections:null},{id:"66513",title:"Annealing Temperature of 55°C and Specificity of Primer Binding in PCR Reactions",doi:"10.5772/intechopen.85164",slug:"annealing-temperature-of-55-c-and-specificity-of-primer-binding-in-pcr-reactions",totalDownloads:1441,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"In our study, we used PCR to clone papA, papEF, papG and F17G genes of Escherichia coli isolated from faecal samples of dogs with diarrhoea. Annealing temperature of 55°C was used in the PCR. Nucleotide sequence analysis of 26 cloned PCR products showed that in PCRs with papA primers, six out of eight obtained PCR products were false due to non-specific binding of the forward primer on both DNA strands; in PCRs with the papEF primers, all seven obtained PCR products originated from specific binding of the forward primer on the 3′ → 5′ DNA strand and non-specific binding of the forward primed on the 5′ → 3′ DNA strand; and in PCRs with the F17G primers, four out of eight obtained PCR products were false due to non-specific binding of forward and reverse primer. The anticipated annealing sites for non-specific primer binding in analysed nucleotide sequences are presented. In the case of PCR products obtained with papG-specific primers, all PCR products were amplifications of the papG sequence. When the annealing temperature of papA PCRs was raised to 60°C, all obtained PCR products were amplifications of the correct DNA sequences.",signatures:"Marjanca Starčič Erjavec",downloadPdfUrl:"/chapter/pdf-download/66513",previewPdfUrl:"/chapter/pdf-preview/66513",authors:[{id:"58980",title:"Dr.",name:"Marjanca",surname:"Starčič Erjavec",slug:"marjanca-starcic-erjavec",fullName:"Marjanca Starčič Erjavec"}],corrections:null},{id:"66117",title:"Real-Time Quantitative PCR as a Tool for Monitoring Microbiological Quality of Food",doi:"10.5772/intechopen.84532",slug:"real-time-quantitative-pcr-as-a-tool-for-monitoring-microbiological-quality-of-food",totalDownloads:951,totalCrossrefCites:1,totalDimensionsCites:4,hasAltmetrics:1,abstract:"Microbiological parameters of food provide quality information regarding the processing, storage, and distribution conditions, shelf life, as well as whether the food poses a health risk to the population. In this context, the concern with food safety is a competitive advantage, as the pressure of consumers, who are increasingly interested and concerned about what they are consuming, directs the trade to reach the quality of products and services offered. With regard to microbiological analyses, researchers have been developing sensitive techniques to produce rapid results, since traditional methods of microbiological culture are time-consuming and very laborious. Thus, the real-time quantitative PCR technique (qPCR) offers the possibility of quantifying the total bacterial DNA in a food sample without the need of the microbial growth step. That is, the result can be expressed on the same day, and it is possible to perform a simultaneous quantification of more than one pathogen in a single assay. Therefore, it can be a useful tool for monitoring microbiological quality in food industries. In this chapter, we will present the advantages and disadvantages of this methodology for food microbiology emphasizing the challenge of differentiating viable cells from nonviable cells.",signatures:"Amanda Teixeira Sampaio Lopes and Bianca Mendes Maciel",downloadPdfUrl:"/chapter/pdf-download/66117",previewPdfUrl:"/chapter/pdf-preview/66117",authors:[{id:"284957",title:"Prof.",name:"Bianca",surname:"Mendes Maciel",slug:"bianca-mendes-maciel",fullName:"Bianca Mendes Maciel"},{id:"284958",title:"MSc.",name:"Amanda",surname:"Teixeira Sampaio Lopes",slug:"amanda-teixeira-sampaio-lopes",fullName:"Amanda Teixeira Sampaio Lopes"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"6752",title:"Cholesterol",subtitle:"Good, Bad and the Heart",isOpenForSubmission:!1,hash:"599b1f8bc760449a4ee6ecd816a1df93",slug:"cholesterol-good-bad-and-the-heart",bookSignature:"Madan L. 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\r\n\tMigraine is a widespread brain disease that is classified as the second most disabling condition and has the third-highest prevalence of all medical conditions. In this book, all recent research advances regarding epidemiology and clinical features of both episodic and chronic migraine are reviewed. Correlations with risk factors, comorbidities, as well as hormonal status, and genes are meticulously investigated. Moreover, both migraine complications and episodic syndromes that may be associated with migraine are thoroughly described through the prism of pathophysiology-based studies. The last decade heralded a new era in migraine therapeutics, with the emergence of novel targeted therapies. Recent advances in the field of migraine research have resulted in newly available acute and preventive treatment options, including gepants (calcitonin gene-related peptide (CGRP)-receptor antagonists), anti-CGRP/R monoclonal antibodies (mAbs), and ditans (5-HT1F receptor agonists). Two special topics review therapeutic options for both the acute and prophylactic treatment of migraine. The last topic is dedicated to migraine in children, a special population that differs from adult patients not only in epidemiological and clinical features but also in diagnosis and treatment.
",isbn:"978-1-80356-813-3",printIsbn:"978-1-80356-812-6",pdfIsbn:"978-1-80356-814-0",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,hash:"44a6090845f971a215ddf013f1dc2027",bookSignature:"Dr. Theodoros Mavridis, Dr. Georgios Vavougios and Associate Prof. Dimos-Dimitrios Mitsikostas",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11584.jpg",keywords:"Incidence, Risk Factors, Episodic Migraine, Chronic Migraine, Persistent Aura Without Infarction, Migraine Aura-Triggered Seizure, Nonsteroidal Anti-inflammatory Drugs, Antiemetics, Antidepressants, Antihypertensives, Epidemiology, Pathophysiology",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 29th 2022",dateEndSecondStepPublish:"June 9th 2022",dateEndThirdStepPublish:"August 8th 2022",dateEndFourthStepPublish:"October 27th 2022",dateEndFifthStepPublish:"December 26th 2022",remainingDaysToSecondStep:"21 days",secondStepPassed:!1,currentStepOfPublishingProcess:2,editedByType:null,kuFlag:!1,biosketch:"A neurologist/neuroscientist with a great interest in headache science, neuroimmunology, and vascular neurology/stroke. Holder of MSc in Cardiopulmonary Resuscitation and Ph.D. in spinal cord injury and neurogenesis, with numerous publications and teaching experience in both neurology and emergency medicine.",coeditorOneBiosketch:"George D. Vavougios is visiting lecturer of Neurology at the University of Cyprus. His areas of expertise cover neuroimmunology, virology, epidemiology, and big data in neurology. He is actively involved in deciphering the role of COVID-19 in the brain.",coeditorTwoBiosketch:"Prof. Mitsikostas is a Professor of Neurology at Aeginition Hospital, Medical School of the National & Kapodistrian University of Athens (NKUA), Greece, heading the Headache Outpatient Clinic and the Ward A of Emergency Neurology and Stroke. He co-chairs the Management Group of the Headache Scientific Panel at the European Academy of Neurology, and he serves as President of the Hellenic Headache Society. He is a Past President of the Executive Board of the European Headache Federation.",coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"320230",title:"Dr.",name:"Theodoros",middleName:null,surname:"Mavridis",slug:"theodoros-mavridis",fullName:"Theodoros Mavridis",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v7P9pQAE/Profile_Picture_2022-04-06T13:38:07.jpg",biography:'Theodoros Mavridis, born on December 1st, 1987 in Paleo Faliro, graduated from the Medical School of the Aristotle University of Thessaloniki in 2011 and studied neurology at the Eginition Hospital of the University of Athens (2015-2020). At the same time, he became actively involved with First Aid, receiving the title of provider, trainer, seminar manager as well as trainer of trainers in many First Aid seminars such as Basic Life Support / Automatic External Defibrillator (BLS / AED), Advanced Life Support (ALS), Immediate Life Support (ILS), European Trauma Course (ETC) and Advanced Medical Life Support (AMLS) as a member of the Hellenic Society of Cardiopulmonary Resuscitation (HSCPR), the European Council for Resuscitation (ERC) and the National Association of Emergency Medicine Technicians (NAEMT) of the United States. He received his Master\'s degree in "Cardiopulmonary Resuscitation" with honors (Grade: 9.57 / 10), with a diploma thesis on: "Spinal Cord Injury and Neurogenesis". During his specialty, he got academically involved in many scientific fields of Neurology and especially in Headache Science, Stroke/Cerebrovascular Diseases, Emergency Neurology and Neuroimmunology. Since 2020, he has been a Scientific Research Associate (SRA) for the Department of Stroke and Emergency Neurology at the Eginition Hospital, where he receives training in cerebrovascular ultrasound. Meanwhile, he works as an Associate Neurologist at the Athens Euroclinic S.A. He has published more than 15 scientific articles in international peer-reviewed journals on PubMed / MEDLINE and is a reviewer of scientific manuscripts in more than 5 international peer-reviewed journals. He has taken part in 2 clinical trials on Stroke and Migraine. Under the auspices of the Alzheimer\'s Organization CNS SARS-CoV-2 Consortium, he participates as a primary investigator in a prospective study to record clinical, translational, and phenotypic data of patients after SARS-CoV-2 infection in Greece. He has participated in Greek, European, and international Neurological conferences, with over 85 posters/oral presentations, several of which a keynote speakers, while 4 of them received the best presentation award. He contributed as a member of the organizing committee in 2 Panhellenic Cardiopulmonary Resuscitation conferences. He is currently a Ph.D. candidate under full scholarship at the Medical School of Athens with a thesis on therapeutic interventions in an experimental model of spinal cord injury, while at the same time teaches as a guest speaker for undergraduate and postgraduate programs of the Medical School of Athens in fields such as Neurology, Neurosurgery, First Aid and Pharmacology. He is a chapter author in two scientific books on Migraine ("Migraine" by IntechOpen) and First Aid ("First Aid" by Broken Hill and BC Paschalidis), as well as an academic editor in a book on Headache Science. He is a member and actively participates in many scientific panels of greek, European, and international Neurological societies (EAN, AHS, EHF, HIS, ESNCH) with main interests in Headache Science, Stroke, Cerebrovascular Ultrasound, and Neuroimmunology.',institutionString:"Eginition Hospital",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Eginition Hospital",institutionURL:null,country:{name:"Greece"}}}],coeditorOne:{id:"452393",title:"Dr.",name:"Georgios",middleName:null,surname:"Vavougios",slug:"georgios-vavougios",fullName:"Georgios Vavougios",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003Lep4tQAB/Profile_Picture_1642672480441",biography:"George D. Vavougios, is a postdoctoral researcher for the University of Thessaly (UTH), at the Department of Respiratory Medicine, Larisa, Greece, and a visiting Lecturer of the Department of Neurology, University of Cyprus, Lefkosia, Cyprus since 2021. Furthermore, he is a research associate with the Neuroimmunology Laboratory of the Department of Neurology of the Athens Naval Hospital (ATH) since 2020. He graduated from the Medical School of the University of Patras in 2010 was board certified as a clinical neurologist in 2020. In 2015 he obtained his Ph.D. degree with distinction from the University of Thessaly, for his studies in neurodegenerative disease-associated proteins with respiratory disease. He completed his first post-doctoral study with distinction from the University of Thessaly in 2021 for his work in developing tools to study the transcriptomic overlap and drug repositioning between infectious and neurodegenerative disease. Since 2020, he has been an investigator for the Alzheimer’s Association CNS SARS-CoV-2 Consortium. Since 2021, he has been an institutional panel member of the European Academy of Neurology’s (EAN) Scientific Panel Neuroscience/translational neurology. 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\n\t\t\t
1. Introduction
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Construction of a quality garment requires a great deal of know-how, a lot of coordination and schedule management. Clothing manufacturing consists of a variety of product categories, materials and styling. Dealing with constantly changing styles and consumer demands is so difficult. Furthermore, to adapt automation for the clothing system is also so hard because, beside the complex structure also it is labor intensive. Therefore, garment production needs properly rationalized manufacturing technology, management and planning (Glock et. al, 1995; Caputo, et. al., 2005).
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In garment production, until garment components are gathered into a finished garment, they are assembled through a sub-assembly process. The production process includes a set of workstations, at each of which a specific task is carried out in a restricted sequence, with hundreds of employees and thousands of bundles of sub-assemblies producing different styles simultaneously (Chan et al, 1998). The joining together of components, known as the sewing process which is the most labor intensive part of garment manufacturing, makes the structure complex as the some works has a priority before being assembled (Cooklin, 1991). Furthermore, since sewing process is labor intensive; apart from material costs, the cost structure of the sewing process is also important. Therefore, this process is of critical importance and needs to be planned more carefully (Tyler, 1991). As a consequence, good line balancing with small stocks in the sewing line has to be drawn up to increase the efficiency and quality of production (Cooklin, 1991; Tyler, 1991; Chuter, 1988).
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An assembly line is defined as a set of distinct tasks which is assigned to a set of workstations linked together by a transport mechanism under detailed assembling sequences specifying how the assembling process flows from one station to another (Tyler, 1991). In assembly line balancing, allocation of jobs to machines is based on the objective of minimizing the workflow among the operators, reducing the throughput time as well as the work in progress and thus increasing the productivity. Sharing a job of work between several people is called division of labor. Division of labor should be balanced equally by ensuring the time spent at each station approximately the same. Each individual step in the assembly of product has to be analyzed carefully, and allocated to stations in a balanced way over the available workstations. Each operator then carries out operations properly and the work flow is synchronized. In a detailed work flow, synchronized line includes short distances between stations, low volume of work in process, precise of planning of production times, and predictable production quantity (Eberle et al, 2004).
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Overall, the important criteria in garment production is whether assembly work will be finished on time for delivery, how machines and employees are being utilized, whether any station in the assembly line is lagging behind the schedule and how the assembly line is doing overall (Glock & Kutz, 1995; Hui & Ng, 1999). To achieve this approach, work-time study, assembly line balancing and simulation can be applied to apparel production line to find alternative solutions to increase the efficiency of the sewing line (Kursun & Kalaoglu, 2009).
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This chapter deals with assembly line balancing in garment production by simulation. In this chapter, to analyze the structure of garment assembly, a sewing line will be focused on. Firstly, work flow of sewing line and the chronological sequence of assembly operations needed to transform raw materials into finished garment will be described in detail. Then, a detailed work and time study along the sewing line will be summarized considering the precedence constraints. After time study, real-data taken from factory floor will be discussed for distribution fit and goodness of fit. The chapter goes on creation of model of the sewing line by simulation. To set-up the model, all fitted data and allocation of operations to the operators will be transferred to simulation model. Model will be verified by comparing the actual system. Chapter then addresses how simulation model can be used to analyze assembly line’s problems such as bottlenecks. Simulation model will be compared with the ones of the actual system according to model statistics; number of current and average content in workstations in the system, cycle time, server utilization percentage, average staying time of jobs, average output, throughput values of workstations.. etc., Hence, this chapter concludes balancing of assembly line model in garment production by suggesting possible scenarios that eliminate the bottlenecks along the line by various what-if analyses using simulation technique. Throughout this chapter how assembly line balancing in garment production can be done by using simulation will be understood.
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2. Experimental
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In the production of garment, at first garment model is designed. Then, according to model requirements, a sort of fabrics are cut as well as classified due to their sewing sequences. Then, cut fabrics are sewn and assembled in order to form garment. After the sewing and pressing process, garment is controlled for eliminating sewing faults, and finally it is sent to package and expedition.
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In this chapter, to analyze the structure of garment assembly processes, a trousers sewing line was considered. The first step performed in this study was to understand trousers sewing processes’ components and sewing line problems. The objective was to have a clear idea on how a trousers production-sewing process line flows and then, how the line can be balanced as well as the performance of production line can be increased.
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2.1. Sewing line flow
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The whole trousers manufacturing cycle includes a sequence of different phases of assembly operations. In Fig. 1, a set of assembly operations to transform raw materials (cut fabrics-accessories) into finished product of trousers is shown.
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In the production of trousers, there are mainly four sequence of phases namely (i) pre-preparation of pockets, fly and labels, (ii) production of back of trousers, (iii) production of front of trousers, and (iv) assembling of fabric parts. As seen in Fig.1., at first pockets, fly and labels are prepared in order to be ready for insertion to fabric parts. Then, both back and front pockets are inserted to back and front fabric of the trousers, respectively. Fly is sewn on the front fabric. Front and back fabrics of trousers are prepared individually. Then all fabric parts are assembled in order to form trousers sequentially: Back and front fabrics are assembled. Zipper is attached and, belt and waistband are attached and sewn as well. Finally, hems, pockets, belt loop bartack seams are done and, by this way the sewing process of trousers is finished.
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Figure 1.
Trousers’ sewing line flow
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2.2. Time study
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In order to balance the sewing line as well as to increase the efficiency of the line, at first a detailed work and time study was carried out to find the task durations (Niebel, 1976).
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However, the time required to complete a task depends on a lot of factors such as the task, the operator, the properties of fabric and sub materials, working environment, quality level of the product, the hour of the day, psychology of the operator etc. (Fozzard et al,1996). Therefore to calculate the approximate real process time of a task, 20 measurements were taken for each task and operator working on the line. Time study was performed along the line by chronometer. Each operation was measured in seconds and recorded. Then the data gathered from job floor was tested for firstly independency. It should be noted here that data taken from job floor should be independent. Then gathered data was tested for distribution fit and goodness of fit.
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2.3. Distribution fit and goodness of fit
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To estimate the relevant distribution fit of the data gathered, histogram of each process was obtained firstly. For instance; histograms of process 1-front pocket fringe seam, process 3-small pocket seam, process 18-close front pocket, process 19-pocket edge stitch are shown in Fig. 2. The estimated distributions for the processes mentioned above were obtained as Logistic (42.20,3.47), Weibull (23.95,7.10), Uniform (43.76,60.24), Lognormal (36,1.17,0.972), respectively. The red lines in the figures show the estimated distributions. Similarly, the distributions estimated for all tasks were calculated.
