Factors Predisposing to Patellofemoral Instability
\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"8852",leadTitle:null,fullTitle:"Chemistry and Applications of Benzimidazole and its Derivatives",title:"Chemistry and Applications of Benzimidazole and its Derivatives",subtitle:null,reviewType:"peer-reviewed",abstract:"Finding new strategies for synthesizing benzimidazole derivatives and functionalizing the benzimidazole core has proved to be important due to the compound's various applications in medicine, chemistry, and other areas. The multitude of benzimidazole derivatives marketed as drugs has led to intensive research in the field for the discovery of new biologically active structures. The general applications of benzimidazole derivatives in materials chemistry, electronics, technology, dyes, pigments, and agriculture open up new research horizons. This book guides the rational design of benzimidazole derivatives synthesis with certain applications. Chapters cover such topics as therapeutic use of benzimidazole in conditions like diabetes, viruses, and parasitic diseases; X-ray crystal structure of selected benzimidazole derivatives; benzimidazole compounds for cancer therapy; and others.",isbn:"978-1-78984-553-2",printIsbn:"978-1-78984-552-5",pdfIsbn:"978-1-83962-241-0",doi:"10.5772/intechopen.81426",price:119,priceEur:129,priceUsd:155,slug:"chemistry-and-applications-of-benzimidazole-and-its-derivatives",numberOfPages:228,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"e95984a2b87df5a7ca051cb3345d5e7a",bookSignature:"Maria Marinescu",publishedDate:"October 2nd 2019",coverURL:"https://cdn.intechopen.com/books/images_new/8852.jpg",numberOfDownloads:11636,numberOfWosCitations:23,numberOfCrossrefCitations:12,numberOfCrossrefCitationsByBook:6,numberOfDimensionsCitations:27,numberOfDimensionsCitationsByBook:9,hasAltmetrics:1,numberOfTotalCitations:62,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 30th 2018",dateEndSecondStepPublish:"December 12th 2018",dateEndThirdStepPublish:"February 10th 2019",dateEndFourthStepPublish:"May 1st 2019",dateEndFifthStepPublish:"June 30th 2019",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"250975",title:"Ph.D.",name:"Maria",middleName:null,surname:"Marinescu",slug:"maria-marinescu",fullName:"Maria Marinescu",profilePictureURL:"https://mts.intechopen.com/storage/users/250975/images/system/250975.jpg",biography:"Maria Marinescu received her PhD in 2010 from the University of Bucharest, under the supervision of Prof. Mihaela Hillebrand, studying the chemistry and the electronic structure of the 1,2,3,4,5,6,7,8-octahydroacridine compounds, as a key structures for the new biomolecules and hydrogen-bonding receptors. Dr Maria Marinescu is currently an Assistant Professor at the University of Bucharest, Department of Organic Chemistry, Biochemistry and Catalysis and her current research interests are in organic synthesis of various heterocycles with applications in medicinal and materials chemistry, DFT studies in organic molecules related with their biological properties and applications of organic materials in art and archaeology.",institutionString:"University of Bucharest",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"University of Bucharest",institutionURL:null,country:{name:"Romania"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"384",title:"Chemical Biology",slug:"chemical-biology"}],chapters:[{id:"67827",title:"Introductory Chapter: Short Insight in Synthesis and Applications of Benzimidazole and Its Derivatives",doi:"10.5772/intechopen.87174",slug:"introductory-chapter-short-insight-in-synthesis-and-applications-of-benzimidazole-and-its-derivative",totalDownloads:982,totalCrossrefCites:2,totalDimensionsCites:4,hasAltmetrics:0,abstract:null,signatures:"Maria Marinescu",downloadPdfUrl:"/chapter/pdf-download/67827",previewPdfUrl:"/chapter/pdf-preview/67827",authors:[{id:"250975",title:"Ph.D.",name:"Maria",surname:"Marinescu",slug:"maria-marinescu",fullName:"Maria Marinescu"}],corrections:null},{id:"67843",title:"Catalytic Intermolecular Functionalization of Benzimidazoles",doi:"10.5772/intechopen.87068",slug:"catalytic-intermolecular-functionalization-of-benzimidazoles",totalDownloads:932,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"This chapter describes contemporary strategies for selective catalytic intermolecular functionalization of the benzimidazole scaffold. Functionalization at nitrogen and position C-2 is well developed employing copper, palladium, rhodium, nickel, and cobalt catalysis. Direct CH activation is the predominant approach to C-2 functionalization. Nickel-based catalysts can activate C—O bonds in conjunction with C—H activation at benzimidazole which grants access to a very broad range of phenols and enols as convenient functionalization precursors in this chemistry. The remaining carbon positions of benzimidazoles are typically functionalized via a sequential halogenation/coupling strategy to ensure selectivity. A key success factor in enabling these chemistries has been the fine-tuning of catalyst-ligand combinations.",signatures:"Jørn H. Hansen and Richard Fjellaksel",downloadPdfUrl:"/chapter/pdf-download/67843",previewPdfUrl:"/chapter/pdf-preview/67843",authors:[{id:"286179",title:"Associate Prof.",name:"Jørn H.",surname:"Hansen",slug:"jorn-h.-hansen",fullName:"Jørn H. Hansen"},{id:"305734",title:"Dr.",name:"Richard",surname:"Fjellaksel",slug:"richard-fjellaksel",fullName:"Richard Fjellaksel"}],corrections:null},{id:"66327",title:"X-Ray Crystal Structure Analysis of Selected Benzimidazole Derivatives",doi:"10.5772/intechopen.85291",slug:"x-ray-crystal-structure-analysis-of-selected-benzimidazole-derivatives",totalDownloads:882,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"This chapter describes the X-ray crystal structure analysis of selected benzimidazole derivatives, viz. BIP: 2-(1H-benzimidazol-2-yl)phenol, MBMPBI: 1-(4-methylbenzyl)-2-(4-methylphenyl)-1H-benzimidazole, DPBI: 1,2-diphenyl-1H-benzimidazole, PBIP: 2-(1-phenyl-1H-benzimidazol-2-yl)phenol, FPPBI: 2-(4-fluorophenyl)-1-phenyl-1H-benzimidazole and NPBIBHS: 2-(naphthalen-1-yl)-1-phenyl-1H-benzimidazole benzene hemisolvate. The BIP molecule is planar, and in the crystal, it is arranged in parallel planes, stabilised by π-π interactions and the hydrogen bonds. In MBMPBI, benzimidazole cores of the two independent (A and B) molecules are planar. Two C▬H…N hydrogen bonds link B molecules only, forming centrosymmetric dimers with R22(8) ring motifs. In the DPBI molecule, the benzimidazole core is planar: one hydrogen-bond interaction (C▬H…N) and C▬H…π (three) interaction leading to the three-dimensional arrangement. In the PBIP molecule, the benzimidazole is nearly planar. The hydrogen bonds and a π-π stacking interaction are present in the crystal. In the FPPBI molecule, the benzimidazole unit is almost planar. The C▬H…F hydrogen bonds and weak C▬H…π interactions lead to a three-dimensional architecture in the crystal. In NPBIBHS, the naphthalene fragment lies out of the plane about the benzimidazole core unit. The C▬H…N hydrogen bonds and C▬H…π interactions lead to a three-dimensional architecture in the crystal.",signatures:"Aravazhi Amalan Thiruvalluvar, Gopalsamy Vasuki, Jayaraman Jayabharathi and Sivaraman Rosepriya",downloadPdfUrl:"/chapter/pdf-download/66327",previewPdfUrl:"/chapter/pdf-preview/66327",authors:[{id:"222223",title:"Prof.",name:"Jayabharathi",surname:"Jayaraman",slug:"jayabharathi-jayaraman",fullName:"Jayabharathi Jayaraman"},{id:"284920",title:"Dr.",name:"Aravazhi Amalan",surname:"Thiruvalluvar",slug:"aravazhi-amalan-thiruvalluvar",fullName:"Aravazhi Amalan Thiruvalluvar"},{id:"296645",title:"Dr.",name:"Sivaraman",surname:"Rosepriya",slug:"sivaraman-rosepriya",fullName:"Sivaraman Rosepriya"},{id:"297400",title:"Dr.",name:"Gopalsamy",surname:"Vasuki",slug:"gopalsamy-vasuki",fullName:"Gopalsamy Vasuki"}],corrections:null},{id:"66798",title:"Synthesis and Pharmacological Profile of