Demographic and clinical features of patients diagnosed with oral squamous cell carcinoma around dental implants.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"7566",leadTitle:null,fullTitle:"Gene Expression and Control",title:"Gene Expression and Control",subtitle:null,reviewType:"peer-reviewed",abstract:'Transcription is the most fundamental nuclear event, by which the information of nucleotide sequences on DNA is transcribed into RNA by multiple proteins, including RNA polymerases. Transcription determines the functions of proteins and the behaviour of cells, appropriately responding to environmental changes.This book is intended for scientists, especially those who are interested in the future prospect of gene expression and control in medicine and industry. This book consists of 9 chapters, divided into four parts. Each chapter is written by experts both in the basic and applied scientific field. A collection of articles presented by active and laboratory-based investigators provides evidence from the research, giving us a rigid platform to discuss "Gene Expression and Control."',isbn:"978-1-78985-518-0",printIsbn:"978-1-78985-517-3",pdfIsbn:"978-1-83962-113-0",doi:"10.5772/intechopen.76958",price:119,priceEur:129,priceUsd:155,slug:"gene-expression-and-control",numberOfPages:200,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"d5e33453f41aee5b90bc6f6301820b89",bookSignature:"Fumiaki Uchiumi",publishedDate:"April 17th 2019",coverURL:"https://cdn.intechopen.com/books/images_new/7566.jpg",numberOfDownloads:10142,numberOfWosCitations:2,numberOfCrossrefCitations:7,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:14,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:23,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 11th 2018",dateEndSecondStepPublish:"May 2nd 2018",dateEndThirdStepPublish:"July 1st 2018",dateEndFourthStepPublish:"September 19th 2018",dateEndFifthStepPublish:"November 18th 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"47235",title:"Dr.",name:"Fumiaki",middleName:null,surname:"Uchiumi",slug:"fumiaki-uchiumi",fullName:"Fumiaki Uchiumi",profilePictureURL:"https://mts.intechopen.com/storage/users/47235/images/system/47235.jpg",biography:"Fumiaki Uchiumi, Professor of Pharmaceutical Sciences, Tokyo University of Science, received his Bachelor\\'s degree (Chemistry) from Tokyo University of Science in 1987. In 1993, after obtaining his Ph.D. degree (Molecular Biology) from Tokyo University, he joined Professor S. Tanuma\\'s Laboratory at Tokyo University of Science as an Assistant Professor. He obtained his second Ph.D. (Pharmaceutical Science) from Tokyo University of Science in 1999 and in 2000 was promoted to the position of Lecturer at Tokyo University of Science. Professor Uchiumi then went abroad as a post-doctoral researcher for the United States-Japan Cooperative Cancer Research Program in Professor E. Fanning’s Laboratory at Vanderbilt University, 2000-2001. Professor Uchiumi was promoted to Associate Professor and then Full Professor at Tokyo University of Science in 2010 and 2016, respectively.",institutionString:"Tokyo University of Science",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"6",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"Tokyo University of Science",institutionURL:null,country:{name:"Japan"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1050",title:"Molecular Genetics",slug:"medical-genetics-molecular-genetics"}],chapters:[{id:"63319",title:"Introductory Chapter: Gene Expression Controlling System and Its Application to Medical Sciences",doi:"10.5772/intechopen.80676",slug:"introductory-chapter-gene-expression-controlling-system-and-its-application-to-medical-sciences",totalDownloads:918,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Fumiaki Uchiumi and Masashi Asai",downloadPdfUrl:"/chapter/pdf-download/63319",previewPdfUrl:"/chapter/pdf-preview/63319",authors:[{id:"47235",title:"Dr.",name:"Fumiaki",surname:"Uchiumi",slug:"fumiaki-uchiumi",fullName:"Fumiaki Uchiumi"},{id:"265518",title:"Dr.",name:"Masashi",surname:"Asai",slug:"masashi-asai",fullName:"Masashi Asai"}],corrections:null},{id:"63916",title:"Shaping the Transcriptional Landscape through MAPK Signaling",doi:"10.5772/intechopen.80634",slug:"shaping-the-transcriptional-landscape-through-mapk-signaling",totalDownloads:1120,totalCrossrefCites:1,totalDimensionsCites:5,hasAltmetrics:0,abstract:"A change in the transcriptional landscape is an equilibrium-breaking event important for many biological processes. Mitogen-activated protein kinase (MAPK) signaling pathways are dedicated to sensing extracellular cues and are highly conserved across eukaryotes. Modulation of gene expression in response to the extracellular environment is one of the main mechanisms by which MAPK regulates proteome homeostasis to orchestrate adaptive responses that determine cell fate. A massive body of knowledge generated from population and single-cell analyses has led to an understanding of how MAPK pathways operate. MAPKs have thus emerged as fundamental transcriptome regulators that function through a multi-layered control of gene expression, a process often deregulated in disease, which therefore provides an attractive target for therapeutic strategies. Here, we summarize the current understanding of the mechanisms underlying MAPK-mediated gene expression in organisms ranging from yeast to mammals.",signatures:"Mariona Nadal-Ribelles, Carme Solé, Gerard Martínez-Cebrián,\nFrancesc Posas and Eulàlia de Nadal",downloadPdfUrl:"/chapter/pdf-download/63916",previewPdfUrl:"/chapter/pdf-preview/63916",authors:[{id:"256797",title:"Prof.",name:"Francesc",surname:"Posas",slug:"francesc-posas",fullName:"Francesc Posas"},{id:"256799",title:"Dr.",name:"Mariona",surname:"Nadal",slug:"mariona-nadal",fullName:"Mariona Nadal"},{id:"256800",title:"Dr.",name:"Carme",surname:"Sole",slug:"carme-sole",fullName:"Carme Sole"},{id:"256801",title:"Mr.",name:"Gerard",surname:"Martinez-Cebrian",slug:"gerard-martinez-cebrian",fullName:"Gerard Martinez-Cebrian"},{id:"256802",title:"Prof.",name:"Eulàlia",surname:"De Nadal",slug:"eulalia-de-nadal",fullName:"Eulàlia De Nadal"}],corrections:null},{id:"63812",title:"Autophagy-Related Gene Expression Changes Are Found in Pancreatic Cancer and Neurodegenerative Diseases",doi:"10.5772/intechopen.80981",slug:"autophagy-related-gene-expression-changes-are-found-in-pancreatic-cancer-and-neurodegenerative-disea",totalDownloads:1108,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Genetic alterations can cause cancer, including pancreatic cancer (PC) as well as certain neurodegenerative diseases. Our lab has recently identified genes that are modulated during pancreatic cancer liver metastasis, and some are known to have a role in neurobiology or neurodegenerative diseases. Autophagy or self-eating portrays the lysosomal-dependent degradation and recycling of protein aggregates and defective organisms in eukaryotic cells. Deregulation of autophagy as a cellular mechanism is common in neurodegenerative diseases as well as cancer and may represent a platform by which some genes can affect both disorders. This is exemplified for optineurin, which is an autophagy receptor that was found among genes with intensive modulation of expression in PC liver metastasis. Our results on this autophagy receptor draw the attention to the expression status of this and other autophagy genes in pancreatic cancer progression.",signatures:"Doaa M. Ali and Martin R. Berger",downloadPdfUrl:"/chapter/pdf-download/63812",previewPdfUrl:"/chapter/pdf-preview/63812",authors:[{id:"56407",title:"Prof.",name:"Martin",surname:"Berger",slug:"martin-berger",fullName:"Martin Berger"},{id:"256550",title:"MSc.",name:"Doaa",surname:"Ali",slug:"doaa-ali",fullName:"Doaa Ali"}],corrections:null},{id:"63320",title:"Oral Pathology: Gene Expression in Odontogenic Cysts",doi:"10.5772/intechopen.80555",slug:"oral-pathology-gene-expression-in-odontogenic-cysts",totalDownloads:1416,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Odontogenic cysts are a group of common pathological lesions of the jaw. Typically, they can be found randomly on X-rays as round benign lesions. However, some of them can behave aggressively with a tendency toward malignancy. Among odontogenic cysts with benign pathology, up to 60% of all jaw cysts are radicular cysts, which originate from root canal infection. Pathogenesis involves the interaction between osteoblasts, osteocytes, and osteoclasts as well as the expression of RANK-RANKL/OPG signaling system. Furthermore, collagenases (e.g., MMPs) are expressed in epithelial lining of the cyst. Among odontogenic cysts with potentially aggressive behavior, odontogenic keratocysts (OKCs) have a high rate of recurrence and very debatable treatment options; they can be associated with Gorlin syndrome. Keratocysts have developmental origin and show variability in their gene expression profiles. Their etiology is closely related to genetic factors, especially mutations in different members of Shh signaling pathway, including PTCH gene.",signatures:"Naida Hadziabdic and Amina Kurtovic-Kozaric",downloadPdfUrl:"/chapter/pdf-download/63320",previewPdfUrl:"/chapter/pdf-preview/63320",authors:[{id:"256275",title:"Associate Prof.",name:"Naida",surname:"Hadziabdic",slug:"naida-hadziabdic",fullName:"Naida Hadziabdic"},{id:"256276",title:"Prof.",name:"Amina",surname:"Kozaric",slug:"amina-kozaric",fullName:"Amina Kozaric"}],corrections:null},{id:"63804",title:"Data Mining Approaches for Understanding of Regulation of Expression of the Urea Cycle Genes",doi:"10.5772/intechopen.81253",slug:"data-mining-approaches-for-understanding-of-regulation-of-expression-of-the-urea-cycle-genes",totalDownloads:971,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Urea cycle converts ammonia, a waste product of protein catabolism and a neurotoxin, into non-toxic urea. Urea cycle disorders are a group of rare genetic diseases that have protein-restricted diet as a common treatment modality. Expression of urea cycle genes is regulated in concert by the dietary protein intake, but the mechanism of this regulation is not well understood. Data mining of databases such as ENCODE and Cistrome can be used to gain new information about regulatory elements, transcription factors, and epigenetic mechanisms that regulate expression of urea cycle genes. This can lead to better understanding of the common mechanism, which regulates urea cycle genes, and can generate testable hypotheses about regulation of gene expression and new treatments for urea cycle disorders.",signatures:"Ljubica Caldovic",downloadPdfUrl:"/chapter/pdf-download/63804",previewPdfUrl:"/chapter/pdf-preview/63804",authors:[{id:"257239",title:"Dr.",name:"Ljubica",surname:"Caldovic",slug:"ljubica-caldovic",fullName:"Ljubica Caldovic"}],corrections:null},{id:"63331",title:"Recent Advances about Local Gene Delivery by Ultrasound",doi:"10.5772/intechopen.80036",slug:"recent-advances-about-local-gene-delivery-by-ultrasound",totalDownloads:1151,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Gene therapy has been widely explored as a pharmacological approach, with a great potential to treat various diseases. Generally, many diseases have definite lesion’s site, especially for tumors. This feature results in a great demand on the delivery of therapeutic gene to the local lesion’s site. Ultrasound combined with microbubbles provides a promising platform to deliver gene in a spatiotemporally controlled way. Ultrasound beam can be positioned and targeted onto the deep-seated lesion’s site of diseases by an external mobile transducer. Microbubbles can serve as vehicles for carrying genetic cargo and can be destructed by ultrasound, resulting in the local release of genetic payload. Meanwhile, sonoporation effect will occur upon which the bubbles are exposed to the appropriate ultrasonic energy, producing the transient small holes on the adjacent cell membrane and thus increasing the vascular and cellular permeability. In this chapter, we will review the recent advances about local gene delivery by ultrasound.",signatures:"Zhiyi Chen, Meng Du and Fei Yan",downloadPdfUrl:"/chapter/pdf-download/63331",previewPdfUrl:"/chapter/pdf-preview/63331",authors:[{id:"254953",title:"Prof.",name:"Fei",surname:"Yan",slug:"fei-yan",fullName:"Fei Yan"},{id:"265585",title:"Dr.",name:"Meng",surname:"Du",slug:"meng-du",fullName:"Meng Du"},{id:"265586",title:"Prof.",name:"Zhiyi",surname:"Chen",slug:"zhiyi-chen",fullName:"Zhiyi Chen"}],corrections:null},{id:"65382",title:"Gene Regulation in Ruminants: A Nutritional Perspective",doi:"10.5772/intechopen.82193",slug:"gene-regulation-in-ruminants-a-nutritional-perspective",totalDownloads:1537,totalCrossrefCites:2,totalDimensionsCites:5,hasAltmetrics:0,abstract:"This chapter will focus on cellular regulatory programs implemented by the ruminant physiology in order to respond to external stimuli such as nutrition as well as important physiological events such as parturition. The increasing adoption of “omics” technologies and bioinformatics in nutrition and physiology in ruminant research have allowed us to delineate a clearer picture on what regulates major biological process at a molecular level such as milk synthesis and meat quality and fatty acid composition as well as pathological conditions such as ketosis, mastitis, and heat stress. The assembly of such plethora of information in a blend among nutritional research, molecular biology, and novel tools to study the response of the genome to nutrition has led to emerging disciplines such as nutritional genomics or “nutrigenomics.”",signatures:"Johan S. Osorio and Sonia J. Moisa",downloadPdfUrl:"/chapter/pdf-download/65382",previewPdfUrl:"/chapter/pdf-preview/65382",authors:[{id:"255256",title:"Dr.",name:"Johan",surname:"Osorio",slug:"johan-osorio",fullName:"Johan Osorio"},{id:"263702",title:"Dr.",name:"Sonia",surname:"Moisa",slug:"sonia-moisa",fullName:"Sonia Moisa"}],corrections:null},{id:"63286",title:"Transcriptional Initiation in Ribosomal Protein Genes in the Fission Yeast Schizosaccharomyces pombe",doi:"10.5772/intechopen.80602",slug:"transcriptional-initiation-in-ribosomal-protein-genes-in-the-fission-yeast-schizosaccharomyces-pombe",totalDownloads:826,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Transcription of class II genes in eukaryotic organisms is carried out by the multi-subunit enzyme RNA polymerase II (RNA pol II) and includes the general transcription factors and the mediator. The region inside the promoters, which recruits and specifies the transcriptional machinery, is called “core promoter” and contains sub-regions called “core promoter elements,” which are necessary for transcription initiation, where the most studied and classic element is the TATA-box. Ribosome protein gene (RPG) promoters do not possess a TATA-box (TATA-less promoters), and those, in particular, in the fission yeast Schizosaccharomyces pombe have a TATA-box analog called the HomolD-box. The transcription of RPG promoters is dependent on the RNA pol II transcription system and the HomolD-box is recognized by the transcription factor Rrn7. In this chapter, the authors will describe the general mechanisms associated to the transcription of TATA-less promoters in eukaryotic organisms and how the transcription initiation is carried out in the RPG promoters from those organisms, particularly in Schizosaccharomyces pombe. Finally, the authors will analyze the role of the HomolD-box and the transcription factor Rrn7 in the coordination of transcription initiation from RPG promoters and other ribosome-related genes and the presence of transcriptional modules in their promoters, which could be coordinated and regulated by a discrete number of transcription factors.",signatures:"Diego A. Rojas, Sandra Moreira-Ramos, Fabiola Urbina\nand Edio Maldonado",downloadPdfUrl:"/chapter/pdf-download/63286",previewPdfUrl:"/chapter/pdf-preview/63286",authors:[{id:"254282",title:"Prof.",name:"Edio",surname:"Maldonado",slug:"edio-maldonado",fullName:"Edio Maldonado"},{id:"258212",title:"Dr.",name:"Diego A.",surname:"Rojas",slug:"diego-a.