Types of proteins and lipids in exosomes: The author has permitted the source [42].
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These books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\\n\\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\\n\\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
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IntechOpen and Knowledge Unlatched formed a partnership to support researchers working in engineering sciences by enabling an easier approach to publishing Open Access content. Using the Knowledge Unlatched crowdfunding model to raise the publishing costs through libraries around the world, Open Access Publishing Fee (OAPF) was not required from the authors.
\n\nInitially, the partnership supported engineering research, but it soon grew to include physical and life sciences, attracting more researchers to the advantages of Open Access publishing.
\n\n\n\nThese books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\n\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\n\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
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A clear trend can be deduced analyzing some of the most renowned scientific databases available, showing that the interest aroused by this branch has increased at a notable pace in the last years. This book describes the prominent theories and recent developments of Swarm Intelligence methods, and their application in all fields covered by engineering. This book unleashes a great opportunity for researchers, lecturers, and practitioners interested in Swarm Intelligence, optimization problems, and artificial intelligence.",isbn:"978-1-78984-537-2",printIsbn:"978-1-78984-536-5",pdfIsbn:"978-1-83968-000-7",doi:"10.5772/intechopen.77539",price:119,priceEur:129,priceUsd:155,slug:"swarm-intelligence-recent-advances-new-perspectives-and-applications",numberOfPages:128,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"e7ea7e74ce7a7a8e5359629e07c68d31",bookSignature:"Javier Del Ser, Esther Villar and Eneko Osaba",publishedDate:"December 4th 2019",coverURL:"https://cdn.intechopen.com/books/images_new/7726.jpg",numberOfDownloads:7721,numberOfWosCitations:19,numberOfCrossrefCitations:18,numberOfCrossrefCitationsByBook:2,numberOfDimensionsCitations:39,numberOfDimensionsCitationsByBook:2,hasAltmetrics:1,numberOfTotalCitations:76,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 29th 2018",dateEndSecondStepPublish:"June 19th 2019",dateEndThirdStepPublish:"August 18th 2019",dateEndFourthStepPublish:"November 6th 2019",dateEndFifthStepPublish:"January 5th 2020",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"5",institution:{name:"Tecnalia",institutionURL:null,country:{name:"Spain"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Tecnalia",institutionURL:null,country:{name:"Spain"}}},coeditorTwo:{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Tecnalia",institutionURL:null,country:{name:"Spain"}}},coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"87",title:"Artificial Intelligence",slug:"computer-and-information-science-artificial-intelligence"}],chapters:[{id:"69981",title:"Introductory Chapter: Swarm Intelligence - Recent Advances, New Perspectives, and Applications",doi:"10.5772/intechopen.90066",slug:"introductory-chapter-swarm-intelligence-recent-advances-new-perspectives-and-applications",totalDownloads:784,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:null,signatures:"Eneko Osaba, Esther Villar and Javier Del Ser",downloadPdfUrl:"/chapter/pdf-download/69981",previewPdfUrl:"/chapter/pdf-preview/69981",authors:[{id:"49813",title:"Dr.",name:"Javier",surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser"},{id:"275829",title:"Dr.",name:"Esther",surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez"},{id:"221364",title:"Dr.",name:"Eneko",surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba"}],corrections:null},{id:"66215",title:"Use of Particle Multi-Swarm Optimization for Handling Tracking Problems",doi:"10.5772/intechopen.85107",slug:"use-of-particle-multi-swarm-optimization-for-handling-tracking-problems",totalDownloads:945,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"As prior work, several multiple particle swarm optimizers with sensors, that is, MPSOS, MPSOIWS, MCPSOS, and HPSOS, were proposed for handling tracking problems. Due to more efficient handling of these problems, in this chapter we innovate the strategy of information sharing (IS) to these existing methods and propose four new search methods that are multiple particle swarm optimizers with sensors and information sharing (MPSOSIS), multiple particle swarm optimizers with inertia weight with sensors and information sharing (MPSOIWSIS), multiple canonical particle swarm optimizers with sensors and information sharing (MCPSOSIS), and hybrid particle swarm optimizers with sensors and information sharing (HPSOSIS). Based on the added strategy of information sharing, the search ability and performance of these methods are improved, and it is possible to track a moving target promptly. Therefore, the search framework of particle multi-swarm optimization (PMSO) is established. For investigating search ability and characteristics of the proposed methods, several computer experiments are carried out to handle the tracking problems of constant speed I type, variable speed II type, and variable speed III type, which are a set of benchmark tracking problems. Owing to analyze experimental results, we reveal the outstanding search performance and tracking ability of the proposed search methods.",signatures:"Hiroshi Sho",downloadPdfUrl:"/chapter/pdf-download/66215",previewPdfUrl:"/chapter/pdf-preview/66215",authors:[{id:"88668",title:"Dr.",name:"Hiroshi",surname:"Sho",slug:"hiroshi-sho",fullName:"Hiroshi Sho"}],corrections:null},{id:"69586",title:"Particle Swarm Optimization: A Powerful Technique for Solving Engineering Problems",doi:"10.5772/intechopen.89633",slug:"particle-swarm-optimization-a-powerful-technique-for-solving-engineering-problems",totalDownloads:3228,totalCrossrefCites:14,totalDimensionsCites:35,hasAltmetrics:1,abstract:"This chapter will introduce the particle swarm optimization (PSO) algorithm giving an overview of it. In order to formally present the mathematical formulation of PSO algorithm, the classical version will be used, that is, the inertial version; meanwhile, PSO variants will be summarized. Besides that, hybrid methods representing a combination of heuristic and deterministic optimization methods are going to be presented as well. Before the presentation of these algorithms, the reader will be introduced to the main challenges when approaching PSO algorithm. Two study cases of diverse nature, one regarding the PSO in its classical version and another one regarding the hybrid version, are provided in this chapter showing how handful and versatile it is to work with PSO. The former case is the optimization of a mechanical structure in the nuclear fuel bundle and the last case is the optimization of the cost function of a cogeneration system using PSO in a hybrid optimization. Finally, a conclusion is presented.",signatures:"Bruno Seixas Gomes de Almeida and Victor Coppo Leite",downloadPdfUrl:"/chapter/pdf-download/69586",previewPdfUrl:"/chapter/pdf-preview/69586",authors:[{id:"306844",title:"M.Sc.",name:"Victor",surname:"Coppo Leite",slug:"victor-coppo-leite",fullName:"Victor Coppo Leite"},{id:"308747",title:"MSc.",name:"Bruno",surname:"Seixas Gomes de Almeida",slug:"bruno-seixas-gomes-de-almeida",fullName:"Bruno Seixas Gomes de Almeida"}],corrections:null},{id:"68873",title:"Feature Selection for Classification with Artificial Bee Colony Programming",doi:"10.5772/intechopen.85219",slug:"feature-selection-for-classification-with-artificial-bee-colony-programming",totalDownloads:930,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Feature selection and classification are the most applied machine learning processes. In the feature selection, it is aimed to find useful properties containing class information by eliminating noisy and unnecessary features in the data sets and facilitating the classifiers. Classification is used to distribute data among the various classes defined on the resulting feature set. In this chapter, artificial bee colony programming (ABCP) is proposed and applied to feature selection for classification problems on four different data sets. The best models are obtained by using the sensitivity fitness function defined according to the total number of classes in the data sets and are compared with the models obtained by genetic programming (GP). The results of the experiments show that the proposed technique is accurate and efficient when compared with GP in terms of critical features selection and classification accuracy on well-known benchmark