Benzimidazoles",doi:"10.5772/intechopen.85229",slug:"synthesis-and-pharmacological-profile-of-benzimidazoles",totalDownloads:1651,totalCrossrefCites:5,totalDimensionsCites:6,hasAltmetrics:0,abstract:"Benzimidazoles are a class of heterocyclic, aromatic compounds which share a fundamental structural characteristic of six-membered benzene fused to five-membered imidazole moiety. Molecules having benzimidazole motifs showed promising application in biological and clinical studies. Nowadays it is a moiety of choice which possesses many pharmacological properties extensively explored with a potent inhibitor of various enzymes involved in a wide range of therapeutic uses which are antidiabetic, anticancer, antimicrobial, antiparasitic, analgesics, antiviral, and antihistamine, as well as used in cardiovascular disease, neurology, endocrinology, ophthalmology, and more. The increased interest for benzimidazole compounds has been due to their excellent properties, like increased stability, bioavailability, and significant biological activity. This book chapter mainly discussed recent synthetic methods developed for the benzimidazole derivatives and their pharmacological properties exemplified on several derivatives.",signatures:"Kantharaju Kamanna",downloadPdfUrl:"/chapter/pdf-download/66798",previewPdfUrl:"/chapter/pdf-preview/66798",authors:[{id:"284317",title:"Prof.",name:"Kantharaju",surname:"Kamanna",slug:"kantharaju-kamanna",fullName:"Kantharaju Kamanna"}],corrections:null},{id:"65847",title:"Antidiabetogenic Features of Benzimidazoles",doi:"10.5772/intechopen.84802",slug:"antidiabetogenic-features-of-benzimidazoles",totalDownloads:1041,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Literature data on the insulinogenic effect of 2-aminobenzimidazole prompted us to investigate its novel derivatives, particularly those containing an additional fused cycle in C1,2-α position, including imidazole, dihydroimidazole, or tetrahydropyrimidine ring. Consensus analysis of the hypoglycemic effect of these compounds performed with IT Microcosm and PASS system revealed that activity is mostly characteristic for N9-2,3-dihydroimidazo[1,2-a]benzimidazole derivatives. Substructural analysis of hypoglycemic activity identified substituents that determine the greatest pharmacological effect. According to the in silico assessment of the ADME properties, RU-254 was nominated as a lead compound due to the most optimal calculated and experimental activity and pharmacokinetic parameters. Preclinical studies have shown that identified compound has a pronounced insulinogenic effect and hypoglycemic effect, both in intact animals and in animals with experimental diabetes mellitus. RU-254 also reduces the level of glycated hemoglobin upon chronic administration, slightly decreases the activity of DPP-4, and increases the average number of Langerhans islets in the pancreas. Pharmaceutical drug formulation of RU-254 was developed and investigated for pharmacokinetic, pharmacodynamic, and toxicological properties. The dosage form of the drug under the name limiglidol (compound RU-254, diabenol) was evaluated in the full cycle of clinical studies that confirmed the safety, tolerability, and prominent antidiabetic properties of the drug.",signatures:"Alexander A. Spasov, Pavel M. Vassiliev, Vera A. Anisimova and Olga N. Zhukovskaya",downloadPdfUrl:"/chapter/pdf-download/65847",previewPdfUrl:"/chapter/pdf-preview/65847",authors:[{id:"286012",title:"Prof.",name:"Pavel",surname:"Vassiliev",slug:"pavel-vassiliev",fullName:"Pavel Vassiliev"},{id:"286027",title:"Prof.",name:"Alexander",surname:"Spasov",slug:"alexander-spasov",fullName:"Alexander Spasov"},{id:"286031",title:"Prof.",name:"Olga N.",surname:"Zhukovskaya",slug:"olga-n.-zhukovskaya",fullName:"Olga N. Zhukovskaya"},{id:"286074",title:"Prof.",name:"Vera A.",surname:"Anisimova",slug:"vera-a.-anisimova",fullName:"Vera A. Anisimova"}],corrections:null},{id:"67500",title:"Development of Benzimidazole Compounds for Cancer Therapy",doi:"10.5772/intechopen.86691",slug:"development-of-benzimidazole-compounds-for-cancer-therapy",totalDownloads:1083,totalCrossrefCites:3,totalDimensionsCites:8,hasAltmetrics:0,abstract:"A fact that is largely unknown in the lay press and even the scientific community is that today cancer kills more people worldwide than tuberculosis (TB), malaria, and human immunodeficiency virus (HIV) combined. Benzimidazole is a heterocyclic aromatic organic compound considered to be a useful pharmacophore in a variety of impactful drugs. The purpose of this review is to highlight the benzimidazole-containing agents that are currently in clinical use or in clinical development as anticancer drugs. It is hoped that this review would function as comprehensive working reference of research accomplishment in the field of discovery and development of benzimidazole-based anticancer drugs.",signatures:"Puranik Purushottamachar, Senthilmurugan Ramalingam and Vincent C.O. Njar",downloadPdfUrl:"/chapter/pdf-download/67500",previewPdfUrl:"/chapter/pdf-preview/67500",authors:[{id:"287305",title:"Prof.",name:"Vincent",surname:"Njar",slug:"vincent-njar",fullName:"Vincent Njar"},{id:"299412",title:"Dr.",name:"Puranik",surname:"Purushottamachar",slug:"puranik-purushottamachar",fullName:"Puranik Purushottamachar"},{id:"299413",title:"Dr.",name:"Senthilmurugan",surname:"Ramalingam",slug:"senthilmurugan-ramalingam",fullName:"Senthilmurugan Ramalingam"}],corrections:null},{id:"67074",title:"Benzimidazoles: From Antiproliferative to Multitargeted Anticancer Agents",doi:"10.5772/intechopen.86249",slug:"benzimidazoles-from-antiproliferative-to-multitargeted-anticancer-agents",totalDownloads:1035,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Benzimidazole derivatives are known to act against a range of biological targets and thus gained clinical applications in a wide spectrum of diseases. Few examples of multitargeted benzimidazole derivatives that were reported during the last decade will be described in this chapter. Multitargeting agents for serving the polypharmacology approach to combat shortcomings of the main one-drug-one target main dogma will be briefly explored. In that context, the multitargeting benzimidazole derivatives gain a special attention. This includes discovery (hit-to-lead), structure-activity relationship (SAR), and binding mode of at least one lead (or hit) in each group. Special attention will be given to two structures dovitinib and AT9283 that are reported to exhibit potent in vitro and in vivo activities against a group of kinases and non-kinase target (as shown recently for dovitinib).",signatures:"Yousef Najajreh",downloadPdfUrl:"/chapter/pdf-download/67074",previewPdfUrl:"/chapter/pdf-preview/67074",authors:[{id:"285330",title:"Associate Prof.",name:"Yousef",surname:"Najajreh",slug:"yousef-najajreh",fullName:"Yousef Najajreh"}],corrections:null},{id:"66268",title:"Bisbenzimidazoles: Anticancer Vacuolar (H+)-ATPase Inhibitors",doi:"10.5772/intechopen.85231",slug:"bisbenzimidazoles-anticancer-vacuolar-h-sup-sup-atpase-inhibitors",totalDownloads:1071,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Small molecule chemotherapeutic agents such as Imatinib, Gefitinib, and Erlotinib have played a significant role in the treatment of cancer. Although the unprecedented progress has been achieved in cancer treatment with these targeted agents, there is a strong demand for the development of selective and highly efficacious cancer drugs. V-ATPases are emerging as important target for the identification of novel therapeutic agents for cancer. Our screening and drug discovery processes have identified the bisbenzimidazole derivative (RP-15) as a potent anticancer V-ATPase inhibitor. In the present study, bisbenzimidazoles (compound-25, RP-11 and RP-15) have been tested for proton-pump inhibition activity in human hepatoma cell line (Huh7.5). RP-15 displayed comparable proton-pump inhibition activity to the standard Bafilomycin A1. We