-rojas",fullName:"Diego A. Rojas"},{id:"258213",title:"Dr.",name:"Sandra",surname:"Moreira-Ramos",slug:"sandra-moreira-ramos",fullName:"Sandra Moreira-Ramos"},{id:"258214",title:"Ms.",name:"Fabiola",surname:"Urbina",slug:"fabiola-urbina",fullName:"Fabiola Urbina"}],corrections:null},{id:"63905",title:"Repurposing E. coli by Engineering Quorum Sensing and Redox Genetic Circuits",doi:"10.5772/intechopen.81245",slug:"repurposing-e-coli-by-engineering-quorum-sensing-and-redox-genetic-circuits",totalDownloads:1095,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Because cells have the extraordinary ability to sense and respond to even subtle environmental changes by intricately regulating their gene expression patterns, their behaviors can be intentionally “tuned” by altering the state of their environments in a prescribed or rational manner. Rational control of both external and internal molecular stimuli provides a basis for many biotechnological applications including the expression of foreign protein products. This is done by coordinately controlling product synthesis while retaining the cell in a productive state. Quorum sensing (QS), a molecular signaling modality that mediates cell-cell communication, autonomously facilitates both inter- and intra-species gene regulation. This process can be rewired to enable autonomously actuated, but molecularly programmed, genetic control. Recently, even electrical signals, which have long been used to control the most sophisticated of man-made devices, are now employed to alter cell signaling processes enabling computer programmed behavior, particularly in cells suitably engineered to accommodate electrical signals. By minimally engineering these genetic circuits, new applications have emerged for the repurposing of Escherichia coli, from creating innovative sensor concepts to stimulating the emerging field of electrogenetics.",signatures:"Sally Wang, Gregory F. Payne and William E. Bentley",downloadPdfUrl:"/chapter/pdf-download/63905",previewPdfUrl:"/chapter/pdf-preview/63905",authors:[{id:"255265",title:"Dr.",name:"William",surname:"Bentley",slug:"william-bentley",fullName:"William Bentley"},{id:"270082",title:"BSc.",name:"Sally",surname:"Wang",slug:"sally-wang",fullName:"Sally Wang"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"7204",title:"Gene Expression and Regulation in Mammalian Cells",subtitle:"Transcription Toward the Establishment of Novel Therapeutics",isOpenForSubmission:!1,hash:"10030057b2e2dee7d800ff27658c3a69",slug:"gene-expression-and-regulation-in-mammalian-cells-transcription-toward-the-establishment-of-novel-therapeutics",bookSignature:"Fumiaki Uchiumi",coverURL:"https://cdn.intechopen.com/books/images_new/7204.jpg",editedByType:"Edited by",editors:[{id:"47235",title:"Dr.",name:"Fumiaki",surname:"Uchiumi",slug:"fumiaki-uchiumi",fullName:"Fumiaki Uchiumi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6435",title:"Gene Expression and Regulation in Mammalian Cells",subtitle:"Transcription From General Aspects",isOpenForSubmission:!1,hash:"8573c44c537def5c800a0f6d4ed844d6",slug:"gene-expression-and-regulation-in-mammalian-cells-transcription-from-general-aspects",bookSignature:"Fumiaki Uchiumi",coverURL:"https://cdn.intechopen.com/books/images_new/6435.jpg",editedByType:"Edited by",editors:[{id:"47235",title:"Dr.",name:"Fumiaki",surname:"Uchiumi",slug:"fumiaki-uchiumi",fullName:"Fumiaki Uchiumi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1280",title:"Selected Topics in DNA Repair",subtitle:null,isOpenForSubmission:!1,hash:"bffa19c9b25bf5aaf029cc9e528916f4",slug:"selected-topics-in-dna-repair",bookSignature:"Clark C. 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",isbn:"978-1-83768-436-6",printIsbn:"978-1-83768-435-9",pdfIsbn:"978-1-83768-437-3",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"256aaeeb2cfa765c6a37c73e4fe7402f",bookSignature:"Dr. Guillermo Huerta-Cuellar",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/12020.jpg",keywords:"Stability of Fixed Points, Banach Fixed Points Theorem, Fractional Calculus, Discontinuity of Fixed Points, Stability of Systems, Route to Chaos, Multistability, Perturbations Theory, Unstable Fixed Points, Adaptive Control, Control of Discrete-Time Chaotic Systems, Pseudo-Random Bit Generator",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"June 17th 2022",dateEndSecondStepPublish:"July 15th 2022",dateEndThirdStepPublish:"September 13th 2022",dateEndFourthStepPublish:"December 2nd 2022",dateEndFifthStepPublish:"January 31st 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"a month",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Dr. Guillermo Huerta Cuellar is a researcher in the area of nonlinear dynamics and chaotic systems, with experimental and theoretical results. Has been an author of more than 40 high-level papers, and academic editor in 4 journals, and 3 books.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"237167",title:"Dr.",name:"Guillermo",middleName:null,surname:"Huerta-Cuellar",slug:"guillermo-huerta-cuellar",fullName:"Guillermo Huerta-Cuellar",profilePictureURL:"https://mts.intechopen.com/storage/users/237167/images/system/237167.jpg",biography:"Guillermo Huerta Cuellar received a B.Sc. degree from Instituto de Investigación en\r\nComunicaciones Ópticas (IICO), from the Universidad Autónoma de San Luis Potosí, San Luis\r\nPotosí in 2004. After, he received a Ph.D. degrees from Centro de Investigaciones en Óptica\r\n(CIO), León Guanajuato, Mexico, in 2009. During 2010 to present he have been working at the\r\nExact Sciences and Technology Department in Centro Universitario de los Lagos, Universidad de\r\nGuadalajara. He has been Visiting Researcher in the department of Applied Mathematics at\r\nInstituto Potosino de Investigación Científica y Tecnológica, San Luis Potosí, México (2012-\r\n2014), in Department of Theory of Oscillations and Automatic Control, Faculty of Radiophysics,\r\nLobachevsky State University of Nizhny Novgorod, Russia (2016), sabbatical stay in the\r\nDepartment of Physics and Environmental Science at St. Mary's University, San Antonio, TX, US\r\n(2018-2019), and in División de Matemáticas Aplicadas, Instituto Potosino de Investigación\r\nCientífica y Tecnológica (IPICYT), in San Luis Potosí, S. L. P., México (2019-2020). He has\r\neditor of 3 books, and coauthor of 6 book chapters, international journals and conferences, and\r\nmore of 40 high impact publications. He is member in the National System for Researchers (SNI-\r\nCONACyT-México). He participates as Academic Editor in the Journal Complexity (2021),\r\nFrontiers in Applied Mathematics and Statistics (2022), and Axioms (2022). He has participations\r\nas a reviewer in high impact-factor journals. His research interests include study, characterization,\r\ndynamical behavior and design in nonlinear dynamical systems as lasers, electronics, and in\r\nnumerical models.",institutionString:"University of Guadalajara",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"University of Guadalajara",institutionURL:null,country:{name:"Mexico"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"15",title:"Mathematics",slug:"mathematics"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"478197",firstName:"Veronika",lastName:"Radosavac",middleName:null,title:"Dr.",imageUrl:"//cdnintech.com/web/frontend/www/assets/author.svg",email:"veronika@intechopen.com",biography:null}},relatedBooks:[{type:"book",id:"9272",title:"Optical Fiber Applications",subtitle:null,isOpenForSubmission:!1,hash:"dd156cc0568d8a4204d9f13609d8ff9e",slug:"optical-fiber-applications",bookSignature:"Guillermo Huerta-Cuellar and Roghayeh Imani",coverURL:"https://cdn.intechopen.com/books/images_new/9272.jpg",editedByType:"Edited by",editors:[{id:"237167",title:"Dr.",name:"Guillermo",surname:"Huerta-Cuellar",slug:"guillermo-huerta-cuellar",fullName:"Guillermo Huerta-Cuellar"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10767",title:"Fiber Optics",subtitle:"Technology and Applications",isOpenForSubmission:!1,hash:"f6624b8ef72a4a369383a4b719bba2a4",slug:"fiber-optics-technology-and-applications",bookSignature:"Guillermo Huerta-Cuellar",coverURL:"https://cdn.intechopen.com/books/images_new/10767.jpg",editedByType:"Edited by",editors:[{id:"237167",title:"Dr.",name:"Guillermo",surname:"Huerta-Cuellar",slug:"guillermo-huerta-cuellar",fullName:"Guillermo Huerta-Cuellar"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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\nThis chapter focuses on the diagnostic methods to determine the type of submucosal leiomyomas present, their impact on uterine bleeding and infertility, and the methods used to resect these leiomyomas.
\nIt is important to classify fibroids according to the degree of endometrial cavity distortion when considering therapeutic options such as a surgical approach. The degree of intramural extension has implications for operative difficulty and risk. The most widely used system classifies submucous leiomyomas into three subtypes according to the proportion of the lesion’s diameter that is within the myometrium as determined by saline infusion sonography (SIS) or hysteroscopy. Type 0 leiomyomas are completely intracavitary, type 1 leiomyomas are less than 50% intramural and type 2 leiomyomas more than 50% intramural [2, 3].
\nThis classification has been shown to be predictive of the likelihood of complete surgical resection, which is the most predictive indicator of surgical success. Uterine size and the number of leiomyomas also have been shown to be independent prognostic variables for recurrence [2, 4].
\nA newer and more detailed classification system has been devised and advocated by the International Federation of Gynecology and Obstetrics (FIGO). This system allows for categorization of the relationship of the leiomyoma outer boundary with the uterine serosa, a relationship that is important when evaluating women suitable for resectoscopic surgery. Thus, a type 2 leiomyoma that reaches the serosa is considered to be a type 2–5 lesion and therefore not a candidate for resectoscopic surgery (see Figure 1).
\nFIGO classification of submucous leiomyomas. Reproduced with permission granted by Elsevier.
The methods to confirm the presence of a submucous fibroid include ultrasonography (typically transvaginal ultrasonography, TVUS), saline infusion sonography (SIS), diagnostic hysteroscopy, hysterosalpingography and magnetic resonance imaging (MRI). The diagnosis of submucous fibroids is generally achieved with one or a combination of hysteroscopy and radiological techniques. The aims are to distinguish leiomyomas from adenomyosis, confirmation of submucous location, as well the number, size, location and extent of myometrial penetration of each identified submucous myoma. The relationship of the submucous myoma to the uterine serosa is of particular importance as transcervical resection is not appropriate when the leiomyoma is very close to or in contact with the serosal layer of the uterus, due to an increased risk of uterine perforation and visceral injury with significant associated morbidity.
\nA surgeon can get the best appreciation for the location and relationship of submucosal fibroids to the uterine serosa by reviewing the radiological images themselves prior to the planned operation. This well help them decide the best approach to resecting the fibroids. The quality of the images obtained therefore plays a significant role. These imaging modalities will be discussed in detail below [5].
\nTVUS has a sensitivity of 0.8 and a specificity of 0.7 for diagnosing submucous fibroids, and is generally thought to have limited use for exclusion of submucous fibroids and polyps (negative likelihood ratio 0.29) [6]. However, a prospective study suggested that when TVUS has been used as a first-step investigation, diagnostic hysteroscopy can be avoided in 40% of cases. This would suggest that it is a viable non-invasive initial investigation [6]. Unfortunately, TVUS is very operator dependent, a factor that must be considered when evaluating its reliability.
\n\nHysterosonography or saline infusion sonography (SIS) is a non-invasive imaging technique performed at the time of transvaginal ultrasound. Saline is introduced into the uterine cavity at the time of ultrasound and distends the uterine cavity to give better visualization of the endometrium and any intrauterine tumours or polyps [7].