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After the estimation of the fit distribution, to validate the goodness of fit Chi Squared test, Kolmogorov Smirnov test and Anderson Darling test can be applied. While the Chi Squared test is asymptotic, which is valid only as the number of data points gets larger, it might not be appropriate for this study as 20 measurements were taken for each operator. Since the Kolmogorov Smirnov test is not a limited distribution, being appropriate for any sample size, it was chosen to test the goodness of fit. In order to do the tests, an SPSS program was used. The level of significance was set at 0.05 (95% confidence interval) for the Kolmogorov Smirnov test (Law & Kelton, 2000; Brunk, 1960) and, consequently all the goodness of fit distributions estimated were validated. Table 1 summarizes the estimated fit distributions for all processes.
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Figure 2.
Examples of estimated distributions for some processes
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No:
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Process Name
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Fit Distribution (sec)
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No:
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Process Name
\n\t\t\t\t\t\t\t
Fit Distribution (sec)
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1
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Front pocket fringe seam
\n\t\t\t\t\t\t\t
Logistic (42.20,3.47)
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21
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Attach left fly
\n\t\t\t\t\t\t\t
Uniform (31.34,46.86)
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2
\n\t\t\t\t\t\t\t
Front pocket fringe facing seam
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Uniform (34.15,49.15)
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22
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Attach zipper
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Uniform (48.88,73.62)
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3
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Small pocket seam
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Weibull (23.95,7.10)
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23
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Underfly decoration stitch
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Uniform (45.28,63.22)
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4
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Insert label to front pocket
\n\t\t\t\t\t\t\t
Uniform (23.74,36.86)
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24
\n\t\t\t\t\t\t\t
Attach right fly
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Normal (11.68,2.02)
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5
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Welt pocket overlock
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Uniform (2.68,6.12)
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25
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Close outside leg
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Normal (77.23,4.37)
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6
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Front crotch overlock
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Uniform (17.92,28.28)
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26
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Outside leg double stitch
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Normal (53.28,4.95)
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7
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Sew right fly
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Lognormal (6,1.34,0.775)
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27
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Attach belt loop
\n\t\t\t\t\t\t\t
Uniform (47.78,61.72)
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8
\n\t\t\t\t\t\t\t
Sew right fly tape
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Uniform (2.56,4.64)
\n\t\t\t\t\t\t\t
28
\n\t\t\t\t\t\t\t
Attach waistband
\n\t\t\t\t\t\t\t
Lognormal (93,2.07,0.972)
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\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
9
\n\t\t\t\t\t\t\t
Sew left fly tape
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Lognormal (2,0.034,0.81)
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29
\n\t\t\t\t\t\t\t
Sew waistband lining
\n\t\t\t\t\t\t\t
Normal (44.88,3.96)
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\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
10
\n\t\t\t\t\t\t\t
Insert back welt pocket
\n\t\t\t\t\t\t\t
Normal (57.29,5.66)
\n\t\t\t\t\t\t\t
30
\n\t\t\t\t\t\t\t
Sew waistband mouth
\n\t\t\t\t\t\t\t
Uniform (71.06,89.54)
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\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
11
\n\t\t\t\t\t\t\t
Back welt bottom edge stitch
\n\t\t\t\t\t\t\t
Normal (31.50,2.48)
\n\t\t\t\t\t\t\t
31
\n\t\t\t\t\t\t\t
Close waistband lining
\n\t\t\t\t\t\t\t
Normal (64.96,3.43)
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
12
\n\t\t\t\t\t\t\t
Back welt top edge stitch
\n\t\t\t\t\t\t\t
Uniform (13.43,25.67)
\n\t\t\t\t\t\t\t
32
\n\t\t\t\t\t\t\t
Open waistband loop and insert label
\n\t\t\t\t\t\t\t
Logistic (28.10,4.23)
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
13
\n\t\t\t\t\t\t\t
Close back pocket and edge stitch
\n\t\t\t\t\t\t\t
Uniform (51.78,70.22)
\n\t\t\t\t\t\t\t
33
\n\t\t\t\t\t\t\t
Close back inside leg
\n\t\t\t\t\t\t\t
Uniform (34.36,51.24)
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
14
\n\t\t\t\t\t\t\t
Insert front small pocket and edge stitch
\n\t\t\t\t\t\t\t
Lognormal (37,1.22,0.98)
\n\t\t\t\t\t\t\t
34
\n\t\t\t\t\t\t\t
Close inside leg
\n\t\t\t\t\t\t\t
Normal (45.80,4.79)
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
15
\n\t\t\t\t\t\t\t
Close front small pocket
\n\t\t\t\t\t\t\t
Uniform (30.53,48.27)
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35
\n\t\t\t\t\t\t\t
Inside leg seam
\n\t\t\t\t\t\t\t
Uniform (13.00,22.90)
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
16
\n\t\t\t\t\t\t\t
Insert front pocket fringe
\n\t\t\t\t\t\t\t
Normal (52.42,4.14)
\n\t\t\t\t\t\t\t
36
\n\t\t\t\t\t\t\t
Make waistband edge
\n\t\t\t\t\t\t\t
Logistic (61.80,3.79)
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
17
\n\t\t\t\t\t\t\t
Front pocket edge stitch
\n\t\t\t\t\t\t\t
Logistic (42.10,3.54)
\n\t\t\t\t\t\t\t
37
\n\t\t\t\t\t\t\t
Close waistband
\n\t\t\t\t\t\t\t
Uniform (79.27,95.53)
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
18
\n\t\t\t\t\t\t\t
Close front pocket
\n\t\t\t\t\t\t\t
Uniform (43.76,60.24)
\n\t\t\t\t\t\t\t
38
\n\t\t\t\t\t\t\t
Double hem
\n\t\t\t\t\t\t\t
Uniform (34.11,47.49)
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\n\t\t\t\t\t\t
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19
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Pocket edge stitch
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Lognormal (36,1.17,0.972)
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39
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Pocket bartack seam
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Uniform (54.39,72.31)
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20
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Attach front pocket
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Uniform (65.26,80.54)
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40
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Belt loop bartack seam
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Normal (64.46,4.53)
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Table 1.
Estimated distributions for processes
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For instance; as seen in Table 1, the estimated distribution for the processes 10, 11, 16, 24, 25, 26, 29, 31, 34, 40 were found as normal distribution. In order to test if normal distribution is appropriate for the input data or not, Kolmogorov Smirnov test results were evaluated. With reference to Table 2 results, it was confirmed that the estimated normal distributions for these processes are appropriate for the input data. As seen in Table 2‚ the asymptote significant (2-tailed) values of the mentioned processes were found to be greater than the level of significance (0.05) for the Kolmogrov Smirnov test. Thus, these results can permit us to state that normal distributions for the processes mentioned above are appropriate and herewith, the distribution fit was validated. Similarly, each estimated distribution for each process was validated for goodness of fit by Kolmogorov-Smirnov test and it was found that all estimated distributions are appropriate for the input data so that they are ready to be transformed in simulation model of sewing line.
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\n\t\t\t\t\t\t
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Processes (No)
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\n\t\t\t\t\t\t
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\n\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
10
\n\t\t\t\t\t\t\t
11
\n\t\t\t\t\t\t\t
16
\n\t\t\t\t\t\t\t
24
\n\t\t\t\t\t\t\t
25
\n\t\t\t\t\t\t\t
26
\n\t\t\t\t\t\t\t
29
\n\t\t\t\t\t\t\t
31
\n\t\t\t\t\t\t\t
34
\n\t\t\t\t\t\t\t
40
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
N
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\n\t\t\t\t\t\t\t
20
\n\t\t\t\t\t\t\t
20
\n\t\t\t\t\t\t\t
20
\n\t\t\t\t\t\t\t
20
\n\t\t\t\t\t\t\t
20
\n\t\t\t\t\t\t\t
20
\n\t\t\t\t\t\t\t
20
\n\t\t\t\t\t\t\t
20
\n\t\t\t\t\t\t\t
20
\n\t\t\t\t\t\t\t
20
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Normal Parametersa\n\t\t\t\t\t\t\t
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Mean
\n\t\t\t\t\t\t\t
57.29
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31.50
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52.42
\n\t\t\t\t\t\t\t
11.68
\n\t\t\t\t\t\t\t
77.23
\n\t\t\t\t\t\t\t
53.28
\n\t\t\t\t\t\t\t
44.88
\n\t\t\t\t\t\t\t
64.96
\n\t\t\t\t\t\t\t
45.80
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65.46
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\n\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
Std. Deviation
\n\t\t\t\t\t\t\t
5.66
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2.48
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4.14
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2.020
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4.371
\n\t\t\t\t\t\t\t
4.95
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3.96
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3.43
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4.79
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4.53
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Most Extreme Differences
\n\t\t\t\t\t\t\t
Absolute
\n\t\t\t\t\t\t\t
0.182
\n\t\t\t\t\t\t\t
0.112
\n\t\t\t\t\t\t\t
0.125
\n\t\t\t\t\t\t\t
0.189
\n\t\t\t\t\t\t\t
0.097
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0.150
\n\t\t\t\t\t\t\t
0.159
\n\t\t\t\t\t\t\t
0.134
\n\t\t\t\t\t\t\t
0.126
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0.089
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Positive
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0.163
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0.093
\n\t\t\t\t\t\t\t
0.125
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0.108
\n\t\t\t\t\t\t\t
0.084
\n\t\t\t\t\t\t\t
0.150
\n\t\t\t\t\t\t\t
0.159
\n\t\t\t\t\t\t\t
0.122
\n\t\t\t\t\t\t\t
0.075
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0.071
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Negative
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-0.182
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-0.112
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-0.079
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-0.189
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-0.097
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-0.116
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-0.112
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-0.134
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-0.126
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-0.089
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Kolmogorov-Smirnov Z
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0.814
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0.500
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0.559
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0.846
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0.434
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0.673
\n\t\t\t\t\t\t\t
0.709
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0.599
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0.563
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0.398
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Asymp. Sig. (2-tailed)
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0.522
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0.964
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0.913
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0.471
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0.992
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0.756
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0.696
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0.865
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0.909
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0.997
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Table 2.
a. Test distribution is Normal.Kolmogorov-Simirnov test results
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2.4. Setting up the simulation model
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Simulation is a technique to model a real-life or hypothetical situation on a computer so that it can be used for analyzing the behavior of system. By changing variables predictions can be made on system behavior. It provides predictions on the performance of an existing system. Moreover, by suggesting possible scenarios on system alternative solutions can be compared. Therefore, it is a very useful engineering technique to suggest investment strategies to companies for a particular design problems.
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If the operations in the system are based on chronological sequence of events, then it is called as discrete-event simulation. Since our sewing line consists of a sequence of different phases of assembly operations, it is an example of discrete-event simulation. Therefore, to set up the model, ENTERPRISE DYNAMICS ® simulation program (Student Version) from Incontrol Simulations Solutions, which is a software program for discrete event simulation, was used (Incontrol Simulation Solutions, 2003).
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Before setting up model of sewing line, it is necessary to identify the components of model. With reference to sewing line flow seen in Fig. 1, 40 processes were considered to be assigned to 40 operators, and these operators with their machines including queues, materials, assembly operations with precedence constraints were determined as components of model.
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2.4.1. Model building basics
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In the creation of a model, the decision of right atom at a right place is critical issue. An atom can be a machine, a counter, a queue or a product etc. To create our sewing line model, mainly six different types of atoms were used as shown in Fig. 3. The explanations of atoms that were used in our model are as follows:
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Product: This atom represents the products/customers/raw materials that comes into an atom through an input channel and leave the atom through an output channel
Source: The function of this atom is to produce products into the model
Queue: This atom represents the waiting area for customers or products.
Server: This atom corresponds to a machine or a counter. Atoms coming to a server undergo a process and stay in this atom for a certain time (the process time).
Assembler: The atom which is used for assembly operation
By using these atoms, the model of sewing line was formed as shown in Fig. 4.
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Figure 4.
Simulation model preview of sewing line
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Arrows in the figure show the connections as well as the relations between atoms. Before and after server and assembly atoms or in other words before and after sewing processes, products always wait in queues for being processed like real system. Here, the data for model were entered by considering precedence constraints. Data in Table 1, as explained in the proceeding section, was transformed into simulation model for each operation individually. Also, the interval arrival time of raw material feeding in the system was obtained as an exponential distribution and directly transformed into the model as well.
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Unfortunately, to analyze the real system and create the model, some conjectures were considered:
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The 8 hour working day of the system.
Only one worker is at each machine.
Allowances are not taken into consideration.
Delay times (machine breakdowns, changing apparatus) are not taken into consideration.
There is no energy problem in the system.
Fabric loss is not taken into consideration.
Raw material is unlimited.
The supervisor’s job on the line was ignored.
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2.5. Model verification and validation
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By considering the conjectures, simulation model was run. Verification of model was done step by step comparing with actual system. The model statistics; number of current and average content in atoms in the system, cycle time, server utilization percentage, waiting time of jobs, average output, throughput values of atoms.. etc., were compared with those of the actual system, and in all cases there were no significant differences between the model and the actual system.
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3. Results
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To analyze the results of the system, three performance measures were considered:
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average staying times of jobs in queues,
average content of jobs in machines,
quantity of the average daily output
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Since our system is an example of a nonterminating simulation, it was evaluated in two stages to consider the effect of the warm-up period. Firstly, to find the warm-up period, the simulation model was run for 800 hours (5 months as a working day) at a 95% confidence level. Nevertheless, with these results, the average output quantity of the system for a day cannot be evaluated. To find the quantity of the average daily output, the system was run 100 times, each run consisting of 8 hours of simulated time, taking into account the warm-up period (Law & Kelton, 2000).
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3.1. Results based on reference layout model
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Results of the reference layout model are summarized in Table 3 according to the performance measures. As seen in Table 3, it can be observed that the average number of finished trousers in a day is 295, the average content of jobs in machines is 28 and the average staying time of jobs in queues is 260 sec. The state diagrams of the performance measures for 100 observations (5 months) are shown in Fig. 5-7. When these results were compared with those of the actual system, it was also found that the actual system and the reference model results were alike.
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To increase the efficiency of the line, firstly bottlenecks were determined, and then possible scenarios were tried by what-if analysis. As a result four scenarios were developed for the production of trousers.
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Performance measures
\n\t\t\t\t\t\t\t
Average
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St. Deviation
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L-bound (95%)
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U-bound (95%)
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Min.
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Max.
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\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
Average content of jobs in machines
\n\t\t\t\t\t\t\t
28.34
\n\t\t\t\t\t\t\t
0.04
\n\t\t\t\t\t\t\t
28.33
\n\t\t\t\t\t\t\t
28.35
\n\t\t\t\t\t\t\t
28.26
\n\t\t\t\t\t\t\t
28.42
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\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
Average staying of jobs in queues
\n\t\t\t\t\t\t\t
260.66
\n\t\t\t\t\t\t\t
1.07
\n\t\t\t\t\t\t\t
260.45
\n\t\t\t\t\t\t\t
260.87
\n\t\t\t\t\t\t\t
258.10
\n\t\t\t\t\t\t\t
264.03
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\n\t\t\t\t\t\t
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Average daily output
\n\t\t\t\t\t\t\t
295.12
\n\t\t\t\t\t\t\t
0.48
\n\t\t\t\t\t\t\t
295.03
\n\t\t\t\t\t\t\t
295.21
\n\t\t\t\t\t\t\t
294.00
\n\t\t\t\t\t\t\t
296.00
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Table 3.
Results based on reference layout model
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Figure 5.
Reference layout model: Average content of jobs in machines for 100 observations (5 months)
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Figure 6.
Reference layout model: Average staying of jobs in queues for 100 observations (5 months)
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In order to determine bottlenecks in the reference layout model; number of current and average content in atoms in the system, cycle time, server utilization percentage, waiting time of jobs, average output, throughput values of atoms.. etc. were taken into account. It was observed that process 28: Attach waistband with a higher processing time blocks the system. The server utilization status of process 28 is shown in fig. 8. As seen in the figure, machine is busy with 97.7 percentage of total time. Therefore, in reference layout model, process 28 was identified as bottleneck. By this way, the first scenario was developed by adding one extra machine to the system in order to overcome process 28’s bottleneck problem.
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Figure 7.
Reference layout model: Average daily output for 100 observations (5 months)
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Figure 8.
Overview of the different statuses of process 28 as a percentage of total time
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3.2 Results based on scenario 1
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With only adding extra one machine with an operator to the reference system, the average daily output of the system increased up to 312. That means if one machine with one operator is added to the system, then around 312 trousers will be able to be produced in a day. Moreover, when other performance measures were considered, it was also observed that average content of jobs in machines increased, besides average staying of jobs in queues decreased.
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\n\t\t\t\tTable 4 summarizes results based on scenario 1, when only one extra machine with one operator added to reference model. Fig. 9 shows the average daily output of the system according to scenario 1.
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Performance measures
\n\t\t\t\t\t\t
Average
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St. Deviation
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L-bound (95%)
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U-bound (95%)
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Min.
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Max.