examined the antiproliferative activity of these analogs in two highly invasive and metastatic inflammatory breast cancer (IBC) cell lines (SUM 149PT and SUM190PT) along with Huh7.5. The compound-25 (SUM190PT: IC50 = 0.43±0.11 μM) and its structural analog RP-11 (SUM190PT: IC50 = 0.49±0.09 μM) have shown significant inhibition toward IBC cell lines. Additionally, RP-11 and RP-15 have demonstrated very good cytotoxicity toward the majority of cancer cell lines in the NCI 60 cell line panel.",signatures:"Renukadevi Patil, Olivia Powrozek, Binod Kumar, William Seibel, Kenneth Beaman, Gulam Waris, Neelam Sharma-Walia and Shivaputra Patil",downloadPdfUrl:"/chapter/pdf-download/66268",previewPdfUrl:"/chapter/pdf-preview/66268",authors:[{id:"237361",title:"Dr.",name:"Gulam",surname:"Waris",slug:"gulam-waris",fullName:"Gulam Waris"},{id:"243940",title:"Dr.",name:"Binod",surname:"Kumar",slug:"binod-kumar",fullName:"Binod Kumar"},{id:"289504",title:"Dr.",name:"Shivaputra",surname:"Patil",slug:"shivaputra-patil",fullName:"Shivaputra Patil"},{id:"289506",title:"Dr.",name:"Renukadevi",surname:"Patil",slug:"renukadevi-patil",fullName:"Renukadevi Patil"},{id:"289690",title:"Dr.",name:"Olivia",surname:"Powrozek",slug:"olivia-powrozek",fullName:"Olivia Powrozek"},{id:"289691",title:"Dr.",name:"William",surname:"Seibel",slug:"william-seibel",fullName:"William Seibel"},{id:"289692",title:"Dr.",name:"Kenneth",surname:"Beaman",slug:"kenneth-beaman",fullName:"Kenneth Beaman"},{id:"289693",title:"Dr.",name:"Neelam",surname:"Sharma-Walia",slug:"neelam-sharma-walia",fullName:"Neelam Sharma-Walia"}],corrections:null},{id:"66526",title:"Optical Sensing (Nano)Materials Based on Benzimidazole Derivatives",doi:"10.5772/intechopen.85643",slug:"optical-sensing-nano-materials-based-on-benzimidazole-derivatives",totalDownloads:1208,totalCrossrefCites:1,totalDimensionsCites:5,hasAltmetrics:0,abstract:"Benzimidazole derivatives are well-known biologically active substances, and therefore, they are mostly synthesised for therapeutic purposes. However, such heteroaromatic molecular systems own structure-related properties that enable a variety of applications, especially in optical science. Multifunctionality of the benzimidazole unit, such as electron accepting ability, π-bridging, chromogenic pH sensitivity/switching and metal-ion chelating properties, makes it an exceptional structural candidate for the design of optical chemical sensors and functional materials. Development of smart molecular sensors and novel (nano)materials is the emerging trend observed in materials and optical sensing science in general, in which the benzimidazole molecular systems strongly contribute and participate. In this chapter, we summarised recent advances in optical sensing (nano)materials that incorporate the benzimidazole structural moiety. Solid-state optical sensing systems, including self-assembled molecular materials based on benzimidazoles, are reviewed and discussed. In addition, immobilisation of benzimidazole derivatives onto or into various substrates and matrices, such as organic and inorganic polymers, bulk membranes and nanoparticles, utilising different chemical and physical methods, is presented and analysed.",signatures:"Ema Horak, Robert Vianello and Ivana Murković Steinberg",downloadPdfUrl:"/chapter/pdf-download/66526",previewPdfUrl:"/chapter/pdf-preview/66526",authors:[{id:"288132",title:"Ph.D.",name:"Ema",surname:"Horak",slug:"ema-horak",fullName:"Ema Horak"},{id:"295983",title:"Dr.",name:"Robert",surname:"Vianello",slug:"robert-vianello",fullName:"Robert Vianello"},{id:"295984",title:"Dr.",name:"Ivana",surname:"Murković Steinberg",slug:"ivana-murkovic-steinberg",fullName:"Ivana Murković Steinberg"}],corrections:null},{id:"66558",title:"Benzimidazole as Solid Electrolyte Material for Fuel Cells",doi:"10.5772/intechopen.85430",slug:"benzimidazole-as-solid-electrolyte-material-for-fuel-cells",totalDownloads:951,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"This chapter is focused in the application of benzimidazole, mainly in the form of poly[2,2′-(m-phenylene)-5,5′-bisbenzimidazole] (PBI) and poly(2,5-benzimidazole) (ABPBI), in the fuel cell technology. A short introduction is given of the fuel cell principles, explaining both the theory and the high importance of this technology. PBI and ABPBI are used in a certain type of fuel cells: the polymer electrolyte fuel cells and are key materials in the composition of some of the electrolyte membranes used. Commercially available membranes composed of PBI are indicated in order to give an overview of their potential performance. The synthesis of the polymers is explained. Moreover, the preparation of the different kinds of membranes, both in proton exchange membrane fuel cells (PEMFCs) and anion exchange membrane fuel cells (AEMFCs) is studied. A deep description is given about the properties that make this family of compounds so interesting for the fuel cell technology as well as an how these polymers have been characterized with the corresponding analysis. The comparison with other ion exchange membranes is also discussed. Special attention will be given to the state of the art of different kinds of PBI/ABPBI fuel cell electrolyte membranes, in which our group and others are working nowadays.",signatures:"Daniel Herranz and Pilar Ocón",downloadPdfUrl:"/chapter/pdf-download/66558",previewPdfUrl:"/chapter/pdf-preview/66558",authors:[{id:"289174",title:"Prof.",name:"Pilar",surname:"Ocon",slug:"pilar-ocon",fullName:"Pilar Ocon"},{id:"289175",title:"MSc.",name:"Daniel",surname:"Herranz",slug:"daniel-herranz",fullName:"Daniel Herranz"}],corrections:null},{id:"66205",title:"Supramolecular Assembly of Benzimidazole Derivatives and Applications",doi:"10.5772/intechopen.85333",slug:"supramolecular-assembly-of-benzimidazole-derivatives-and-applications",totalDownloads:804,totalCrossrefCites:0,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Herein, we focus on the chemical and physical properties of benzimidazole and its derivatives used for the synthesis of supramolecular materials. The design and modification of benzimidazole opens the scope of the diversity of structures (different sizes and morphologies) that can be built. The synthesized materials include not only small coordination complexes but also isolated crystals, metal-organic frameworks, metal-coordination polymers, smart nanocontainers, and more advanced macrostructures such as microflowers and nanowires. These supramolecular structures are based on noncovalent interactions, mostly on metal coordination chemistry and π-π stacking interactions. Moreover, the same molecule, due to its chemical structure, can undergo both sorts of interactions in order to induce the self-assembly into supramolecular materials. In this process, as it is shown in this chapter, the conditions used for the assembly determine the final structure and morphology of the fabricated macromolecule. 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Patellofemoral articulation plays a major role in locomotion and other activities that involve knee flexion and extension. Problems of patellofemoral tracking are very common, ranging from mild lateral maltracking and tilt, to frank instability and dislocation of the patella. Patellofemoral instability can be defined as movement of the patella out of its normal position, and can be divided into dislocation and subluxation. Natural history of this condition is that of a relatively high recurrence. Even in the absence of recurrent instability, patients who sustain patella dislocation or subluxation may develop a number of significant problems, including persistent knee pain, functional limitations, decreased athletic performance, and arthritic degeneration of the patellofemoral articulation. Especially for the recurrent dislocator, surgical treatment plays an important role in management, since the natural history of this condition is that of relatively poor return to normal function.