\nThe procedure is best performed when the endometrium is thin and the patient is not pregnant, therefore the first ten days of a menstrual cycle. The cervix is identified by speculum examination and a fine catheter inserted into the cervical os with a saline containing syringe at the end of the catheter. A transvaginal ultrasound is then performed at the same time as the injection of the saline. The procedure takes no more than 10–15 minutes. The benefit of saline infusion sonography is that the intramural component of a submucous fibroid is then better visualized by the ultrasound (see Figure 2) [5]. There is high-quality evidence from a Cochrane systematic review that demonstrates SIS and hysteroscopy to be equivalent for the diagnosis of submucous leiomyomas, with both superior to TVUS [8]. The main drawbacks of this technique are the risk of infection (1%) and the discomfort associated with injection of sterile saline into the uterus.
\nUltrasound before and after instillation of saline as a contrast medium.
Hysteroscopy involves inserting a telescope (usually 2.7–4 mm) into the endometrial cavity. The procedure may be performed in an outpatient setting without anaesthetic, even in nulliparous women and is highly successful, although some women (approximately 25%) will require local anaesthesia and some women may prefer general anaesthesia. If the patient requires a local anaesthetic, it can be administered by a paracervical block using 5 mL of 1% lignocaine. This can be injected at the level where a tenaculum is applied to the cervix and also at the 3 o’ clock and 9 o’ clock positions deep enough to the level of the internal cervical os. Other options are topical local anaesthetic gel, spray or cream [9, 10].
\nAs for any procedure on the uterus it is essential to exclude the possibility of pregnancy and active infection. The administration of a non-steroidal anti-inflammatory prior to the procedure has been demonstrated to reduce the patient’s posthysteroscopy discomfort [11].
\nTwo methods of uterine distension are used—carbon dioxide and normal saline instillation. A randomized controlled trial (RCT) of carbon dioxide versus normal saline instillation during hysteroscopy found that normal saline provided comparable visualization to carbon dioxide with reduced procedure time and patient discomfort [12]. The distending pressure normally used is 80–100 mmHg.
\nDiagnostic hysteroscopy can be used to assess and document uterine abnormalities which should then be recorded by digital images. These can be used to plan an operative procedure and also facilitate the patient’s understanding of their pathology (see Figure 3). The procedure should be performed quickly to avoid patient discomfort and manipulation of the cervix when rotating the hysteroscope should be avoided.
\nHysteroscopic image of fibroid prior to resection.
Magnetic resonance imaging (MRI) is a costly imaging technique which is not available in all units. However, the use of T2-weighted images allows accurate localisation of the demarcation between the endometrium and myometrium. MRI is the most accurate modality in assessing the adnexae and the uterus because it provides information on the size, location, number and perfusion of leiomyomas as well as the presence of other uterine pathology including adenomyosis or endometriosis [13].
\nA double-blinded study demonstrated that although TVUS and MRI are roughly equivalent in diagnosing the presence of leiomyomas, the determination of other features such as location and proportion of the tumour in the endometrial cavity, is best accomplished with MRI. It was shown to be the most reliable method of evaluation when compared with vaginal ultrasound, hysterosonography and hysteroscopy, with 100% sensitivity and 91% specificity (gold standard was pathological examination) [14].
\nMRI was superior to the TVUS and SIS in evaluating the relationship of submucous leiomyomas to the myometrium [15]. MRI is becoming more available for the assessment of submucosal fibroids; however, the costs involved and its availability limit its use.
\nIf a submucosal fibroid is confirmed with selected diagnostic modalities, the decision to operate should be individualized based on the patient and their symptoms. It is believed that one in three women with fibroids experience abnormal uterine bleeding (AUB) and that the presence of a submucosal fibroid increases the chance of this. The two most common indications for surgery are described below [16, 17].
\nThere is little evidence implicating the role of FIGO staged submucous leiomyomas as the cause of haemorrhage requiring urgent intervention [18]. However, there is evidence to suggest that submucous leiomyomas can cause chronic abnormal uterine bleeding and heavy menstrual bleeding (HMB).
\nA systematic review of 11 studies demonstrated the prevalence of submucous myomas in women with AUB was 23.4%. Submucous myomas were found in 23.4% of premenopausal women (six studies) and 4.5% of postmenopausal women with AUB (one study). Although these studies fell short of proving that submucous myomas cause AUB they suggest that there may be a relationship. The incidence of submucous fibroids in 323 consecutive asymptomatic women undergoing sterilization was reported at 1.8%, whereas in a series of women with abnormal uterine bleeding, submucous fibroids were reported more frequently (6–34%) [19].
\nBroadbent and Magos [20], measured menstrual blood loss before and after hysteroscopic surgery of submucosal fibroids and showed that surgery improved both dysmenorrhea and heavy bleeding. They demonstrated that after surgery there was a significant reduction in the duration, blood loss and pain score associated with menstruation.
\nThere are various theories for the pathophysiology of how submucous fibroids contribute to abnormal uterine bleeding and menorrhagia. It is thought that the mechanisms involved in haemostasis and prostaglandin production in the endometrium can be disturbed by the presence of fibroids. Another hypothesis is that it can be due to increased endometrial surface area of the endometrium. Both submucous and intramural fibroids have the potential to cause this [21].
\nWomen undergoing IVF treatment in the presence of a submucosal fibroid have lower clinical pregnancy rates than those without fibroids (10% vs. 30%) as seen in a retrospective comparative study of over 400 assisted reproductive treatment cycles. This may suggest an association between submucosal fibroids and subfertility. One major drawback was that in this study there were only nine patients in the submucosal fibroid group. Similar results were recorded in a study by Farhi et al. [22, 23]. There have been no appropriately designed studies to demonstrate a direct causal relationship between the presence of fibroids and infertility.
\nMany hypotheses have been generated to explain how fibroids might cause infertility. Perfusion studies have shown that blood flow to uterine fibroids is less than that to the adjacent myometrium. Blood flow to the uterine arteries is also different in a fibroid uterus than a non-fibroid uterus [24]. This and the fact that there may be endometrial inflammation and an altered local hormonal environment may affect embryo implantation. Myomas also seem to alter uterine contractility possibly interfering with sperm and ovum interaction or embryo migration [25]. This may especially be true in a uterus with multiple large fibroids with cavity distortion.
\nSix systematic reviews or meta-analyses published between 2001 and 2010 assessed whether fibroids have an impact on fertility. On the whole, it appears that women with fibroids have decreased fertility. The presence of fibroids, regardless of location, significantly decreases both implantation and clinical pregnancy rates (RR 0.821; 95% CI 0.722–0.932,
All systematic reviews and meta-analyses agree that subserosal fibroids do not have an impact on fertility. Submucosal fibroids (fibroids with endometrial impingement), however, have been shown uniformly to have a negative impact on rates of implantation, clinical pregnancy rate, miscarriage and live birth/ongoing pregnancy, although available studies are few and small [24, 27].
\nIn conclusion, submucosal fibroids are associated with reduced fertility and an increased miscarriage rate. Hysteroscopic myomectomy for submucosal fibroids is likely to improve fertility outcomes; however, the quality of available studies is poor and further research is required. The relative effect of multiple or different sized fibroids on fertility outcomes are also uncertain [28].
\nSurgical resection remains the mainstay for women with symptomatic submucosal fibroids. Medical therapy with gonadotrophin-releasing hormone analogues (GnRHa) appears useful in the short term but side effects limit their long-term use [5]. Medical management of fibroids delays efforts to conceive and is not recommended for the management of infertility associated with fibroids. However, short-term GnRH analog use in infertile women with fibroids can be useful for preoperative correction of anaemia or short-term reduction in fibroid volume [28].
\nNewer, novel therapies including aromatase inhibitors, mifepristone, selective estrogen receptor modulators and selective progesterone receptor modulators have shown promise in symptom improvement and fibroid regression without the hypoestrogenic symptoms associated with GnRH analogues however they are currently only used in the setting of approved clinical trials on the management of fibroids in women with infertility.
\nThe same applies to other alternatives to surgery such as uterine artery embolization (UAE), magnetic resonance-guided focused ultrasound surgery (MRgFUS), myolysis and radio-frequency ablation (RFA) all of which are still being investigated in terms of their long-term impact on fertility [24, 28].
\nTranscervical resectoscopic myomectomy (TCRM) was performed in 1976 with a modified urologic resectoscope [29]. Traditionally, this has been the most common method of hysteroscopic resection of fibroids, but various new modalities such as vapourisation, morcellation and dissection are now being used in the surgical management of fibroids [3].
\nHysteroscopic myomectomy is the least invasive surgical approach for fibroid removal. It is most effective for patients with submucosal fibroids completely within the uterine cavity (type 0) or with at least 50% of the fibroid volume within the uterine cavity (type 1). Fibroids with less than 50% of the fibroid volume in the cavity (type 2) are much more difficult to resect completely and are more often associated with the need for repeated procedures.
\nSubmucous fibroids less than or equal to 5 cm diameter can be removed hysteroscopically however anything larger in diameter should be removed abdominally whether by laparoscopy or laparotomy (midline or pfannensteil) depending on surgeon’s skill and preference. Type 2 fibroids tend to require a multi-staged procedure when compared to type 0 and 1 [4, 24].
\nAchievement of a high likelihood of surgical success requires good patient selection and relevant factors such as the number of submucous myomas, their location, size and type, and their relationship to the uterine serosa should be considered. When evaluating the suitability of patients for TCRM, it is important to consider the myoma type, the potential for incomplete excision and the patient’s tolerance for more than one procedure if required. The indication for fibroid resection is also very important.
\nWith resection of fibroids for abnormal bleeding, it is found that type 2 myomas could be eventually resected but required a larger number of repeat procedures than the more superficial types 0 and 1 myomas, which almost invariably are completed with a single operation [30, 31].
\nA recently published randomized controlled trial compared treatment of submucous myomas in 215 women with primary infertility. Fertility rates increased after TCRM for type 0 and type 1 myomas, but no significant difference was noted between the groups for type 2 myomas. However, a number of questions related to the effects of resection of myomas on fertility remain unanswered and highlight the need for careful patient selection in this population [32].
\nThe same applies with regard to multiple pregnancy loss. Data from Pritts et al. suggest that in selected patients submucous myomectomy may reduce the rate of spontaneous abortion; however, more data are required to confirm this [27].
\nCommencing the patient on a gonadotrophin hormone-releasing (GnRH) analogue or selective progesterone receptor modulator (mifepristone or ulipristal acetate) [33] prior to the surgery allows the surgeon to operate when the endometrium is thin which can reduce operative time by allowing better visualization during the procedure. Theoretically, this also reduces intraoperative bleeding and fluid absorption. However, its main proven benefit is that it can reduce menstrual blood loss and correction of anaemia prior to surgery. This also aids with restoration of haemoglobin and iron stores for the woman. Whereas high-quality data exist demonstrating the efficacy of GnRH agonists in facilitating the treatment of anaemia before the procedure the data regarding the impact on other outcomes is more mixed, although the use of selective progesterone receptor blockers may show promise [34–36].
\nVarious methods are available for preoperative ripening of the cervix prior to hysteroscopic resection. The benefit of cervical ripening is to reduce the risk of cervical tears and uterine perforation that is associated with forceful dilatation. These risks are increased in postmenopausal women, for those without previous vaginal delivery and for women with previous surgery for cervical surgery or neoplasia. Options for ripening include laminaria tents, preoperative prostaglandins such as misoprostol and intraoperative intracervical injection of dilute vasopressin [3].
\nProbably the best available evidence is for use of prostaglandins. High-quality evidence from randomized controlled trials suggests that misoprostol, a synthetic prostaglandin E1 analogue (200–400 mcg) taken orally or vaginally, 12–24 hours before surgery, facilitates cervical dilation and minimizes traumatic complications in premenopausal women [37]. The cervix is then usually dilated to accept a size 10 Hegar dilator.
\nThe risk of infection from hysteroscopic procedures is low, in the order of 0.5–1% with a risk of endometritis following resectoscopic myomectomy of 0.51% [38]. Most operators would however routinely administer prophylactic antibiotics to limit postoperative febrile morbidity, although there is no prospective data to support this practice.
\nResection of a submucosal fibroid is usually performed after the administration of general anaesthetic, although it may be performed with spinal anaesthesia or with local anaesthetic; paracervical block and intrauterine injection of local anaesthetic in association with intravenous sedation [39].
\nIncreasingly over the last decade, more operative hysteroscopic procedures have been performed in an office-based setting. Mcilwaine et al. showed in a study of 42 patients that the Myosure lite device (uses electromechanical energy) can be successfully used to resect small fibroids in the outpatient setting with a high level of patient satisfaction with the use of local anaesthetic in a paracervical block [40].
\nPatients are generally placed in lithotomy position: Trendelenburg positioning should be avoided. After an examination under anaesthesia, a bivalve speculum is placed in the vagina and the cervix identified. After placing a single tooth tenaculum on the anterior lip of the cervix (if the patient is conscious local anaesthetic spray can be applied prior to this), the cervix is dilated with Hegar dilators to size 10 sufficient to accommodate the 9 mm outer sheath of a standard resectoscope. The longer dilators with a gradually tapered tip are safer and minimize the risk of perforation [41].
\nThe correct and safe use of instruments available will enable the surgeon to most effectively carry out hysteroscopic fibroid resection. In the past, smaller fibroids have been removed with conventional instruments such as grasping polyp forceps or scissors; however, there is now a growing trend towards performing the procedure with devices under direct vision [3]. They have the added benefit of early recognition of the complication of uterine perforation and reducing its associated morbidity.
\nFor optimum safety and effectiveness, the surgeon should have a detailed understanding of the design and assembly, and where necessary, troubleshooting strategies for the system in use.