problems.",signatures:"Sibel Arslan and Celal Ozturk",downloadPdfUrl:"/chapter/pdf-download/68873",previewPdfUrl:"/chapter/pdf-preview/68873",authors:[{id:"285817",title:"Associate Prof.",name:"Celal",surname:"Ozturk",slug:"celal-ozturk",fullName:"Celal Ozturk"},{id:"285818",title:"Mrs.",name:"Sibel",surname:"Arslan",slug:"sibel-arslan",fullName:"Sibel Arslan"}],corrections:null},{id:"69877",title:"Sensor-Driven, Spatially Explicit Agent-Based Models",doi:"10.5772/intechopen.89830",slug:"sensor-driven-spatially-explicit-agent-based-models",totalDownloads:934,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Conventionally, agent-based models (ABMs) are specified from well-established theory about the systems under investigation. For such models, data is only introduced to ensure the validity of the specified models. In cases where the underlying mechanisms of the system of interest are unknown, rich datasets about the system can reveal patterns and processes of the systems. Sensors have become ubiquitous allowing researchers to capture precise characteristics of entities in both time and space. The combination of data from in situ sensors to geospatial outputs provides a rich resource for characterising geospatial environments and entities on earth. More importantly, the sensor data can capture behaviours and interactions of entities allowing us to visualise emerging patterns from the interactions. However, there is a paucity of standardised methods for the integration of dynamic sensor data streams into ABMs. Further, only few models have attempted to incorporate spatial and temporal data dynamically from sensors for model specification, calibration and validation. This chapter documents the state of the art of methods for bridging the gap between sensor data observations and specification of accurate spatially explicit agent-based models. In addition, this work proposes a conceptual framework for dynamic validation of sensor-driven spatial ABMs to address the risk of model overfitting.",signatures:"Francis Oloo",downloadPdfUrl:"/chapter/pdf-download/69877",previewPdfUrl:"/chapter/pdf-preview/69877",authors:[{id:"306922",title:"Dr.",name:"Francis",surname:"Oloo",slug:"francis-oloo",fullName:"Francis Oloo"}],corrections:null},{id:"69848",title:"Design of the Second-Order Controller by Time-Domain Objective Functions Using Cuckoo Search",doi:"10.5772/intechopen.89832",slug:"design-of-the-second-order-controller-by-time-domain-objective-functions-using-cuckoo-search",totalDownloads:900,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The proportional-integral-derivative (PID) controllers are widely used in many industrial control applications. However, the lead-lag controllers are more practical. Traditionally, time-domain or frequency-domain methods have been used to design a lead-lag controller in order to meet the design specifications. This chapter will focus on the design of controller by optimizing the time-domain objective function. The proposed objective function includes the first peak time, maximum peak time, rise time, maximum overshoot, maximum undershoot, setting time, and steady-state error. In the study, cuckoo search algorithm is adopted to search the optimal controller parameters. Cuckoo search is a recently developed meta-heuristic optimization method, which is a population-based algorithm inspired by the behavior of some cuckoo species in combination with the Lévy flight behavior. A numerical example is simulated to illustrate the use of the proposed method.",signatures:"Huey-Yang Horng",downloadPdfUrl:"/chapter/pdf-download/69848",previewPdfUrl:"/chapter/pdf-preview/69848",authors:[{id:"218415",title:"Associate Prof.",name:"Huey-Yang",surname:"Horng",slug:"huey-yang-horng",fullName:"Huey-Yang Horng"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:{id:"25",series:{id:"14",title:"Artificial Intelligence",issn:"2633-1403",editor:{id:"218714",title:"Prof.",name:"Andries",middleName:null,surname:"Engelbrecht",slug:"andries-engelbrecht",fullName:"Andries Engelbrecht",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNR8QAO/Profile_Picture_1622640468300",biography:"Andries Engelbrecht received the Masters and PhD degrees in Computer Science from the University of Stellenbosch, South Africa, in 1994 and 1999 respectively. He is currently appointed as the Voigt Chair in Data Science in the Department of Industrial Engineering, with a joint appointment as Professor in the Computer Science Division, Stellenbosch University. Prior to his appointment at Stellenbosch University, he has been at the University of Pretoria, Department of Computer Science (1998-2018), where he was appointed as South Africa Research Chair in Artifical Intelligence (2007-2018), the head of the Department of Computer Science (2008-2017), and Director of the Institute for Big Data and Data Science (2017-2018). In addition to a number of research articles, he has written two books, Computational Intelligence: An Introduction and Fundamentals of Computational Swarm Intelligence.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Stellenbosch University",institutionURL:null,country:{name:"South Africa"}}}}},tags:null},relatedBooks:[{type:"book",id:"149",title:"Recent Advances on Video Coding",subtitle:null,isOpenForSubmission:!1,hash:"3e7cf16c546740b7b07ff0b182637f23",slug:"recent-advances-on-video-coding",bookSignature:"Javier Del Ser Lorente",coverURL:"https://cdn.intechopen.com/books/images_new/149.jpg",editedByType:"Edited by",editors:[{id:"49813",title:"Dr.",name:"Javier",surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6587",title:"Nature-inspired Methods for Stochastic, Robust and Dynamic Optimization",subtitle:null,isOpenForSubmission:!1,hash:"0ed45966bfc64bb7ce110191bfbec73d",slug:"nature-inspired-methods-for-stochastic-robust-and-dynamic-optimization",bookSignature:"Javier Del Ser and Eneko Osaba",coverURL:"https://cdn.intechopen.com/books/images_new/6587.jpg",editedByType:"Edited by",editors:[{id:"49813",title:"Dr.",name:"Javier",surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5966",title:"Heuristics and Hyper-Heuristics",subtitle:"Principles and Applications",isOpenForSubmission:!1,hash:"da699185a8b84a430d96d54bc35acdb2",slug:"heuristics-and-hyper-heuristics-principles-and-applications",bookSignature:"Javier Del Ser Lorente",coverURL:"https://cdn.intechopen.com/books/images_new/5966.jpg",editedByType:"Edited by",editors:[{id:"49813",title:"Dr.",name:"Javier",surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3135",title:"Recent Advances on Meta-Heuristics and Their Application to Real Scenarios",subtitle:null,isOpenForSubmission:!1,hash:"3dfd9b1d407d9b6bd43cddc277d2678c",slug:"recent-advances-on-meta-heuristics-and-their-application-to-real-scenarios",bookSignature:"Javier Del Ser",coverURL:"https://cdn.intechopen.com/books/images_new/3135.jpg",editedByType:"Edited by",editors:[{id:"49813",title:"Dr.",name:"Javier",surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6646",title:"Artificial Intelligence",subtitle:"Emerging Trends and Applications",isOpenForSubmission:!1,hash:"133520f4918b2d1f1c304ffeadba89a9",slug:"artificial-intelligence-emerging-trends-and-applications",bookSignature:"Marco Antonio Aceves-Fernandez",coverURL:"https://cdn.intechopen.com/books/images_new/6646.jpg",editedByType:"Edited by",editors:[{id:"24555",title:"Dr.",name:"Marco Antonio",surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8841",title:"Deterministic Artificial Intelligence",subtitle:null,isOpenForSubmission:!1,hash:"bd65f564ea0b77f91dea36cfcbaa1da7",slug:"deterministic-artificial-intelligence",bookSignature:"Timothy Sands",coverURL:"https://cdn.intechopen.com/books/images_new/8841.jpg",editedByType:"Edited by",editors:[{id:"258189",title:"Prof.",name:"Timothy",surname:"Sands",slug:"timothy-sands",fullName:"Timothy Sands"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7795",title:"Artificial Intelligence",subtitle:"Scope and Limitations",isOpenForSubmission:!1,hash:"7e536b4fe8982ca9015228fe6f58c6ea",slug:"artificial-intelligence-scope-and-limitations",bookSignature:"Dinesh G. 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\r\n\tCartilage lesions of the knee are common and should be treated correctly if symptomatic. Until now, multiple (surgical) techniques have been described; however, there is no consensus on which one should be used. Also, treatment techniques using platelet-rich plasma, mesenchymal stem cells, and different king of growth hormones have been mentioned. In this book, the importance of other knee structures when treating these knee cartilage defects will be discussed as the meniscus, integrity of ligaments, and the importance of the alignment of the lower limb will be emphasized. The book will give an update on the different treatment approaches in knees with this (osteo-)chondral lesion.