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Average content of jobs in machines
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30.22
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0.06
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30.21
\n\t\t\t\t\t\t
30.23
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30,07
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30.38
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\n\t\t\t\t\t
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Average staying of jobs in queues
\n\t\t\t\t\t\t
230.97
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1.28
\n\t\t\t\t\t\t
230.72
\n\t\t\t\t\t\t
231.22
\n\t\t\t\t\t\t
227.24
\n\t\t\t\t\t\t
233.64
\n\t\t\t\t\t
\n\t\t\t\t\t
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Average daily output
\n\t\t\t\t\t\t
312.13
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0.80
\n\t\t\t\t\t\t
311.97
\n\t\t\t\t\t\t
312.29
\n\t\t\t\t\t\t
311.00
\n\t\t\t\t\t\t
315.00
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Table 4.
Results based on scenario 1
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With scenario 1, it was found that the utility percentage of server 28 decreased to 62.6% (busy). However, despite the decrease in server utility of process 28, this time new bottleneck was appeared in other machine. The server 37 was identified as second bottleneck along the line after one extra machine was added. Fig. 10 shows its usage percentage due to total working time.
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Figure 9.
Scenario 1: Average daily output for 100 observations (5 months)
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Figure 10.
Overview of the different statuses of process 37 as a percentage of total time
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Therefore, as a second scenario it was decided to add one more extra machine with one more operator to the system to overcome server 37’s work load. Indeed, the aim of adding new machine is to increase efficiency of sewing line.
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3.3. Results based on scenario 2
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By adding one more extra machine with one more operator to the system, the bottleneck problem in server 37 was also solved. By this way, the average daily output of the system increased from 312 (according to scenario 1) up to 322 as seen in Fig. 11. Moreover, average staying of jobs in queues decreased from 230 to 221 as seen in Table 5 and the work load of server 37 decreased from 95.5% to 60.30%.
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Performance measures
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Average
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St. Deviation
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L-bound (95%)
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U-bound (95%)
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Min.
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Max.
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
Average content of jobs in machines
\n\t\t\t\t\t\t\t
30.31
\n\t\t\t\t\t\t\t
0.06
\n\t\t\t\t\t\t\t
30.30
\n\t\t\t\t\t\t\t
30.32
\n\t\t\t\t\t\t\t
30.17
\n\t\t\t\t\t\t\t
30.46
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
Average staying of jobs in queues
\n\t\t\t\t\t\t\t
221.29
\n\t\t\t\t\t\t\t
0.83
\n\t\t\t\t\t\t\t
221.12
\n\t\t\t\t\t\t\t
221.45
\n\t\t\t\t\t\t\t
219.48
\n\t\t\t\t\t\t\t
224.36
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
Average daily output
\n\t\t\t\t\t\t\t
322.25
\n\t\t\t\t\t\t\t
1.20
\n\t\t\t\t\t\t\t
322.01
\n\t\t\t\t\t\t\t
322.49
\n\t\t\t\t\t\t\t
319.00
\n\t\t\t\t\t\t\t
325.00
\n\t\t\t\t\t\t
\n\t\t\t\t\t
Table 5.
Results based on scenario 2
\n\t\t\t\t
Figure 11.
Scenario 2: Average daily output for 100 observations (5 months)
\n\t\t\t\t
However, despite the better performance measures, adding additional machine to the system brought new bottlenecks. This time, bottlenecks occurred in server 1, server 2 (see Fig. 12) and server 16.
\n\t\t\t\t
Figure 12.
Overview of the different statuses of process 1 and process 2 as a percentage of total time
\n\t\t\t\t
Therefore, as a new strategy three machines with three operators were added to the system in order to decrease server 1, server 2 and server 16’s workloads and increase the efficiency of the line as well.
\n\t\t\t
\n\t\t\t
\n\t\t\t\t
3.4. Results based on scenario 3
\n\t\t\t\t
As seen in Table 6, the daily production of trousers is increased to 340 with scenario 3. Also, with the same scenario the average content of jobs in machines was higher than the scenario 2, but the average staying times of jobs in queues was found to be slightly higher (Fig. 13) than the reference layout. Moreover with scenario 3, the workloads of server 1 and server 2 decreased to 65.7% and 64.8%, respectively. As far as performance measures are concerned, the first important thing for production is the daily output, which is directly related to the line efficiency; therefore results such as the average staying of jobs in queues can be ignored for this reason, but only when they are within acceptable limits.
\n\t\t\t\t
However, the balance of sewing line can be increased by adding new servers to the system. Therefore, as a final scenario to increase the line efficiency more, four additional servers were added to system for recently overloaded servers; server 30 (96.8% busy), server 25 (97.9%busy), server 20 (98.8%busy), and server 14 (61.1%busy and 37% distributing).
\n\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
Performance measures
\n\t\t\t\t\t\t\t
Average
\n\t\t\t\t\t\t\t
St. Deviation
\n\t\t\t\t\t\t\t
L-bound (95%)
\n\t\t\t\t\t\t\t
U-bound (95%)
\n\t\t\t\t\t\t\t
Min.
\n\t\t\t\t\t\t\t
Max.
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
Average content of jobs in machines
\n\t\t\t\t\t\t\t
36.26
\n\t\t\t\t\t\t\t
0.05
\n\t\t\t\t\t\t\t
36.25
\n\t\t\t\t\t\t\t
36.27
\n\t\t\t\t\t\t\t
36.13
\n\t\t\t\t\t\t\t
36.38
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
Average staying of jobs in queues
\n\t\t\t\t\t\t\t
291.35
\n\t\t\t\t\t\t\t
1,59
\n\t\t\t\t\t\t\t
291.04
\n\t\t\t\t\t\t\t
291.66
\n\t\t\t\t\t\t\t
286.52
\n\t\t\t\t\t\t\t
295.27
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\t
Average daily output
\n\t\t\t\t\t\t\t
339.95
\n\t\t\t\t\t\t\t
1,27
\n\t\t\t\t\t\t\t
339.70
\n\t\t\t\t\t\t\t
340.20
\n\t\t\t\t\t\t\t
337.00
\n\t\t\t\t\t\t\t
343.00
\n\t\t\t\t\t\t
\n\t\t\t\t\t
Table 6.
Results based on scenario 3
\n\t\t\t\t
Figure 13.
Scenario 3: Average staying of jobs in queues for 100 observations (5 months)
\n\t\t\t
\n\t\t
\n\t\t
\n\t\t\t
3.5 Results based on scenario 4
\n\t\t\t
With final scenario, the best performance results were obtained as summarized in Table 7. The average daily output of the system increased from 295 (according to reference layout) up to 419. Average staying of jobs in queues decreased from 260 (according to reference layout) to 186. Additionally, average content of jobs in machines increased from 28 (according to reference layout) up to 39.56. With reference to this scenario, it can be said that the balancing of sewing line seems appropriate for all performance measures.
\n\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Performance measures
\n\t\t\t\t\t\t
Average
\n\t\t\t\t\t\t
St. Deviation
\n\t\t\t\t\t\t
L-bound (95%)
\n\t\t\t\t\t\t
U-bound (95%)
\n\t\t\t\t\t\t
Min.
\n\t\t\t\t\t\t
Max.
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Average content of jobs in machines
\n\t\t\t\t\t\t
39.56
\n\t\t\t\t\t\t
0.11
\n\t\t\t\t\t\t
39.54
\n\t\t\t\t\t\t
39.58
\n\t\t\t\t\t\t
39.32
\n\t\t\t\t\t\t
39.78
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Average staying of jobs in queues
\n\t\t\t\t\t\t
186.82
\n\t\t\t\t\t\t
2.39
\n\t\t\t\t\t\t
186.35
\n\t\t\t\t\t\t
187.29
\n\t\t\t\t\t\t
181.40
\n\t\t\t\t\t\t
191.63
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Average daily output
\n\t\t\t\t\t\t
419.21
\n\t\t\t\t\t\t
1.30
\n\t\t\t\t\t\t
418.96
\n\t\t\t\t\t\t
419.46
\n\t\t\t\t\t\t
415.00
\n\t\t\t\t\t\t
422.00
\n\t\t\t\t\t
\n\t\t\t\t
Table 7.
Results based on scenario 3
\n\t\t\t
Furthermore, the results of scenario 4 shows that the system became nearly balanced after 30 working days by running it for 8 hours at a 95% confidence level (Fig. 14).
\n\t\t\t
Moreover, workloads of the server 30, server 25, server 20 and server 14 decreased to 62.5%, 63.9 %, 68.6 % (Fig.15), and 55.1%, respectively. As it can be understood from above also when the workloads of the all servers became around 60 % (busy), it was observed that system got nearly balanced.
\n\t\t\t
As a summary, considering precedence constraints four scenarios were developed according to determined bottlenecks in the models. Table 8 summarizes the total changes that were suggested in each scenario. Scenario 1 includes one new operator with one machine, scenario 2 includes two new operators with two machines. Scenario 3 consists of five new operators with five machines and scenario 4 consists of nine operators with nine machines.
\n\t\t\t
Figure 14.
Scenario 4: Average daily output for 100 observations (5 months)
\n\t\t\t
Figure 15.
Overview of the different statuses of process 20 and process 25 as a percentage of total time
\n\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\tDetermined bottlenecks in the model\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\tSuggested solution for consecutive scenario\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t\tTotal changes in the line according to reference layout\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Reference Layout
\n\t\t\t\t\t\t
Server 28
\n\t\t\t\t\t\t
Add one new operator with one machine
\n\t\t\t\t\t\t
-
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Scenario 1
\n\t\t\t\t\t\t
Server 37
\n\t\t\t\t\t\t
Add one new operator with one machine
\n\t\t\t\t\t\t
One new operator with one machine was added
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Scenario 2
\n\t\t\t\t\t\t
Server 1,2, 16
\n\t\t\t\t\t\t
Add three new operators with three machines
\n\t\t\t\t\t\t
Two new operators with two machines were added
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Scenario 3
\n\t\t\t\t\t\t
Server 30, 25, 20, 14
\n\t\t\t\t\t\t
Add four new operators with four machines
\n\t\t\t\t\t\t
Five new operators with five machines were added
\n\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t\t\t\t
Scenario 4
\n\t\t\t\t\t\t
-
\n\t\t\t\t\t\t
-
\n\t\t\t\t\t\t
Nine new operators with nine machines were added
\n\t\t\t\t\t
\n\t\t\t\t
Table 8.
Summary of suggested scenarios
\n\t\t\t
As mentioned above in detail, with the suggested scenarios trousers’ sewing line was tried to be balanced. It is appearent from the Fig. 16 that the best results are obtained with scenario 4. The number of averaged finished trousers per day is increased by 42% with scenario 4. The averaged content of jobs increased by 40 % whereas the average staying of jobs is decreased by 28 %. As seen from the figure; the daily output of the system is increased to 312 with scenario 1, 322 with scenario 2, 340 with scenario 3, and 419 with scenario 4. To sum up, with the suggested scenarios the efficiency of the line was increased, and the line was balanced.
\n\t\t\t
Figure 16.
Total results of suggested scenarios according to performance measures
\n\t\t
\n\t\t
\n\t\t\t
4. Summary
\n\t\t\t
In this chapter, the structure of garment assembly line was analyzed by simulation. A trousers sewing line was considered for simulation model. Firstly, the work flow of the line as well as the chronological sequence of assembly operations needed to transform raw materials into finished trousers were described in detail. Then, a detailed work and time studies were performed along the line. Secondly, real-data gathered from factory floor was tested for distribution fit, and a Kolmogrov-Smirnov test was carried out for the goodness of fit. Afterwards, the creation of model was explained. To set-up the model, all fitted data and allocation of operations to the operators with machines considering precedence constraints were transferred to simulation model. Model verification was done by comparing the results of the model with the ones of the actual system. Then, bottlenecks in the line were determined. In order to eliminate bottlenecks in the line and to balance line, the model statistics; number of current and average content in workstations in the system, cycle time, server utilization percentage, average staying time of jobs in queues, average output, throughput values of workstations.. etc. were taken into account. Due to model statistics, possible scenarios were formed by various what-if analyses in order to balance line as well as increase its efficiency. These scenarios can provide investment decision alternatives to company administrators. Moreover, in order to present more comprehensive decision alternatives, study can be enhanced by a cost analysis of the possible scenarios.
\n\t\t\t
To conclude, this chapter has demonstrated the use of simulation technique to solve assembly line balancing problem in a garment production.
\n\t\t
\n\t\n',keywords:null,chapterPDFUrl:"https://cdn.intechopen.com/pdfs/18006.pdf",chapterXML:"https://mts.intechopen.com/source/xml/18006.xml",downloadPdfUrl:"/chapter/pdf-download/18006",previewPdfUrl:"/chapter/pdf-preview/18006",totalDownloads:18076,totalViews:1969,totalCrossrefCites:4,totalDimensionsCites:12,totalAltmetricsMentions:0,impactScore:5,impactScorePercentile:94,impactScoreQuartile:4,hasAltmetrics:0,dateSubmitted:"November 22nd 2010",dateReviewed:"April 9th 2011",datePrePublished:null,datePublished:"August 17th 2011",dateFinished:null,readingETA:"0",abstract:null,reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/18006",risUrl:"/chapter/ris/18006",book:{id:"299",slug:"assembly-line-theory-and-practice"},signatures:"Senem Kursun Bahadir",authors:[{id:"48882",title:"Dr.",name:"Senem",middleName:null,surname:"Kurşun Bahadır",fullName:"Senem Kurşun Bahadır",slug:"senem-kursun-bahadir",email:"kursuns@itu.edu.tr",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction ",level:"1"},{id:"sec_2",title:"2. Experimental ",level:"1"},{id:"sec_2_2",title:"2.1. Sewing line flow",level:"2"},{id:"sec_3_2",title:"2.2. Time study",level:"2"},{id:"sec_4_2",title:"2.3. Distribution fit and goodness of fit",level:"2"},{id:"sec_5_2",title:"2.4. Setting up the simulation model",level:"2"},{id:"sec_5_3",title:"2.4.1. Model building basics",level:"3"},{id:"sec_7_2",title:"2.5. Model verification and validation",level:"2"},{id:"sec_9",title:"3. Results ",level:"1"},{id:"sec_9_2",title:"3.1. Results based on reference layout model",level:"2"},{id:"sec_11",title:"3.2 Results based on scenario 1",level:"1"},{id:"sec_11_2",title:"3.3. Results based on scenario 2",level:"2"},{id:"sec_12_2",title:"3.4. Results based on scenario 3",level:"2"},{id:"sec_14",title:"3.5 Results based on scenario 4",level:"1"},{id:"sec_15",title:"4. Summary ",level:"1"}],chapterReferences:[{id:"B1",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBrunk\n\t\t\t\t\t\t\tH. 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J.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1988\n\t\t\t\t\tIntroduction to Clothing Production Management, Blackwell Science, Oxford, 60\n\t\t\t\t\t63 .\n\t\t\t'},{id:"B4",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCooklin\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1991\n\t\t\t\t\tIntroduction to Clothing Manufacturing, Blackwell Science, Oxford, 104\n\t\t\t\t\n\t\t\t'},{id:"B5",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tEberle\n\t\t\t\t\t\t\tH.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHermeling\n\t\t\t\t\t\t\tH.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHornberger\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKilgus\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMenzer\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRing\n\t\t\t\t\t\t\tW.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2004\n\t\t\t\t\tClothing Technology, Beuth-Verlag GmbH, Berlin\n\t\t\t'},{id:"B6",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFozzard\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSpragg\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTyler\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1996 Simulation of flow lines in clothing manufacture: Part 1: model construction, International Journal of Clothing Science and Technology, 8\n\t\t\t\t\t17\n\t\t\t\t\t27\n\t\t\t\t\n\t\t\t'},{id:"B7",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGlock\n\t\t\t\t\t\t\tR. E.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKunz\n\t\t\t\t\t\t\tG. I.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1995\n\t\t\t\t\tApparel Manufacturing-Sewn Product Analysis, Prentice Hall, New Jersey, 4\n\t\t\t\t\n\t\t\t'},{id:"B8",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHui\n\t\t\t\t\t\t\tC.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tNg\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1999 A study of the effect of time variations for assembly line balancing in the clothing industry International Journal of Clothing Science and Technology,\n\t\t\t\t\t11\n\t\t\t\t\t181\n\t\t\t\t\t188\n\t\t\t\t\n\t\t\t'},{id:"B9",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tIncontrol\n\t\t\t\t\t\t\tSimulation.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSoftware\n\t\t\t\t\t\t\tB. V.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2003\n\t\t\t\t\tEnterprise Dynamics Tutorial, Netherland\n\t\t\t'},{id:"B10",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKursun\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKalaoglu\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2009 Simulation of Production Line Balancing in Apparel Manufacturing, FIBRES & TEXTILES in Eastern Europe\n\t\t\t\t\t17\n\t\t\t\t\t4 75), 68\n\t\t\t\t\t71\n\t\t\t\t\n\t\t\t'},{id:"B11",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLaw\n\t\t\t\t\t\t\tA. W.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKelton\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2000\n\t\t\t\t\tSimulation Modeling & Analysis, McGraw-Hill Press (3rd Ed.)\n\t\t\t'},{id:"B12",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tNiebel\n\t\t\t\t\t\t\tB.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1976\n\t\t\t\t\tMotion and time study, III. R. D. Irwin, Homewood\n\t\t\t'},{id:"B13",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTyler\n\t\t\t\t\t\t\tD. J.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1991\n\t\t\t\t\tMaterials Management In Clothing Production, BSP Professional Books Press, London\n\t\t\t'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Senem Kurşun Bahadır",address:"",affiliation:'
Istanbul Technical University, Faculty of Textile Technologies and Design, Istanbul, Turkey
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“The truth goes through three stages: first, it is ridiculed, then it is violently opposed, and then, it is accepted as self-evident.”