\nThe most commonly employed system for removal of submucous myomas is the urologic resectoscope, slightly modified for gynaecological use. With this instrument, the fibroid can be resected under direct vision. The resectoscope consists of a 26 French gauge outer sheath diameter and 0° or 30° fore-oblique telescope with a 4 mm outer diameter. All modern resectoscopes are of a continuous flow design, allowing constant turnover of distending media that facilitates visualization of the fibroid by rinsing out blood and debris. There is a large calibre inflow (cystoscopy tubing) and outflow tubing that are connected to a fluid management system. The inflow is pressurized with a peristaltic pump with a maximum pressure setting of 150 mmHg and a maximum flow setting of 450 mL/minute, similar to standard resectoscopy [42]. Pressures selected are based on the mean arterial pressure of the patient as a first-line barrier to fluid intravasation, typically 80 mmHg.
\nStandard technique to remove polyps and submucous myomas is resectoscopy with monopolar high-frequency electrical current. By means of a 5mm wire loop electrode, mounted on a working element with handpiece and integrated in an endoscope, tissue can be cut. Monopolar current necessitates the use of nonconducting, nonphysiologic, electrolyte-free irrigation and distention liquids such as sorbitol 5% or glycine 1.5% [3, 41, 42].
\nThe outflow tubing should be connected to both the under the buttocks collection bag as well the outflow adaptor of the hysteroscope itself. This maintains a negative pressure in the outflow tract and allows for continuous suction of debris-laden fluid from the endometrial cavity and an accurate count of fluid lost. The negative pressure may be increased if the view is too cloudy or decreased if there is inadequate uterine distension prior to increasing the distension pressure [5, 41].
\nMore commonly bipolar resectoscopes are being used as they require the use of isotonic conductive media, such as normal saline or lactate Ringers solution. This is because in a bipolar loop the active and return electrodes are in close proximity to one another a lower impedance media can be used. The risk of volume overload and electrolyte disturbance is significantly reduced with isotonic solutions.
\nSmall-diameter bipolar electrodes or laser fibers can be passed through the instrument channel of most standard hysteroscope sheaths 5 mm or greater in diameter. In some instances, dissection of smaller submucous myomas can be accomplished with such energy sources.
\nThe hysteroscopic morcellator is gaining more popularity in recent years. It was developed based on an orthopaedic shaver. It is a hollow device with a sideways opening that allows the blade to morcellate the leimyoma. It also has the ability to suction morcellated fragments of the fibroid simultaneously. This can also be used with saline distension media and does not require electrical current [42] (see Figure 4).
\nSurgeon holding
There are three basic methods for removing leiomyomas under hysteroscopic direction; morcellation, cutting with an electrosurgical loop and vaporization. The most commonly employed approaches use the resectoscope, a radiofrequency electrosurgical generator, and either a loop or a bulk-vapourising electrode.
\nWhen performing radiofrequency-based hysteroscopic myomectomy on women who wish to preserve fertility, care should be taken to minimize thermal damage to the tissue adjacent to the incision and that the loop does not touch adjacent healthy endometrium.
\nThe traditional resectoscopic removal involves a slicing action of the fibroid. It can be performed with monopolar or bipolar cutting or coagulating current at a setting of 100 W. The electrosurgical loop is advanced beyond the fibroid and a repeated action of passing the cutting loop over the tissue in a backward direction, away from the fundus of the uterus is performed. In a pedunculated fibroid, the stalk can be transected and then removed by polyp forceps. Performing the procedure in a systematic way, starting at the top of the fibroid and working ones’ way down to its base is the ideal approach. It is important to avoid damage to normal endometrial tissue with the loop as much as possible. Repetitively removing the resectoscope from the uterus to remove tissue fragments is time consuming, causes cervical trauma and can lead to a loss of uterine distention with compensatory increased use of distention media. To avoid this resected tissue, fragments can be pushed towards the uterine fundus and removed at the end of the operation. The closer the association of the fibroid with the serosa of the uterus, the more challenging the resection is due to the significant intramural component. Methods to facilitate extrusion of the intramural component include using the natural contractility of the uterus [43], intraoperative prostaglandins to stimulate uterine smooth muscle contraction [38], intravenous ergometrine [44] and repeated release of the uterine distending pressure, to allow for natural uterine extrusion.
\n\nFor deep type 1 and type 2 fibroids that approach the uterine serosa (millimetres), it may be safer to perform a laparoscopy at the same time as the resection. This does not always prevent perforation but ensures early recognition of this complication and associated damage to other viscera. There is also the thought that the gas used to distend the abdominal cavity at laparoscopy can create a safety buffer in the unfortunate event of a perforation [45]. Type 0 and most type 1 fibroids are much more easily removed.
\nWhen a submucosal fibroid has a significant intramural component (type 2), a multi-staged procedure will result in a more complete resection and is generally also thought to be safer as it avoids the complication of perforation which can occur during resection of the base of the fibroid.
\nElectrosurgical vapourisation of fibroids involves using an electrode of cylindrical or spherical shape which uses current to vapourise the tissue. This does not produce any tissue fragments which can be a disadvantage if a specimen is required for histopathological assessment [46]. There is some lower quality evidence which suggests that reduced systemic absorption of distention media may occur with hysteroscopic myomectomy using this approach [47]. This could be because tissue fragments are not produced and the procedure can be performed faster without the need for removing tissue fragments. As with any current, the duration of contact, resistance of the tissue and the power (wattage) determine the degree of current delivered through the dispersive electrode. The surgeon is responsible for being aware of the power settings, as if they are too high there is a risk of skin burns to the patient through the skin plate (see Figure 5).
\nAnother technique with increasing popularity is hysteroscopic morcellation. Using a modified prototype based on an orthopaedic arthroscopic tissue shaver, Dr. Mark Hans Emanuel was able to create a first-generation device that used mechanical energy rather than electrical energy to resect uterine tissue.
\nHysteroscopic resection of a type 0 Fibroid (top) and at the end of a completed resection (bottom).
Hysteroscopic morcellation aims to remove uterine leiomyomas during a single insertion of a hysteroscope into the uterus. This contrasts with traditional hysteroscopic resection of leiomyomas, in which the instrument is reinserted into the uterus multiple times. Hysteroscopic morcellation is intended to reduce the risk of traumatic injury to the uterus and the risk of inadvertent fluid overload associated with traditional procedures (because the procedure may be completed more rapidly). An intended advantage of the procedure over thermal ablation techniques is avoiding the risk of thermal injury.
\nA hysteroscope is inserted into the uterus through the cervix, and saline is pumped through a small channel in the hysteroscope to distend the uterus. A specially designed morcellator is introduced via the hysteroscope and used to cut and simultaneously aspirate the leiomyoma tissue. The aspirated tissue can be collected for histological analysis. For polyps and type 0 and type 1 submucous myomas, hysteroscopic morcellation has been demonstrated to be both faster and easier to learn than traditional resectoscopy. The earliest published trial with a hysteroscopic morcellation device by Emanuel and colleagues showed a significant reduction in operating room time when removing polyps and type 0 and type 1 submucous myomas. In that study, polyps were removed with a 72% reduction in operating room time with a morcellator as compared with a resectoscope type 0 and type 1 myomas were removed in 61% less time, respectively [42]. Hence, hysteroscopic morcellation is most useful for small or pedunculated leiomyomas [48].
\nHysteroscopic resection of submucosal fibroids is very safe in experienced hands. However, potential surgical complications include fluid overload, intraoperative and postoperative bleeding, uterine perforation, gas embolism, and infection with associated uterine synechiae.
\nExcess absorption of non-crystalloid distension media can cause serious fluid and electrolyte imbalance, pulmonary and cerebral oedema, cardiac failure, and death [49]. Although complications associated with excess fluid absorption are relatively uncommonly encountered, premenopausal women undergoing resectoscopic surgery in the uterus may be at greater risk because of the inhibitory impact of female gonadal steroids (most likely estrogen) on the sodium/potassium ATP’ase pump [50]. Studies have demonstrated that 100 mL intravasation correlates with a sodium decrease of approximately 1 mmol/L. One study demonstrated that cerebral oedema could be identified during computed tomography scanning from an intravasation of only 500 mL. Therefore, a meticulous measure of the inflow and outflow of fluid used is extremely important [51].
\nFluid absorption is increased when intrauterine pressure exceeds mean arterial pressure. Consequently, the intrauterine pressure should be maintained at the lowest pressure that allows good visualization for performance of the hysteroscopic myomectomy.
\nNonconducting (electrolyte free) distention mediums such as glycine 1.5% or mannitol 5% are used with the monopolar electrosurgical system. With excess absorption of these fluids, there is a risk of hyponatraemia; however, the more serious complication is of cerebral oedema due to a hypo-osmolar effect on plasma concentration. This rare side effect can be fatal.
\nElectrolyte containing isotonic distention media (normal saline) can be used when mechanical or bipolar resections are employed. Its use reduces the risk of hyponatraemia and changes in serum osmolality when compared with nonconducting media. It can still cause fluid overload with consequent pulmonary oedema and therefore meticulous fluid balance should still be maintained.
\nOther major complications consist of haemorrhage and uterine perforation. Perforation of the uterus can occur with dilators, mechanical grasping tools or the resectoscopic system. If perforation occurs with mechanical instruments, and no bowel injury is suspected, the patient can be managed expectantly with close observation for a 24-hour period. Laparoscopy must be performed if bowel injury is suspected, where there appears to be a large perforation, or in the presence of heavy bleeding. If perforation occurs with an activated electrode, one has to assume that there has been a bowel injury until proven otherwise, and laparoscopy or laparotomy is recommended.
\nUterine perforation can be a complication with serious associated morbidity. Reassuringly, the risk of this is generally low. In a study of 2100 operative hysteroscopies performed by experienced surgeons, 782 involved fibroid resection and uterine perforation occurred in 1.2% of those procedures and 1.6% of all hysteroscopies [52]. The prospective Mistletoe study which analysed techniques of endometrial ablation demonstrated a slightly higher uterine perforation rate of up to 2.5% when using the electrosurgical resection loop [53]. Up to a third of uterine perforations are thought to occur during cervical dilatation before the resection is actually commenced. This could be avoided by use of cervical priming agents as discussed prior to allow easier dilatation. Unrecognized injury is a serious incident as it is possible that a bowel burn may have occurred, if perforation occurred when using an activated electrode, potentially leading to peritonitis and a high index of suspicion must always be exercised.
\nThe above group also looked at rates of haemorrhage. Haemorrhage was defined as abnormal bleeding at the end of the procedure. In the 782 fibroid resections, the risk of operative haemorrhage was 0.4% [46].
\nHeavy bleeding from the endometrial cavity is uncommon after hysteroscopic surgery in general. If there is continuous bleeding after resection, a Foley catheter can be inserted into the uterine cavity and distended with up to 40 mL of saline until the bleeding settles from a tamponade effect. The balloon can be removed if the bleeding has settled in a few hours.
\nOther pharmacological agents that have been investigated to reduce blood loss at myomectomy include tranexamic acid, prostaglandin E2 analogues (misoprostol and dinoprostone) and ascorbic acid. Randomized controlled trails of these agents compared to placebo showed statistically significant reduction in blood loss; however, sample sizes in these studies were small and had low to moderate quality evidence [54].
\nA more invasive option for controlling bleeding is uterine artery embolization with interventional radiologic techniques if bleeding persists despite above measures.
\nOne must be very careful to avoid unintentional activation of the monopolar or bipolar pedals. If this occurs while the active electrode is resting on the patient it can cause serious burns to the abdomen, perineum, vagina or vulva [3].
\nMore sinister burns occur when the uterus is perforated by an active electrode causing injury to surrounding structures, most commonly the bowel or blood vessels. This type of injury can be prevented by making sure not to activate the electrode while it is being advanced into the endometrial cavity. It should only be activated when being withdrawn. As discussed before, if a uterine perforation is suspected due to an active electrode, the surgeon must perform an exploratory laparoscopy or laparotomy depending on the extent of perforation.
\nIntrauterine adhesions can occur after hysteroscopic myomectomy to the point that they adversely impact fertility. The incidence of intrauterine adhesions after hysteroscopic myomectomy was shown in one study to be 7.5% [55]. Postoperative adjuvant therapy, including estrogen therapy for four to eight weeks or insertion of an intrauterine device, paediatric Foley catheter or other balloon for one week postoperatively, have all been used to prevent further adhesion development. However, there is scant evidence to support the use of these postoperative therapies [56, 57].
\nIf, on preoperative assessment, it can be anticipated that a large proportion of the cavity will be stripped of endometrium after resection, an abdominal approach (laparotomy, laparoscopy or “robotic”) to myomectomy should be considered to reduce the formation of adhesions. In a retrospective study, when second look hysteroscopy was performed after one to three months on 153 women who underwent TCRM, 2 of 132 (1.5%) with single myomectomy had intrauterine adhesions [58].
\nThere is a lack of prospective randomized controlled trials assessing the true impact of surgical management of submucosal fibroids on fertility. This would be challenging to perform for obvious reasons. Many studies do not document that a comprehensive assessment of various causes of infertility was performed on the patient prior to surgery to isolate only those patients where the fibroid was the causative factor of subfertility. Other confounding factors are that conception rates are not recorded before and after surgery.
\nA recently published RCT compared TCRM with no treatment in 215 women with primary infertility with demonstrated submucous fibroids on ultrasound. The two randomized groups were women who underwent either TCRM or diagnostic hysteroscopy with biopsy only. At follow up, 63% of the treatment group conceived but only 28% of the biopsy group had (RR 2.1 CI 1.5–2.9). The investigators concluded that fertility rates increased after hysteroscopic myomectomy in women with type 0 and type 1 myomas (
Similarly, Bozdag et al. demonstrated an improvement in spontaneous conception rates after the surgical removal of submucosal fibroids, but pregnancy rates following the removal of intramural or subserosal fibroids were no more improved than in the expectant management group of women with intramural or subserosal fibroids in situ [60]. A recent meta-analysis also demonstrated similar findings, with an improvement in pregnancy rates in infertile patients undergoing surgical removal of submucosal fibroids, but not in those undergoing surgical removal of intramural fibroids [27].