",isbn:"978-1-83768-204-1",printIsbn:"978-1-83769-984-1",pdfIsbn:"978-1-83768-205-8",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"90b8cac7c6b437387a540790d072699f",bookSignature:"Dr. Karl Almqvist, Dr. Ahmed Ebrahim El Hamaky and Dr. Taiceer Abdulwahab",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11693.jpg",keywords:"Defect, Cartilage Function, Subchondral Bone, Envelope of Function, Alignment, Knee Stability, Meniscal Function, Surgical Treatment, Microfracture, Use of Scaffolds, Debridement",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 4th 2022",dateEndSecondStepPublish:"July 7th 2022",dateEndThirdStepPublish:"September 5th 2022",dateEndFourthStepPublish:"November 24th 2022",dateEndFifthStepPublish:"January 23rd 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"a month",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"An experienced researcher, specializing in sports medicine and knee pathologies, is currently involved in the development of innovative techniques for the treatment of cartilage lesions. Dr. Almqvist is an editorial board member at Sage Journals, Affiliated with the Orthocure Clinic, Dubai as an Orthopedic Consultant, Mediclinic City Hospital as a Consultant Orthopaedic surgeon, and is a member of ISAKOS.",coeditorOneBiosketch:"Dr. El Hamaky is a practitioner with over 11 years of experience in Orthopedic Surgery, is a member of the Egyptian Board of Orthopedic Surgery, a member of the AO Foundation, and was awarded his medical degree from the University of Cairo.",coeditorTwoBiosketch:"Dr. Taiceer Abdulwahab is an experienced practitioner, specializing in orthopedic surgery, trauma, and sports medicine, previously affiliated with The University of Bristol, The University of Edinburgh, The University of Warwick, and The University of Leicester, and is a member of the Royal College of Surgeons (MRCS) London, UK.",coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"251312",title:"Dr.",name:"Karl",middleName:null,surname:"Almqvist",slug:"karl-almqvist",fullName:"Karl Almqvist",profilePictureURL:"https://mts.intechopen.com/storage/users/251312/images/system/251312.jpg",biography:"Prof. Dr. Almqvist trained at the University of Ghent in Belgium and worked at the Ghent University Hospital where he was Head of Clinic, Department of Physical Medicine and Orthopaedic Surgery, prior to moving to Dubai in 2014. He also has considerable teaching experience and is an assistant professor in Physiotherapy and Orthopaedic Surgery at Ghent University. Karl Fredrik has published extensively and written a number of book chapters. He is a regular speaker at international meetings and is on the editorial board or is a reviewer for the major sports orthopedic journals.\r\nHe obtained his Ph.D. in 2001 (Human differentiated articular cartilage cells in biodegradable matrices – Preparative studies for their use in the repair of cartilage defects).\r\nKarl Fredrik is active in a number of orthopaedic organisations, and is the past Chairman of the Sports Committee of the International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine as well as the past Chairman of the Cartilage Committee of the European Society of Sports Traumatology, Knee Surgery & Arthroscopy.\r\nThe main area of interest Karl Fredrik is knee surgery. His expertise covers the whole range of knee conditions from sports injuries to knee replacement.",institutionString:"Orthocure Dubai",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null}],coeditorOne:{id:"452670",title:"Dr.",name:"Ahmed",middleName:null,surname:"Ebrahim El Hamaky",slug:"ahmed-ebrahim-el-hamaky",fullName:"Ahmed Ebrahim El Hamaky",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003N9dpTQAR/Profile_Picture_2022-03-04T13:32:24.jpg",biography:"An orthopedic surgeon with 11 years experience in orthopedic surgery, trained in highly specialized facilities in Egypt such as Al kasr al ainy University hospitals, Al Helal Orthopedic tertiary hospital, Air force specialized hospital. His interest and specialty are mainly sports medicine and surgery either shoulder or knee arthroscopic and primary arthroplasty surgeries. He shifted his career to Dubai Mediclinic City Hospital, Dubai.",institutionString:"Mediclinic City Hospital",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Mediclinic City Hospital",institutionURL:null,country:{name:"United Arab Emirates"}}},coeditorTwo:{id:"204153",title:"Dr.",name:"Taiceer",middleName:null,surname:"Abdulwahab",slug:"taiceer-abdulwahab",fullName:"Taiceer Abdulwahab",profilePictureURL:"https://mts.intechopen.com/storage/users/204153/images/system/204153.jpeg",biography:"Dr. Taiceer Abdulwahab, is an Orthopaedic Surgeon at Mediclinic City Hospital, Dubai, United Arab Emirates. He is also an Assistant Clinical Professor of Orthopaedic Surgery at Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai.\r\nHe is a Master of Surgery (ChM) in Trauma & Orthopaedic Surgery, degree obtained at the University of Edinburgh School of Medicine in partnership with the Royal College of Surgeons of Edinburgh, UK. He received his Master of Science (MSc) in Trauma & Orthopaedic Surgery degree from Warwick School of Medicine, University of Warwick, UK. He also received a Postgraduate Award (PGA) in Understanding Research & Critical Appraisal at the Warwick School of Medicine, University of Warwick, UK.\r\nDr. Abdulwahab obtained his primary medical qualification, Bachelor of Medicine & Bachelor of Surgery (MBChB) from the Bristol School of Medicine, University of Bristol, UK.\r\nDr. Taiceer Abdulwahab is a Member of the Royal College of Surgeons of England (MRCS).\r\nHe has presented at various international conferences including the International Congress for Joint Arthroplasty (ICJR) and the European College of Sports & Exercise Physicians (ECOSEP) with FIFA update, as well as published in peer-reviewed journals, Editor for a book titled 'Meniscus of the Knee', and investigator in several randomized controlled trials.\r\nHe is Trauma Doctor for the annual Emirates Rugby 7s.\r\nHe has a special interest in Sports Surgery (Arthroscopic Shoulder and Knee surgery).",institutionString:"Mediclinic City Hospital",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Mediclinic City Hospital",institutionURL:null,country:{name:"United Arab Emirates"}}},coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"466998",firstName:"Dragan",lastName:"Miljak",middleName:"Anton",title:"Mr.",imageUrl:"https://mts.intechopen.com/storage/users/466998/images/21564_n.jpg",email:"dragan@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review, to approval and revision, copy-editing and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. A unique name with a unique work ethic right at your service."}},relatedBooks:[{type:"book",id:"6550",title:"Cohort Studies in Health Sciences",subtitle:null,isOpenForSubmission:!1,hash:"01df5aba4fff1a84b37a2fdafa809660",slug:"cohort-studies-in-health-sciences",bookSignature:"R. Mauricio Barría",coverURL:"https://cdn.intechopen.com/books/images_new/6550.jpg",editedByType:"Edited by",editors:[{id:"88861",title:"Dr.",name:"R. Mauricio",surname:"Barría",slug:"r.-mauricio-barria",fullName:"R. 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The extracellular vesicles are secreted by most cell types of any living organism from archaea, bacteria, and eukarya. Extracellular vesicles are isolated from biological fluids such as blood, semen, cerebrospinal fluid, and saliva [1, 2]. Exosomes are formed by the fusion of multivesicular bodies (MVBs) with the cell membrane and then released into the extracellular space [3]. Exosomes are extracellular vesicles with a diameter of 30–100 nm. Exosomes are used in therapeutic applications like a delivery system. The exosomes and retroviral vectors are efficient transporters of biotransformation. The exosomes are used in immunotherapies and biotherapies. Exosomes and lentiviruses are excellent vehicles to carry encapsulated cargo with reduced immunogenicity with multiple cell types and tissue barriers, including the blood-brain barrier. The inherent properties of exosomes are to enclose nucleic acids, proteins, lipids, and chemical agents. Exosomes have been considered to carry the coding, and non-coding RNA (miRNA and siRNA) along with the lentiviral vectors which give a stable integration into target cells [4, 5, 6, 7, 8, 9]. Some findings proposed that the human immune deficiency virus (HIV) particles like exosomes contribute to HIV pathogenesis, but the recent findings reported that the exosomes exert an effect on the replication of HIV [10]. The potential research on exosomes will be helpful in the vaccine or therapeutic design to treat HIV patients along with antiretroviral therapy. The exosome adopted picture is given in Figure 1.
A: View of an Multivesicular endosome (MVE) sparsely labelled with AuTf after a 20 min incubation at 37°C. note the apparent fusion of the MVE and the plasma membrane. This may represent incipient MVE exocytosis. Bar, 100 nm. × 107,000. Fig. B: View of MVE exocytosis in an unfixed reticulocyte. This cell was incubated for 30 min with AuTf, subjected to a 20 min chase with unconjugated transferrin, and then quick-frozen without prior fixation and freeze-substituted. Bar, 200 rim. × 61,000. Fig C: Freeze-fracture, deep-etch view of a large MVE filled with numerous inclusions. The remaining free lumen possesses a markedly lower protein concentration than the surrounding cytoplasm and is deeply etched. Bar, 200 nm. × 63,000. Fig. D: View of an MVE lightly labelled by AuTf after a 20 min incubation at 37°C. AuTf (white dots) is bound to the walls of the MVE and is clustered heavily around the inclusions, making the outline of the individual gold beads difficult to discern. Bar, 100 nm. × 127,000. All A, B, C, D figures are adopted from Harding et al. [
The circulated exosomes in plasma are small and nanometre in size. Due to the small size, the exosomes are easily separated from human plasma through low density, differential ultracentrifugation, or ultrafiltration [12]. The exosomes are isolated from the semen for HIV-1 infection assays [13]. The exosomes in the host play an important role in HIV-1 infection, releasing intracellular and extracellular material and establishing cell-cell communication. The exosome study in HIV research is a hotspot because it has great significance in predicting acquired immunodeficiency syndrome (AIDS). The microparticles containing the chemokine receptor CCR5, the principal coreceptor for macrophage-tropic human immuno-deficiency virus-1 was released from the surface of the CCR5+Chinese hamster ovary cells and peripheral blood mononuclear cells. It proves that intercellular communication is associated with the cellular membranes of the HIV-1 infection [14]. Exosomes utilise the primary and secondary host cells. The human T cell immunoglobin mucin (TIM) proteins are used by retroviruses, such as HIV, for viral entry. The TIM1 proteins promote the infection of multiple viruses, such as HIV, through virion-associated phosphatidylserine [15]. As AIDS is incurable by antiretroviral therapy, a hypothesis is explained that the ‘Trojan exosomes’ can be a novel approach to vaccine development [16].