Direction of patellofemoral instability is almost always lateral (rare cases of medial dislocation have been reported to occur secondary to iatrogenic causes). Overall incidence of this injury has been shown to be around 6 per 100,000, with the highest incidence occurring in the 2nd decade of life (around 30 per 100,000), and becoming significantly lower after 30 years of age (around 2 per 100,000).[1,2]Traditionally, this injury was thought to occur in sedentary, overweight, adolescent females, but most recent data has shown this stereotype to be inaccurate, with most injuries actually occurring in young athletic individuals, often males, during sports participation and other intense physical activity. [3]
Proper articulation and movement of the patella within the femoral trochlear groove requires complex interplay between a number of important static and dynamic soft-tissue stabilizers, the bony architecture of the patellofemoral joint, and the overall alignment of the lower extremity. Abnormalities in one or more of these factors can result in or predispose to clinically relevant patellofemoral instability, and are described below.
Instability of the patellofemoral articulation can occur when the bony anatomy of the patella, the femoral trochlea, or both is abnormal, i.e. dysplastic. In order to understand how dysplasia contributes to instability, normal anatomy and biomechanics of this joint have to first be described.
The patella is the largest sesamoid bone in the body, i.e. it is a bone that is imbedded within a tendon – in this case the extensor mechanism of the knee. It has a multifaceted articular surface, with lateral and medial facets separated by a central ridge, and a much smaller odd facetlocated far medially. The articular cartilage of the patella is the thickest in the body, designed to withstand significant joint reactive forces that occur at the patellofemoral joint, which range from 0.5 to 9.7 x body weight with daily activities, and may approach values of 20 x body weight with certain sporting activities. [4]
The patella’s most important function is as a fulcrum for the extensor mechanism. It increases the distance of the line of action of the extensor mechanism from the center of rotation of the knee, therebyincreasing the force that can be generated by contraction of the quadriceps. Total patellectomy has been shown to decrease the maximum force generated by the quadriceps by 50%. [5]
Anatomy of the femoral trochlea typically closely matches the articular shape of the patella, with a longer and higher lateral wall that serves as the most important bony restraint to lateral translation. In full extensionthe patella sits on the non-articular anterior surface of the distal femur, and typically enters the trochlea at 20-30 degrees of knee flexion, depending on the length of the patella tendon. The contact area increases and moves proximally with greater flexion; the lateral facet engages the trochlea first, while the medial facet engages it last.
Since the flexion angle at which the patella engages the trochlea depends on the length of the patella tendon, patella alta – the condition in which the length of the patella tendon is abnormally increased and the patella position is abnormally high - contributes to instability by increasing the range at which there is no bony contribution to stability. Patella alta has been shown to be associated with recurrent patellofemoral instability. [6,7]
Once the patella enters the trochlea, dysplasia of the patella, the trochlea, or both, can contribute to instability by decreasing the bony restraint and consequently the amount of energy required to dislocate. Patellofemoral dysplasia has been classified by Dejour et al. [8] (Figure 1) Dysplasia typically occurs on both sides of the joint, with congruous articulation between the two bones, although incongruous articulation can also occur, and leads to some of the worst instability.
Dejour classification of trochlea dysplasia
Soft-tissue structures important to the patellofemoral joint include the lateral retinaculum, the iliotibial band, and vastus lateralis muscle on the lateral side, and the medial retinaculum, medial patellofemoral ligament, and the vastus medialis oblique muscle on the medial side. Normally, these all work in concert to provide proper stability and tracking of the patellofemoral articulation. When medial stabilizers are weakened or disrupted, the typical lateral instability may occur. Tightness or excessive force by the lateral stabilizers typically does not cause actual instability, as long as the medial structures are normal, but may cause symptomatic abnormalities in patella tilt and tracking, as described below.
The lateral retinaculum tightness is commonly implicated in abnormal lateral tilt of the patella. However, it is not considered to be a major factor contributing to lateral instability of the patella. Lateral release alone in the setting of instability has been shown to result in 100% rate of recurrence [9], indicating the very limited, if any, contribution of the lateral retinaculum to development of lateral instability. Moreover, biomechanically the lateral retinaculum may even contribute up to 10% to medial stability [10], and addition of a lateral release to medial soft-tissue repairs has been shown to actually decrease the force required to dislocate the patella, compared to medial repair alone. [11]
Iliotibial band (ITB) is a continuation of tensor fascia lata, which originates on the anterior superior iliac spine, and inserts on the Gerdy’s tubercle of the anterolateral proximal tibia. It exerts its effect on the patellofemoral joint via fibers attaching to the lateral retinaculum. Abnormal tightness of the ITB can result in lateral patellar maltracking with pain, and is a common finding in patellofemoral tracking abnormalities and patellofemoral pain syndrome (which is one of the most common causes of anterior knee pain). Non-operative treatment with stretching and therapeutic modalities can be quite successful in decreasing ITB tightness and alleviating symptoms.
The other dynamic stabilizer on the lateral side is the vastus lateralis muscle, which has a force vector 30-40 degrees lateral to anatomic femoral axis. Disruption of the attachment of the vastus lateralis to the patella from overly aggressive and excessively proximal lateral retinacular release can result in iatrogenic instability of the patella in the medial direction. [12]
The main dynamic stabilizer on the medial side, counteracting the pull of the vastus lateralis and the ITB, is the vastus medialis oblique (VMO) muscle, which has a 60 degree force vector to the anatomic femoral axis, and is most active at 0-30 degrees of knee flexion. In addition to its role as a dynamic stabilizer [13], the VMO also serves as a static stabilizer, and its sectioning has been shown to produce increased lateral translation of the patella. [14] After an injury to the quadriceps muscle group, the VMO is the typically the first to weaken and last to recover.
The most important of the static medial soft-tissue stabilizers is the medial patellofemoral ligament (MPFL), which provides 53-60% of the check-rein to lateral displacement of the patella at 0-30 degrees of knee flexion. [10, 15] Because of its importance for stability, MPFL’s anatomy and function have been extensively studied. This ligament is located in the second layer of the medial knee - deep to the crural fascia, superficial to the knee joint capsule - in the same layer as the superficial medial collateral ligament (MCL). It is a very thin ligament, measuring 0.44mm in thickness, withan average length of 58mm, an hourglass shape, measuring approximately 13mm width at its midpoint, 17mm on the patella side, and 15mm on the femoral side. [16-18]MPFL attaches to the proximal half of the medial border of the patella and to the medial femoral condyle. Its femoral attachment is located anterior and distal to the adductor tubercle, and posterior and proximal to the medial femoral epicondyle and the origin of the MCL. [17,18]
Sectioning of the MPFL in cadaveric studies has been shown to increase lateral patella subluxation by 50% [19], and decrease the force required to translate the patella laterally by 10mm by 50%. [20] MPFL functions isometrically (meaning its length is unchanged) during early flexion, mostly between 0-30 degrees of flexion, where it is the most important static stabilizer; it becomes progressively lax after 70 degrees of flexion. Isometry of the MPFL has been found to be most sensitive to the femoral insertion. Therefore, it is crucial to locate the anatomic femoral insertion site of the MPFL during surgical repair or reconstruction of this ligament.
In addition to abnormalities of bones and soft-tissues around the patellofemoral joint, instability of this joint can also result from abnormalities in the overall alignment of the lower extremity, especially those abnormalities that increase laterally-directed forces on the patella. Clinically, this can be measured by assessing the Q-angle.
The Q-angle is defined as the complement of the angle between the force vectors of the quadriceps and patella tendons. The Q-angle typically measures 12 degrees in males and 16 degrees in females, is highest in extension, and represents the laterally directed force acting on the patella. Malalignment that increases the Q-angle increases the laterally-directed forces and thus predisposes to patellofemoral instability. The Q-angle is increased by genu valgum, femoral anteversion, external tibial torsion, and pes planus.