\nIn summary, the evidence suggests that in women with otherwise unexplained infertility, submucosal fibroids should be removed in order to improve conception and pregnancy rates but removal of subserosal fibroids is not recommended, and this approach is endorsed by national bodies [61]. There is fair evidence to recommend against myomectomy in women with intramural fibroids (hysteroscopically confirmed intact endometrium) and otherwise unexplained infertility, regardless of the size of the fibroids.
\nDerman et al. in 1991 performed the first large-scale trial of the long-term success of hysteroscopic electrosurgical resection of fibroids [62]. Over a 9-year follow-up period, 84% of patients avoided a further procedure and 7% of patients needed a second hysteroscopic resection. Further studies by Emanuel et al. and Hart et al. showed that 91% of patients avoided further surgery at two years follow-up and 73% at eight years follow-up. It was also shown that risk factors for requiring surgery included a larger uterus and multiple fibroids [51].
\nFive series involving over 1400 women have shown that hysteroscopic myomectomy is an effective management option for dysfunctional uterine bleeding. Failure rates ranged from 14.5% to 30% for up to 4 years’ follow-up [63]. This would suggest surgery should be considered as first-line treatment for the management of symptomatic fibroids, including submucous fibroids. Submucous myomas (types 0, 1 and 2) up to 5 cm in diameter can be removed hysteroscopically. Type 2 myomas are more likely to require a two-staged procedure than types 0 and 1 because of the risk of excessive fluid absorption and uterine perforation. The risk of uterine perforation is particularly high when there is less than 5 mm distance between the uterine serosa and the fibroid [2].
\nAfter TCRM alone, long-term cohort studies have indicated that patient satisfaction is in the range of 70–80%, with 14–16% of women requiring additional surgery [64].
\nWhen women with heavy menstrual bleeding who are not interested in future fertility and have selected type 2 and type 1 submucous myomas, generally 3 cm or less in diameter, endometrial ablation appears to confer a high degree of success in the short term [3]. In a single-armed, one-year study of the Novasure radiofrequency ablation system (Hologic Inc., Bedford, MA) in patients with type 1 or 2 myomas, 95% of the 65 patients were successfully treated [65]. At the present time, there is inadequate evidence to suggest that one device or technique, such as resectoscopic ablation, is clearly more efficacious than another.
\nTherefore, if the main symptom is heavy menstrual bleeding only and fertility is not required, consideration should be given at the time of transcervical resection of myoma to also perform endometrial ablation. This has been demonstrated in a cohort study, which showed a higher success rate in controlling bleeding when ablation was added to myomectomy [66].
\nAs can be seen from the success of surgery, for most patients the chance of avoiding further surgery is about 80% with long-term follow-up [67], but the success is lower in patients with type 2 fibroids [2, 67].
\nThe recurrence rate of fibroids is 15% and 10% of women who have a myomectomy will eventually need a hysterectomy within 10 years. Factors more likely to be associated with recurrence of fibroids are the woman’s age, number of fibroids, larger uterine size and childbirth after myomectomy [68].
\nThe success rate of a repeat resection has been described by Istre and Langebrekke [17]. Twenty-eight per cent of their 118 patients who needed repeat surgery (ablation or myomectomy) eventually proceeded to a hysterectomy. The main indication was pain due to a haematometra. One of the major causes of primary surgery failure was found to be deep adenomyosis and associated pain. It was suggested that MRI could be used as a diagnostic tool in those presenting with failed initial surgery, to select patients with adenomyosis, who are less likely to benefit from repeat surgery unless it is a hysterectomy. Of course, this option would not be of use to patients wishing to preserve fertility [69].
\nWe would like to thank the authors of the publications cited who have enabled us to write an up-to-date account of hysteroscopic surgery of submucosal fibroids. We would like to recognize these two publications as providing some of the background to our chapter,
Oral cancer remains as a significant cause of mortality worldwide as most of these the tumors are detected and treated in late stages. The etiology of oral cancer is multifactorial. Tobacco and alcohol are still considered the main risk factors as about 80% of the patients who develop oral tumors are tobacco and/or alcohol users [1]. Additional etiologic factors have also been suggested such as infection by human papillomavirus (HPV) and other oncogenic viruses, immunosuppression states, genetic alterations, and deficient nutrition.
Dental implants are one of the top choices for the oral rehabilitation of partially or totally edentulous patients. The stability and comfort provided by the implants-anchored crowns are among their clinical advantages. Moreover, the success rate of dental implants surpasses 94.6% [2]. However, the soft tissue and supporting structures around the dental implants remain exposed to the oral cavity and may undergo pathological changes. The most frequent lesions are those of inflammatory nature triggered by the accumulation of bacterial biofilm. When the inflammatory lesion is confined to the soft tissue, it is named as peri-implant mucositis. On the other hand, when there is loss of supporting bone, the lesion is known as peri-implantitis. Due to the high incidence of peri-implant inflammatory diseases, some dental professionals treat the lesion but do not send the specimens to the microscopical analysis. About 3.6% of the lesions are malignant tumors (mainly squamous cell carcinomas, the most common malignancy of the oral cavity) [3]. In 2001, the first cases of malignant lesions developing around dental implants were published [4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22]. Since then, the potential relationship of titanium implants with malignant tumor development has been discussed [1, 5, 13].
The aim of this chapter was to offer the readership the most recent information regarding the clinical features of oral cancer around dental implants, its differential diagnosis, and potential oncogenic mechanisms.
A review of literature available until September 2021 was conducted in the PubMed/Medline database using the term “Oral squamous cell carcinoma around dental implants.” Only cases with definitive microscopic diagnosis of OSCC arising in the soft tissue around one or more dental implants were included. The literature review revealed 43 cases of patients with OSCC around dental implants in the 19 published manuscripts [4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22]. All clinical and epidemiological information about the sample is summarized in the Table 1.
Author | Gender/age | Cancer site | Lesion | Risk factors* | Prev. Rep. CA | Primary diagnosis |
---|---|---|---|---|---|---|
Block et al. 2001 [4] | M/72 | Mandible | Mimicked PI | Yes | Yes | PI |
Shaw et al. 2004 [5] | M/67 | Mandible | Exophytic mass | NA | Yes | PI |
F/69 | Mandible | Mimicked PI | NA | Yes | NA | |
Czerninski et al. [15] | F/52 | Mandible | Mimicked PI | Yes | No | PI |
M/80 | Mandible | Mimicked PI | No | Yes | PI | |
Abu El Naaj [16] | F/70 | Mandible | Exophytic white | No | Yes | NA |
Schache el al. [17] | F/77 | Mandible | Exophytic mass | No | No | NA |
Gallego et al. [18] | F/81 | Mandible | PI mass | No | Yes | OL |
Kwok et al. [19] | M/71 | Mandible | “Inflammatory process” | Yes | No | PI |
F/67 | Mandible | Exophytic mass | Yes | Yes | NA | |
M/62 | Mandible | Non-healing ulcer | Yes | No | Na | |
De Ceulaer et al. [20] | F/77 | Mandible | Mimicked PI | Yes | Yes | PI |
M/71 | Mandible | Swelling | Yes | Yes | PI | |
F/62 | Mandible | Mimicked PI | Yes | Yes | PI | |
Meijer et al. [21] | F/69 | Mandible | Exophytic mass | No | Yes | PI |
Orhan et al. [22] | F/69 | Mandible | Numb chin syndrome, with mixed RO-RL lesion | NA | Yes | NA |
Pfammatter et al. [6] | F/55 | Mandible | mimicked PI, numbness | Na | Yes | Metastasis |
Moergel et al. [7] | F/63 | Mandible | Exophytic mass | No | Yes | NA |
F/70 | Mandible | Exophytic mass | Yes | Yes | NA | |
M/72 | Mandible | Exophytic mass | No | Yes | NA | |
M/57 | Mandible | mimicked PI | Yes | Yes | PI | |
M/72 | Mandible | Exophytic mass | NA | No | NA | |
F/54 | Mandible | Exophytic mass | No | NA | NA | |
M/47 | Mandible | Ulcer | Yes | No | NA | |
M/88 | Mandible | Ulcer | No | No | NA | |
F/42 | Mandible | Ulcer | NA | Yes | NA | |
F/59 | Mandible | Ulcer | NA | Yes | NA | |
M/73 | Maxilla | Exophytic mass | Yes | Yes | NA | |
M/77 | Mandible | Exophytic mass | Yes | No | NA | |
F/68 | Mandible | Exophytic mass | Yes | Yes | NA | |
F/69 | Mandible | Exophytic mass | No | Yes | NA | |
Marini et al. [8] | F/51 | Mandible | Exophytic mass | No | No | PI |
Bhandari et al. [9] | F/71 | Maxilla | Erythematous | No | No | PI |
Chainani-Wu et al. [10] | F/60 | Maxilla | Fistula | No | No | PI |
Vadim Raiser et al. [11] | F/55 | Maxilla | White Exophytic mass | NA | NA | OL |
F/70 | Mandible | Erythematous mass | NA | NA | NA | |
Noguchi et al. [12] | F/65 | Mandible | gingival swelling | Yes | NA | Neoplasia |
Malthiéry et al. [13] | M/77 | Mandible | Mimicked PI | NA | No | PI |
Granados et al. [14] | M/83 | Mandible | Ulcerous lesion | NA | Yes | NA |
M/60 | Mandible | Verrucous lesion | NA | NA | NA | |
F/54 | Mandible | “Gum lesion” | NA | NA | NA | |
M/64 | Mandible | Excrescent lesion | NA | NA | NA |
Demographic and clinical features of patients diagnosed with oral squamous cell carcinoma around dental implants.
M = Male; F = Female; Pre.Rep.CA = Previously reported cancer; PI = Peri-implantitis; OL = Oral lichen planus; NA = Not available. * Patients who smokers and/or drinkers were considered.
The age of patients with oral cancer around dental implants ranged from 61 to 75 years old. There was a predominance of females (24 cases - 57.14%) when compared to males (18 cases - 42.86%). The typical clinical appearance of oral cancer around dental implants was an exophytic mass (20 tumors—47.62%) with few cases presenting as ulcer (4 tumors—9.52%). The bone osteolysis was frequently observed in the area of tumor causing the implant loss in some patients. The tumors affected mainly mandible (38 cases—90.47%) of the patients with multiples osseointegrated implants. Of note, oral cancer around dental implants is frequently clinically mistaken as peri-implantitis (Table 1).
Although peri-implantitis is the most common local risk factor for dental implant failure, the development of oral cancer involving the soft tissue around the titanium also impact the quality of life of the patient negatively. The oral cancer can manifest as hypertrophy, erythema, and/or ulcerative lesion of the soft tissue, and these features are similar to inflammatory peri-implant diseases such as peri-implantitis and/or peri-implant mucositis, as described by others [7, 10, 11]. Furthermore, these inflammatory peri-implant diseases frequently present the same epidemiological pattern and risk factors for oral cancer, that is, patients older than 60 years old and chronic tobacco and/or alcohol consumers [1]. Although there are protocols for peri-implantitis treatment, frequently, the peri-implant tissue removed during this surgical treatment is not submitted for histopathological analysis [23, 24]. Then, the number of reported cases of peri-implant malignancy seems to be low in mouth but it may be being underreported by health professionals [24]. Recently, in a study of 111 biopsies of peri-implant lesions, 3.6% of those had histopathological diagnosis of oral squamous cell carcinomas [3]. Another investigation demonstrated that 2.9% of 68 dental implant-related lesions were oral squamous cells carcinomas [25].
Figure 1 illustrates a case report of an edentulous 64-year-old woman. She had an exophytic mass associated with ulcerated area and covered by a yellowish membrane in the anterior region of the mandible. The lesion was surrounded multiple osseointegrated implants (Figure 1A). She did not report adverse habits, for example, tobacco or alcohol consumption. Periapical radiographic exhibited an ill-defined bone destruction underneath the area of the lesion (Figure 1B). The histopathological analysis exhibited keratinizing well-differentiated epithelial neoplastic cells, some undergoing atypical mitosis, and invading the subjacent fibrous connective tissue (Figure 1C). The diagnosis of oral cancer was confirmed.
Clinical and microscopic findings of oral squamous cell carcinoma around dental implants. a) Exophytic ulcer covered by necrotic tissue at the anterior-inferior alveolar ridge.b) Periapical radiograph showing an ill-defined bone loss in the peri-implant region. c) Neoplastic squamous epithelium-infiltrating subjacent submucosa with corneal pearls and discrete pleomorphism. d and e) epithelial cells with atypical mitotic figures infiltrating the tissue.
The early diagnosis of malignant tumors around dental implants is challenging because incipient lesions may resemble inflammatory peri-implant lesions [1, 2, 4, 5, 6, 7, 10, 12, 15, 16, 17, 18, 21]. In the Table 1, 14 out of 43 cases of oral cancer surrounding dental implants (33.33%) had the primary diagnosis of peri-implant lesions. Therefore, this clinical misinterpretation might delay the diagnosis of oral cancer facilitating its dissemination and resulting in a worst prognosis of the disease. These facts underscore how critical is the histological exam of every lesion around dental implants surgically removed. Furthermore, the peri-implant lesion that does not present the classical features of an inflammatory condition and that does not respond to conventional treatment, particularly if the patient has risk factor for oral cancer, should be submitted to the biopsy and histopathological analysis [23, 24, 25].