HIV-1 patients in antiretroviral therapy may develop the risk of non-AIDS-defining-cancers (NDCs). The transactivation response RNA containing exosomes from the HIV-1 infected T cells promotes the growth and progression of particular NADCs. In the host, the HIV-infected T cell exosome enters through the epidermal growth factor receptor by stimulating ERK1/2 phosphorylation via the EGF/TLR3 dependent manner leading to NADCs [17]. HIV-1 infected patients are more likely aggressive to develop cervical cancer. The HIV-1-associated exosomes promote the growth and progression of cervical cancer in HIV-1 patients [18]. A study reported the presence of the transactivation response element (TAR) miRNA encoded by HIV-1 infected cells and patient sera. This TAR miRNA was isolated from the exosomes derived from the HIV-1 infected cells. From the study, it was observed that the HIV-1 RNA molecules within the exosome helped in the intercellular viral spread in infected host cells [19]. This TAR RNA stimulated the production of proinflammatory cytokines from exosomes derived from HIV-1 infected cells [20]. The stable epigenetic repression of the HIV-1 expression
Exosomes are nano-sized membrane vesicles released by fusion of the multivesicular body or the organelle of the endocytic pathway origin with the plasma membrane of the cells. The exosome biogenesis is an endosomal sorting complex required for transport (ESCRT) dependent or ESCRT independent. The endosomal pathways are not entirely separated but the different subpopulations of exosomes work synergistically in different cell types of machinery. The cell type or cellular machinery is an important factor that controls the secretion of exosomes [24]. The formation of the exosome is behind with multiple mechanisms. In the early endosome formation, the best mechanism involves the recruitment of the endosomal sorting complex required for transport (ESCRT) machinery to the ubiquitinated proteins. The ESCRT complex is made up of four protein complexes (ESCRT-0, -I, -II, and -III) along with accessory proteins (Alix, VPS4, and VTA-1). These protein complexes bind to the exosome cargos through the intraluminal vesicles (ILVs). One of the ESCRT-III complexes induces the inward budding and fission of the vesicles to form the microvesicular bodies [25, 26, 27, 28]. The exosome cargos formation depends on the synthesis of ceramide as a mechanism to induce the vesicle curvature and budding [29]. The exosome formation depends on the synthesis of the tetraspanin-mediated organisation of specific proteins, such as the amyloidogenic protein and pre-melanosome protein [30, 31]. After the formation of exosomes, the exosomes played an important role in cellular functions such as cellular migration and invasion, immunity, normal development and adult physiology, fertilisation and mating behaviour, nervous system [24]. Exosomes and HIV-1 particles share important features in biogenesis, biophysical, molecular, and cellular uptake mechanisms. Both HIV-1 and exosomes are surrounded by a phospholipid bilayer in a size of 100–200 nm but their separation is a technical challenge by centrifugations. Exosomes are membrane-derived vesicles that harbour genomic, proteomic, and lipid cargos and also participate in the progression of HIV-1 pathogenesis. Exosomes derived from the HIV-1 infected dendritic cells were more infective than the cell-free HIV-1 or exosome-derived T cells. During HIV-1 infection, the exosomes from the dendritic cells contain fibronectin and galectin-3. In the T-cells exposed to exosomes cargo derived from HIV-1 infected dendritic cells, the gene expression of the pro-inflammatory cytokines IFN-γ, TNF-α, IL-1β, and RANTES and activation of p38/Stat pathways was observed [32]. A class of proteins called ‘Tetraspanins’ provides a powerful approach to distinguish exosomes and HIV-1 infected cells during the progression of the disease [33]. The Epstein–Barr virus (EBV) that causes tumours in humans induces the transfer of viral oncoprotein, LMP1, and a virus-encoded miRNA through exosome [34]. Exosomes are involved in viral transmission and immune sensing in the host. Hepatitis-A and hepatitis-C viruses use exosomes for viral transmission and antibody-mediated immune responses in the host [35]. The cytomegalovirus, the herpes simplex virus, human papillomavirus, the respiratory syncytial virus was mediated exosome cargo of various molecules, such as dendritic cell-specific ICAM-3 grabbing nonintegrin (DC-SIGN) and MHC-I and II [36].
The architecture of the exosome is very complex and contains proteins, nucleic acids, and lipids. Various databases are available for information on exosomal proteins, mRNA, MicroRNAs and lipids [37, 38]. The integrated database provides high-throughput datasets on vesicular components of prokaryotes, mammalian and nonmammalian eukaryotes extracellular vesicles [38]. An exosome contains several tetraspanins such as CD9, CD63, CD81, CD82 takes part in cell penetration, invasion and fusion events, heat shock proteins HSP70 and HSP90 involved in stress response in antigen binding and presentation, Alix, TSG101 proteins are involved in exosome release, annexins and Rab proteins are involved in membrane transport and fusion. The exosome biogenesis proteins Alix, flotillin, and TSG101 participate in exosome biogenesis. The proteins, such as TSG101, HSP70, CD81, and CD63, are highly enriched in exosomes and considered as the exosome marker proteins. Exosomes contain all types of RNA such as miRNA, ribosomal RNA, long non-coding RNA, piwi interacting RNA, transfer RNA, small nuclear and nucleolar RNA, etc. [39, 40]. Besides proteins and nucleic acids, the exosomes contain the lipids, such as phosphatidylserine, phosphatidic acid, arachidonic acid, cholesterol, and sphingomyelin. The human plasma and serum exosomes contain high-density lipoproteins (HDL), low/very low-density lipoproteins (LDL/VLDL), Apo AI, Apo-B100, etc. [41]. The various proteins and lipid components of the exosome are given in Table 1.
Categories of protein | Names |
---|---|
Tetraspanins | CD9, CD63, CD81, CD82, CD37, CD53 |
Heat shock proteins (HSP) | HSP90, HSP70, HSP27, HSP60 |
Cell adhesion | Integrins, Lactadherin, Intercellular Adhesion Molecule |
Antigen presentation | Human leukocyte antigen I and II /peptide complexes |
Multivesicular body Biogenesis | Tsg101, Alix, Vps, Rab proteins |
Membrane transport | Lysosomal-associated membrane protein 1/2, CD13, PG regulatory-like protein |
Signalling proteins | GTPase HRas, Ras-related protein, furloss, extracellular signal-regulated kinase, Src homology 2 domain phosphatase, GDP dissociation inhibitor, Syntenin-1, 14-3-3 Proteins, Transforming protein RhoA |
Cytoskeleton components | Actins, Cofilin-1, Moesin, Myosin, Tubulins, Erzin, Radixin, Vimentin |
Transcription and protein synthesis | Histone1, 2, 3, Ribosomal proteins, Ubiquitin, major vault protein, Complement factor 3 |
Metabolic enzymes | Fatty acid synthase Glyceraldehyde-3-phosphate dehydrogenase Phosphoglycerate kinase 1 Phosphoglycerate mutase 1 Pyruvate kinase isozymes M1/M2 ATP citrate lyase ATPase Glucose-6-phosphate isomerase Peroxiredoxin 1 Aspartate aminotransferase Aldehyde reductase |
Trafficking and membrane fusion | Ras-related protein 5, 7 Annexins I, II, IV, V, VI Synaptosomal-associated protein Dynamin, Syntaxin-3 |
Antiapoptosis | Alix, Thioredoxin, Peroxidase |
Growth factors and cytokine | Tumour necrosis factor-α, TNF receptors, Transforming growth factor-β |
Death receptors | FasL, TNF-related apoptosis-inducing ligand |
Iron transport | Transferrin receptor |
LTA4, LTB4, LTC4, PGE2, 15d-PGJ2, PGE2, PA, Ceramides, Cholesterol, Bis(monoacylglycero)phosphate, Phosphatidyl serine, Spingomyelin | LTA4 hydrolase, LTC4 synthase, COX-1, COX-2, PGE synthase, PLD2, DGK, nSMase2 |
Types of proteins and lipids in exosomes: The author has permitted the source [42].
Exosomes contain receptors for virus entry. SARS-CoV-2 spreaders are contributed by exosomes as they transfer the receptors CD9 and ACE2 to recipient cells susceptible to the SARS-CoV-2. During the SARS-CoV-2 infection, the SARS-CoV-2 virus is directed into the exosome pathways and the components are packaged into exosomes for secretion [43].