To summarize contributions of various anatomic structures to patellofemoral stability, stability in extension and early flexion (up to 30 degrees) is primarily dependent on integrity and function of the medial soft-tissue stabilizers, both static (MPFL) and dynamic (VMO), while stability in greater degrees of flexion is dependent to a greater degree on bony architecture and congruity of the femoral trochlea and the patella. Factors contributing to instability include 1) inadequate bony restraints, such as patella alta and patellofemoral dysplasia; 2) inadequate medial soft-tissue restraints, such as VMO weakness or MPFL disruption/attenuation; and 3) excessive laterally-directed forces, typically resulting from lower extremity malalignment producing a high Q-angle. (Table 1)
Inadequate Bony Restraints of the Patellofemoral Joint | \n\t\t\tFemoral trochlea dysplasia (excessively shallow) Patella dysplasia Combined patellofemoral dysplasia Patella alta | \n\t\t
Inadequate Medial Soft-tissue Restraints | \n\t\t\tMPFL tear or elongation VMO disruption VMO weakness | \n\t\t
Lower extremity malalignment | \n\t\t\tAbnormally high Q-angle Excessive femoral anteversion Excessive external tibial torsion Genu valgum Proximal tibia vara Pes planus | \n\t\t
Factors Predisposing to Patellofemoral Instability
The two most common types of clinical presentation of patella instability are 1) acute dislocation from an injury, and 2) recurrent instability (either dislocation or subluxation), typically occurring with minor or no injury, with a history of previous dislocation. Another common presenting complaint related to patellofemoral tracking is painful maltracking without sensation of instability, with or without history of previous dislocation.
Acute dislocation may occur from a direct or an indirect mechanism of injury. Indirect mechanism accounts for the majority of acute dislocations, and occurs most commonly with cutting, pivoting, and squatting movements with sports and other strenuous physical activities. Typically the foot is planted, the femur is rotated internally and/or the tibia is rotated externally, and there is a valgus force at the knee joint; in this position, sudden contraction of the quadriceps produces a strong laterally directed force vector, resulting in dislocation of the patella. Dislocation from a direct injury mechanism, which is much less common, occurs when the patella is struck with a laterally directed blow.
Most cases of acute patella dislocation reduce spontaneously as the knee is brought into extension, and therefore evaluation in the emergency room or doctor’s office may not readily provide the diagnosis. Patient may report feeling or hearing a “pop” or a “snap” and seeing/feeling their kneecap “move out of place”, followed by spontaneous reduction with a “clunk” as the knee is extended. On presentation typical complaints are those of pain, swelling, limited motion, and difficulty bearing weight. Occasionally the reduction is not spontaneous and requires reduction in the emergency room (by gently extending the knee and manipulating the patella back into the trochlear groove).
Physical examination after acute dislocation may be significantly limited by guarding due to pain and hemarthrosis (bleeding) in the knee. If this is the case, arthrocentesis should be considered, with aspiration of the hemarthrosis and injection of a short-acting local anesthetic. This allows for a more accurate examination of the knee, as well as quicker restoration of knee motion and strength.
Examination should focus on ruling out fractures, injuries to major ligamentous stabilizers of the knee joint, and finally assessing patellar stability. Combination of hemarthrosis and a sports-related mechanism of injury may initially suggest a diagnosis of ananterior cruciate ligament (ACL) tear, and careful examination of anterior, posterior, varus, valgus, and rotational stability of the knee should be performed.
Patients may exhibit medial knee tenderness and ecchymosis (bruising) at the femoral origin of the MPFL, near the medial epicondyle and adductor tubercle, and injury to the MCL (which also originates in this area) should be ruled out. There is often tenderness over the medial facet and lateral femoral condyle. Less commonly there is a palpable soft-tissue defect adjacent to the medial facet, especially if there is a complete tear at the VMO insertion. Range of motion of the knee is usually very limited due to pain and apprehension; crepitus during motion (in a knee without preexisting arthritis) is concerning for osteochondral fracture and presence of intraarticular fragments. Examination of patellar medial-lateral translation with the knee extended and at 30 degrees of flexion should be attempted, but may not be possible due to patient guarding. Apprehension with attempted lateral translation at 30 degrees of knee flexion is suggestive of patella instability and is known as the “patella apprehension” test.
Patients with this problem sometimes report a clear history of recurrent dislocations or subluxations, but in other cases the presentation is more vague, and may include such complaints as sensation of the whole knee giving out, weakness of the knee, anterior and anterolateral pain, difficulty navigating stairs, and inability to participate in sports. A thorough history and careful physical examination are essential to arrive at the correct diagnosis. Important history points include previous injuries and dislocations, provoking activities and positions of the knee, family history of instability or laxity of other joints, and childhood problems of the lower extremity (including those of the hip and foot).
Physical examination must include evaluation of lower extremity alignment, including measurement of the Q-angle, as well as a comparison to the contralateral knee. The Q-angle is typically measured in a supine position, and is formed by the intersection of a line drawn from the ASIS (anterior superior iliac spine) to the patella and from the patella to the tibial tubercle.
Examination of patients with patella instability should also assess genu varum (“bowlegs”) or genu valgum (“knock-knees”), external tibial torsion, femoral anteversion (best assessed by abnormally increased femoral internal rotation with the patient prone), pes planus (“flat feet”), and generalized ligamentous laxity. Strength of the quadriceps, hip flexors, abductors, and rotators must be assessed, as weakness in these muscle groups can contribute to patellofemoral maltracking and instability.
The patellaitself can be evaluated for resting position, tilt, passive translation, apprehension, and dynamic tracking. In extension and 30 degrees of knee flexion the patella position should be central within the trochlear groove, and while it may rest laterally tilted, the examiner should be able to “lift it off” the lateral trochlea and bring it to at least a horizontal position. Inability to do this suggests excessive tightness of the lateral retinaculum. With the knee in flexion, the normal position of the patella should be pointing directly forward; a “grosshoppper eyes” appearance may be noted in patients with recurrent instability or lateral maltracking, with both patellae pointing superiorly and laterally.
Passive lateral translation of the patella is measured with the knee flexed to 30 degrees and the quadriceps muscles relaxed, and must be compared to the contralateral side. Passive lateral translation should be no more than one half the patellar width, without sensation of apprehension or pain. Pain and/or crepitus with patellar compression into the groove (“patella grind”) may indicate arthritis or osteochondral injury. Finally, patellofemoral tracking during active knee range of motion should be central. Abnormal tracking is classically manifested by a positive “J-sign”, which is a sudden lateral movement of the patella as it exists the femoral trochlea during terminal extension.
Radiographic imaging is essential for proper evaluation of a patient suspected of having patellofemoral instability. The imaging modalities most commonly used for this condition include plain radiographs, magnetic resonance imaging (MRI), and ultrasound (US). The computed tomography (CT) scan is used less commonly. Initial evaluation should always begin with plain radiographs, while more advanced imaging is ordered as necessary, based on clinical examination and plain radiographic findings.
The plain radiographic evaluation should include a minimum of three views – anterior-posterior (AP), lateral, and axial, or “sunrise”, views. The AP view allows assessment of coronal plan malalignment, such as genu varum or valgum, as well as presence of any tibiofemoral arthritis. The lateral view is used to assess patella alta or baja.Several signs of trochlear dysplasia can also be appreciated on the lateral view, including the crossing sign, supratrochlear spur, and the double contour. [8](Figure 2)
“Crossing sign” on a preoperative lateral radiograph in a 35 year old female with recurrent instability, significant malalignment and trochlea dysplasia. This sign represents abnormally elevated floor of the trochlear groove rising above the top of the wall of one of the femoral condyles (arrow).