The etiology of oral cancer is multifactorial. OSCC is the most prevalent oral malignant tumor and it is associated with lifestyle risk factors such as alcohol consumption and smoking [26]. Curiously, tobacco smoking is also the predictor of dental implants failure and more smokers have post-operative infections and peri-implant crestal bone loss than nonsmokers [27, 28]. Although the information about lifestyle-related factors that predispose to oral cancer was incomplete in most of cases included in the Table 1, 34.88% of patients diagnosed with squamous cell carcinoma around dental implants were smokers and/or drinkers. These overlapping risk factors may drive the clinician to attribute the onset of an atypical lesion involving dental implants to a deficient or anomalous immune response of a patient who consumes tobacco and/or alcohol. However, it is essential that the clinicians are aware that the classic signs of inflammation persist in such patients and that these features are useful to distinguish a benign from a malignant lesion. Additionally, the histopathological analysis remains as the gold standard for the diagnosis of lesions located in the oral cavity [23].
A well-defined concept is that patients with previous history of cancer have higher risk of developing other tumors. Twenty-three (54.76%) of all cases of squamous cell carcinoma around dental implants arose in patients with history of cancer. Interestingly, we observed that 19 (82.60%) patients had OSCC previously. Furthermore, other patients had lung [6, 15], intestine [15], thyroid [17], and breast [17, 22] cancer previously. As the development of OSCC has been also associated with genomic instability and genetic predisposition [1], one can hypothesize that a patient who had a malignant lesion are more susceptible to local aggressions such as the contact of the soft tissue with dental implant materials.
Titanium is one of the most common components in implants alloys used in dental and medical fields [1, 29]. High biocompatibility, appropriate mechanical properties, inertness, and corrosion resistance are among the main advantages of titanium [25, 29, 30]. When the titanium implant is installed in extra oral sites, where it is protected from the contact with the environment, it has inert behavior. On the other hand, dental implants are continuously exposed to the oral cavity hostile conditions [31]. The area between the implants and the abutment or the prosthetic crown is particularly susceptible to the bacterial biofilm accumulation, saliva, pH and temperature changes, and functional micromotion (Figure 2) [31].
Illustration of potential risk factors and mechanisms on the development of squamous cell carcinoma around dental implants.
When the dental implant surface is exposed to any source of oxygen or nitrogen, a chemical reaction takes place and a thin layer of titanium dioxide (TiO2) is formed and deposited in the outer surface of the implants. This layer is extremely resistant to corrosion. However the chemical agents of the oral cavity can reduce the protection of the dioxide deposit and induce the corrosion development [31]. Saliva and other chemicals introduced into the oral cavity through feeding or in contact with bacterial biofilms influence the gradual biodegradation of metallic structures including the titanium used in dental implants [29]. Furthermore, acidic solution combined with mechanical friction strength potentiates the damages to the implants surfaces. Interestingly, some studies with cytology have demonstrated the presence of titanium particles in the peri-implant tissues [23, 25] regardless of the presence of peri-implantitis or peri-implant mucositis. It has been suggested that this material accumulation may be the result of the corrosive process of the dental implants [29, 30, 32], implant-abutment friction at the installation of the implants, and/or implantoplasty [29, 31, 33, 34]. The degree of titanium corrosion can be influenced by quality and quantity of saliva, diet, alloy polishing, genetics, oral hygiene, amount and distribution of the occlusal forces, and microbiota [29, 30, 32].
The above data show that titanium is not entirely bioinert as suggested years ago. Then, even with their good biological properties, titanium alloys are susceptible to corrosion attack with release of metal ions to the surrounding hard and soft oral tissues, lymph nodes, peripheral, and even distant organs [30]. Consequently, titanium ions have been implicated in the development of oral cancer around dental implants [1, 34].
As stated previously, the relationship between titanium dental implants and oral cancer has been suggested based on the increasing number of tumors arising in the peri-implant tissue. However, as far as we know, there is not any study dedicated to unveil the potential carcinogenic mechanisms triggered by titanium ions.
Titanium particles have been shown to induce the expression of breast cancer gene 1 (BRCA1) and checkpoint kinase 2 (CHK2) in epithelial cells
In 2006, the International Agency for Research on Cancer (IARC) classified the titanium dioxide as a possible carcinogen for humans [41]. However, in view of the few case reports of oral cancer around dental implants the authors were unable to exclude the existence of other confounding carcinogens as tobacco and/or alcohol [1, 7, 19].
The literature review showed that most cases of OSCC around dental implants had initial clinical features compatible with peri-implantitis. Therefore, this clinical misinterpretation of an inflammatory process in peri-implant mucosa may delay the diagnosis of oral cancer facilitating the local progression and dissemination of cancer cells, resulting in worst patient’s prognosis. Thus, the peri-implant lesion not responding to conventional anti-inflammatory treatment, particularly if the patient has risk factor for oral cancer, should be submitted to the biopsy and histopathological analysis, avoiding delay in the diagnosis of the tumor.
This study was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code (#001). We also thank Dr. Marcelo Júnior Zanda for providing the clinical images.
The authors declare they do not have conflict of interest.
Ove Odredbe i uvjeti ističu pravila i regulacije u svezi korištenja IntechOpenove stranice www.intechopen.com i svih poddomena u vlasništvu IntechOpena, tvrtke sa sjedištem u 5 Princes Gate Court, London, SW7 2QJ, Ujedinjeno Kraljevstvo.
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\\n\\nSljedeća terminologija odnosi se na Odredbe i uvjete, te na sve naše ugovore:
\\n\\nKlijent, stranka, vi, vaš odnosi se na vas, osobu koja pristupa ovoj stranici i prihvaća IntechOpenove Odredbe i uvjete;
\\n\\nKompanija, tvrtka, mi, naše odnosi se na tvrtku IntechOpen;
\\n\\nStranke, strane odnosi se na klijenta i na nas, ili samo na klijenta ili nas.
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\\n\\nMi koristimo kolačiće. Korištenjem IntechOpenove stranice slažete se s korištenjem kolačića u skladu s IntechOpenovom Politikom privatnosti. Većina modernih, interaktivnih stranica koristi kolačiće kako bi omogućila ponovno pronalaženje korisničkih detalja kod svakog posjeta. Na našoj stranici kolačići se uglavnom koriste kako bi omogućili funkcionalnost i olakšali posjetiteljima korištenje stranice.
\\n\\nIntechOpen ili njegovi suradnici niti u jednom slučaju neće biti odgovorni za štete (štete uključuju gubitak podataka ili profita, druge poslovne prekide, te sve ostale štete) koje nastanu zbog korištenja materijala na IntechOpenovoj stranici ili nemogućnosti da se iste koriste, čak i ako je IntechOpen ili njegov predstavnik o takvoj šteti obaviješten pismenim ili usmenim putem. Neke jurisdikcije ne dozvoljavaju ograničenja garancija ili ograničenja obveza za posljedične ili slučajne štete pa se u tom slučaju ova ograničenja možda ne odnose na vas.
\\n\\nMaterijali koji se pojavljuju na IntechOpenovoj stranici mogu sadržavati manje greške, tipfelere ili fotografske greške. IntechOpen može napraviti promjene na bilo kojem materijalu koji se nalazi na stranici u bilo koje vrijeme.
\\n\\nIntechOpen nije formalno povezan niti s jednom vanjskom stranicom čije poveznice vode na www.intechopen.com, osim ako to nije izravno navedeno. Iz tog razloga IntechOpen nije odgovoran za sadržaj koji se pojavljuje na takvim stranicama. Poveznica na IntechOpenovu stranicu ne implicira povezanost sa IntechOpenom. Korištenje takvih poveznica isključiva je odgovornost korisnika.
\\n\\nZadržavamo pravo vlasništva nad cjelokupnom stranicom www.intechopen.com i nad svim materijalom na toj stranici. Koristeći se našim uslugama, slažete se da maknete sve poveznice na našu stranicu odmah nakon što to od vas zatražimo. Također, zadržavamo pravo da ove Odredbe i uvjete, i politiku o poveznicama izmjenimo u bilo koje vrijeme. Koristeći se poveznicama na naše stranice slažete se s ovim Odredbama i uvjetima.
\\n\\nAko smatrate da je bilo koja poveznica na našoj stranici sumnjiva iz bilo kojeg razloga, molimo vas da nas kontaktirate. U tom slučaju razmotrit ćemo micanje poveznice s naše stranice, iako nismo obvezni to napraviti.
\\n\\nBez prethodne privole i izričite pisane dozvole, ne možete stvarati okvire oko naših stranica ili koristiti druge tehnike koje na bilo koji način mogu promijeniti prezentaciju ili izgled naše stranice.
\\n\\nIntechOpen može ove Odredbe izmijeniti u bilo koje vrijeme i bez prethodne obavijesti. Koristeći ovu stranicu vi se slažete s trenutnim Odredbama i uvjetima koje su na snazi.
\\n\\nOve Odredbe i uvjeti su sastavljeni u skladu s odredbama prava Ujedinjenog Kraljevstva, a za sve sporove nadležan je sud u Londonu, Ujedinjeno Kraljevstvo.
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\n\nSljedeća terminologija odnosi se na Odredbe i uvjete, te na sve naše ugovore:
\n\nKlijent, stranka, vi, vaš odnosi se na vas, osobu koja pristupa ovoj stranici i prihvaća IntechOpenove Odredbe i uvjete;
\n\nKompanija, tvrtka, mi, naše odnosi se na tvrtku IntechOpen;
\n\nStranke, strane odnosi se na klijenta i na nas, ili samo na klijenta ili nas.
\n\nSve odredbe koje se odnose na ponudu, prihvat ili razmatranje plaćanja, a za koja mi pružamo asistenciju klijentu, bilo na ugovoreni ili fiksni način, a s ciljem da se ostvare potrebe i želje klijenta u svezi s našim uslugama, su podložne zakonskim odredbama Ujedinjenog Kraljevstva.
\n\nOsim ako nije suprotno navedeno, IntechOpen i/ili svi davatelji licence vlasnici su intelektualnog vlasništva nad svim materijalima na www.intechopen.com. Sva prava intelektualnog vlasništva su pridržana. Stranice sa www.intechopen.com možete gledati, preuzimati, dijeliti, dijeliti poveznice i printati za osobnu uporabu, a temeljem pravila sadržanih u ovim Odredbama i uvjetima.
\n\nMi koristimo kolačiće. Korištenjem IntechOpenove stranice slažete se s korištenjem kolačića u skladu s IntechOpenovom Politikom privatnosti. Većina modernih, interaktivnih stranica koristi kolačiće kako bi omogućila ponovno pronalaženje korisničkih detalja kod svakog posjeta. Na našoj stranici kolačići se uglavnom koriste kako bi omogućili funkcionalnost i olakšali posjetiteljima korištenje stranice.
\n\nIntechOpen ili njegovi suradnici niti u jednom slučaju neće biti odgovorni za štete (štete uključuju gubitak podataka ili profita, druge poslovne prekide, te sve ostale štete) koje nastanu zbog korištenja materijala na IntechOpenovoj stranici ili nemogućnosti da se iste koriste, čak i ako je IntechOpen ili njegov predstavnik o takvoj šteti obaviješten pismenim ili usmenim putem. Neke jurisdikcije ne dozvoljavaju ograničenja garancija ili ograničenja obveza za posljedične ili slučajne štete pa se u tom slučaju ova ograničenja možda ne odnose na vas.
\n\nMaterijali koji se pojavljuju na IntechOpenovoj stranici mogu sadržavati manje greške, tipfelere ili fotografske greške. IntechOpen može napraviti promjene na bilo kojem materijalu koji se nalazi na stranici u bilo koje vrijeme.
\n\nIntechOpen nije formalno povezan niti s jednom vanjskom stranicom čije poveznice vode na www.intechopen.com, osim ako to nije izravno navedeno. Iz tog razloga IntechOpen nije odgovoran za sadržaj koji se pojavljuje na takvim stranicama. Poveznica na IntechOpenovu stranicu ne implicira povezanost sa IntechOpenom. Korištenje takvih poveznica isključiva je odgovornost korisnika.
\n\nZadržavamo pravo vlasništva nad cjelokupnom stranicom www.intechopen.com i nad svim materijalom na toj stranici. Koristeći se našim uslugama, slažete se da maknete sve poveznice na našu stranicu odmah nakon što to od vas zatražimo. Također, zadržavamo pravo da ove Odredbe i uvjete, i politiku o poveznicama izmjenimo u bilo koje vrijeme. Koristeći se poveznicama na naše stranice slažete se s ovim Odredbama i uvjetima.
\n\nAko smatrate da je bilo koja poveznica na našoj stranici sumnjiva iz bilo kojeg razloga, molimo vas da nas kontaktirate. U tom slučaju razmotrit ćemo micanje poveznice s naše stranice, iako nismo obvezni to napraviti.
\n\nBez prethodne privole i izričite pisane dozvole, ne možete stvarati okvire oko naših stranica ili koristiti druge tehnike koje na bilo koji način mogu promijeniti prezentaciju ili izgled naše stranice.
\n\nIntechOpen može ove Odredbe izmijeniti u bilo koje vrijeme i bez prethodne obavijesti. Koristeći ovu stranicu vi se slažete s trenutnim Odredbama i uvjetima koje su na snazi.