HIV-1 could transmit via the semen through sexual intercourse and is the leading cause of HIV-1 transmission worldwide during vaginal and rectal intercourse by human beings. The major route of transmission is the vaginal secretion during the sexual intercourse to the person who is involved in this period [44]. Exosomes play an important role in intracellular communication. Semen exosomes are epididymosomes and prostasomes. Epididymosomes and prostasomes are exosomes involved in the acquisition of fertilising ability, modulation of motility, maturation of spermatozoa and could be a possible biomarker in the early diagnosis of male infertility [45].
The identified proteins in the blood exosome and semen exosome are useful as a biomarker applicable to different fields of medicine, especially in reproduction and infectious diseases. The proteomic profiling of semen exosomes and blood exosomes from HIV-infected and uninfected individuals was compared. The compositional and functional variabilities were observed. Semen exosomes were enriched in clusterin protein compared with the blood exosome in HIV-infected and uninfected patients [46]. The antiretroviral activity of the human semen exosome was reported. The human semen exosome inhibits the HIV-1 replication, and it could be useful as a therapeutic purpose for HIV-1. Semen exosomes restrict HIV-1 transmission by vaginal cells. This study of the semen exosomes helps the development of the therapeutic diagnosis during the transmission of HIV-1 [13]. Semen and vaginal fluid exosomes of healthy individuals could inhibit the HIV-1 infection and block the transfer of HIV-1 into vaginal cells [47].
Exosomes play an important role in pathogenesis in HIV-1 patients. The exosomes in HIV-1 patients and their relationship in immune and oxidative stress response have been documented [49]. Exosome plasma proteomic profiles were identified and characterised in HIV patients of alcohol drinkers and cigarette smokers. The exosome proteins, such as hemopexin and properdin, could be used as a potential biomarker for physiological effects that may arise in HIV-infected individuals tobacco and alcohol abusers [50]. Exosome-associated most cytokines were observed in the HIV-1 infected patients. The exosomes purified from HIV-positive patients induced the CD38 expression in naive and central memory CD4+ and CD+ T cells leads to inflammation and viral propagation [12]. The expression levels of miR21 were lower in the plasma-derived exosome of HIV-1 elite controller with decreasing CD4 T cell count [51].
In the HIV-1-associated neurocognitive disorders, the HIV-exosomes accelerate the dysfunction of primary human brain microvascular endothelial cells (HBMVECs) by inducing mitochondrial hyperfusion. HIV-1 exosome increases the mitochondrial hyperfusion due to loss of phosphorylated dynamin-related protein1(p-DRP1). HIV-exosomes dysregulate the mitochondrial function could adversely change the effect of the brain microvascular endothelium [52]. The important role of exosomes in HAND has been reported to lead to a disease like Alzheimer’s. The HIV patients on ART are the main cause of the deposition of Beta-amyloid (Aβ) leads to dementia. The neuroinflammation is induced by HIV proteins, such as Tat, gp120, and Nef. Exosomes serve as a link between HIV and Alzheimer’s disease by packaging and transporting the toxic proteins [53]. The exosome played an important role in signalling in the central nervous system and acts as a potential vehicle to deliver various therapeutics to treat HIV neuroinflammation [54]. The exosomes played an important role in transporting cargo in many neurological disorders, such as mental disorders, brain injury, abnormal neuronal development, neurodegenerative diseases, epilepsy, stroke, and brain cancer [55].
Exosomes in semen and plasma could be used as a biomarker for the diagnosis of HIV-1 patients. Exosomes could be used as an immunological and oxidative stress marker in HIV patients. Exosomes either promote or inhibit HIV-1 pathogenesis in the human body. The exosomes could be used as a diagnostic biomarker, therapeutic tool for successful implementation, and clinical application in HIV-1 patients [56]. Plasma neuronal exosomes are used as biomarkers in HIV-associated neurological disorders and Alzheimer’s disease [57]. In a recent study, the researchers used the exosome-based strategy to block HIV in mice in a block and lock approach [58].
The exosome formation and secretion after a retrovirus infection is a very complex process. Further study of the virally complex microvesicles will clarify their role in infection. The main function of the exosome in semen and plasma is immune activation, immune suppression, transfer of functional miRNA, intracellular and intercellular communication. The exosome study will manage the broad biological and medical implications towards the pathogenesis of HIV-1 infected individuals. The current understanding of the exosome biology and function with regards to the HIV-1 infection is in early-stage now. The role of exosomes in the host-HIV-1 infections can open a new era of understanding of disease mechanisms, therapeutic interventions, and future diagnostic purposes in the field of medical science research.
Indian Council of Medical Research (ICMR), Govt. of India.
No conflict of interest by the authors.
The exosomes are nanovesicles derived from various cell types under the physiological or pathological conditions of the body of human beings.
Basically, exosomes carry the host and pathogen-derived genomic, proteomic, lipidomic materials. The exosomes exchange information between the cells during the progression of AIDS.
Exosomes in the HIV-1 patients have the dual activity that could inhibit HIV-1 infection or progress the HIV-1 infection within the host.
Exosomes may activate the resting CD4+T lymphocytes and, by activating these cells, lead to chronic infection.
The study of biological information in an exosome could be used as a marker in HIV-1 patients and could be helpful in diagnosis and treatment.
Semen exosomes are rich in nucleic acids and protein binding factors than blood exosomes.
Health care is vulnerable to error, and so all health care environments and professionals are involved in complex care processes. Since the IOM report [1], almost all countries and health care organizations are attending to Patient Safety issues. In more recent years, the European Council launched a recommendation [2] that shows the importance of establishing patient safety culture in all health care settings. We can read in this recommendation that a poor patient safety represents both a severe public health problem and a high economic burden on limited health resources. A large proportion of adverse events, both in the hospital sector and in primary care, are preventable with systemic factors appearing to account for a majority of them.
\nBefore implementing patient safety programs, health care staff must understand their safety culture [3]. Quantitative instruments designed to assess safety culture have been developed, and a few review articles have been published, which allows a more comprehensive way of implementing models of safety culture [4]. Measuring health care safety culture enables us to identify improvements, safety behaviors, and outcomes for both patients and staff. These instruments should also serve as decision making tools, especially for managers.
\nMuch has been done in hospital environment, and more recently, primary care has also been in the sights. A few review articles were published allowing researchers and primary care staff to take robust decisions on tools to assess patient safety culture [5, 6, 7].
\nWith the publication of the National Patient Safety Plan (2015–2020), the Portuguese Directory of Health along with the Portuguese Hospital Association carried out patient safety culture assessment either in hospitals or in primary care. It was published as a national standard, and every 2 years, patient safety culture is assessed either in primary care or in hospitals nationwide.
\nThe purpose of this study was to translate, adapt, validate, and analyze the reliability and validity of the Portuguese version of the Medical Office Survey on Patient Safety Culture.
\nThe Medical Office Survey on Patient Safety Culture (MOSPSC) is a self-administered tool, which was developed by the Agency for Healthcare Research and Quality (AHRQ) in 2007 [8], and is designed specifically for outpatient medical office providers and other staff and asks for their opinions about the culture of patient safety and health care quality in their medical offices. Although in Portugal the health system is completely different than in the United States, we considered that the primary care environment and culture are similar, which lead us to test its use.
\nThis survey has 38 items grouped into 10 composites and includes questions that ask respondents about problems related to exchange information with other settings and about access to care. Respondents are also asked to rate their medical office in five areas of health care quality (patient centered, effective, timely, efficient, and equitable) and to provide an overall rating on patient safety (Table 1).
\nComposites | \nItems | \n
---|---|
1. Teamwork | \nC1; C2; C5; C13 | \n
2. Patient Care Tracking/Follow Up | \nD3; D5; D6; D9 | \n
3. Organizational Learning | \nF1; F5; F7 | \n
4. Overall Perceptions of Patient Safety and Quality | \nF2; F3; F4R; F6R | \n
5. Staff Training | \nC4; C7; C10R | \n
6. Owner/Managing Partner/Leadership Support for Patient Safety | \nE1R; E2R; E3; E4R | \n
7. Communication about Error | \nD7R; D8R; D11; D12 | \n
8. Communication Openness | \nD1; D2; D4R; D10R | \n
9. Office Processes and Standardization | \nC8R; C9; C12R; C15 | \n
10. Work Pressure and Pace | \nC3R; C6R; C11; C14R | \n
MOSPSC composites and items.
According to the MOSPSC author’s [8], patient safety culture composites and its definitions are:
Teamwork—the extent to which the office has a culture of teamwork, mutual respect, and close working relationships among staff and providers.
Patient Care Tracking/Follow Up—the extent to which the office reminds patients about appointments, documents how well patients follow treatment plans, follows up with patients who need monitoring, and follows up when reports from an outside provider are not received.
Organizational Learning—the extent to which the office has a learning culture that facilitates making changes in office processes to improve the quality of patient care and evaluates changes for effectiveness.