Arthur Schopenhauer
"First they ignore you, then they laugh at you, then they fight you, then you win."
Mahatma Gandhi
1. Introduction
Though neither of these quotes is quite true, they lead this introduction because those who are working to heal broken brains and stop the suicide epidemic are closer to winning than when they started. There are no guarantees that collective successes will overcome medical resistance to accepting the obvious: what “they” are doing does not work to heal brain wounds, and “they” ignore and denigrate a safe and effective treatment that does. Yet those trying to get urgent help to suicidal brain wounded service members see victory on the near horizon for the varieties of truths told in the research and worldwide clinical medicine. As with many advances, an anecdote helps elucidate the main point: changing minds and medicine, even with science, data and facts, is not easy work.
Two renegade Australian MDs, Barry Marshall and J. Robin Warren, in 1981 knew there was a simple treatment for gastritis and peptic ulcers: an antibiotic to kill Heliobacter pylori bacteria. Now, Helicobacter pylori may be the most successful pathogen in human history. While not as deadly as the bacteria that cause tuberculosis, cholera, and the plague, it infects more people than all the others combined. Yet conventional medicine already knew that ulcers were caused by stress. An entire set of industries grew up around “healing” stress and its aftermath: antacids, stomach surgery for bleeding ulcers, gastritis, stomach cancer, depression. “To gastroenterologists, the concept of a germ causing ulcers was like saying that the Earth is flat.” [1] To them, the cause of all the illness and death was psychosomatic, “all in the head.” Marshall went so far to prove his point that he gave himself ulcers by drinking a broth of H.pylori and curing himself. And still not recognition. Cut to the chase: For their relentless persistence and science on H.pylori, in 2005 Marshall and Warren won the Nobel Prize. Treatment with an antibiotic is standard medicine for stomach cancer [2]. Twenty-four years to go from goats to Nobel laureates. Along the way, the men were ridiculed and denounced by learned councils around the world. And then the “truth.”
As you read these pages, we expect that you will be whipsawed by the truths exposed as authors and readers wonder about the answer to the Obvious Question: Since this works, why are they opposed to it? As you will see, there are no complete answers, but the data and the peer-reviewed research do provide compelling and overwhelming evidence of the safety, efficacy, and cost-effectiveness of this treatment. Over 7500 successes cannot be entirely wrong.
2. Background
On August 30, 2002, Medicare announced its intention to issue a national coverage determination (NCD) for Hyperbaric Oxygen Therapy (HBOT) in the treatment of diabetic wounds of the lower extremities. The arguments that led to that determination [3] established that oxygen under pressure was safe and effective for this fourteenth indication, or disease state.
The evolution in thinking and the subsequent research was enabled by the 1999 refinement and restatement of the drug definition of HBOT as the use of greater than atmospheric pressure oxygen as a drug to treat basic pathophysiologic processes and their diseases [4]. The UHMS defines hyperbaric oxygen (HBO2) as an intervention in which an individual breathes near 100% oxygen intermittently while inside a hyperbaric chamber that is pressurized to greater than sea level pressure (1 atmosphere absolute, or ATA) [5]. With that definition the totality of on-label indications could be understood as cohesive sets of diagnoses connected by HBOT effects on the acute and/or chronic underlying pathophysiology common to the diseases.
Doctors noticed that the definition necessarily could be applied to the use of HBOT for additional diseases that shared this pathology. Of the 14/15 indications accepted by the FDA/CMS, at least five are non-healing wounds and therefore closely related to brain wounding from blast, falls, impact, stroke, Improvised explosive devices, and concussion. Those indications are: Crush injury, compartment syndrome, and other acute traumatic ischemias; Arterial Insufficiency, entailing enhancement of healing in selected problem wounds (includes uses like Diabetic Foot Wounds, Hypoxic Wounds); Radiation tissue damage (soft tissue and bony necrosis); Skin grafts and flaps (compromised); and Air or gas embolism (resulting from rapid decompression and blast injury [6].)
The accurate drug definition of HBOT, and its implications for the findings and data in research into traumatic brain injury, is used in this paper to argue for HBOT safety and effectiveness in the treatment of Traumatic Brain Injury. The argument is constructed by identifying the underlying pathophysiology in traumatic brain injury. Evidence for the beneficial effects of HBOT on TBI is presented. Benefits to patients with TBI is discussed. Evidence for HBOT for TBI risk/benefit and cost/are discussed. The conclusion is simple: coverage of HBOT for TBI.
3. Traumatic brain injury basics
Research over the last two decades has revealed the complex microcosms of multiple pathophysiological processes resulting from insults to the brain, including traumatic brain injury [7]. The three essential components determining the outcome of head injuries are brain blood flow; the pressure in the skull leading to swelling; and hypoxia, the lack of oxygen [8].
According to the Centers for Disease Control and Prevention (CDC), “traumatic brain injury (TBI) is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.” TBI severity ranges from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury [9]. The CDC keeps current statistics on TBI death and disability.
Traumatic brain injury (TBI) is a major cause of death and disability in the United States. Those who survive a TBI can face effects that last a few days, or the rest of their lives. Among TBI-related ED visits and hospitalizations in 2014, statistics notable for the CDC include:
Hospitalization rates were highest among persons 75 years of age and older
The highest rates of ED visits included persons 75 years of age and older
For adults 55 years of age and older, falls were the leading cause of hospitalizations and ED visits
Among TBI-related deaths in 2014, rates were highest for persons 75 years of age and older
In 2014, an average of 155 people in the United States died each day from injuries that include a TBI
Between 2001 and 2010, the estimated average annual numbers of TBI in the US equaled: TBI contributed to the deaths of 56,800 people; 282,000 hospitalizations; and 2.5 M ER visits.
Accidental traumatic brain injuries contributed to more deaths than suicides and homicides together [10].
Approximately 5.3 M people in the US live with a permanent TBI [11]
The lifetime economic cost of TBI, including direct and indirect medical costs, was estimated to be approximately $76.5 billion (in 2010 dollars) [12].
Current estimates put the yearly costs of TBI among veterans at $48 billion [13].
UCLA researchers, citing animal and human studies, speak of “a neurometabolic cascade of events that involves bioenergetic challenges, cytoskeletal and axonal alterations, impairments in neurotransmission and vulnerability to delayed cell death and chronic dysfunction.. .. linking the neurometabolic cascade to clinical characteristics as well as on new connections being made between acute post-concussion pathophysiology, long-term biological changes and chronic sequelae.” [14] Further: “The etiology of postconcussive syndrome is debated, but may be caused by diffuse axonal injury or persistent metabolic alterations resulting in neuronal dysfunction and develops in 38–80% of patients with TBI….” [15].
Advanced neuroimaging reveals the basic neurobiology of concussion/mild TBI in animal models, which is increasingly corroborated in human studies. These images of the brain with such techniques as diffusion tensor imaging (DTI) validate the wounding from the brain injury.
Since HBOT has been studied as a science for over 84 years [16], a wealth of evidence exists - with or without brain imaging or functional imaging such as SPECT scans - that points to the wounding of the brain as an underlying cause of TBI and, in many cases, the cooccurrence of Post-traumatic stress disorder (PTSD). Controversy continues to wage over proper diagnoses of TBI and PTSD. The author is aware for over a decade of clinical medicine and the accumulation of “anecdotal evidence” in over 7500 successful uses of HBOT to help treat and heal TBI, that those combat veterans presenting with “PTSD only” diagnoses from the VA are overwhelmingly afflicted with undiagnosed TBI. Researchers have not yet fully understood how TBI commonly affects the neurological and clinical presentation of PTSD [17]. Despite this high prevalence, the pathogenesis of TBI, PTSD and TBI/PTSD remains largely unknown, hindering prevention and treatment efforts [18].
No matter how acquired, TBI in a veteran or a civilian, is an injury to the brain tissue. Damage is physiological, behavioral, and emotional. Symptoms can include altered consciousness; headaches; structural damage to brain matter and blood vessels and nerves; loss of neurological function that can lead to loss of motor, sensory, coordination, balance, vision, hearing and other abilities; inability to multi-task, slowed reaction time, decreased attention and concentration, inability to think fast; and frequent incapacity to work, sleep, relax, think or discern what is normal. When wounded, the brain, like all body organs, responds with the inflammatory process which proceeds to form scars, scar tissue, and chronic wounds. When the brain injury is compounded by post traumatic stress disorder (PTSD) the victim is subjected to hyperarousal, avoidance behaviors, trauma re-experiencing, increased mental vigilance, difficulty falling asleep, nightmares, constant anxiety resulting from progressive sleep deprivation and elevation of injurious stress hormones. Behaviors and emotions are magnified, intensifying the patient’s negative responses: relationship problems, domestic violence, substance abuse, depression, criminal activity, unemployment, incarceration, homelessness, and too frequently suicide. Where the degenerative cycle can be arrested with drugs or psychological interventions, the result may be a lifetime of degraded quality of life on welfare – not only for the patient but typically for the caregiver as well.
In 2016, researchers at the Uniformed Services University of the Health Sciences in Bethesda, Md., found evidence of tissue damage caused by blasts alone, not by concussions or other injuries [19]. According to the New York Times, this could be the medical explanation for shell shock and the sequalae of psychological problems called PTSD [20]. The implications are clear: IEDs, breeching, enemy and/or friendly fire from personal weapons can lead directly to physical brain damage and the accompanying effects, many of which are diagnosed as “only PTSD.”
Not to be overlooked are the complex interactions among brain injury, trauma, and physical/emotional/behavior/mental health. Psychiatrist Bessel van der Kolk, in The Body Keeps the Score [21], explains how trauma and its resulting stress harms us through physiological changes to body and brain, and that those harms can persist throughout life. Stress, trauma, depression, mental and physical health are so intertwined that it is hard to know the seat of the disease. The author argues that trauma is one of the West’s most urgent public health issues. The list of its effects is long: on mental and physical health, employment, education, crime, relationships, domestic or family abuse, alcoholism, drug addiction. As with PTSD and TBI, whether a brain insult precedes mental health problems, it is certain that the brain and the body will suffer in time.
Several studies have looked at this downward cycle in untreated brain injuries [22] and noted a correspondence between the symptoms resulting from that brain injury and the HBOT Mechanisms of Action that work to arrest and heal the traumatic brain injury.
4. Hyperbaric oxygenation mechanisms of action
Medical studies have shown that Hyperbaric Oxygen Therapy is medicine’s best way to provide oxygen to all parts of the body in the shortest period of time. Among many effects, HBOT has been shown to be effective in:
Reducing local swelling (edema) and reperfusion injury
Promoting wound healing
Improving and repairing injury, by increasing oxygen delivery to damaged tissues
Improving infection control
Releasing nitric oxide with migration to point of injury
Increasing the production of collagen
Releasing stem cells with migration to area of injury
Improving blood flow to the affected area of the brain
Restarting stunned cellular metabolism and stunned mitochondria
Generating blood vessel growth (angiogenesis)
Activating stem cells 8x normal to repair neural pathways (neurogenesis)
Decreasing markers of inflammation in the body and brain [23]
While it is uncommon to hear HBOT talked about in terms of healing wounds to the brain, the facts are now obvious: a major organ of the body is damaged. “Treatments” in the DoD and Veterans Administration for a brain-wounded population of at least 414,000 post-9/11 veterans typically resolve to rest and “a mix of cognitive, physical, speech, and occupational therapy, along with medication to control specific symptoms such as headaches or anxiety.” [24] Virtually the last time TBI is referred to as a wound is when speaking of “the Invisible Wounds of War.”
Brain wound healing demands that the body grow new tissue: blood vessels, connective tissue, new brain tissue. Cells have to grow and divide to form new tissue, necessitating stimulation of cells to divide and multiply. DNA must be stimulated [25]. By 2008 DNA analysts found that a single hyperbaric treatment turns on as many as 8101 genes in the 24 hours following HBOT treatment [26]. In short, “the turned-on genes are those genes that code for growth and repair hormones and the anti-inflammatory genes.” [27] As already noted, HBOT is already approved for several on-label indications collectively similar as wound healing. It is worth noting that HBOT chambers are present in 1158 of a total of 3342 hospitals in the US [28]. Those chambers are primarily used for Wound Healing. For a variety of reasons, those chambers are not put to use on off-label uses of HBOT. Nevertheless, the bulk of science on animal and human patients with TBI has been collected in both hospital-based and private clinics.
Dr. Paul Harch prepared voluminous evidence on HBOT for wound healing in his arguments for recognition of DFW in 2002 [29]. More specific to TBI, Dr. Philip James, in “Head Injuries – the Curse of Life in the Fast Lane,” [30] traces the development of HBOT-for-TBI research as far back as 1972 [31]. The study found that tissue oxygen levels that fight hypoxia rise with the increase in either the oxygen concentration or pressure: hyperbaric oxygenation. James writes that “this one study answers all the questions and objections raised about using hyperbaric oxygen treatment for patients with head injury.” [32] Oddo in 2011 identified hypoxia as a culprit. Brain hypoxia is associated with poor short-term outcome after severe traumatic brain injury independently of elevated ICP, low CPP, and injury severity. Reduced brain oxygen (Pbto [2]) may be an important therapeutic target after severe traumatic brain injury [33]. Dr. Daphne Denham, the nation’s premier expert on HBOT treatment of acute concussion, reported that 98% of her patients in her Fargo ND clinic [348 out of 350] treated within ten days of suffering a concussion, completely resolved their symptoms in five treatments or less [average of 2.4 treatments] [34]. The only difference in her patients and the thousands of concussed athletes in North Dakota who linger with symptoms for weeks and months using standard of care medicine [AKA “the tincture of time”] was HBOT. [NOTE: Maroon and Bost in 2011 write that nonpharmaceutical alternatives, dietary supplements and hyperbaric oxygen “may be a better first-line choice for the treatment of PCS, which has generally been underreported by both athletes and the military.” [35] Of note for the CMS population is the work of Dr. Anne McKee on the connections between concussion and Chronic Traumatic Encephalopathy (CTE) [36]. “CTE is a progressive neurodegeneration clinically associated with memory disturbances, behavioral and personality change, Parkinsonism, and speech and gait abnormalities…. traumatic injury may interact additively with [Alzheimer’s Disease] to produce a mixed pathology with greater clinical impact or synergistically by promoting pathological cascades that result in either AD or CTE.”
Of no small importance is groundbreaking research from Washington State University. Researchers found that HBOT can halve the pain and symptoms of opiate withdrawal/detox [37].
And in current investigations of the use of HBOT to arrest and reverse the effects of COVID-19, preliminary evidence from China [38] (five cases) strongly suggests that based on the immutable science of HBOT and recent clinical application to deteriorating severely hypoxemic COVID-19 pneumonia patients, HBOT has significant potential to impact the COVID-19 pandemic. Fifty-eight patients as of this writing have been positively affected. Further, clinicians in at least five independent studies in the US using HBOT are raising the PO2 levels in patients in ICUs to the point where they avoid being put on ventilators and, in many cases, are being sent home after as few as five treatments [39].
5. Decades of science: studying HBOT to treat TBI
A review of the scientific evidence produced in both animal and human HBOT trials over the past twenty years demonstrates conclusively that Hyperbaric Oxygenation of TBI is safe and effective [40]. As early as 1977, Holbach and Wasserman demonstrated that HBOT at 1.5ata puts the most oxygen into the brains of chronic stroke patients [41]. The overriding principle of wound healing, of course, is that the wound must have energy and oxygen to heal. Hypoxia is the most pervasive result of brain insults of all kinds, occasioned by inflammation that leads to reduced oxygen delivery to all body organs.
Following a Consensus Conference in 2008, at which it was declared that HBOT was safe [42], DoD/Army/VA researchers commenced a series of studies to discern whether HBOT was effective in treating TBI. Those studies over nearly eight years consumed over $126Million. Other studies in the private sector costing orders of magnitude fewer dollars were also conducted. To date, there have been at least seventeen peer-reviewed studies that have produced data and findings [43].
U.S. and Israelis clinical trials have provided well-structured, controlled studies demonstrating HBOT medicinal properties in mild TBI and persistent post-concussive symptoms [44]. Positive symptom scores for TBI and PTSD symptom scores for the two government-sponsored studies [45], the Army-sponsored study of Miller et al. [46], a civilian-sponsored study of Harch et al. [47], and an Israeli civilian study [48] show statistically significant improvements over baseline after HBOT treatments.
The studies involved patients with TBI who also suffered from Persistent Post-Concussive Syndrome (PPCS) for at least two years. It was highly unlikely that spontaneous recovery would occur. Five studies provide useful cross-study comparable measures. The U.S. studies used the Immediate Post-Concussion Assessment, Cognitive Testing, Rivermead Post-Concussion Questionnaire, and PTSD Checklist–Military (PCL-M) as the primary and secondary endpoint measures. Even though the Army/VA/DoD sponsored studies claim to be “sham-controlled,” they are really dosing and-pressure-varying trials.
Clinical improvements in the studies were significant and consistent. Looking at dose response profiles shows that lower oxygen levels (100% O2) and lower pressures (2.0 ATA) are probably better for PTST/mTBI and PPCS symptom recovery.
Government-sponsored study authors assumed incorrectly that their control groups received inactive treatment. Yet they write; “We recognize that a sham is not inert, and we cannot completely discount the physiological effects of minimal increases in nitrogen or oxygen from pressurized room air. However, we believe it is biologically implausible that air at 1.2 ATA (equivalent to 2 m of seawater pressure) has a beneficial effect on healing the damaged brain remotely after mTBI [49]. (It is worth noting that the comment bears on relationship to the established science about the medicinal effects of low levels of either oxygen or pressure.) [50] Positive improvements from pretreatment (baseline) measures are observed in all the DoD/VA/Army and civilian studies. The measured responses to both HBO and HBA treatment groups are therapeutic, but a minimal effective dose of O2 at 1ata pressure has not been established in the hyperbaric medical literature. Thus, the use of a sham is problematic and confounding for study interpretation.