The two most commonly used techniques for axial, or “sunrise”, radiographs of the knee, are Merchant’s and Laurin views. These views, especially in comparison to the contralateral knee (ideally on the same cassette) are invaluable in detecting such abnormalities as lateral patellar tilt, patellar subluxation, dysplasia, patellofemoral arthritis, vertical fractures of the patella (including avulsion fractures), and osteochondral fragments. A number of angles and indices measured on the axial views have been described to objectively characterize patellofemoral dysplasia, subluxation and tilt. The sulcus angle (normally 138 +/- 6 degrees) for example, as measured on the Merchant view, identifies trochlear dysplasia when it is greater than145 degrees, and has been noted to beabnormal in significant number of patients with patella instability. [21](Figure 3)
Example of a shallow trochlea, with a sulcus angle measuring 148 degrees, and lateral patella subluxation, in the same patient from
The more advanced imaging modalities used in evaluation of patellofemoral instability include ultrasound, CT, and MRI. Ultrasound was recently shown in one study to have a 90% accuracy and predictive value in identifying the location and severity of injury to the MPFL. [22]MRI also has high sensitivity and accuracy in detecting MPFL injuries [23], and additionally is very useful for indentifying articular cartilage damage and osteochondral fragments, over 40% of which may be missed on plain radiographs. [24,25]A relatively high number of associated injuries have been found on MR imaging of knees after patella dislocation, including as many as 21% with meniscal tears, 19% with MCL injury, 7% with patella fractures, 13% with loose bodies, and 49% with osteochondral injury. [25] Finally, in cases where the history, physical examination and plain radiographs are inconclusive, MRI can help arrive at the diagnosis of a recent acute patella dislocation by demonstrating a classic bone bruising pattern on the medial patella facet and the lateral femoral condyle.(Figure 4)
Classic bone bruise pattern of the lateral femoral condyle and medial patella facet after an acute first-time patella dislocation; other than a partial tear of the MPFL no other abnormalities were noted in this 45 year old male.
The most common location of MPFL injury from a patella dislocation has been debated. What is known for certain is that this ligament can tear anywhere along its course, including femoral avulsions, patella avulsions, and midsubstance ruptures. Moreover, a not insignificant number of patients may have combined injuries, and some studies suggest that these may be more common in children compared to adults. [25, 26]
CT imaging during work-up of patellofemoral instability is most useful for assessing bony anatomy(dysplasia and incongruence) and malalignment. CT imaging is probably most useful in assessing the tibial tubercle to trochlear groove distance (TT-TG distance), which measures the lateral offset of the tibial tubercle from the deepest point of the trochlear groove, and is considered to be the true measure of the Q-angle. The normal TT-TG distance is a range of 7-17mm (average 13mm), whereas values of greater than 20mm have been found to be predictive of patellofemoral instability [27], and should prompt consideration of a distal (tibial tubercle) realignment procedure when surgical treatment is contemplated (discussed below).
In summary, radiographic imaging of patellofemoral instability should always begin with a series of plain radiographs, including an AP, lateral, and sunrise views. Acute dislocations should receive additional imaging with a MRI, to assess injury to the MPFL, and evaluate for intraarticular fragments and other associated injuries. An ultrasound can also be used to evaluate the MPFL, but is less helpful in assessing articular cartilage injuries. Finally, a CT scan is most commonly used for pre-operative assessment of trochlear dysplasia, tibial tubercle offset, and localization of bony fragments.
While it is reasonable to attempt non-operative treatment for most first-time acute patella dislocations, it is important to remember that “non-operative treatment” does not mean “no treatment”. Initial management should be aimed at controlling pain and swelling, and protecting the knee from further injury.
There is no consensus on the type and duration of immobilization after an acute episode of patellar dislocation. Treatment protocols reported in the literature range from immediate range of motion and weightbearing to brace or cast immobilization in full extension for 6 weeks. Studies have shown that more rigid methods of knee immobilization (i.e. with a cast), result in lower risk of recurrent dislocations, but higher risk of knee stiffness. [28]
The authors’ treatment protocol for acute first-time dislocation includes immobilization with a knee brace locked in extension for a minimum of 2 weeks, with weight-bearing allowed in the brace. Younger patients (who tend to be at a higher risk of recurrent dislocation) may be immobilized for a longer period of time, up to 4 weeks for documented complete tears of the MPFL.
Once the acute inflammation has subsided, physical therapy is helpful to reduce swelling, improve range of motion and muscle strength, stabilize patellofemoral tracking, regain proprioception of the knee, and normalize the gait pattern. Physical therapists often prefer to do patella taping during rehabilitation, as it has been shown in some studies to increase quadriceps muscle torque, control patellar motion, and activate VMO earlier than VL during stairs ascent/descent. [29,30] With regard to strengthening exercises, studies have shown that closed-chain exercises may be more efficacious in strengthening the vastus medialis,compared to open-chain exercises.[31,32]
Pre-requisites for allowing return to sportsinclude complete resolution of pain and swelling, no sensation of instability, full range of motion of the knee, and return of at least 80% of quadriceps muscle strength. This may be expected by approximately 3 months from initial injury. A patellar-stabilizing low-profile brace may be worn for athletic activities, although no studies have demonstrated efficacy of bracing in preventing recurrence of instability. [33]
Studies looking at the natural history of a first-time patella dislocation suggest an overall rate of recurrence of 15-44%, while persistence of instability after one episode of recurrence can be as high as 65%. [28,34,35]There is 7 times higher odds of recurrent instability in patients with a previous history of dislocation, compared to first-time dislocators, with the risk being higher for both knees. [2] The initial injury from a first time dislocation compromises the integrity of the MPFL. A torn or stretched out MPFL decreases the energy required to dislocate the patella laterally, and may predispose to recurrent instability even with less strenuous activities. Recurrent dislocations may produce further injury to the articular cartilage, ligaments and retinaculum, with irreversible articular cartilage damage being especially of concern, particularly in the young patients.(Figure 5)
Axial MRI images of the same patient in
Even in the absence of recurrent instability, the natural history of a first-time patella dislocation may include other problems, such as persistent pain, mechanical symptoms, and knee-related dysfunction with inability to return to pre-injury functional status. Unsatisfactory results of non-surgically treated patella dislocators were as high at 63% and 75% in some studies. [28,35] Over half the patients with a first-time patella dislocation reported, at 6 months after the injury, being significantly limited in their ability to engage in strenuous physical activity, and unable to return to sports. [1]
Despite the relatively unsatisfactory outcomes of non-operative treatment for patellofemoral instability, the natural history of a first-time dislocation has not been significantly improved by an acute medial repair. A number of prospective trials (level 1 and 2) comparing medial repair versus non-operative treatment for first time dislocation showed no difference in recurrent instability or functional outcome scores. [36-40] Therefore, non-operative treatment is typically recommended after the initial episode of instability, with indications for acute surgery including presence of osteochondral fragments or persistent static patella subluxation. [24]
The surgical procedures for patella instability can be divided into the general categories of proximal and distal realignment. (Table 2) Proximal realignment most commonly is done to the soft-tissue stabilizers, and includes procedures such as VMO advancement, medial retinaculum and MPFL imbrication, MPFL repair, and MPFL reconstruction. Distal realignment is typically done by changing the position of the tibial tubercle via one of several osteotomies (Elmslie-Trillat, Fulkerson AMZ, and Hughston). Patellofemoral instability which results from severe dysplasia of the femoral trochlea can also be treated with reshaping of the trochlea (trochleaplasty). The surgical procedures and their outcomes are discussed below.
\n\t\t\t | \n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
\n\t\t\t\t | \n\t\t\tMedial retinaculum and MPFL imbrication MPFL repair MPFL reconstruction VMO advancement | \n\t\t\tProcedures mostly of historic significance –Rough-Goldthwait (lateral slip of patella tendon transferred medially) –Galleazzi (semitendinosis tendon transferred to the patella) | \n\t\t
\n\t\t\t\t | \n\t\t\tFemoral trochleaplasty | \n\t\t\tTibial tubercle osteotomy/transfer –Hughston (for patella alta) –Elmslie-Trillat (for instability) –Fulkerson/AMZ (for instability and arthritis) | \n\t\t
Surgical Options for Treatment of Patellofemoral Instability
As previously mentioned, lateral retinacular is the one procedure that has definitively been shown to be ineffective as a stand-alone surgical option for treatment of patella instability. [33] Studies have demonstrated a very high instability recurrence rate (up to 100% in one study) and poor results in terms of patient satisfaction when lateral release was used as the main surgical treatment for patella instability. [9,41,42] Even as an add-on procedure to medial repair or reconstruction, the utility of the lateral release has been questioned [11], and therefore this procedure should be reserved for patients with significant static lateral tilt of the patella, lateral patellofemoral compression and pain. Lateral retinacular release can be performed with an arthroscopic or an open approach, and involves dividing the lateral retinacular layer from the level of the patella tendon up to the insertion of the vastus lateralis. Care must be taken to protect the lateral geniculate artery while performing the proximal portion of the release.