Overall Perceptions of Patient Safety and Quality—the extent to which the quality of patient care is more important than getting more work done, office processes are good at preventing mistakes, and mistakes do not happen more than they should.
Staff Training—the extent to the office gives providers and staff effective on-the-job training, trains them on new processes, and does not assign tasks they have not been trained to perform.
Owner/Managing Partner/Leadership Support for Patient Safety—the extent to which office leadership actively supports quality and patient safety, places a high priority on improving patient care processes, does not overlook mistakes, and makes decisions based on what is best for patients.
Communication about Error—the extent to which providers and staff are willing to report mistakes they observe and do not feel like their mistakes are held against them, and providers and staff talk openly about office problems and how to prevent errors from happening.
Communication Openness—the extent to which providers in the office are open to staff ideas about how to improve office processes, and staff are encouraged to express alternative viewpoints and do not find it difficult to voice disagreement.
Office Processes and Standardization—the extent to which the office is organized, has an effective workflow, has standardized processes for completing tasks, and has good procedures for checking the accuracy of work performed.
Work Pressure and Pace—the extent to which there are enough staff and providers to handle the patient load, and the office work pace is not hectic.
Since the publication of the National Patient Safety Plan (2015–2020), the Portuguese Directory of Health along with the Portuguese Hospital Association carried out patient safety culture assessment either in hospitals or in primary care. For this purpose, the MOSPSC was the chosen tool because [8]:
it raises provider and staff awareness about patient safety;
it assesses the current status of patient safety culture;
it identifies strengths and areas for patient safety culture improvement;
it examines trends in patient safety culture change over time;
it evaluates the cultural impact of patient safety initiatives and interventions;
it conducts comparisons within and across organizations;
it has been used in several countries in Europe (which makes benchmark possible) [9, 10], and the results of the LINEUS study [9] show that it is useful and applicable to assess patient safety culture at primary health care services in Europe.
The European Society for Quality and Safety in Family Practice (EQuiP) and the World Family Doctors. Caring for People (WONCA Europe) [11] conducted a study to spread the MOSPSC among EQuiP delegates, explore their views and opinions on the MOSPSC, and explore with them the feasibility of the MOSPSC among European countries. Nineteen countries were involved, and 63% of respondents find it would be interesting to use MOSPSC.
\nImmediately after author’s permission for MOSPSC use, the survey was translated from English to Portuguese (T1) and backward (T2) by two independent translators, native speakers of Portuguese, and bilingual in English/Portuguese, experienced in this method and knowledgeable about the research objective (Step 1). The two versions (T1 and T2) were compared with the original version of the MOSPSC (Step 2). Back translation by two independent translators (R-T1 and R-T2) was carried out by bilingual native English, who were unfamiliar with the original version of tool and not knowledgeable about the study objectives (Step 3). Discrepancies were assessed, and the cross-cultural adaptations were undertaken (Step 4). Content validity and semantic analysis were undertaken by six experts chosen from the primary care sector and knowledge on this topic and with research experience (Step 5).
\nThe pretest was applied (Step 6), which was aimed at assessing whether the MOSPSC was understandable to a larger number of people in the target population. The last version of the MOSPSC was then administered in Web-based format, and we used all recommendations from AHRQ [11] to publicize and promote the survey.
\nThe Portuguese Directory of Health published a national standard that requires patient safety culture assessment in primary care units (PCUs) nationwide (52 PCUs) every 2 years. A personalized link was sent to all PCUs, where a focal point was in charge of facilitating the administration of the survey. In order to track and maximize response rates, a link was sent to each office PCU. We sent another link so that the focal point could check response rates along the administration period, which occurred from March 16 till April 30, 2017.
\nOur goal was to assess the validity and reliability of the Portuguese version of the MOSPSC, by verifying if the 10 patient-safety culture composites were appropriate for the Portuguese population. The R software was used for statistical analysis, and the negatively worded items were reverse-scored and they are denoted by R letter.
\nDescriptive statistics were used to examine response variability and missing data. To identify and eliminate those items with missing data, an individual descriptive item analysis was performed. A missing-value analysis was performed to verify if it was necessary to remove surveys from the data set. Every survey with missing values was removed, and surveys with more than 1 response in the option “not applicable” were removed. For the remaining surveys with only one answer in option “not applicable,” it was replaced by the middle category in a five-point Likert scale. An empirical rule of 10 respondents per patient safety culture item in a survey with 38 items means that at least 380 completed surveys were needed.
\nA reliability analysis (internal consistency) was performed using Cronbach’s α, where it indicates the extent to which surveys items can be treated as a single latent construct. Values >0.7 reliability is considered adequate for a survey instrument [12], although some authors consider >0.6 adequate [13]. For the entire survey, Cronbach’s α should be at least 0.9 [12]. However, the validity of this measure has been questioned, and several authors have suggested alternative measures. In this study, we also used the average inter-item correlation (AIIC), which is independent of the number of items and sample size. This measure evaluates how items within a composite correlate, i.e., there is evidence that the items are measuring the same underlying composite. A rule-of-thumb is that AIIC should be between 0.15 and 0.5 [14].
\nAn exploratory factor analysis (EFA) was performed. EFA is a cluster of common methods used to explore the underlying pattern of relationships among multiple observed variables. EFA is useful for assessing the dimensionality of questionnaire scales that measure underlying latent variables. Researchers use EFA to hypothesize and, later, confirm, through replication or confirmatory factor analysis (CFA), the model that gave rise to the interrelationships among the scale?s variables. EFA for ordinal data, a benefit over conventional criteria, where the Pearson correlation matrix is used. Pearson correlations assume that data have been measured on, at least, an equal interval scale, and a linear relationship exists between the variables. These assumptions are typically violated in the case of variables measured using ordinal rating scales. Pearson correlations have been found to underestimate the strength of relationships between ordinal items.
\nEFA is useful for assessing the dimensionality of survey scales that measure underlying latent variables. This factor analysis gives an indication of the number of factors that the survey appears to measure of its intended subject. In this way, through EFA, we can investigate if the Portuguese data will produce different factors from the American structure.
\nSince the data are ordinal, it was used a polychoric correlation matrix for EFA analysis and a Varimax rotation. To decide on the number of factors, it was used a parallel analysis [15, 16]. Items with a factor loading lower than 0.4 on all factors were excluded. Libraries
We used confirmatory factor analysis (CFA) for ordinal data to compare the Portuguese sample factor structure to the factor structure reported for the original HSOPSC. CFA for ordinal data will use diagonally weighted least squares (DWLS) to estimate the model parameters, but it will use the full weight matrix to compute robust standard errors and a mean- and variance-adjusted test statistic. We used the goodness-of-fit index (GFI), which accounts for the proportion of observed covariance between the manifest variables (items), explained by the fitted model (a concept similar to the coefficient of determination in linear regression). Generally, GFI values between 0.9 and 0.95 indicate good fit, and GFI values above 0.95 indicate a very good fit. Bentler’s comparative fit index (CFI) was used to correct the underestimation that can occur when samples are small. CFI is independent from the sample size. Values between 0.9 and 0.95 indicate good fit, and values equal to or above 0.95 indicate a very good fit. The Tucker-Lewis index (TLI) varies between 0 and 1; values close to 1 indicate a good fit. Parsimony GPI (PGFI) is obtained to compensate for the “artificial” improvement in the model, which is achieved simply by adding more parameters, i.e., a more complex model may have better fit than a simpler model (parsimonious). Values between 0.6 and 0.8 indicate a reasonable fit and values above 0.8 a good fit. The index root mean square error of approximation (RMSEA) was used to adjust the model simply by adding more parameters. Empirical studies suggest that the model fit is considered good for values ranging between 0.05 and 0.08 and very good for values less than 0.05. The
A total of 7299 respondents provided feedback (response rate of 32.2%), 38% were nurses, 27% physicians, and 19% secretary/clerk (Table 2).
\n\n | Respondents | \n|
---|---|---|
N | \n% | \n|
Physicians | \n1954 | \n27 | \n
Nurses | \n2729 | \n38 | \n
Assistant | \n456 | \n6 | \n
Secretary | \n1380 | \n19 | \n
Technicians | \n560 | \n7 | \n
Others | \n136 | \n2 | \n
Total | \n7215 | \n\n |
Missing values | \n84 | \n\n |
Total | \n7299 | \n\n |
Demographic characteristics.
Average composite positive responses were obtained (Table 3). The lowest positive scores were found in composites
Composite | \nAverage positive responses (%) | \n
---|---|
1. Teamwork | \n76 | \n
2. Patient Care Tracking/Follow Up | \n76 | \n
3. Organization Learning | \n71 | \n
4. Overall Perceptions of Patient Safety and Quality | \n69 | \n
5. Staff Training | \n44 | \n
6. Owner/Managing Partner/Leadership Support for Patient Safety | \n31 | \n
7. Communication about Error | \n54 | \n
8. Communication Openness | \n52 | \n
9. Office Processes and Standardization | \n53 | \n
10. Work Pressure and Pace | \n21 | \n
Composite average positive responses.