Deng and his team in a metanalysis evaluated nine studies comparing the efficacy between hyperbaric oxygen treatment and controls in traumatic brain injury patients [51]. “Brain metabolism, cognitive function, and outcome were taken into consideration. Results showed that HBO treatment significantly improved the Glasgow outcome scale (GOS) score and reduced overall mortality in patients with severe TBI compared with controls. In patients with mild TBI, HBO showed function alleviating the cognitive disorder after trauma, including memory, executive function, attention, and information processing speed.” In patients with TBI, HBO showed significant improvement of Glasgow outcome scale score and reduction of overall mortality while NBO may play a favorable role in improving brain metabolism.
6. Implications of the science
For over four years, clinical and “evidence-based” medicine continue to show that HBOT is safe and effective in treating brain injuries. Objective analysis of the data from all the pivotal RCTs and crossover studies show in over 700 patients that positive improvements result from HBOT treatment protocols. And objective analyses of the studies and data reinforce the findings and the clinical evidence [52].
Dr. Wolf is a principle co-author of the first Army study. This recent USAF paper reanalyzing the data in the cornerstone DOD/VA/Army study concludes: “This pilot study demonstrated no obvious harm [and] both groups showed improvement in scores and thus a benefit. Subgroup analysis of cognitive changes and PCL-M results regarding PTSD demonstrated a relative risk of improvement…. There is a potential gain and no potential loss. The VA/Clinical Practice Guidelines define a “B evidence rating” as “a recommendation that clinicians provide (the service) to eligible patients. At least fair evidence was found that the intervention improves health outcomes and concludes that benefits outweigh harm …. Hyperbaric oxygen therapy for mild traumatic brain injury and PTSD should be considered a legitimate adjunct therapy if future studies demonstrate similar findings or show comparable improvement to standard-of-care or research-related treatment modalities.” [53] Subsequent studies meet those criteria.
The Journal of Hyperbaric Medicine is the most prestigious journal on Hyperbaric Medicine in the world. In 2012 its editor wrote: “ While we applaud good science, there comes a point.. .. of stagnation as the standard of evidence required for the blessing of organized medicine exceeds reality (where most of us live.… I feel, as do many of my colleagues, that there is sufficient clinical and research evidence to justify the use of [HBOT] as a standard-of-care treatment for [TBI] that should be reimbursed by CMS and Tricare…. I have no doubt that, over the next several years, [HBOT] will be proven beyond a reasonable doubt to be one of the most effective treatments for [TBI]…. There is a preponderance of evidence now to justify the use and funding for the treatment….” [54] Wang et al. concur: “Compelling evidence suggests the advantage of hyperbaric oxygen therapy (HBOT) in traumatic brain injury. …Patients undergoing hyperbaric therapy achieved significant improvement. … with a lower overall mortality, suggesting its utility as a standard intensive care regimen in traumatic brain injury.” [55].
The Samueli Institute wrote of DoD studies: “Results showed that both the HBO and sham procedures were associated with significant improvements in post-concussion symptoms and secondary outcomes, including PTSD (which most participants had), depression, sleep quality, satisfaction with life, and physical, cognitive, and mental health functioning.. .. these results are consistent with 2 other sham-controlled clinical trials among service members and veterans involving a range of HBOT doses. … The most remarkable lesson of this study was the difference in clinical outcomes between the 2 chamber procedures (HBO 1.5 ATA and ‘sham’ air 1.3 ATA) and routine post-concussion care. … These findings reinforce the argument that effective interventions [i.e., the current standard of care practiced by military medicine] do not yet exist within the present structure of care or that routine post-concussion interventions within the [DOD or VHA] may even have iatrogenic effects that contribute to symptom persistence, the equivalent of a negative placebo (nocebo) effect.” [56].
While this research has been going on, the VA has been quietly conducting a controlled “demonstration project” to monitor the effects of HBOT for “PTSD-only” veterans. For nearly three years, first two and now five sites around the US are using HBOT to treat PTSD and TBI patients: Tulsa OK, Travis AFB, Joint Base Sam Houston, Tampa, and Fargo ND. While the numbers are small, the results are extremely positive. 30 out of 30 patients have all shown positive medical improvement [57]. Significantly, numerous of the participants are diagnosed with TBI by the VA or have been found to have undiagnosed TBI. Either way, the overwhelming number of patients have improved significantly. These results are significant for reasons related to previous attempts to treat PTSD. The National Academies, writing in 2014 stated: “DoD and VA are spending substantial time, money, and effort on the management of PTSD in service members and veterans [$9.3Billion+ through 2014] [yet] neither department knows with certainty whether those many programs and services are actually successful in reducing the prevalence of PTSD in service members or veterans and in improving their lives.” [58].
A Summary of the positive findings in the studies sponsored by DoD/VA/Army is instructive. They find that HBOT “offered statistical and in some measures clinically significant improvement over local routine TBI care.” They even note the improvements in all groups when measured against the no-treatment group. Even their “expert” consultants wrote that HBOT heals brain injuries. The Army’s premier researcher, Dr. Scott Miller, despite seeming to be looking for “the final nail in the coffin” of HBOT, says on the Veterans Affairs web site: “People did get better and we can’t ignore those results.” [59].
7. NOTE BENE: the sham and placebo controversies in HBOT
Expert commentary on the issues surrounding the HBOT “sham” revealed the fundamental flaws in the DoD/VA/Army research [60]. In a sham treatment, the researcher goes through the motions without actually performing the treatment. The intent is to have an inert or medically inactive procedure or substance used to compare results with active substances. A placebo is often used with half the people in a drug trial to help show whether the drug being studied is more effective than an inactive “sugar pill.” The results of each group are compared. [NOTE: Debate continues on whether it is possible, under the circumstances of HBOT treatment, to construct a true sham-controlled study.]
The placebo effect is very difficult, if not impossible, to prove in HBOT studies on patients suffering from PPCS that accompanies TBI. Further studies cannot ignore a placebo, but the overwhelmingly positive effects in so many, and so widely different studies, make the likelihood of a placebo unusual. [NOTE: when physiologic changes, such as both structural and functional increases in brain mass and activity are noted – as they were not in DoD/VA/Army studies, since they refuse to perform such objective science – it is impossible to ascribe the changes to the placebo effect. In numerous of the non-government published peer-reviewed studies on the use of HBOT for TBI, however, such positive transformations have been noted in the treated patients. Objective evidence of changes are shown in peer-reviewed research using such methods as SPECT scans, RightEye, qEEG, etc. Those changes can only be the effect of exposure to HBOT [61].]
A worldwide surge of challenges arose when the DoD/Army/VA studies purported to use a sham in their studies and reported that HBOT “does not work.” [62] International researchers and authorities could read that both the data and the discussion in all the purported randomized controlled studies said virtually the same thing: “Both intervention groups [sham and treated] demonstrated improved outcomes compared with PCS care alone” [63] Dr. Pierre Marois spoke for many: “By definition “sham” is “something false or empty”. Hyperbaric treatments at 1.2 ATA substantially increase the amount of dissolved oxygen in the blood and simultaneously induce cascades of metabolic changes and genes activation. Therefore, the supposedly sham treatment of Miller’s study is not close to being a placebo.” [64].
The clearest example to date that demonstrates that these gas/pressure combinations have a therapeutic effect on brain injury models is the article by Malek et al. [65] They demonstrated that HBO (100% O2) and HBA (21% O2/79% N2) were equivalent in protecting neurons after transient forebrain ischemia in the gerbil using 2.5 ATA. The role of a potential placebo effect was ruled out in this study and demonstrates the activity of HBO and HBA in a neurologic injury model.
The certainty that hyperbaric medicine begins with any increase in oxygen concentration and/or pressure is further substantiated by on-going work at the University of Wisconsin [66]. Animal studies already show a significant increase in mobilized stem progenitor cells and decrease in Inflammatory cytokines when HBOT and HBAT (room-air) are applied at pressures as low as 1.2ata. Together these findings support the likelihood of biologic activity, consubstantial with HBOT, being activated at much lower dose of hyperoxia than previously postulated. Those results, coupled with decades of experiments by the US Navy and US Air Force [67], demonstrate that the Army’s and UHMS’s claims that hyperbaric medicine only occurs at pressures higher than 1.4ata are fallacious. Any increase in oxygen concentration and/or pressure is a medical intervention.
The USAF TBI study used the Agency for Healthcare Quality and Research recommendations for future HBOT research for TBI. One pertinent comment was the following: “Whether placebo-controlled trials are necessary to evaluate HBOT has received a great deal of attention in discussions about HBOT. Participants on all sides of this debate make the assumption that an “evidence-based” approach implies devotion to double-blind, placebo-controlled trials without regard to practical or ethical considerations. This assumption is false. Double-blind, placebo-controlled trials are the “gold standard” for government regulators overseeing the approval of new pharmaceuticals, but not for clinical decision-making or insurance coverage decisions. Evidence-based clinical decisions rely more heavily on comparisons of one treatment to other potentially effective therapies, not to placebos.” [68].
8. The economic argument in favor of coverage
In what will be a ground-breaking analysis released on Veterans’ Day, November 11, 2020, The TreatNOW Coalition, building on the seminal work done in 2011 [69], will update and expand the “true cost of ownership” to the American taxpayer of untreated brain injuries. Most studies attempting to estimate costs typically pay attention to the obvious cost categories – drugs, yearly health care costs, ER visits, hospitalizations, psychiatric care, home health care, long term care, lost wages, and sometimes even the impact on the family. TreatNOW has gone much further in examining the “ripple effect” through the family and into society.
The Study looks at impact on the family in categories such as physical and mental damage to immediate family members, including children and care-givers; social services for children affected by turmoil; and spousal suicides occasioned by violence and abuse. Divorce, homelessness, drug abuse, incarceration, death-by-cop, and the estimated 135 people seemingly affected with every suicide [70].
A major “cost” to society beyond the medical expenditures are the tax implications of taking a brain-wounded citizen out of the work force. In too many cases, that actually equates to two lost incomes and taxes because a care-giver is typically a full-time aide to the wounded.
Brain Injury Facts about veterans are hard to pin down accurately since there are so much missing data. For example, the VA estimates that 70% of veterans are not part of the VA system. The VA also estimates TBIs alone for the period of 2000–2017 is over 414,000. RAND estimates that about one-third of all returning vets reported symptoms of some mental health or cognitive condition. More recent estimates range up to 800,000+ for post-9/11, and an equal number of living veterans from service in the 20th century. Civilian casualties are estimated by the CDC as 2.5 million per year, with more than 5 million American effectively unemployable and unable to perform activities of daily living.
To summarize a much more robust analytical picture: untreated brain injuries cost billions of dollars each year when many of them could be reversed by application of HBOT to help heal the underlying and frequently ignored or misdiagnosed brain injury. It costs somewhere between $40,000 and $60,000 per year for each brain injured patient. HBOT treatment has shown an 85% probability of making a significant contribution to the health and welfare of treated patients, at a cost of approximately $20,000. Thus, for less than 2% of the costs of sustaining the brain wounded on welfare, those brain injuries could be treated. The possibility of returning Quality of life and independence to a significant fraction of those wounded is high.
9. Coverage with evidence
Should further research be required before HBOT for TBI receives an indication, the Center for Medicare and Medicaid (CMS) issued Guidance for the Public, Industry, and CMS Staff, Coverage with Evidence Development, November 20, 2014 [71]. CMS and AHRQ declared that the principal purpose of the study would be to test whether the item or service (HBOT for TBI) meaningfully improves health outcomes of affected beneficiaries who are represented by the enrolled subjects. Unsurprisingly, the data and the demographics support immediate use of HBOT.
10. Conclusion
It has been the experience of independent scientists over the last decade that peer-reviewed evidence from around the world attests to the safety and efficacy of HBOT in treating and helping to heal TBI and other neurological disorders. Yet the bulk of research on brain diseases and injury focuses on description and causes rather than treatments. Research into “treatments” is by design focused on treating symptoms. Clinical Practice Guidelines from the VA/DoD, for example, specifically focus on the “management” of concussion/mild traumatic brain injury [72]. Their CPG is a compendium of best practices for dealing with symptoms, not with healing or curing. No mention is made in the document of the wound to the brain, nor to healing that wound. And none of the treatments listed as standard of practice are approved by the FDA for treating TBI [73].
Unsurprisingly, huge sums are being poured into worldwide research, some coordinated, most in a competitive surge to devise better ways to understand the structure, function, aberrations and diseases, and treatments for the brain. The US (the Brain Initiative), Europe (Human Brain Project), Japan (Brain/MINDS Project), China (Brain Project), Israel, Australia and Canada have funded major projects [74]. Groups like One Mind and Paul Allen’s Brain Institute are exploring how the brain works and what causes neurological disorders. While the projects vary slightly in their aims, the thrust is on knowledge rather than clinical medicine and healing. Longer-term goals of course include medicine to the patient. Yet precious little in all the efforts is being done to find immediate-use methods to intervene in areas of wide and profound importance to human mental health.
On a more mundane basis, federal, state, local, public and private efforts continue year-after-year to address in conferences and papers and legislation the perennial, interrelated issues of suicide, mental health, brain injury, addiction, and neurocognitive and neurological decline. It is hardly surprising that the expenditures promise phenomenal rewards for breakthroughs. Meanwhile, billions are expended treating symptoms of underlying brain damage that the science demonstrates is both treatable and potentially reversible, not later, but now.
Wright and Figueroa summarize for the majority of researchers on the use of HBOT to treat and help heal TBI: “There is sufficient evidence for the safety and preliminary efficacy data from clinical studies to support the use of HBOT in mild traumatic brain injury/persistent post concussive syndrome (mTBI/PPCS). The reported positive outcomes and the durability of those outcomes has been demonstrated at 6 months post HBOT treatment. Given the current policy by Tricare and the VA to allow physicians to prescribe drugs or therapies in an off-label manner for mTBI/PPCS management and reimburse for the treatment, it is past time that HBOT be given the same opportunity. This is now an issue of policy modification and reimbursement, not an issue of scientific proof or preliminary clinical efficacy.” [75].
It is time to recognize the worldwide body of data, reduce healthcare costs, improve the lives of millions of brain-wounded and their families, and avoid lifetimes of lost earnings and the social impact of avoidable suffering. HBOT should be endorsed for the treatment of Traumatic Brain Injury. This can be achieved by extending CMS coverage to this diagnosis.