Most proximal soft-tissue realignment procedures focus on restoring the integrity of the MPFL, as injury to this ligament is considered the “essential lesion” of patella instability. With its important to patellofemoral stability well demonstrated in multiple biomechanical studies, some argue that full dislocation is impossible without significant MPFL injury. [43] Clinical reports support this notion, showing a ruptured MPFL in as many as 90% of acute dislocations [44], and either rupture or attenuated MPFL in almost 100% of cases of recurrent instability. [45] After an acute injury the MPFL either fails to heal or heals in a non-anatomic position, losing its isometry and ability to work properly as a medial stabilizer. Restoration of MPFL integrity, including its anatomic insertion sites, has been shown to restore patellofemoral tracking to normal [15,19,46], and is an important component of any surgical plan for patella stabilization. Options for restoring MPFL integrity include imbrication/tightening of the elongated ligament, repair of the ligament, or reconstruction of the ligament.
Ideal situation for an MPFL repair is an acute injury with avulsion from the patella or femoral insertion site, in a patient without significant predisposing factors such as dysplasia or malalignment. Femoral avulsions may be especially important injuries to consider for acute repair study, since at least one study demonstrated much higher rate of recurrent instability in first-time dislocators with MPFL avulsion from the femur. [47] MFPL avulsions from the insertion sites can be repaired through bone tunnels or with suture anchors, and mid-substance ruptures can be repaired with a strong non-absorbable braided suture. The repair is typically performed open, but arthroscopic techniques for repairing avulsion from the patella have also been described. [48,49]
Imbrication of the medial stabilizing structures is sometimes used for cases of mild recurrent instability (subluxation, rather than frank dislocation), and an intact but elongated MPFL. It is a “non-anatomic” procedure, which cannot address problems at the insertion sites of the ligament. With inability to precisely quantify how much of the ligament and retinaculum should be imbricated, this procedure may either fail to restore appropriate tension to the MPFL and result in recurrent instability, or over-tension the medial stabilizers and result in excessive compressive forces of the medial side of the patellofemoral joint. [50] Medial imbrication can be done arthroscopically or open,[51-53]and is similar in its technique and goals to capsular plication in the shoulder.
Outcomes ofmedial repair and imbrication procedures have shown promise in some studies[49,51,54-59], including one prospective study that demonstrated a higher rate of return to pre-injury activity level after arthroscopic repair, when compared to non-operative treatment. [40] However, randomized controlled trials have not shown any significant benefit of surgical repaircompared to non-operative treatment for first-time dislocators, with similar rates of recurrent instability and similar functional outcomes scores. [36-39]
A 2007 systematic review of 70 level I-IV trials evaluating medial repair and non-operative treatment for first-time patella dislocators concluded that initial management of these injuries should be non-operative except in select cases, including: 1) presence of intraarticular osteochondral fragments (Figure 6); 2) what the authors describe as “significant disruption of medial patellar stabilizers”; 3) lateral subluxation of the patella on the injured side, when compared to otherwise normal contralateral alignment (Figure 7); 4) persistent symptoms despite non-operative treatment; and 5) recurrent instability event.[24] With regard to recurrent instability, MPFL repair has been shown to have a relatively high rate of failure (26-46%) [60,61], and is not recommended as a stand-alone procedure.
Arthroscopic picture of a large osteochondral fragment after a previous patella dislocation, and a donor site on the medial patellar facet from which it likely originated (overgrown with fibrocartilage)
Axial radiograph showing static subluxation of the left patella in a 16 year old boy after an acute first-time dislocation. Note the small bony fleck adjacent to the medial patella facet, representing patellar avulsion of the MPFL.
Given the relative failure of medial repair to decrease the risk of recurrent instability and improve functional outcomes, much attention over the past two decades has been directed to MPFL reconstruction. Historically, non-anatomic procedures (such as Roux-Goldthwait and Galleazzi transfers),were used to re-create the medial stabilizers, but in the long-term these procedures has shown relative high rates of recurrent instability (22%), osteoarthritis (78%), and patient dissatisfaction (54%). [62] Unlike these and other medial soft-tissue stabilization procedures, the recently popularized techniques of MPFL reconstruction have shown excellent outcomes in terms of recurrent instability and function, [63] as well as relatively low risk of development and progression of arthritis. [64]
The first report of anatomic MPFL reconstruction was described by Ellera Gomes in 1992 [65], and since then many variations on the procedure have been described. Variations in surgical techniques include different choices of surgical approach, graft material, and fixation method. Furthermore, there are options of associated procedures to be performed along with the MFPL reconstruction, such as the lateral retinacular release, VMO advancement, and tibial tubercle transfer. To the authors’ knowledge, there have not been any comparative studies showing advantage of one technique or approach over the other.
The typical grafts used for MPFL reconstruction (most commonly the semitendinosus tendon) have biomechanical properties significantly superior to those of the native MPFL, with higher strength, stiffness, and load to failure. [17,66] The advantage of these superior biomechanical characteristics is the ability of the graft to withstand greater loads in cases of dysplasia and malalignment. Conversely, overtightening or malpositioning the graft can lead to maltracking and excessive medial compressive forces.
Multiple studies of MPFL reconstruction for acute and recurrent patella instability have shown excellent results, with low rates of recurrent instability, low complications rates, and good improvement in subjectively and objectively reported outcomes. [63,65,67-73] However, no consensus has been achieved with regard to the surgical approach, choice of graft, graft positioning, and fixation methods. [63,72] With this in mind, several important points of the surgical technique of MPFL reconstruction, with the relevant pearls and pitfalls, deserve mention.
A single or a double incision technique may be used, and the goal of both approaches should be to comfortably and safely access the femoral and patella insertion sites of the MPFL; visualization of the mid-substance of the ligament is less important. However, the layer where MPFL normally runs (2nd layer of the medial knee – same layer that contacts the superficial MCL and VMO aponeurosis) must be identified, so that the graft can be properly placed into this layer, and remain extraarticular.
Next, patella and femoral insertion sites of the MPFL are located and prepared for graft implantation. While patellar insertion site of the MPFL can be approximated to the proximal half of the medial facet, the femoral attachment site needs to be located more precisely, as isometry and function of this ligament are especially sensitive to its femoral insertion. Locating the femoral insertion site may be difficult with direct visualization, especially through a small incision, and intraoperative radiographic imaging (fluoroscopy) is typically used to localize this site via previously described landmarks. [74] Once both patella and femoral sites are indentified and prepared, the graft is secured to one of the sites (surgeon’s choice), brought through the 2nd layer of the knee to the other site, tensioned, and secured. Multiple techniques for graft fixation on both the patella and femoral sides exist, including suture anchors, bone tunnels, interference screws, knotless anchors, and suspensory buttons. While no single technique has been shown to be superior to others in clinical studies, suture anchor fixation of the graft to the surface of the bone has been shown to be weaker than fixation of the graft within a tunnel. [43]
Technical errors of MPFL reconstruction typically result from improper graft position and/or graft tension. Recurrent instability can occur when the tension on the reconstructed ligament is inadequate. In biomechanical studies properly tensioned grafts have been shown to restore stability and normal tracking of the patellofemoral articulation without excessive contact pressures, while overtensioned grafts restricted motion and resulted in increased medial patellofemoral pressures. [75] Malpositioning the graft and making it too short may as much as double the graft tension in flexion [76], which is likely to lead to eventual development of patellofemoral arthrosis.