From an initial data set of 7299 respondents, it was removed 587 surveys with missing values and 2408 surveys with more than 2 answers on the option “not applicable,” getting a final data set with 4304 surveys, exceeding the minimum necessary. The surveys with one answer in the option “not applicable” were replaced by the middle category in a five-point Likert scale.
\nReliability analysis using Cronbach’s α was performed on the 10 composites to ensure that individuals were responding consistently to items (Table 4). Considering Cronbach’s α, all composites had values higher than 0.6, where composite 1 achieved the highest value and composite 9 the lowest. Analyzing AIIC coefficient, only composites 1 and 3 obtained values outside from the reference. In terms of global consistency, both coefficients lead to a good overall consistency.
\nComposite | \nNo of items | \nCronbach’s α | \nAIIC | \n
---|---|---|---|
1. Teamwork | \n4 | \n0.82 | \n0.53 | \n
2. Patient Care Tracking/Follow Up | \n4 | \n0.71 | \n0.38 | \n
3. Organization Learning | \n3 | \n0.79 | \n0.56 | \n
4. Overall Perceptions of Patient Safety and Quality | \n4 | \n0.69 | \n0.38 | \n
5. Staff Training | \n3 | \n0.69 | \n0.43 | \n
6. Owner/Managing Partner/Leadership Support for Patient Safety | \n4 | \n0.69 | \n0.36 | \n
7. Communication about Error | \n4 | \n0.75 | \n0.43 | \n
8. Communication Openness | \n4 | \n0.73 | \n0.40 | \n
9. Office Processes and Standardization | \n4 | \n0.63 | \n0.31 | \n
10. Work Pressure and Pace | \n4 | \n0.75 | \n0.42 | \n
Total | \n38 | \n0.92 | \n0.24 | \n
Internal consistency statistics.
To examine whether a different structure would give a better fit to the data, an exploratory factor analysis was performed. To determine how many composites should be retained, it was obtained the path diagram in Figure 1, where a new structure is proposed. Eight composites were obtained with 37 items (item F6R was not considered since he had an eigenvalue lower than 0.4). Comparing this structure with the one proposed by MOSPSC, composites 1, 5, and 6 did not suffer any changes, composites 2 and 10 gained one item each, composite 4 lost 2 items, composite 8 gained one item and changed other, and composite 3 gained several items from composites 4, 7 and 9.
\nPath diagram of exploratory factor analysis. Rectangles represent items, circles represent factors (composites), and the values on the arrows are the eigenvalues.
It was obtained the coefficients for internal consistency for the new proposed structure by EFA (Table 5). In a general way, it was obtained better internal consistency coefficients than with the original structure.
\nComposite | \nNo. of items | \nCronbach’s α | \nAIIC | \n
---|---|---|---|
1. Teamwork* | \n4 | \n0.82 | \n0.53 | \n
2. Patient Care Tracking/Follow Up + 8. Communication Openness (D1) | \n5 | \n0.73 | \n0.35 | \n
3. Organization Learning + 7. Communication about Error (D11, D12) + 9. Office Processes and Standardization (C9, C15) + 4. Overall Perceptions of Patient Safety and Quality (F2) | \n8 | \n0.88 | \n0.48 | \n
4. Overall Perceptions of Patient Safety and Quality [F2, F6R] | \n2 | \n0.76 | \n0.61 | \n
5. Staff Training* | \n3 | \n0.69 | \n0.43 | \n
6. Owner/Managing Partner/Leadership Support for Patient Safety* | \n4 | \n0.69 | \n0.36 | \n
8. Communication Openness [D1] + 7. Communication about Error (D7R) + 2. Patient Care Tracking/Follow Up (D8) | \n5 | \n0.78 | \n0.41 | \n
10. Work Pressure and Pace + 9. Office Processes and Standardization (C12R) | \n5 | \n0.79 | \n0.42 | \n
Total | \n38 | \n0.92 | \n0.243 | \n
Internal consistency statistics after structure proposed by exploratory factor analysis.
Composites who did not suffer any changes after EFA.
Curve brackets represent added items and rectangular brackets represent removed items from the composite.
The fit of the data to the dimensional structure proposed in the original instrument was analyzed using structural equations models through confirmatory factor analysis (CFA). Correlations between composites are presented in Table 6, where it can be observed that there are high values between some composites. This will produce a nonpositive definite matrix of the covariances of the latent variables. In this sense, composite 9 was removed.
\n\n | 1 | \n2 | \n3 | \n4 | \n5 | \n6 | \n7 | \n8 | \n9 | \n10 | \n
---|---|---|---|---|---|---|---|---|---|---|
1 | \n\n | \n | \n | \n | \n | \n | \n | \n | \n | |
0.495 | \n1 | \n\n | \n | \n | \n | \n | \n | \n | \n | |
0.758 | \n0.588 | \n1 | \n\n | \n | \n | \n | \n | \n | \n | |
0.591 | \n0.533 | \n0.859 | \n1 | \n\n | \n | \n | \n | \n | \n | |
0.570 | \n0.368 | \n0.538 | \n0.516 | \n1 | \n\n | \n | \n | \n | \n | |
0.405 | \n0.302 | \n0.520 | \n0.515 | \n0.549 | \n1 | \n\n | \n | \n | \n | |
0.736 | \n0.679 | \n0.841 | \n0.659 | \n0.499 | \n0.487 | \n1 | \n\n | \n | \n | |
0.788 | \n0.622 | \n0.773 | \n0.648 | \n0.498 | \n0.463 | \n0.893 | \n1 | \n\n | \n | |
0.820 | \n0.606 | \n0.929 | \n0.765 | \n0.669 | \n0.571 | \n0.798 | \n0.763 | \n1 | \n\n | |
0.147 | \n0.117 | \n0.191 | \n0.270 | \n0.357 | \n0.326 | \n0.230 | \n0.153 | \n0.530 | \n1 | \n
Correlations of the 10 composites.
Figure 2 shows the relation of the individual items to the composites. The standardized path between coefficients shows the strength of these relations. A coefficient less than 0.1 indicates a low effect; coefficients around 0.3 indicate a medium effect, while large effects are suggested by coefficients higher or equal of 0.5. In this model, coefficients ranged between 0.45 and 0.87.
\nConfirmatory factor model where composite 9 was removed (34 items).
Table 7 shows the fit of the confirmatory factor analysis for the model proposed in Figure 2. The indices CFI and GFI showed a very good fit; RMSEA and TLI showed a good fit and PGFI a reasonable fit.
\nGoodness of fit indices | \nValues | \n
---|---|
CFI | \n0.98 | \n
TLI | \n0.97 | \n
PGFI | \n0.69 | \n
GFI | \n0.99 | \n
RMSEA | \n0.064 (p value < 0.001) | \n
Confirmatory factor analysis model fit indices.
It was also obtained a good overall internal consistency (Cronbach’s α = 0.91, AICC = 0.243).
\nConsidering the model proposed by EFA (Figure 1), it was obtained the CFA model in Figure 3. In this model, coefficients ranged between 0.45 and 0.88.
\nConfirmatory factor model for model proposed by EFA (37 items).
The goodness-of-fit indices (Table 8) obtained for EFA model (Figure 3) are very similar to the ones obtained for the model proposed in Figure 2.
\nGoodness of fit indices | \nValues | \n
---|---|
CFI | \n0.98 | \n
TLI | \n0.97 | \n
PGFI | \n0.72 | \n
GFI | \n0.98 | \n
RMSEA | \n0.066 (p value < 0.001) | \n
Confirmatory factor analysis model fit indices for model proposed by EFA.
We have described the results of a translation, an adaptation, and a validation and analyzed the reliability of the Medical Office Survey on Patient Safety Culture in Portuguese Primary Health Care. As far as we know, this is the first study on patient safety culture in primary health care in Portugal with this depth of analysis of the structure of the survey proposed by the Medical Office Survey.
\nThe lowest positive scores were found in composites
The original survey had a good overall consistency, where the composite
A limitation of the study is the low response rate; however, it is not unusual for an open population study once it was Web-only administrated, although we have identified ways to publicize your survey and tracked response rates.
\nAnother limitation of the study was the number of missing values. It reduced the representativeness of the sample and can therefore distort inferences about the population. In future studies, the results will be compared using imputation methods on missing values and the impact on the results will be evaluated.
\nA strength of this study is the statistical method used, particularly in exploratory factor analysis and confirmatory factor analysis, since they are the most appropriate to the data type of this study, where bias was reduced. The majority of the studies on the context of this study still use methods assuming that data are continuous.