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\n"}]},successStories:{items:[]},authorsAndEditors:{filterParams:{},profiles:[{id:"396",title:"Dr.",name:"Vedran",middleName:null,surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/396/images/7281_n.png",biography:"After obtaining his Master's degree in Mechanical Engineering he continued his education at the Vienna University of Technology where he obtained his PhD degree in 2004. He worked as a researcher at the Automation and Control Institute, Faculty of Electrical Engineering, Vienna University of Technology until 2008. His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. He has contributed in stochastic estimation of control area especially, in the Multiple Target Tracking and Interactive Multiple Model (IMM) research, Ball & Beam Control Problem, Robotics, Levitation Control. He has contributed in developing Algorithms for Fingerprint Matching, Computer Vision and Face Recognition. He has been supervising Pattern Recognition, Formal Languages and Distributed Processing projects for several years. He has reviewed many books on Management, Computer Science. Currently, he is an active and permanent reviewer for many international conferences and symposia and the program committee member for many international conferences.\nIn teaching he has taught the core computer science subjects like, Digital Design, Real Time Embedded System Programming, Operating Systems, Software Engineering, Data Structures, Databases, Compiler Construction. 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This chapter aims specifically at the mechanism of solubility of polysaccharides from the molecular level. General understandings of the solubility including definition, testing methods, and the solution behaviors were provided; the relationships between polysaccharide solubility and the structural features in terms of molecular weight, degree of branching, charging properties, chain flexibility, and the special groups were all discussed. With all the information provided, the molecular modification and further applications of polysaccharides in both food and nonfood areas could be promoted.",book:{id:"5935",slug:"solubility-of-polysaccharides",title:"Solubility of Polysaccharides",fullTitle:"Solubility of Polysaccharides"},signatures:"Mark Q. 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Mainly, the versatile techniques of ultra−/high-performance liquid chromatography (UPLC/HPLC) are in use for the analysis of assay and organic impurities/related substances/degradation products of a drug substance or drug product or intermediate or raw material of pharmaceuticals. A suitable analytical method is developed only after evaluating the major and critical separation parameters of chromatography (examples for UPLC/HPLC are selection of diluent, wavelength, detector, stationary phase, column temperature, flow rate, solvent system, elution mode, and injection volume, etc.). The analytical method development is a process of proving the developed analytical method is suitable for its intended use for the quantitative estimation of the targeted analyte present in pharmaceutical drugs. And it mostly plays a vital role in the development and manufacture of pharmaceuticals drugs.",book:{id:"8912",slug:"biochemical-analysis-tools-methods-for-bio-molecules-studies",title:"Biochemical Analysis Tools",fullTitle:"Biochemical Analysis Tools - Methods for Bio-Molecules Studies"},signatures:"Narasimha S. 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RNA‐seq data analyses typically consist of (1) accurate mapping of millions of short sequencing reads to a reference genome, including the identification of splicing events; (2) quantifying expression levels of genes, transcripts, and exons; (3) differential analysis of gene expression among different biological conditions; and (4) biological interpretation of differentially expressed genes. Despite the fact that multiple algorithms pertinent to basic analyses have been developed, there are still a variety of unresolved questions. In this chapter, we review the main tools and algorithms currently available for RNA‐seq data analyses, and our goal is to help RNA‐seq data analysts to make an informed choice of tools in practical RNA‐seq data analysis. In the meantime, RNA‐seq is evolving rapidly, and newer sequencing technologies are briefly introduced, including stranded RNA‐seq, targeted RNA‐seq, and single‐cell RNA‐seq.",book:{id:"5160",slug:"bioinformatics-updated-features-and-applications",title:"Bioinformatics",fullTitle:"Bioinformatics - Updated Features and Applications"},signatures:"Shanrong Zhao, Baohong Zhang, Ying Zhang, William Gordon,\nSarah Du, Theresa Paradis, Michael Vincent and David von Schack",authors:[{id:"176364",title:"Dr.",name:"Shanrong",middleName:null,surname:"Zhao",slug:"shanrong-zhao",fullName:"Shanrong Zhao"}]},{id:"49873",title:"An Introduction to Actinobacteria",slug:"an-introduction-to-actinobacteria",totalDownloads:8178,totalCrossrefCites:33,totalDimensionsCites:108,abstract:"Actinobacteria, which share the characteristics of both bacteria and fungi, are widely distributed in both terrestrial and aquatic ecosystems, mainly in soil, where they play an essential role in recycling refractory biomaterials by decomposing complex mixtures of polymers in dead plants and animals and fungal materials. They are considered as the biotechnologically valuable bacteria that are exploited for its secondary metabolite production. Approximately, 10,000 bioactive metabolites are produced by Actinobacteria, which is 45% of all bioactive microbial metabolites discovered. Especially Streptomyces species produce industrially important microorganisms as they are a rich source of several useful bioactive natural products with potential applications. Though it has various applications, some Actinobacteria have its own negative effect against plants, animals, and humans. On this context, this chapter summarizes the general characteristics of Actinobacteria, its habitat, systematic classification, various biotechnological applications, and negative impact on plants and animals.",book:{id:"5056",slug:"actinobacteria-basics-and-biotechnological-applications",title:"Actinobacteria",fullTitle:"Actinobacteria - Basics and Biotechnological Applications"},signatures:"Ranjani Anandan, Dhanasekaran Dharumadurai and Gopinath\nPonnusamy Manogaran",authors:[{id:"48914",title:"Dr.",name:"Dharumadurai",middleName:null,surname:"Dhanasekaran",slug:"dharumadurai-dhanasekaran",fullName:"Dharumadurai Dhanasekaran"}]},{id:"72074",title:"The Chemistry Behind Plant DNA Isolation Protocols",slug:"the-chemistry-behind-plant-dna-isolation-protocols",totalDownloads:3797,totalCrossrefCites:4,totalDimensionsCites:7,abstract:"Various plant species are biochemically heterogeneous in nature, a single deoxyribose nucleic acid (DNA) isolation protocol may not be suitable. There have been continuous modification and standardization in DNA isolation protocols. Most of the plant DNA isolation protocols used today are modified versions of hexadecyltrimethyl-ammonium bromide (CTAB) extraction procedure. Modification is usually performed in the concentration of chemicals used during the extraction procedure according to the plant species and plant part used. Thus, understanding the role of each chemical (viz. CTAB, NaCl, PVP, ethanol, and isopropanol) used during the DNA extraction procedure will benefit to set or modify protocols for more precisions. A review of the chemicals used in the CTAB method of DNA extraction and their probable functions on the highly evolved yet complex to students and researchers has been summarized.",book:{id:"8912",slug:"biochemical-analysis-tools-methods-for-bio-molecules-studies",title:"Biochemical Analysis Tools",fullTitle:"Biochemical Analysis Tools - Methods for Bio-Molecules Studies"},signatures:"Jina Heikrujam, Rajkumar Kishor and Pranab Behari Mazumder",authors:[{id:"74521",title:"Dr.",name:"Rajkumar",middleName:null,surname:"Kishor",slug:"rajkumar-kishor",fullName:"Rajkumar Kishor"},{id:"309357",title:"Prof.",name:"Pranab Behari",middleName:null,surname:"Mazumder",slug:"pranab-behari-mazumder",fullName:"Pranab Behari Mazumder"},{id:"318351",title:"Ph.D. Student",name:"Jina",middleName:null,surname:"Heikrujam",slug:"jina-heikrujam",fullName:"Jina Heikrujam"}]}],onlineFirstChaptersFilter:{topicId:"6",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"83015",title:"Acute Changes in Lipoprotein-Associated Oxidative Stress",slug:"acute-changes-in-lipoprotein-associated-oxidative-stress",totalDownloads:0,totalDimensionsCites:null,doi:"10.5772/intechopen.106489",abstract:"As inflammatory and oxidative stress are associated with cardiometabolic diseases, detection of abnormal fasting levels of inflammatory and oxidative biomarkers are indicative disease presence and may be too late for any preventive management. Metabolic flexibility refers to the ability of various metabolic processes to compensate for these acute changes and return all metabolites to baseline levels. By monitoring responses of key biomarkers to a standardized physiologic challenge, it is possible to assess the ability of the body to restore homeostasis, that is a measure of metabolic flexibility. Acute changes in lipoprotein-associated biomarkers of oxidative stress have been demonstrated following meal consumption. These include changes in circulating levels of oxidized low-density lipoproteins (LDL), levels of autoantibodies to malondialdehyde-modified LDL, as well as the oxidative susceptibility of isolated plasma LDL. These responses depend on the type and amount of dietary fats in the meal. Management with certain lipid-lowering drugs could also be shown to affect these meal-induced changes. However, plasma levels may be underestimated as we can demonstrate a spike in lipoprotein-associated biomarkers of oxidative stress resulting from the release oxidatively modified epitopes from the arterial wall by an intravenous bolus of heparin.",book:{id:"11671",title:"Importance of Oxidative Stress and Antioxidant System in Health and Disease",coverURL:"https://cdn.intechopen.com/books/images_new/11671.jpg"},signatures:"Ngoc-Anh Le"},{id:"83041",title:"Responses of Endoplasmic Reticulum to Plant Stress",slug:"responses-of-endoplasmic-reticulum-to-plant-stress",totalDownloads:0,totalDimensionsCites:null,doi:"10.5772/intechopen.106590",abstract:"Global climate change has resulted in alterations in the biotic and abiotic conditions of the planet. This has led to changes in the agricultural system resulting from reduced water availability, increased temperature increase in the population and occurrences of pests and diseases. Plants are adversely affected when they experience any stress retarding their growth, development and productivity. Endoplasmic Reticulum (ER) is an organelle that shows a tremendous response when subjected to stress conditions. Therefore, to explore and comprehend plants’ multidimensional interactions when subjected to stress conditions, an insight into the molecular stress signalling in the ER in response to the stress situation is discussed in this chapter.",book:{id:"11674",title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg"},signatures:"Vishwa Jyoti Baruah, Bhaswati Sarmah, Manny Saluja and Elizabeth H. Mahood"},{id:"83046",title:"Gene Expression and Transcriptome Sequencing: Basics, Analysis, Advances",slug:"gene-expression-and-transcriptome-sequencing-basics-analysis-advances",totalDownloads:2,totalDimensionsCites:0,doi:"10.5772/intechopen.105929",abstract:"Gene expression studies are extremely useful for understanding a broad range of biological, physiological, and molecular responses. The techniques for gene expression reflect differential patterns of gene regulation and have evolved with time from detecting one gene to many genes at a time laterally. Gene expression depends on the spatiotemporal expression in a particular tissue at a given time point and needs critical examination and interpretation. Transcriptome sequencing or RNA-seq using next-generation sequencing (short and long reads) is the most widely deployed technology for accurate quantification of gene expression. According to the biological aim of the experiment, replications, platform, and chemistries, propelling improvement has been demonstrated and documented using RNA-seq in plants, humans, animals, and clinical sciences with respect to gene expression of mRNA, small non-coding, long non-coding RNAs, alternative splice variations, isoform variations, gene fusions, single-nucleotide variants. Integrating transcriptome sequencing with other techniques such as chromatin immunoprecipitation, methylation, genome-wide association studies, manifests insights into genetic and epigenetic regulation. Epi-transcriptome including RNA methylation, modification, and alternative polyadenylation events can also be explored through long-read sequencing. In this chapter, we have presented an account of the basics of gene expression methods, transcriptome sequencing, and the various methodologies involved in the downstream analysis.",book:{id:"11349",title:"Gene Expression",coverURL:"https://cdn.intechopen.com/books/images_new/11349.jpg"},signatures:"Yogesh Shukla, Amol Phule, Harshvardhan Zala, Nakul D. Magar, Priya Shah, K. Harish, Tejas C. Bosamia, Kalyani M. Barbadikar, Maganti Sheshu Madhav, Satendra Kumar Mangrauthia, Chirravuri Naga Neeraja and Raman Meenakshi Sundaram"},{id:"83043",title:"Applications of CRISPR/Cas9 for Selective Sequencing and Clinical Diagnostics",slug:"applications-of-crispr-cas9-for-selective-sequencing-and-clinical-diagnostics",totalDownloads:6,totalDimensionsCites:0,doi:"10.5772/intechopen.106548",abstract:"In this chapter, we will discuss the applications of CRISPR/Cas9 in the context of clinical diagnostics. We will provide an overview of existing methods and their use cases in the diagnostic field. Special attention will be given to selective sequencing approaches using third-generation sequencing and PAM-site requirements. As target sequences in an AT-rich environment cannot easily be accessed by the commercially available SpCas9 due to rarity of NGG PAM-sites, new enzymes such as ScCas9 with PAM-site requirements of NNG will be highlighted. Original research on CRISPR/Cas9 systems to determine molecular glioma markers by enriching regions of interest will be discussed in the context of potential future applications in clinical diagnostics.",book:{id:"11804",title:"CRISPR Technology",coverURL:"https://cdn.intechopen.com/books/images_new/11804.jpg"},signatures:"Maximilian Evers, Björn Brändl, Franz-Josef Müller, Sönke Friedrichsen and Stephan Kolkenbrock"},{id:"82914",title:"Glance on the Critical Role of IL-23 Receptor Gene Variations in Inflammation-Induced Carcinogenesis",slug:"glance-on-the-critical-role-of-il-23-receptor-gene-variations-in-inflammation-induced-carcinogenesis",totalDownloads:15,totalDimensionsCites:0,doi:"10.5772/intechopen.105049",abstract:"In this chapter, we will discuss the importance of genetic variations in the IL-23 receptor (IL-23R) gene in driving the process of inflammation-induced carcinogenesis. By applying bladder cancer (BLC) as a model, we will focus on two contradictory genetic mutations within the receptor gene. The first one is enhanced by cancer and induces inflammation-induced carcinogenesis via up-regulating IL-23/IL-17 inflammatory axis. However, the other preventive one deregulates this inflammatory pathway by distorting the protein nature of the receptor, leading to block its binding affinity. During the process of carcinogenesis, cancer genetically inclines the balance towards the protumor, via over-expressing the IL-23R on the surfaces of immune-bearing cells, particularly tumor-associated monocytes (TAMs) and thus increasing the levels of pro-angiogenic cytokines IL-23 