\n',keywords:"hyperbaric oxygen, TBI, PTSD, concussion",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/73833.pdf",chapterXML:"https://mts.intechopen.com/source/xml/73833.xml",downloadPdfUrl:"/chapter/pdf-download/73833",previewPdfUrl:"/chapter/pdf-preview/73833",totalDownloads:677,totalViews:0,totalCrossrefCites:0,dateSubmitted:"June 17th 2020",dateReviewed:"October 9th 2020",datePrePublished:"October 30th 2020",datePublished:"July 7th 2021",dateFinished:"October 30th 2020",readingETA:"0",abstract:"Hyperbaric Oxygen Therapy can help heal brain wounds: TBI/PTSD/Concussion. Peer-reviewed positive scientific and clinical evidence in over 7500 cases demonstrates that HBOT helps heal wounded brains and returns patients to a life denied them by DOD/VA/Army that will not talk about, or even use or pay for HBOT treatment for TBI/PTSD/PCS/Concussion. Successful treatment with HBOT [40 one-hour sessions] virtually eliminates suicidal ideation, an effective “suicide prevention” method. Patients also reduce their drug intake to nearly zero and experience 50% reduction in pain and time to withdrawal. The history of HBOT for TBI is littered with bad science, but evidence-based and clinical medicine data show the safety, efficacy and cost effectiveness of HBOT as a standard of care that should be put on-label and insured.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/73833",risUrl:"/chapter/ris/73833",signatures:"Robert Louis Beckman",book:{id:"9656",type:"book",title:"Advancement and New Understanding in Brain Injury",subtitle:null,fullTitle:"Advancement and New Understanding in Brain Injury",slug:"advancement-and-new-understanding-in-brain-injury",publishedDate:"July 7th 2021",bookSignature:"Zamzuri Idris",coverURL:"https://cdn.intechopen.com/books/images_new/9656.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-1-83881-920-0",printIsbn:"978-1-83881-919-4",pdfIsbn:"978-1-83881-933-0",isAvailableForWebshopOrdering:!0,editors:[{id:"73844",title:"Prof.",name:"Zamzuri",middleName:null,surname:"Idris",slug:"zamzuri-idris",fullName:"Zamzuri Idris"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"324575",title:"Dr.",name:"Robert Louis",middleName:"Louis",surname:"Beckman",fullName:"Robert Louis Beckman",slug:"robert-louis-beckman",email:"heal@treatnow.org",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"",level:"1"},{id:"sec_2",title:"1. Introduction",level:"1"},{id:"sec_3",title:"2. Background",level:"1"},{id:"sec_4",title:"3. Traumatic brain injury basics",level:"1"},{id:"sec_5",title:"4. Hyperbaric oxygenation mechanisms of action",level:"1"},{id:"sec_6",title:"5. Decades of science: studying HBOT to treat TBI",level:"1"},{id:"sec_7",title:"6. Implications of the science",level:"1"},{id:"sec_8",title:"7. NOTE BENE: the sham and placebo controversies in HBOT",level:"1"},{id:"sec_9",title:"8. The economic argument in favor of coverage",level:"1"},{id:"sec_10",title:"9. Coverage with evidence",level:"1"},{id:"sec_11",title:"10. Conclusion",level:"1"}],chapterReferences:[{id:"B1",body:'DISCOVER: The Dr. Who Drank Infectious Broth, Gave Himself an Ulcer, and Solved a Medical Mystery. http://discovermagazine.com/2010/mar/07-dr-drank-broth-gave-ulcer-solved-medical-mystery'},{id:"B2",body:'See Germs Are Us: Exploring the Human Microbiome: Michael Specter/The New Yorker, October 22, 2012 http://www.newyorker.com/reporting/2012/10/22/121022fa_fact_specter'},{id:"B3",body:'Harch, Paul G., M.D. Argument for Medicare/Medicaid Coverage of Hyperbaric Oxygen Therapy Treatment of Diabetic Foot Wounds, June 2001'},{id:"B4",body:'Harch PG, Neubauer RA. Hyperbaric oxygen therapy in global cerebral ischemia/anoxia and coma, Chapter 18. In: Jain KK, ed. Textbook of Hyperbaric Medicine. 3rd Revised Edition. Seattle, WA, USA: Hogrefe and Huber Publishers; 1999:319-345'},{id:"B5",body:'https://www.uhms.org/resources/hbo-indications.html'},{id:"B6",body:'A growing body of literature related to blast injury and TBI/PTSD attests to the damage attributable to combat. Various names have been used to describe the damage done by blasts: Shell Shock, Soldier\'s heart, Battle fatigue, Anxiety disorder, Railway spine, Stress syndrome, Nostalgia, Combat stress reaction, Traumatic war neurosis, Invisible wounds, Post traumatic stress disorder, and Traumatic brain injury. For a full bibliography on a decades-long body of research and data, see: https://treatnow.org/knowledgebase/3-blast-biography/; and https://treatnow.org/knowledgebase_category/2020/Bibliography. Importantly, the United States Army Textbook of Military Medicine, 1991, Neurological Abnormalities of the Blast Casualty, “Evaluation for Head Injury and Arterial Air Embolis,” “Definitive Therapy in Hyperbaric Chamber.” Also, it was reiterated again in 2006 that combat casualty care for traumatic brain injury was HBOT. Zajtohuk, R. Ed in Chief, Textbook of Military Medicine, Series on Combat Casualty Care, Part 1, Vol. 6, p. 313'},{id:"B7",body:'Giza, C.C. and Hovda, D.A. The New Neurometabolic Cascade of Concussion. Neurosurgery. October 2014: 75(0 4): S24–S33; James, P.B., Philip B. James, MD, Oxygen and the Brain; the Journey of Our Lifetime, North Palm Beach, FL: Best Publishing Co., 2014, Chap. 19: Head Injuries, the curse of life in the fast lane'},{id:"B8",body:'James, p.333'},{id:"B9",body:'Centers for Disease Control and Prevention (2019). Surveillance Report of Traumatic Brain Injury-related Emergency Department Visits, Hospitalizations, and Deaths—United States, 2014. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services'},{id:"B10",body:'https://www.usnews.com/news/healthiest-communities/articles/2019-11-21/suicide-is-top-cause-of-deaths-tied-to-traumatic-brain-injury'},{id:"B11",body:'https://www.brainandspinalcord.org/brain-injury-statistics/'},{id:"B12",body:'https://www.cdc.gov/traumaticbraininjury/severe.html'},{id:"B13",body:'See https://treatnow.org/knowledgebase/untreated-brain-injuries_costs-to-society/'},{id:"B14",body:'Giza and Hovda, S24–S33'},{id:"B15",body:'Leila H Eadie (editorial). New technology and potential for telemedicine in battlefield brain injury diagnostics. Concussion (2016) 1(4), CNC22'},{id:"B16",body:'Behnke, A.R., et al. “The circulatory and respiratory disturbances of acute compressed-air illness and the administration of oxygen as a therapeutic measure.” American Journal of Physiology 114 (3): 526-533. http://ajplegacy.physiology.org/cgi/content/citation/114/3/526 January 31, 1936)'},{id:"B17",body:'Management of Post-Traumatic Stress Working Group. VA/DoD Clinical Practice Guidelines for Management of Post-Traumatic Stress. Washington, D.C.: Department of Veteans Affairs and Department of Defense; Oct. 2010. Available at: www.healthquality.va.gov/PTSD-FULL-2010c.pdf'},{id:"B18",body:'Controversy continues to wage over proper diagnoses of TBI and PTSD. The authors are aware from over a decade of clinical medicine and the accumulation of “anecdotal evidence” in over 7,200 successful uses of HBOT to help treat and heal TBI, that those veterans presenting with “PTSD only” diagnoses from the VA are overwhelmingly afflicted with undiagnosed TBI. Further, although populations at high risk for PTSD (e.g., military populations) have a high incidence of exposure to traumatic brain injury (TBI), additional work is needed to fully characterize the ways in which TBI can affect the clinical and neurological presentation of PTSD. Spadoni, A.D., Huang, M., Simmons, A.N., 2018. Emerging approaches to neurocircuits inPTSD and TBI: imaging the interplay of neural and emotional trauma. Curr. Top.Behav. Neurosci. 38, 163-192; Tanev, K.S., Pentel, K.Z., Kredlow, M.A., Charney, M.E., 2014. PTSD and TBI co-morbidity: scope, clinical presentation and treatment options. Brain Inj 28, 261-270. https://doi.org/10.3109/02699052.2013.873821; and Vasterling, J.J., Verfaellie, M., Sullivan, K.D., 2009. Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: perspectives from cognitive neuroscience. Clin. Psychol. Rev., Posttraumatic Stress Disorder Wars Afghanistan Iraq 29, 674-684. https://doi.org/10.1016/j.cpr.2009.08.004'},{id:"B19",body:'Baughman Shively, S., Iren Horkayne-Szakaly, Robert V Jones, James P Kelly, Regina C Armstrong, Daniel P Perl. Characterisation of interface astroglial scarring in the human brain after blast exposure: a post-mortem case series. The Lancet, Neurology, June 2016. DOI: http://dx.doi.org/10.1016/S1474-4422(16)30057-6'},{id:"B20",body:'Worth, RF, What if PTSD Is More Physical Than Psychological? A new study supports what a small group of military researchers has suspected for decades: that modern warfare destroys the brain. New York Times, JUNE 10, 2016. http://nyti.ms/1TYYp6U'},{id:"B21",body:'van der Kolk. B. The Body Keeps the Score: Brain, mind, and body in the healing of trauma. London: Penguin Publishing Group, 2014'},{id:"B22",body:'Amir Hadanny & Shai Efrati (2016): Treatment of persistent post-concussion syndrome due to mild traumatic brain injury: current status and future directions, Expert Review of Neurotherapeutics, DOI: 10.1080/14737175.2016.1205487; Harch PG. Hyperbaric oxygen in chronic traumatic brain injury: oxygen, pressure, and gene therapy. Med Gas Res 2015;5:9; Harch PG. The genetically modulated healing effects of hyperbaric oxygen therapy. Altern Ther Health Med 2015; 21:46-55; and Figueroa XA, Wright JK. Clinical results in brain injury trials using HBO2 therapy: another perspective. Undersea Hyperb Med J 2015;42:19'},{id:"B23",body:'Extensive bibliographies on the use of HBOT for brain wounds and other injuries can be found in Jain, KK, The Textbook of Hyperbaric Medicine, Fifth edition. Cambridge, MA: Hogrefe & Huber Publishers, 2009; Philip B. James, MD, Oxygen and the Brain; the Journey of Our Lifetime, North Palm Beach, FL: Best Publishing Co., 2014; and Paul G. Harch, MD and Virginia McCullough, The Oxygen Revolution, Third Edition: Hyperbaric Oxygen Therapy: The Definitive Treatment of Traumatic Brain Injury (TBI) & Other Disorders, Hatherleigh Press, 2016'},{id:"B24",body:'https://www.research.va.gov/topics/tbi.cfm'},{id:"B25",body:'Stephen R. Thom, Hyperbaric oxygen – its mechanisms and efficacy, Plast Reconstr Surg. 2011 Jan; 127(Suppl 1): 131S–141S'},{id:"B26",body:'Godman, C.A. et al. Hyperbaric oxygen treatment induces antioxidant gene expression. ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 02 June 2010 https://doi.org/10.1111/j.1749-6632.2009.05393.x'},{id:"B27",body:'Harch and McCullough, 3rd Edition, Chapter 1'},{id:"B28",body:'American Hospital Directory, www.ahd.com'},{id:"B29",body:'Harch, Paul G., M.D. Argument for Medicare/Medicaid Coverage of Hyperbaric Oxygen Therapy Treatment of Diabetic Foot Wounds, June 2001. The 129 references accompanying that document have been incorporated into the References accompanying this Application'},{id:"B30",body:'James, Oxygen and the Brain, Chapter 19'},{id:"B31",body:'Kelly Jr. DL, et al. Effects of hyperbaric oxygenation and tissue oxygen studies in experimental paraplegia. JNS, Journal of Neurosurgery, 1972:36: 425-429'},{id:"B32",body:'Oxygen and the Brain, p. 339'},{id:"B33",body:'Oddo, M, Levine JM, Mackenzie L, et al. Brain hypoxia is associated with short-term outcome after severe head injury independently of intracranial hypertension and low cerebral perfusion pressure. Neurosurgery 2011;69:1037-1045'},{id:"B34",body:'https://tinyurl.com/ybldktqn'},{id:"B35",body:'Maroon, J.C. and Bost, J. “Concussion management at the NFL, College, High School, and Youth Sports Levels,” Chap 7, in textbook, Clinical Neurosurgery, Vol. 58, The Congress of Neurological Surgeons, 2011, p51'},{id:"B36",body:'McKee A.C. et al Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy following Repetitive Head Injur, J Neuropathol Exp Neurol. 2009 Jul; 68(7): 709-735'},{id:"B37",body:'Daniel Nicoara, Raymond M. Quock et al. Hyperbaric oxygen treatment suppresses withdrawal signs in morphine-dependent mice. Brain Research, 2016; 1648:434 DOI:10.1016/j.brainres.2016.08.017'},{id:"B38",body:'Harch PG. Hyperbaric oxygen treatment of novel coronavirus (COVID-19) respiratory failure. Med Gas Res [Epub ahead of print] [Apr 24, 2020] http://www.medgasres.com/preprintarticle.asp?id=282177. “Through Henry\'s Law HBOT enhances multiple stages in [respiratory failure] by increasing: 1) the dissolving of oxygen in the alveolar and inflammatory barrier, 2) the diffusion rate of oxygen, 3) the diffusion distance of oxygen, 4) the dissolution of oxygen in blood plasma, 5) the oxygen saturation of hemoglobin in red blood cells, and 6) the delivery of oxygen to the microcirculation and tissue. The net result is a reversal of the downward spiral of COVID-19 patients [note: HBOT affects similar processes in the degenerative concussion cascade after TBI]. The elevation of systemic levels of oxygen with HBOT has been traditionally misunderstood in terms of respiratory metabolite effects with a transient hyperoxemia that dissipates once the patient leaves the chamber. However, for 358 years, and especially in the modern era (1960 to present), permanent and later trophic effects of HBOT have been documented with both single and repetitive HBOT. [3] One of the mechanisms of action was recently elucidated as epigenetic modulation through direct effects of hydrostatic pressure and hyperoxia of gene expression/suppression of over 40% of the protein-coding genes in the human genome. The largest clusters of upregulated genes are the growth, repair, cell signaling, and anti-inflammatory genes, and the largest clusters of down-regulated genes are the pro-inflammatory genes and those that control programmed cell death. A single HBOT has been shown in multiple studies to have dramatic persisting effects on disease pathophysiology, especially inflammation, its ubiquitous acute form, reperfusion injury (e.g., carbon monoxide poisoning, necrotizing infection, resuscitation, and others), and extreme forms of acute respiratory distress syndrome (ARDS) and on reversing the lethal oxygen debt from cardiac arrest. In the Chinese COVID-19 patients HBOT was likely treating pulmonary and systemic hypoxia, inflammation, other pulmonary pathophysiologic targets, reversing oxygen debt, and modulating gene expression both acutely and durably as evidenced by the patient\'s sustained improvement with each daily HBOT.” These are similar processes experienced in use of HBOT to treat TBI, yet another substantiation of HBOT Mechanisms of Action. Ironically, the “Chinese physicians replicated an historical experience with HBOT in a near identical pulmonary viral pandemic, the Spanish flu pandemic of 1918. Dr. Orval Cunningham of Kansas City, USA applied hyperbaric oxygen therapy (pressure and oxygen) to a moribund cyanotic Spanish flu patient with agonal breathing who experienced the same dramatic reversal of his disease that the Chinese physicians witnessed. “See: Zhong X, Tao X, Tang Y, Chen R. The outcomes of hyperbaric oxygen therapy to retrieve hypoxemia of severe novel coronavirus pneumonia: first case report. Zhonghua Hanghai Yixue yu Gaoqiya Yixue Zazhi. 2020. doi: 10.3760/cma.j.issn.1009-6906.2020.0001; Zhong XL, Niu XQ, Tao XL, Chen RY, Liang Y, Tang YC. The first case of HBOT in critically ill endotracheal intubation patient with COVID-19. Beijing, China: Novel Coronavirus Pneumonia Research Network Sharing Platform of China Association for Science and Technology. 2020; Jain KK. Textbook of Hyperbaric Medicine. 6th ed. Cham, Switzerland: Springer. 2017; Rogatsky GG, Shifrin EG, Mayevsky A. Acute respiratory distress syndrome in patients after blunt thoracic trauma: the influence of hyperbaric oxygen therapy. Adv Exp Med Biol. 2003;540:77-85; Sellers LM. The fallibility of the forrestian principle. “semper primus pervenio maxima cum VI”. Laryngoscope. 1964;74:613-633'},{id:"B39",body:'Thibodeaux K, Speyrer M, Raza A, Yaakov R, Serena TE, Hyperbaric oxygen therapy in preventing mechanical ventilation in COVID-19 patients: a retrospective case series. J Wound Care. 2020 May 1;29(Sup5a):S4-S8'},{id:"B40",body:'Figueroa HBOT Clinical Studies 2020, available at https://treatnow.org/knowledgebase/hbot-significant-research-showing-the-safety-and-efficacy-of-hbot-for-tbi-ptsd/. This spread sheet contains seventeen peer-reviewed scientific papers on the use of HBOT for TBI'},{id:"B41",body:'Holbach KH, Caroli A, Wassmann H. Cerebral energy metabolism in patients with brain lesions of normo- and hyperbaric oxygen pressures. J Neurol. 1977;217:17-30'},{id:"B42",body:'DoD “HBOT for TBI” Consensus Conference White Paper, 28 October 2008'},{id:"B43",body:'Figueroa HBOT Clinical Studies 2020, see note 31'},{id:"B44",body:'Xavier A. Figueroa, PhD and James K. Wright, MD (Col Ret), USAF Hyperbaric Oxygen: B-Level Evidence in Mild Traumatic Brain Injury Clinical Trials. Neurology® 2016;87:1-7'},{id:"B45",body:'Cifu DX, Walker WC, West SL, et al. Hyperbaric oxygen for blast-related postconcussion syndrome: three-month outcomes. Ann Neurol 2014;75:277-286; Cifu DX, Hart BB, West SL, Walker W, Carne W. The effect of hyperbaric oxygen on persistent postconcussion symptoms. J Head Trauma Rehabil 2014;29:11-20; Wolf G, Cifu D, Baugh L, Carne W, Profenna L. The effect of hyperbaric oxygen on symptoms after mild traumatic brain injury. J Neurotrauma 2012;29:2606-2612; Weaver LK, Wilson SH, Lindblad AS, et al. Hyperbaric oxygen for post-concussive symptoms in United States military service members: a randomized clinical trial. Undersea Hyperb Med. 2018;45:129-156'},{id:"B46",body:'Miller RS, Weaver LK, Bahraini N, et al. Effects of hyperbaric oxygen on symptoms and quality of life among service members with persistent postconcussion symptoms: a randomized clinical trial. JAMA Intern Med 2015;175: 43-52'},{id:"B47",body:'Harch PG, Andrews SR, Fogarty EF, et al. A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder. J Neurotrauma 2012;29:168-185'},{id:"B48",body:'Boussi-Gross R, Golan H, Fishlev G, et al. Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury: randomized prospective trial. PLoS One 2013; 8:e79995'},{id:"B49",body:'Miller RS, Weaver LK, Bahraini N, et al. Effects of hyperbaric oxygen on symptoms and quality of life among service members with persistent postconcussion symptoms: a randomized clinical trial. JAMA Intern Med 2015; 175: 43-52'},{id:"B50",body:'James; MacLaughlin; Thom; Marois; etc'},{id:"B51",body:'Deng Z, Chen W, Jin J, Zhao J, Xu H. The neuroprotection effect of oxygen therapy: A systematic review and meta-analysis. Niger J Clin Pract. 2018 Apr;21(4):401-416'},{id:"B52",body:'Wang F, et al. Hyperbaric oxygen therapy for the treatment of traumatic brain injury: a meta-analysis. Neurol Sci. 2016 Jan 8. PubMed PMID: 26746238; and Deng Z, Chen W, Jin J, Zhao J, Xu H. The neuroprotection effect of oxygen therapy: A systematic review and meta-analysis. Niger J Clin Pract. 2018 Apr;21(4):401-416'},{id:"B53",body:'E.G. Wolf, L.M. Baugh, C.M.S. Kabban, et al. Cognitive function in a traumatic brain injury hyperbaric oxygen randomized trial. UHM 2015, Vol. 42, No. 4, 2015. http://bit.ly/2faBldN'},{id:"B54",body:'UHM 2012, Vol. 39, No. 4 – How many deaths will it take? AN EDITORIAL PERSPECTIVE. Undersea & Hyperbaric Medical Society, Inc. How many deaths will it take till they know? Monkeys, madmen and the standard of evidence. George Mychaskiw II, DO, FAAP, FACOP, Editor-in-Chief Chair, Department of Anesthesiology, Nemours Children’s Hospital, Orlando, Florida USA'},{id:"B55",body:'Wang F, et al. Hyperbaric oxygen therapy for the treatment of traumatic brain injury: a meta-analysis. Neurol Sci. 2016 Jan 8. PubMed PMID: 26746238'},{id:"B56",body:'Samueli Institute. “Is Hyperbaric Oxygen Therapy Effective for Traumatic Brain Injury? Preliminary Report.” Prepared for the Hyperbaric Oxygen Research Program, USAMRMC, USAMMDA. February 18, 2015'},{id:"B57",body:'Center for Compassionate Innovation, VHA Office of Community Engagement (10P10), Room 786, VA Central Office Washington, DC 20420 202-461-6969 Email to: communityengagement@va.gov'},{id:"B58",body:'Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment. The National Academies. The Institute of Medicine. Washington DC: The National Academies Press, 2014. https://bit.ly/2oYJ17l'},{id:"B59",body:'https://www.research.va.gov/currents/winter2015/winter2015-9.cfm'},{id:"B60",body:'Ibid., and http://brainjury.org/blog/2014/07/03/what-the-bleep-is-wrong-with-the-dodva-hbot-studies/'},{id:"B61",body:'Hadanny A, Abbott S, Suzin G, et al. Effect of hyperbaric oxygen therapy on chronic neurocognitive deficits of post-traumatic brain injury patients: retrospective analysis. BMJ Open 2018;8:e023387. https://bit.ly/2RBOQSd'},{id:"B62",body:'Hoge, C.W and Jonas, W.B., “The Ritual of Hyperbaric Oxygen and lessons for the Treatment of Persistent Postconcussion Symptoms in Military Personnel,” invited commentary in JAMA, American Medical Association, November 17, 2014, p. E-1'},{id:"B63",body:'R. Scott Miller, M.D., COL, US Army, Director, Hyperbaric Oxygen Research Program, US Army Medical Materiel Development Activity, Ft. Detrick, MD. Effects of Hyperbaric Oxygen on Symptoms and Quality of Life Among Service Members With Persistent Postconcussion Symptoms. JAMA Intern Med. Published online November 17, 2014. doi:10.1001/jamainternmed.2014.5479'},{id:"B64",body:'Pierre Marois MD, FRCP(c), Physiatrist, Dept. of Pediatrics and Dept. of Rehabilitation, Ste-Justine University Hospital, Montreal, Canada, Letter to the Editor, JAMA, 10/20/2016'},{id:"B65",body:'Malek M, Duszczyk M, Zyszkowski M, Ziembowicz A, Salinska E. Hyperbaric oxygen and hyperbaric air treatment result in comparable neuronal death reduction and improved behavioral outcome after transient forebrain ischemia in the gerbil. Exp Brain Res 2013;224:1-14'},{id:"B66",body:'MacLaughlin KJ, Barton GP, Braun RK, Eldridge MW. Effect of intermittent hyperoxia on stem cell mobilization and cytokine expression. Med Gas Res. 2019 Jul-Sep;9(3):139-144. PhD research will recommence after COVID-19 shutdown'},{id:"B67",body:'Oxygen and the Brain, pp. 352-354'},{id:"B68",body:'McDonagh MS, Carson S, Ash JS, et al. Hyperbaric oxygen therapy for brain injury, cerebral palsy, and stroke. Rockville, MD: Agency for Healthcare Research and Quality; 2003 Sep. AHRQ Publication No. 03-E050'},{id:"B69",body:'Doering, N. et al. Untreated Brain Injury: Scope, Costs, and a Promising New Treatment. Unpublished Research Report, Reimers Systems, Inc. 2012'},{id:"B70",body:'Editorial. “How many people are affected by one suicide?” Centre for Suicide Prevention Feb 24, 2019'},{id:"B71",body:'https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=27'},{id:"B72",body:'Grammar, G.G., DeGrabe, T.J., and Picon, L.M. VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF CONCUSSION-MILD TRAUMATIC BRAIN INJURY. VHA, VA HSR&D Cyberseminars, 2016 Update'},{id:"B73",body:'See: https://treatnow.org/knowledgebase/va_dod-interventions-and-responses-to-invisible-wounds/'},{id:"B74",body:'See for example, https://www.newscientist.com/article/dn27318-megabucks-pouring-into-global-brain-science-projects/#ixzz6O7t8RSuc'},{id:"B75",body:'Ibid'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Robert Louis Beckman",address:"heal@treatnow.org",affiliation:'
Foundation for the Study of Inflammatory Disease, TreatNow.org, North Bethesda, USA
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Microbiology",slug:"immunology-and-microbiology-applied-microbiology"},numberOfBooks:5,numberOfSeries:0,numberOfAuthorsAndEditors:211,numberOfWosCitations:143,numberOfCrossrefCitations:122,numberOfDimensionsCitations:265,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicId:"893",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"9294",title:"Fluorescence Methods for Investigation of Living Cells and Microorganisms",subtitle:null,isOpenForSubmission:!1,hash:"a97a566a3a19eb9e0c9ba61042bb06c5",slug:"fluorescence-methods-for-investigation-of-living-cells-and-microorganisms",bookSignature:"Natalia Grigoryeva",coverURL:"https://cdn.intechopen.com/books/images_new/9294.jpg",editedByType:"Edited by",editors:[{id:"239430",title:"Dr.",name:"Natalia",middleName:"Yu.",surname:"Grigoryeva",slug:"natalia-grigoryeva",fullName:"Natalia 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Rinken"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5733",title:"Archaea",subtitle:"New Biocatalysts, Novel Pharmaceuticals and Various Biotechnological Applications",isOpenForSubmission:!1,hash:"bf16076922561a7860bc5800f8efdba6",slug:"archaea-new-biocatalysts-novel-pharmaceuticals-and-various-biotechnological-applications",bookSignature:"Haitham Sghaier, Afef Najjari and Kais Ghedira",coverURL:"https://cdn.intechopen.com/books/images_new/5733.jpg",editedByType:"Edited by",editors:[{id:"47210",title:"Dr.",name:"Haitham",middleName:null,surname:"Sghaier",slug:"haitham-sghaier",fullName:"Haitham Sghaier"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:5,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"59033",doi:"10.5772/intechopen.73551",title:"The Potential for ‘Next-Generation’, Microalgae-Based Feed Ingredients for Salmonid Aquaculture in Context of the Blue Revolution",slug:"the-potential-for-next-generation-microalgae-based-feed-ingredients-for-salmonid-aquaculture-in-cont",totalDownloads:1713,totalCrossrefCites:21,totalDimensionsCites:44,abstract:"Microalgae-based ingredients have potential to ensure continued growth of salmonid aquaculture for global sustainable food security in the blue economy. Algal biorefineries must valorize the entire crop to grow profitable microalgae-based economies. With massive growth and demand for novel sustainable ingredients, farmed salmonid feed sectors are highly promising areas to focus on. Microalgae-based ingredients for salmonid feeds may have market advantages in terms of lower input costs, aerial foot-print, wastewater remediation benefits and carbon credits for industrial CO2 conversion. A handful of microalgae-based ingredients have been proposed as candidates to supply well-balanced nutrients and immunostimulatory compounds. However, technical gaps exist and need addressing before the industry could economically incorporate microalgae-based ingredients into commercial feeds. Current knowledge on comprehensive biochemical composition is incomplete, highly heterogeneous, and information on their nutritional value is scattered and/or inconsistent. The aim of this chapter is to consolidate relatively fragmented data on biochemical composition and nutritional value of microalgae-based ingredients focusing on farmed salmonid feeds. Presented are discussions on the potential for such ‘next-generation’ ingredients, opportunities/challenges for their use and a compendium of studies evaluating their performance in feeds for economically relevant farmed salmonids, including rainbow trout (Oncorhynchus mykiss), Arctic charr (Salvelinus alpinus) and Atlantic salmon (Salmo salar).",book:{id:"6541",slug:"microalgal-biotechnology",title:"Microalgal Biotechnology",fullTitle:"Microalgal Biotechnology"},signatures:"Sean Michael Tibbetts",authors:[{id:"228874",title:"Dr.",name:"Sean",middleName:null,surname:"Tibbetts",slug:"sean-tibbetts",fullName:"Sean Tibbetts"}]},{id:"59210",doi:"10.5772/intechopen.73791",title:"Spirulina Phycobiliproteins as Food Components and Complements",slug:"spirulina-phycobiliproteins-as-food-components-and-complements",totalDownloads:2615,totalCrossrefCites:15,totalDimensionsCites:26,abstract:"Spirulina has a documented history of use as a food for more than 1000 years, and has been in production as a dietary supplement for 40 years. Among many of Spirulina bioactive components, blue protein C-phycocyanin and its linear tetrapyrrole chromophore phycocyanobilin occupy a special place due to broad possibilities for application in various areas of food technology. The subject of this chapter is up-to-date food applications of these Spirulina components, with a focus on their use as food colorants, additives, nutriceuticals, and dietary supplements. Their other actual and future food application possibilities will also be briefly presented and discussed.",book:{id:"6541",slug:"microalgal-biotechnology",title:"Microalgal Biotechnology",fullTitle:"Microalgal Biotechnology"},signatures:"Dragana Stanic-Vucinic, Simeon Minic, Milan R. Nikolic and Tanja\nCirkovic Velickovic",authors:[{id:"69834",title:"Dr.",name:"Dragana",middleName:null,surname:"Stanic-Vucinic",slug:"dragana-stanic-vucinic",fullName:"Dragana Stanic-Vucinic"},{id:"69858",title:"Prof.",name:"Tanja",middleName:null,surname:"Cirkovic Velickovic",slug:"tanja-cirkovic-velickovic",fullName:"Tanja Cirkovic Velickovic"},{id:"225918",title:"Prof.",name:"Milan",middleName:null,surname:"Nikolic",slug:"milan-nikolic",fullName:"Milan Nikolic"},{id:"225919",title:"Dr.",name:"Simeon",middleName:null,surname:"Minic",slug:"simeon-minic",fullName:"Simeon Minic"}]},{id:"59469",doi:"10.5772/intechopen.74043",title:"Cyanobacteria and Microalgae in the Production of Valuable Bioactive Compounds",slug:"cyanobacteria-and-microalgae-in-the-production-of-valuable-bioactive-compounds",totalDownloads:2302,totalCrossrefCites:6,totalDimensionsCites:25,abstract:"In the last decades, an increasing attention has been directed toward the possibilities of growing algae commercially. This interest has been partially due to the fact that some strains of microalgae and cyanobacteria have demonstrated the ability to produce a variety of bioactive products. Both, primary and secondary metabolism of these microorganisms has been demonstrated to play a key role in the production of special chemicals. Antioxidants, for instance, can be produced by some algal strains to protect photosynthetic cells from oxidative stress. Microalgae can produce a variety of polyunsaturated and monounsaturated fatty acids with clear health benefits for human nutrition. Potential products obtained from cyanobacteria and microalgae exhibiting interesting medical properties include polysaccharides, glycerol, glycoproteins, and antibiotics. From the aforementioned products, especially relevant has become the search of new antibiotics. The potential spread of bacterial resistance and the foreseen decrease on efficiency on antibiotics, has largely stimulated the research on novel antibiotics sources. Among these sources, cyanobacteria and microalgae have demonstrated a vast and just barely explored potential.",book:{id:"6541",slug:"microalgal-biotechnology",title:"Microalgal Biotechnology",fullTitle:"Microalgal Biotechnology"},signatures:"Elena Martínez-Francés and Carlos Escudero-Oñate",authors:[{id:"188725",title:"Dr.",name:"Carlos",middleName:null,surname:"Escudero-Oñate",slug:"carlos-escudero-onate",fullName:"Carlos Escudero-Oñate"},{id:"228683",title:"MSc.",name:"Elena",middleName:null,surname:"Martínez-Francés",slug:"elena-martinez-frances",fullName:"Elena Martínez-Francés"}]},{id:"59257",doi:"10.5772/intechopen.73702",title:"Bioeconomic Assessment of Microalgal Production",slug:"bioeconomic-assessment-of-microalgal-production",totalDownloads:1476,totalCrossrefCites:7,totalDimensionsCites:14,abstract:"Today, microalgae play an important role for the worldwide biofuel demand, together with the production of high value-added products used in pharmaceutical, nutraceutical and cosmetic industries. In 2014, the European Union adopted a strategy for developing the bioeconomy, by utilizing microalgae which represent an emerging biological resource of great importance for its potential applications in different fields. Huge potential of tiny microalgae could support a microalgae-based biorefinery and microalgae-based bioeconomy opening up vast opportunities in the global algae business. Nevertheless, in spite of having been studied for over 50 years now, there are still only just a few corporations that are cultivating algae on a large or commercial scale due to operational and capital cost. Techno-economic modeling is a powerful tool for guiding research priorities and assessing the economics, environmental impact and sustainability of microalgal productions. In this chapter, microalgal productions are assessed within bioeconomical aspects and case-studies on microalgal biorefinery are discussed.",book:{id:"6541",slug:"microalgal-biotechnology",title:"Microalgal Biotechnology",fullTitle:"Microalgal Biotechnology"},signatures:"Didem Özçimen, Benan İnan, Anıl Tevfik Koçer and Meyrem Vehapi",authors:[{id:"32444",title:"Dr.",name:"Didem",middleName:null,surname:"Özçimen",slug:"didem-ozcimen",fullName:"Didem Özçimen"},{id:"228422",title:"MSc.",name:"Benan",middleName:null,surname:"İnan",slug:"benan-inan",fullName:"Benan İnan"},{id:"240583",title:"MSc.",name:"Anıl Tevfik",middleName:null,surname:"Koçer",slug:"anil-tevfik-kocer",fullName:"Anıl Tevfik Koçer"},{id:"240584",title:"MSc.",name:"Meyrem",middleName:null,surname:"Vehapi",slug:"meyrem-vehapi",fullName:"Meyrem Vehapi"}]},{id:"57981",doi:"10.5772/intechopen.72175",title:"Application of Electrochemical Methods in Biosensing Technologies",slug:"application-of-electrochemical-methods-in-biosensing-technologies",totalDownloads:2102,totalCrossrefCites:7,totalDimensionsCites:14,abstract:"Introducing biochemical factor to electronic devices have created a new branch of science. Recent development in biosensing technology enabled progress in pathogens detection. Currently, wide range of biomarkers (enzymes, peptides, DNA, microorganisms, etc. )recognize various target analytes, starting from basic metabolism changes to serious infections caused by pathogens. Improved sensitivity, selectivity and response time of sensors have instantly replaced traditional techniques. Easy handling, low production costs and miniaturization have met therapeutics need. Biosensing technologies are very strong point in telemedicine in public healthcare. This chapter will focus on electrochemical techniques for pathogens detection and show trending applications in biosensing technologies.",book:{id:"6319",slug:"biosensing-technologies-for-the-detection-of-pathogens-a-prospective-way-for-rapid-analysis",title:"Biosensing Technologies for the Detection of Pathogens",fullTitle:"Biosensing Technologies for the Detection of Pathogens - A Prospective Way for Rapid Analysis"},signatures:"Karolina Dziąbowska, Elżbieta Czaczyk and Dawid Nidzworski",authors:[{id:"212390",title:"B.Sc.",name:"Karolina",middleName:null,surname:"Dziąbowska",slug:"karolina-dziabowska",fullName:"Karolina Dziąbowska"},{id:"212521",title:"Dr.",name:"Elżbieta",middleName:null,surname:"Czaczyk",slug:"elzbieta-czaczyk",fullName:"Elżbieta Czaczyk"},{id:"212524",title:"Dr.",name:"Dawid",middleName:null,surname:"Nidzworski",slug:"dawid-nidzworski",fullName:"Dawid Nidzworski"}]}],mostDownloadedChaptersLast30Days:[{id:"58097",title:"Detection and Control of Indoor Airborne Pathogenic Bacteria by Biosensors Based on Quorum Sensing Chemical Language: Bio-Tools, Connectivity Apps and Intelligent Buildings",slug:"detection-and-control-of-indoor-airborne-pathogenic-bacteria-by-biosensors-based-on-quorum-sensing-c",totalDownloads:1790,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Nowadays, lifestyles and climate change lead people to spend long periods in indoors spaces, where reduced ventilation and artificial light favor the concentration and spread of airborne pathogenic microorganisms. Current procedures for microbiological air evaluation are based on air sampling coupled to traditional microbiological culture-dependent methods such as biochemical tests and molecular rDNA 16S sequencing. These techniques generate an important delay in the application of prevention and control measures. This chapter presents whole cell-based biosensors that are able to detect quorum sensing signaling molecules produced by airborne pathogenic bacteria as a tool for indoor air monitoring. Furthermore, a general biosensor model is proposed. In this model, in vivo biosensors technology can be connected to online applications (Apps), being part of intelligent buildings, in order to reduce