\nAs it is well known in Portugal, the Directory of Health has been doing patient safety culture assessment every 2 years since 2014, which allows all health units to enhance patient safety.
\nThe Portuguese version of the MOSPSC resulted in nine composites with good reliability and construct validity, where the structure differs from the original by removing one composite. In further studies, it will be performed longitudinal studies to evaluate the impact of patient safety culture interventions on staff and patients.
\nPatient safety culture assessment is of a vital importance for all levels of care. In Portugal, we are caring out this assessment every 2 years, which allows institutions to identify patient safety culture status in primary care, and it is also seen as an intervention to raise staff awareness about patient safety issues and a mechanism to evaluate the impact of patient safety improvement initiatives. This assessment also allows primary care institutions to compare their patient safety culture survey results with others and is a way to track changes in patient safety culture over time.
\nThe authors would like to extend their gratitude to all staff that took time to complete the MOSPSC. This work is partially financed by national funds through FCT Fundação para a Ciência e a Tecnologia under the project UID/MAT/00006/2013 and by the Health and Technology Research Centre (H&TRC).
\nThe authors declare that there are no conflicts of interest.
The research complied with every one of the dilemmas concerned with ethics. The privacy and secrecy or anonymity of staff made certain.
\nThis is a brief overview of the main steps involved in publishing with IntechOpen Compacts, Monographs and Edited Books. Once you submit your proposal you will be appointed a Author Service Manager who will be your single point of contact and lead you through all the described steps below.
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The protection requirement of these two types differs as the protection needs of an independent microgrid are intended for protecting components and systems within the microgrid, whereas a grid connected microgrid demands both internal and external protection. The first part of this chapter is dedicated to independent microgrids. How protection devices such as residual current circuit breakers, miniature and moulded case circuit breakers, and surge protective devices should be selected for an example microgrid is discussed while referring to the relevant standards. In the next section, the protection of a grid connected microgrid is discussed. Particularly, micro-source protection, microgrid protection, loss of mains protection and fault ride-through requirements are discussed while referring to two commonly used distributed generator connection codes. 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In this way, as a thermochemical treatment, pyrolysis represents a significant opportunity so long it leads to the recovery of both energy and chemical content of mixed, contaminated, or deteriorated plastics. An excellent history of an academic-industrial adventure started in 2008 at the Department of Chemistry of the University of Florence demonstrates the possibility of employing microwaves to recycle plastics to preserve their energy and chemical content. After that, Techwave started industrialization of the process in 2019, realizing a small-scale prototype followed by a full-scale pilot plant using different plastic materials (e.g., polystyrene, acrylonitrile-butadiene-styrene (ABS), and polypropylene). Nowadays, the plant may process 90 kg/h of plastics with a low formation of char and gas and an interesting amount of liquid useful as a source of chemicals or fuel because it has an LHV of 35–43 kJ/kg. The Microwave-Assisted Pyrolysis (MAP) is an industrial novelty in plastic recycling, and it looks very promising for a much more modern and innovative plastic waste recovery system.",book:{id:"11145",title:"Recent Microwave Technologies",coverURL:"https://cdn.intechopen.com/books/images_new/11145.jpg"},signatures:"Marco Frediani, Piero Frediani, Gianni Innocenti, Irene Mellone, Roberto Simoni and Gianpaolo Oteri"},{id:"82420",title:"Applications of Microwaves in Medicine and Biology",slug:"applications-of-microwaves-in-medicine-and-biology",totalDownloads:23,totalDimensionsCites:0,doi:"10.5772/intechopen.105492",abstract:"This chapter deals with the description of recent research activities oriented on the perspective of microwave technologies in medicine and biology. It brings new ideas about the possibilities of using microwaves in thermotherapy—above all toward hyperthermia in cancer treatment. 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An overview of different liquids and their electromagnetic properties is first given. The principles behind the reconfigurability of the electrical characteristics of typical guiding structures based on mode shape variation in the presence of fluids are discussed. 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Vehicle-to-network (V2N), vehicle-to-vehicle (V2V), vehicle-to-infrastructure (V2I), and vehicle-to-people (V2P) are included in V2X. V2X will lead to a high degree of interconnection of vehicles. The concept of VLC is presented in the second part. Intelligent reflecting surface (IRS) for nano-optics and FSO communication is introduced in the third part. At the same time, IRS keeps pace with the phase in communication links. Prospects of THz in glamorous cities are introduced in the fourth part. These new technologies will lead to trends in the future. 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The considered model proposes a microscopic point of view on microwave heating, which transforms electrical energy into heat.",book:{id:"11145",title:"Recent Microwave Technologies",coverURL:"https://cdn.intechopen.com/books/images_new/11145.jpg"},signatures:"Serge Lefeuvre and Olga Gomonova"},{id:"82076",title:"Power Divider/Combiner",slug:"power-divider-combiner",totalDownloads:17,totalDimensionsCites:0,doi:"10.5772/intechopen.104911",abstract:"With the remarkable progress in the use of Internet of Things (IoT) and 5G, there is a demand for higher performance such as miniaturization, broadband/multiband, low loss, and high integration for several microwave circuits. This chapter treats microwave power dividers/combiners used in amplifiers, mixers, phase shifters, antenna feeding networks, and so on. Here, the treated circuits are composed of LC-ladder circuits and an absorption resistor. 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Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"414880",title:"Dr.",name:"Maryam",middleName:null,surname:"Vatankhah",slug:"maryam-vatankhah",fullName:"Maryam Vatankhah",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Borough of Manhattan Community College",country:{name:"United States of America"}}},{id:"414879",title:"Prof.",name:"Mohammad-Reza",middleName:null,surname:"Akbarzadeh-Totonchi",slug:"mohammad-reza-akbarzadeh-totonchi",fullName:"Mohammad-Reza Akbarzadeh-Totonchi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ferdowsi University of Mashhad",country:{name:"Iran"}}},{id:"414878",title:"Prof.",name:"Reza",middleName:null,surname:"Fazel-Rezai",slug:"reza-fazel-rezai",fullName:"Reza Fazel-Rezai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"American Public University System",country:{name:"United States of America"}}},{id:"426586",title:"Dr.",name:"Oladunni A.",middleName:null,surname:"Daramola",slug:"oladunni-a.-daramola",fullName:"Oladunni A. Daramola",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Federal University of Technology",country:{name:"Nigeria"}}},{id:"357014",title:"Prof.",name:"Leon",middleName:null,surname:"Bobrowski",slug:"leon-bobrowski",fullName:"Leon Bobrowski",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Bialystok University of Technology",country:{name:"Poland"}}},{id:"302698",title:"Dr.",name:"Yao",middleName:null,surname:"Shan",slug:"yao-shan",fullName:"Yao Shan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Dalian University of Technology",country:{name:"China"}}},{id:"354126",title:"Dr.",name:"Setiawan",middleName:null,surname:"Hadi",slug:"setiawan-hadi",fullName:"Setiawan Hadi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Padjadjaran University",country:{name:"Indonesia"}}},{id:"125911",title:"Prof.",name:"Jia-Ching",middleName:null,surname:"Wang",slug:"jia-ching-wang",fullName:"Jia-Ching Wang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Central University",country:{name:"Taiwan"}}},{id:"332603",title:"Prof.",name:"Kumar S.",middleName:null,surname:"Ray",slug:"kumar-s.-ray",fullName:"Kumar S. Ray",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Statistical Institute",country:{name:"India"}}},{id:"415409",title:"Prof.",name:"Maghsoud",middleName:null,surname:"Amiri",slug:"maghsoud-amiri",fullName:"Maghsoud Amiri",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Allameh Tabataba'i University",country:{name:"Iran"}}},{id:"357085",title:"Mr.",name:"P. Mohan",middleName:null,surname:"Anand",slug:"p.-mohan-anand",fullName:"P. Mohan Anand",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"356696",title:"Ph.D. Student",name:"P.V.",middleName:null,surname:"Sai Charan",slug:"p.v.-sai-charan",fullName:"P.V. Sai Charan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"357086",title:"Prof.",name:"Sandeep K.",middleName:null,surname:"Shukla",slug:"sandeep-k.-shukla",fullName:"Sandeep K. Shukla",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}}]}},subseries:{item:{id:"17",type:"subseries",title:"Metabolism",keywords:"Biomolecules Metabolism, Energy Metabolism, Metabolic Pathways, Key Metabolic Enzymes, Metabolic Adaptation",scope:"Metabolism is frequently defined in biochemistry textbooks as the overall process that allows living systems to acquire and use the free energy they need for their vital functions or the chemical processes that occur within a living organism to maintain life. Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. Thus all studies on metabolism will be considered for publication.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11413,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. 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