and IL-17.",book:{id:"11672",title:"Chemokines Updates",coverURL:"https://cdn.intechopen.com/books/images_new/11672.jpg"},signatures:"Mohammed El-Gedamy"},{id:"82259",title:"p53 Tumor Suppressor: Functional Regulation and Role in Gene Therapy",slug:"p53-tumor-suppressor-functional-regulation-and-role-in-gene-therapy",totalDownloads:7,totalDimensionsCites:0,doi:"10.5772/intechopen.105029",abstract:"p53, a homo-tetrameric protein found in mammalian cells, derives its name from the fact that it settles at around 53KDa position in SDS-PAGE, due to a “kink” in its structure. In its functional state, p53 forms a homo-tetramer and binds to the promoters of a wide array of genes. Binding of p53 downregulates the transcription of target genes. Most of the gene targets of p53 are involved in cell cycle progression, and therefore, any malfunctions associated with p53 have catastrophic consequences for the cell. The gene encoding for p53 known as TP53 is the most well-studied gene in the entire genome because of being the most highly mutated gene in all cancer types. It is due to this widely accepted and documented “cell protective feature” that p53 is generally referred to as “the guardian of the genome.” In this chapter, we will discuss the involvement of p53 in relation to carcinogenesis. We will also cover the major functions of p53 under normal conditions, major mutations of the TP53 gene, and their association with different forms of cancer.",book:{id:"10246",title:"P53 - A Guardian of the Genome and Beyond",coverURL:"https://cdn.intechopen.com/books/images_new/10246.jpg"},signatures:"Zeenat Farooq, Shahnawaz Wani, Vijay Avin BR, Rakesh Kochhar and Mumtaz Anwar"}],onlineFirstChaptersTotal:81},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:11,numberOfPublishedChapters:91,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:332,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:11,numberOfPublishedChapters:143,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:124,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:23,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403",scope:"Artificial Intelligence (AI) is a rapidly developing multidisciplinary research area that aims to solve increasingly complex problems. In today's highly integrated world, AI promises to become a robust and powerful means for obtaining solutions to previously unsolvable problems. This Series is intended for researchers and students alike interested in this fascinating field and its many applications.",coverUrl:"https://cdn.intechopen.com/series/covers/14.jpg",latestPublicationDate:"August 17th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:11,editor:{id:"218714",title:"Prof.",name:"Andries",middleName:null,surname:"Engelbrecht",slug:"andries-engelbrecht",fullName:"Andries Engelbrecht",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNR8QAO/Profile_Picture_1622640468300",biography:"Andries Engelbrecht received the Masters and PhD degrees in Computer Science from the University of Stellenbosch, South Africa, in 1994 and 1999 respectively. He is currently appointed as the Voigt Chair in Data Science in the Department of Industrial Engineering, with a joint appointment as Professor in the Computer Science Division, Stellenbosch University. Prior to his appointment at Stellenbosch University, he has been at the University of Pretoria, Department of Computer Science (1998-2018), where he was appointed as South Africa Research Chair in Artifical Intelligence (2007-2018), the head of the Department of Computer Science (2008-2017), and Director of the Institute for Big Data and Data Science (2017-2018). In addition to a number of research articles, he has written two books, Computational Intelligence: An Introduction and Fundamentals of Computational Swarm Intelligence.",institutionString:null,institution:{name:"Stellenbosch University",institutionURL:null,country:{name:"South Africa"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:6,paginationItems:[{id:"22",title:"Applied Intelligence",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",isOpenForSubmission:!0,editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",slug:"carlos-travieso-gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",biography:"Carlos M. Travieso-González received his MSc degree in Telecommunication Engineering at Polytechnic University of Catalonia (UPC), Spain in 1997, and his Ph.D. degree in 2002 at the University of Las Palmas de Gran Canaria (ULPGC-Spain). He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. He won the “Catedra Telefonica” Awards in Modality of Knowledge Transfer, 2017, 2018, and 2019 editions, and awards in Modality of COVID Research in 2020.\n\nPublic References:\nResearcher ID http://www.researcherid.com/rid/N-5967-2014\nORCID https://orcid.org/0000-0002-4621-2768 \nScopus Author ID https://www.scopus.com/authid/detail.uri?authorId=6602376272\nScholar Google https://scholar.google.es/citations?user=G1ks9nIAAAAJ&hl=en \nResearchGate https://www.researchgate.net/profile/Carlos_Travieso",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"23",title:"Computational Neuroscience",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",isOpenForSubmission:!0,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null},{id:"24",title:"Computer Vision",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",isOpenForSubmission:!0,editor:{id:"294154",title:"Prof.",name:"George",middleName:null,surname:"Papakostas",slug:"george-papakostas",fullName:"George Papakostas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hYaGbQAK/Profile_Picture_1624519712088",biography:"George A. Papakostas has received a diploma in Electrical and Computer Engineering in 1999 and the M.Sc. and Ph.D. degrees in Electrical and Computer Engineering in 2002 and 2007, respectively, from the Democritus University of Thrace (DUTH), Greece. Dr. Papakostas serves as a Tenured Full Professor at the Department of Computer Science, International Hellenic University, Greece. Dr. Papakostas has 10 years of experience in large-scale systems design as a senior software engineer and technical manager, and 20 years of research experience in the field of Artificial Intelligence. Currently, he is the Head of the “Visual Computing” division of HUman-MAchines INteraction Laboratory (HUMAIN-Lab) and the Director of the MPhil program “Advanced Technologies in Informatics and Computers” hosted by the Department of Computer Science, International Hellenic University. He has (co)authored more than 150 publications in indexed journals, international conferences and book chapters, 1 book (in Greek), 3 edited books, and 5 journal special issues. His publications have more than 2100 citations with h-index 27 (GoogleScholar). His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. Dr Ventura also holds the positions of Affiliated Professor at Virginia Commonwealth University (Richmond, USA) and Distinguished Adjunct Professor at King Abdulaziz University (Jeddah, Saudi Arabia). Additionally, he is deputy director of the Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI) and heads the Knowledge Discovery and Intelligent Systems Research Laboratory. He has published more than ten books and over 300 articles in journals and scientific conferences. Currently, his work has received over 18,000 citations according to Google Scholar, including more than 2200 citations in 2020. In the last five years, he has published more than 60 papers in international journals indexed in the JCR (around 70% of them belonging to first quartile journals) and he has edited some Springer books “Supervised Descriptive Pattern Mining” (2018), “Multiple Instance Learning - Foundations and Algorithms” (2016), and “Pattern Mining with Evolutionary Algorithms” (2016). He has also been involved in more than 20 research projects supported by the Spanish and Andalusian governments and the European Union. He currently belongs to the editorial board of PeerJ Computer Science, Information Fusion and Engineering Applications of Artificial Intelligence journals, being also associate editor of Applied Computational Intelligence and Soft Computing and IEEE Transactions on Cybernetics. Finally, he is editor-in-chief of Progress in Artificial Intelligence. He is a Senior Member of the IEEE Computer, the IEEE Computational Intelligence, and the IEEE Systems, Man, and Cybernetics Societies, and the Association of Computing Machinery (ACM). Finally, his main research interests include data science, computational intelligence, and their applications.",institutionString:null,institution:{name:"University of Córdoba",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"26",title:"Machine Learning and Data Mining",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",isOpenForSubmission:!0,editor:{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. His research interests include intelligent and embedded systems.",institutionString:"Universidad Autonoma de Queretaro",institution:{name:"Autonomous University of Queretaro",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null},{id:"27",title:"Multi-Agent Systems",coverUrl:"https://cdn.intechopen.com/series_topics/covers/27.jpg",isOpenForSubmission:!0,editor:{id:"148497",title:"Dr.",name:"Mehmet",middleName:"Emin",surname:"Aydin",slug:"mehmet-aydin",fullName:"Mehmet Aydin",profilePictureURL:"https://mts.intechopen.com/storage/users/148497/images/system/148497.jpg",biography:"Dr. Mehmet Emin Aydin is a Senior Lecturer with the Department of Computer Science and Creative Technology, the University of the West of England, Bristol, UK. His research interests include swarm intelligence, parallel and distributed metaheuristics, machine learning, intelligent agents and multi-agent systems, resource planning, scheduling and optimization, combinatorial optimization. Dr. Aydin is currently a Fellow of Higher Education Academy, UK, a member of EPSRC College, a senior member of IEEE and a senior member of ACM. In addition to being a member of advisory committees of many international conferences, he is an Editorial Board Member of various peer-reviewed international journals. He has served as guest editor for a number of special issues of peer-reviewed international journals.",institutionString:null,institution:{name:"University of the West of England",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null}]},overviewPageOFChapters:{paginationCount:6,paginationItems:[{id:"82526",title:"Deep Multiagent Reinforcement Learning Methods Addressing the Scalability Challenge",doi:"10.5772/intechopen.105627",signatures:"Theocharis Kravaris and George A. Vouros",slug:"deep-multiagent-reinforcement-learning-methods-addressing-the-scalability-challenge",totalDownloads:19,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Multi-Agent Technologies and Machine Learning",coverURL:"https://cdn.intechopen.com/books/images_new/11445.jpg",subseries:{id:"27",title:"Multi-Agent Systems"}}},{id:"82196",title:"Multi-Features Assisted Age Invariant Face Recognition and Retrieval Using CNN with Scale Invariant Heat Kernel Signature",doi:"10.5772/intechopen.104944",signatures:"Kamarajugadda Kishore Kumar and Movva Pavani",slug:"multi-features-assisted-age-invariant-face-recognition-and-retrieval-using-cnn-with-scale-invariant-",totalDownloads:14,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Pattern Recognition - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/11442.jpg",subseries:{id:"26",title:"Machine Learning and Data Mining"}}},{id:"82063",title:"Evaluating Similarities and Differences between Machine Learning and Traditional Statistical Modeling in Healthcare Analytics",doi:"10.5772/intechopen.105116",signatures:"Michele Bennett, Ewa J. Kleczyk, Karin Hayes and Rajesh Mehta",slug:"evaluating-similarities-and-differences-between-machine-learning-and-traditional-statistical-modelin",totalDownloads:7,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Machine Learning and Data Mining - Annual Volume 2022",coverURL:"https://cdn.intechopen.com/books/images_new/11422.jpg",subseries:{id:"26",title:"Machine Learning and Data Mining"}}},{id:"81791",title:"Self-Supervised Contrastive Representation Learning in Computer Vision",doi:"10.5772/intechopen.104785",signatures:"Yalin Bastanlar and Semih Orhan",slug:"self-supervised-contrastive-representation-learning-in-computer-vision",totalDownloads:59,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Pattern Recognition - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/11442.jpg",subseries:{id:"26",title:"Machine Learning and Data Mining"}}}]},overviewPagePublishedBooks:{paginationCount:11,paginationItems:[{type:"book",id:"7723",title:"Artificial Intelligence",subtitle:"Applications in Medicine and Biology",coverURL:"https://cdn.intechopen.com/books/images_new/7723.jpg",slug:"artificial-intelligence-applications-in-medicine-and-biology",publishedDate:"July 31st 2019",editedByType:"Edited by",bookSignature:"Marco Antonio Aceves-Fernandez",hash:"a3852659e727f95c98c740ed98146011",volumeInSeries:1,fullTitle:"Artificial Intelligence - Applications in Medicine and Biology",editors:[{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. His research interests include intelligent and embedded systems.",institutionString:"Universidad Autonoma de Queretaro",institution:{name:"Autonomous University of Queretaro",institutionURL:null,country:{name:"Mexico"}}}]},{type:"book",id:"7726",title:"Swarm Intelligence",subtitle:"Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/7726.jpg",slug:"swarm-intelligence-recent-advances-new-perspectives-and-applications",publishedDate:"December 4th 2019",editedByType:"Edited by",bookSignature:"Javier Del Ser, Esther Villar and Eneko Osaba",hash:"e7ea7e74ce7a7a8e5359629e07c68d31",volumeInSeries:2,fullTitle:"Swarm Intelligence - Recent Advances, New Perspectives and Applications",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",institution:{name:"Tecnalia",institutionURL:null,country:{name:"Spain"}}}]},{type:"book",id:"7656",title:"Fuzzy Logic",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7656.jpg",slug:"fuzzy-logic",publishedDate:"February 5th 2020",editedByType:"Edited by",bookSignature:"Constantin Volosencu",hash:"54f092d4ffe0abf5e4172a80025019bc",volumeInSeries:3,fullTitle:"Fuzzy Logic",editors:[{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",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}]},{type:"book",id:"9963",title:"Advances and Applications in Deep Learning",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/9963.jpg",slug:"advances-and-applications-in-deep-learning",publishedDate:"December 9th 2020",editedByType:"Edited by",bookSignature:"Marco Antonio Aceves-Fernandez",hash:"0d51ba46f22e55cb89140f60d86a071e",volumeInSeries:4,fullTitle:"Advances and Applications in Deep Learning",editors:[{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. 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Ribeiro-Barros",profilePictureURL:"https://mts.intechopen.com/storage/users/171036/images/system/171036.jpg",institutionString:"University of Lisbon",institution:{name:"University of Lisbon",institutionURL:null,country:{name:"Portugal"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Sustainable Economy and Fair Society",value:91,count:1}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:1}],authors:{paginationCount:250,paginationItems:[{id:"274452",title:"Dr.",name:"Yousif",middleName:"Mohamed",surname:"Abdallah",slug:"yousif-abdallah",fullName:"Yousif Abdallah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274452/images/8324_n.jpg",biography:"I certainly enjoyed my experience in Radiotherapy and Nuclear Medicine, particularly it has been in different institutions and hospitals with different Medical Cultures and allocated resources. Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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