airborne pathogenic bacteria concentration and dissemination.",book:{id:"6319",slug:"biosensing-technologies-for-the-detection-of-pathogens-a-prospective-way-for-rapid-analysis",title:"Biosensing Technologies for the Detection of Pathogens",fullTitle:"Biosensing Technologies for the Detection of Pathogens - A Prospective Way for Rapid Analysis"},signatures:"Claudia Ibacache-Quiroga, Natalia Romo, Rodrigo Díaz-Viciedo and\nM. Alejandro Dinamarca",authors:[{id:"211459",title:"Prof.",name:"Alejandro",middleName:null,surname:"Dinamarca",slug:"alejandro-dinamarca",fullName:"Alejandro Dinamarca"},{id:"211467",title:"Ms.",name:"Natalia",middleName:null,surname:"Romo",slug:"natalia-romo",fullName:"Natalia Romo"},{id:"211474",title:"Dr.",name:"Claudia",middleName:null,surname:"Ibacache-Quiroga",slug:"claudia-ibacache-quiroga",fullName:"Claudia Ibacache-Quiroga"},{id:"230663",title:"Dr.",name:"Rodrigo",middleName:null,surname:"Díaz-Viciedo",slug:"rodrigo-diaz-viciedo",fullName:"Rodrigo Díaz-Viciedo"}]},{id:"65478",title:"The Oleaginous Red Yeast Rhodotorula/Rhodosporidium: A Factory for Industrial Bioproducts",slug:"the-oleaginous-red-yeast-em-rhodotorula-rhodosporidium-em-a-factory-for-industrial-bioproducts",totalDownloads:1290,totalCrossrefCites:5,totalDimensionsCites:9,abstract:"Rhodotorula genus, amended in 2015, is polyphyletic and contains Rhodotorula species that grow as single-cell yeast (monomorphic) and reproduce asexually via budding/fission (anamorphic); it also contains Rhodosporidium species that reproduce sexually (teleomorphic) and alternate between a yeast phase and dikaryotic filamentous phase (dimorphic). Several species of these “red yeast” produce industrial bioproducts, namely biofuel feedstocks, carotenoids, enzymes, and biosurfactants. This chapter highlights the biotechnology areas that Rhodotorula/Rhodosporidium contributes to and the future market value of those industries. The primary yeast species to be discussed include Rhodosporidium toruloides, Rhodotorula glutinis, Rhodosporidium diobovatum, Rhodosporidium kratochvilovae, Rhodotorula graminis, Rhodotorula babjevae, and Rhodotorula taiwanensis.",book:{id:"8107",slug:"yeasts-in-biotechnology",title:"Yeasts in Biotechnology",fullTitle:"Yeasts in Biotechnology"},signatures:"Mathew Lyman, Salustra Urbin, Cheryl Strout and Bonnee Rubinfeld",authors:[{id:"282320",title:"Dr.",name:"Mathew",middleName:null,surname:"Lyman",slug:"mathew-lyman",fullName:"Mathew Lyman"},{id:"290955",title:"Dr.",name:"Salustra",middleName:null,surname:"Urbin",slug:"salustra-urbin",fullName:"Salustra Urbin"},{id:"295704",title:"Dr.",name:"Cheryl",middleName:null,surname:"Strout",slug:"cheryl-strout",fullName:"Cheryl Strout"},{id:"295705",title:"Dr.",name:"Bonnee",middleName:null,surname:"Rubinfeld",slug:"bonnee-rubinfeld",fullName:"Bonnee Rubinfeld"}]},{id:"60275",title:"The Influence of Microalgae Addition as Co-Substrate in Anaerobic Digestion Processes",slug:"the-influence-of-microalgae-addition-as-co-substrate-in-anaerobic-digestion-processes",totalDownloads:1376,totalCrossrefCites:2,totalDimensionsCites:7,abstract:"Growth microalgae could be used as co-substrates in anaerobic digestion processes to produce biogas of a high-calorific value, which could be expended as heat or electricity in cogeneration engines. Lignocellulosic and high-carbon content wastes, due to their characteristics, hinder anaerobic digestion processes. The use of microalgae as a co-substrate with high-carbon content residues can adjust the C/N ratio and thereby obtain, in some cases, a higher biogas production and greater biodegradability of wastes during anaerobic digestion than without co-digestion options. In addition, microalgae and cyanobacteria are photosynthetic microorganisms that can produce oxygen and oxidize the organic matter and NH4+ contained in wastewaters. The growth of microalgae in industrial effluents and wastewaters can considerably reduce the organic matter contained in them and their pollutant load. This growth can take advantage of the nutrients that still remain in industrial effluents, avoiding the use of clean water for the growth of biomass. The chapter will focus on an overview of microalgae anaerobic co-digestion with different wastes and the benefits of this option.",book:{id:"6541",slug:"microalgal-biotechnology",title:"Microalgal Biotechnology",fullTitle:"Microalgal Biotechnology"},signatures:"Bárbara Rincón, María José Fernández-Rodríguez, David de la\nLama-Calvente and Rafael Borja",authors:[{id:"74541",title:"Dr.",name:"Barbara",middleName:null,surname:"Rincon",slug:"barbara-rincon",fullName:"Barbara Rincon"},{id:"89771",title:"Dr.",name:"Rafael",middleName:null,surname:"Borja",slug:"rafael-borja",fullName:"Rafael Borja"},{id:"246719",title:"MSc.",name:"María José",middleName:null,surname:"Fernández-Rodríguez",slug:"maria-jose-fernandez-rodriguez",fullName:"María José Fernández-Rodríguez"},{id:"246720",title:"MSc.",name:"David",middleName:null,surname:"De La Lama-Calvente",slug:"david-de-la-lama-calvente",fullName:"David De La Lama-Calvente"}]},{id:"64889",title:"Common Methods to Understand and Develop Indigenous Probiotics Yeast for Ruminant",slug:"common-methods-to-understand-and-develop-indigenous-probiotics-yeast-for-ruminant",totalDownloads:1397,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"Probiotic yeast enhanced the ruminal gut microbial balance by producing intercellular effectors and important metabolites. The impact of yeast addition on animal health is influenced by different interlinked factors including animal genomics, its gut microbiota, and environment. Therefore, all factors should be considered regarding achieving the maximum outputs from animal probiotic yeast. In the situation of a high feeding cost, microbial feed supplements provide a suitable nutritional approach, which allows increased nutrient digestion rate and accordingly improves animal performance. Many yeast products are commercially available, but their efficiency as probiotic dietary addition in a particular breed is mostly questionable. Therefore, identification of ideal probiotic yeast strain is of great interest in this context. Innovative methods in relation to develop new probiotic are mainly focused on the exploring novel microbial strains from indigenous sources. It has been noted that for the identification of best probiotic strain for the host, a linkage between culture-independent and culture-dependent methods is a functional step. In this chapter, we will discuss the mode of action of probiotic yeast on animal lower gut microbiota and identification of ideal probiotic yeast by using advanced molecular methods.",book:{id:"8107",slug:"yeasts-in-biotechnology",title:"Yeasts in Biotechnology",fullTitle:"Yeasts in Biotechnology"},signatures:"Shakira Ghazanfar, Aayesha Riaz, Ghulam Muhammad Ali, Saima Naveed, Irum Arif, Sidra Irshad, Naeem Riaz and Khanzadi Nazneen Manzoor",authors:[{id:"202370",title:"Dr.",name:"Shakira",middleName:null,surname:"Ghazanfar",slug:"shakira-ghazanfar",fullName:"Shakira Ghazanfar"},{id:"286878",title:"Dr.",name:"Ghulam",middleName:null,surname:"Muhammad Ali",slug:"ghulam-muhammad-ali",fullName:"Ghulam Muhammad Ali"},{id:"286879",title:"Ms.",name:"Irum",middleName:null,surname:"Arif",slug:"irum-arif",fullName:"Irum Arif"},{id:"286880",title:"Ms.",name:"Sidra",middleName:null,surname:"Irshad",slug:"sidra-irshad",fullName:"Sidra Irshad"},{id:"286881",title:"Ms.",name:"Khanzadi",middleName:null,surname:"Nazneen Manzoor",slug:"khanzadi-nazneen-manzoor",fullName:"Khanzadi Nazneen Manzoor"},{id:"297912",title:"Dr.",name:"Naeem",middleName:null,surname:"Riaz",slug:"naeem-riaz",fullName:"Naeem Riaz"},{id:"304921",title:"Dr.",name:"Aayesha",middleName:null,surname:"Riaz",slug:"aayesha-riaz",fullName:"Aayesha Riaz"},{id:"304923",title:"Dr.",name:"Saima",middleName:null,surname:"Naveed",slug:"saima-naveed",fullName:"Saima Naveed"}]},{id:"58181",title:"FRET-Based Enzyme Activity Reporter: Practical Hints for Kinases as Indicators of Virulence",slug:"fret-based-enzyme-activity-reporter-practical-hints-for-kinases-as-indicators-of-virulence",totalDownloads:1450,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Modulation of protein kinases activity is often requested for pathogenicity or virulence. This chapter provides several hints for one who might be interested in using FRET-based kinase activity reporters. The archetypes of these reporters, which are now within the arsenal of biosensors, were devoted to the detection and characterization of the activity of the cAMP-Protein kinase A pathway. Based on the principle of this biosensor, other FRET-based kinase activity reporters emerged. Here, the choice of the kinase to be monitored, the artifacts that might be met, and the flexibility and amenability of the FRET-based kinase activity reporters both for high-throughput analysis and dissection of protein kinase functions are discussed.",book:{id:"6319",slug:"biosensing-technologies-for-the-detection-of-pathogens-a-prospective-way-for-rapid-analysis",title:"Biosensing Technologies for the Detection of Pathogens",fullTitle:"Biosensing Technologies for the Detection of Pathogens - A Prospective Way for Rapid Analysis"},signatures:"Corentin Spriet, Angelina Kasprowicz, Dave Trinel and Jean-\nFrançois Bodart",authors:[{id:"98539",title:"Prof.",name:"Jean-François",middleName:"Laurent",surname:"Bodart",slug:"jean-francois-bodart",fullName:"Jean-François Bodart"},{id:"226954",title:"Dr.",name:"Corentin",middleName:null,surname:"Spriet",slug:"corentin-spriet",fullName:"Corentin Spriet"},{id:"230593",title:"MSc.",name:"Angelina",middleName:null,surname:"Kasprowicz",slug:"angelina-kasprowicz",fullName:"Angelina Kasprowicz"},{id:"230594",title:"MSc.",name:"Dave",middleName:null,surname:"Trinel",slug:"dave-trinel",fullName:"Dave Trinel"}]}],onlineFirstChaptersFilter:{topicId:"893",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:98,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:287,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:106,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:10,numberOfPublishedChapters:103,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:12,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"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:"May 18th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:27,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:49,paginationItems:[{id:"80495",title:"Iron in Cell Metabolism and Disease",doi:"10.5772/intechopen.101908",signatures:"Eeka Prabhakar",slug:"iron-in-cell-metabolism-and-disease",totalDownloads:1,totalCrossrefCites:0,totalDimensionsCites:null,authors:null,book:{title:"Iron Metabolism - Iron a Double‐Edged Sword",coverURL:"https://cdn.intechopen.com/books/images_new/10842.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"81799",title:"Cross Talk of Purinergic and Immune Signaling: Implication in Inflammatory and Pathogenic Diseases",doi:"10.5772/intechopen.104978",signatures:"Richa Rai",slug:"cross-talk-of-purinergic-and-immune-signaling-implication-in-inflammatory-and-pathogenic-diseases",totalDownloads:7,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:"81764",title:"Involvement of the Purinergic System in Cell Death in Models of Retinopathies",doi:"10.5772/intechopen.103935",signatures:"Douglas Penaforte Cruz, Marinna Garcia Repossi and Lucianne Fragel Madeira",slug:"involvement-of-the-purinergic-system-in-cell-death-in-models-of-retinopathies",totalDownloads:4,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:"81756",title:"Alteration of Cytokines Level and Oxidative Stress Parameters in COVID-19",doi:"10.5772/intechopen.104950",signatures:"Marija Petrusevska, Emilija Atanasovska, Dragica Zendelovska, Aleksandar Eftimov and Katerina Spasovska",slug:"alteration-of-cytokines-level-and-oxidative-stress-parameters-in-covid-19",totalDownloads:8,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Chemokines Updates",coverURL:"https://cdn.intechopen.com/books/images_new/11672.jpg",subseries:{id:"18",title:"Proteomics"}}}]},overviewPagePublishedBooks:{paginationCount:27,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 and Technology from the Department of Chemistry, National University of Singapore, in 2010. She was a lecturer at Temasek Polytechnic, Singapore from July 2009 to March 2013. She relocated to her motherland of Sri Lanka and spearheaded the Functional Food Product Development Project at the National Institute of Fundamental Studies from April 2013 to October 2016. She was a senior lecturer on a temporary basis at the Department of Food Technology, Faculty of Technology, Rajarata University of Sri Lanka. She is currently Deputy Principal of the Australian College of Business and Technology – Kandy Campus, Sri Lanka. She is also the Global Harmonization Initiative (GHI) Ambassador to Sri Lanka.",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. 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"}}}]},{type:"book",id:"7978",title:"Vitamin A",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7978.jpg",slug:"vitamin-a",publishedDate:"May 15th 2019",editedByType:"Edited by",bookSignature:"Leila Queiroz Zepka, Veridiana Vera de Rosso and Eduardo Jacob-Lopes",hash:"dad04a658ab9e3d851d23705980a688b",volumeInSeries:3,fullTitle:"Vitamin A",editors:[{id:"261969",title:"Dr.",name:"Leila",middleName:null,surname:"Queiroz Zepka",slug:"leila-queiroz-zepka",fullName:"Leila Queiroz Zepka",profilePictureURL:"https://mts.intechopen.com/storage/users/261969/images/system/261969.png",biography:"Prof. Dr. Leila Queiroz Zepka is currently an associate professor in the Department of Food Technology and Science, Federal University of Santa Maria, Brazil. She has more than fifteen years of teaching and research experience. She has published more than 550 scientific publications/communications, including 15 books, 50 book chapters, 100 original research papers, 380 research communications in national and international conferences, and 12 patents. She is a member of the editorial board of five journals and acts as a reviewer for several national and international journals. Her research interests include microalgal biotechnology with an emphasis on microalgae-based products.",institutionString:"Universidade Federal de Santa Maria",institution:{name:"Universidade Federal de Santa Maria",institutionURL:null,country:{name:"Brazil"}}}]},{type:"book",id:"7953",title:"Bioluminescence",subtitle:"Analytical Applications and Basic Biology",coverURL:"https://cdn.intechopen.com/books/images_new/7953.jpg",slug:"bioluminescence-analytical-applications-and-basic-biology",publishedDate:"September 25th 2019",editedByType:"Edited by",bookSignature:"Hirobumi Suzuki",hash:"3a8efa00b71abea11bf01973dc589979",volumeInSeries:4,fullTitle:"Bioluminescence - Analytical Applications and Basic Biology",editors:[{id:"185746",title:"Dr.",name:"Hirobumi",middleName:null,surname:"Suzuki",slug:"hirobumi-suzuki",fullName:"Hirobumi Suzuki",profilePictureURL:"https://mts.intechopen.com/storage/users/185746/images/system/185746.png",biography:"Dr. Hirobumi Suzuki received his Ph.D. in 1997 from Tokyo Metropolitan University, Japan, where he studied firefly phylogeny and the evolution of mating systems. He is especially interested in the genetic differentiation pattern and speciation process that correlate to the flashing pattern and mating behavior of some fireflies in Japan. He then worked for Olympus Corporation, a Japanese manufacturer of optics and imaging products, where he was involved in the development of luminescence technology and produced a bioluminescence microscope that is currently being used for gene expression analysis in chronobiology, neurobiology, and developmental biology. 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\r\n\tIn general, the harsher the environmental conditions in an ecosystem, the lower the biodiversity. Changes in the environment caused by human activity accelerate the impoverishment of biodiversity.
\r\n
\r\n\tBiodiversity refers to “the variability of living organisms from any source, including terrestrial, marine and other aquatic ecosystems and the ecological complexes of which they are part; it includes diversity within each species, between species, and that of ecosystems”.
\r\n
\r\n\tBiodiversity provides food security and constitutes a gene pool for biotechnology, especially in the field of agriculture and medicine, and promotes the development of ecotourism.
\r\n
\r\n\tCurrently, biologists admit that we are witnessing the first phases of the seventh mass extinction caused by human intervention. It is estimated that the current rate of extinction is between a hundred and a thousand times faster than it was when man first appeared. The disappearance of species is caused not only by an accelerated rate of extinction, but also by a decrease in the rate of emergence of new species as human activities degrade the natural environment. The conservation of biological diversity is "a common concern of humanity" and an integral part of the development process. Its objectives are “the conservation of biological diversity, the sustainable use of its components, and the fair and equitable sharing of the benefits resulting from the use of genetic resources”.
\r\n
\r\n\tThe following are the main causes of biodiversity loss:
\r\n
\r\n\t• The destruction of natural habitats to expand urban and agricultural areas and to obtain timber, minerals and other natural resources.
\r\n
\r\n\t• The introduction of alien species into a habitat, whether intentionally or unintentionally which has an impact on the fauna and flora of the area, and as a result, they are reduced or become extinct.
\r\n
\r\n\t• Pollution from industrial and agricultural products, which devastate the fauna and flora, especially those in fresh water.
\r\n
\r\n\t• Global warming, which is seen as a threat to biological diversity, and will become increasingly important in the future.
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