The authors’ preferred technique for MPFL reconstruction is with a double-incision approach, using a semitendinosis autograft or allograft (based on patient preference). The medial facet of the patella is exposed first and burred down to bleeding bone, to encourage healing. Two tunnels are created in the medial facet by reaming over guidewires (Figure 8A), the position of which can be checked with fluoroscopy (Figure 8B). The graft is loaded onto an adjustable suspensory fixation device and its free ends aresecured into the patellar tunnels with interference screws. (Figure 8C) The femoral insertion site is identified with fluoroscopy using a radiographic template (Figure 8D) and a guidewire is drilled into this area, exiting on the lateral side of the knee. Once this guidewire is in place, a suture is passed from the patellar insertion to the femoral guidewire, and the knee is then taken through the range of motion to assess isometry of the suture at the early angles of flexion, which predicts the isometry of the reconstructed ligament. A femoral tunnel is then reamed to but not through the lateral cortex (Figure 8E). The graft is now brought through the appropriate layer to the entrance of the femoral tunnel (Figure 8F); the button of the suspensory deviceis passed through the tunnel and flipped on the lateral femoral cortex, and the graft is then drawn into the tunnel (Figure 8G and 8H). The graft tension is then adjusted, and once appropriate tension is obtained, interference screw is used to back-up graft fixation at the medial aperture of the femoral tunnel. Additional procedures are performed as necessary.
MPFL reconstruction with a double incision technique, using semitendinosus autograft, interference screws/knotless anchors on the patella side, and interference screw + cortical suspensory button-loop device on the femoral side. a) guidewires drilled into the medial facet of the patella; note the incision for semitendinosus harvest; b) position of the guidewires confirmed radiographically; c) semitendinosus graft secured to the patella; d) intraoperative lateral image showing a radiographic template overlying the distal femur, allowing placement of the guidewire in the appropriate position for a femoral tunnel; e) femoral tunnel is reamed under fluoroscopic visualization; f) graft is passed to the femoral tunnel; g) intraoperative radiographs (AP and lateral) of the final reconstruction, demonstrating patella tunnels and the suspensory button-loop fixation device on the lateral femoral cortex; h) intraoperative photograph of the final reconstruction (different case – single incision technique, with gracilis autograft)
A number of osteotomies and transfers of the tibial tubercle have been described, aiming to realign, offload or do both to the patellofemoral joint. These can address such problems as patella alta and excessively high Q-angle.
Hughston osteotomy transfers the tibial tubercle distally and medially. It improves the TT-TG distance and also inferiorizes the position of the patella, and is a useful surgical procedure for severe patella alta. However, there is a risk with this procedure of globally increased patellofemoral contact pressure.
In the absence of patella alta, the two osteotomies most commonly for patellofemoral instability are the Elmslie-Trillat osteotomy, otherwise known as Tibial Tubercle Medialization (TTM), and the Fulkerson osteotomy, otherwise known as tibial tubercle anteromedialization (AMZ). Elmslie Trillat is a single-plane osteotomy that translates the tibia tubercle straight medially, and has demonstrated relatively low rates of recurrent instability, good functional outcomes and return to activities, although patient satisfaction decreases over time. [77-79] The AMZ is an oblique-plane osteotomy, translating the tubercle anteriorly and medially, (Figure 9) allowing both improvement of the TT-TG distance and offloading of the lateral and distal patella facet and the lateral femoral trochlea, and is commonly used both for patellofemoral instability and lateral patellofemoral arthrosis. It does, however, increase the load on the medial trochlea and patella, and is contraindicated when there is preexisting arthritis in these areas. A number of studies evaluating outcomes of the AMZ have shown 74-95% good or excellent results, with better outcomes in males, patients with intact patellar cartilage, and in cases when osteotomy was done for instability (and not for painful maltracking/arthritis). [80-82]
Postoperative radiographs after AMZ procedure (combined with MPFL reconstruction), in the same patient as in
Femoral trochleaplasty is a relatively new procedure which seeks to address severe femoral trochlea dysplasia, such as with “dome-shaped” trochlea. The surgical technique involves removing a sulcus of cancellous bone from under the trochlear groove, and then impacting the cortical shell into this space. The procedure has been shown to improve stability of the patellofemoral joint, but does not prevent development of subsequent patellofemoral arthritis. [83]
Initial management of a first-time dislocator should include immobilization of the knee in extension and appropriate imaging, including plain radiographs (bilateral patellofemoral views for comparison) and an MRI. Patients without osteochondral injury, static subluxation, or predisposing factors can typically be treated nonoperatively, with a period of immobilization (2-4 weeks), followed by therapy to restore motion, strength, stability and proprioception. Consideration may be given to acute MPFL repair in cases of severe injury to the ligament, especially avulsions from bone. The authors prefer to perform such a repair with two suture anchors.
Patients with significant osteochondral injury typically require arthroscopic or open procedure to remove or repair the fragment, and consideration should be given to addressing the MPFL injury at the same time, with repair or reconstruction. Patients with significant predisposing factors such as dysplasia or malalignment are at particularly high risk for recurrent dislocation with non-operative treatment, and should be considered for MFPL reconstruction, even after a first-time dislocation. The goal of this seemingly aggressive approach is to prevent recurrent instability that may result in additional osteochondral injury, and thus predispose to patellofemoral arthrosis.
Recurrent dislocators who wish to remain active and athletic, as well as patients who experience instability with daily activities, typically require MPFL reconstruction, although arthroscopic or open plication of the MPFL and medial retinaculum can be done for patients with mild instability (subluxation, rather than dislocation) and no significant dysplasia or malalignment. In patients with recurrent instability and lower extremity malalignment consideration should be given to tibial tubercle transfer. Selection of appropriate osteotomy is as follows: Hughston osteotomy (distal and medial) for patella alta, Elmslie-Trillat (medial) for recurrent instability with increased TT-TG distance but normal patellar height, and Fulkerson/AMZ (anterior and medial) for recurrent instability and lateral patellofemoral arthrosis or compression. Patients with severe trochlear dysplasia, such as a “dome-shaped trochlea” should be considered for trochleaplasty.
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
First-time dislocation | \n\t\t\tNo dysplasia No malalignment No intraarticular fragments No static subluxation of the patella | \n\t\t\tNon-operative (initial immobilization, followed by rehabilitation therapy) | \n\t\t
First-time dislocation | \n\t\t\tIntraaticular fragments | \n\t\t\tArthroscopy or open procedure for fragment removal or repair | \n\t\t
First-time dislocation | \n\t\t\tMPFL avulsion from bone (femur or patella) AND static subluxation of the patella (compared to contralateral side) | \n\t\t\tAcute MFPL repair (with suture anchors) | \n\t\t
First-time dislocation | \n\t\t\tPatellofemoral dysplasia and/or malalignment | \n\t\t\tMFPL reconstruction +/- tibial tubercle osteotomy (TTO) | \n\t\t
Recurrent dislocation | \n\t\t\tNo significant dysplasia or malalignment | \n\t\t\tMPFL reconstruction | \n\t\t
Recurrent dislocation | \n\t\t\tSignificant malalignment (high Q-angle, TT-TG distance > 20mm) | \n\tMPFL reconstruction with TTO | \n
Recurrent dislocation | \n\tSevere trochlear dysplasia | \n\tMPFL reconstruction with trochleaplasty | \n
Recurrent subluxation | \n\tNo dysplasia or malalignment, intact MPFL | \n\tConsider arthroscopic or open imbrication of the MFPL and medial retinaculum | \n
Algorithm for selecting appropriate treatment for a patient with patella instability
Immediate postoperative care is focused on multimodal pain management program, swelling control, and protecting the repair, reconstruction or osteotomy.Physical therapy protocols vary depending on the degree of preoperative instability, the type of surgery performed (bony versus soft-tissue, repair versus reconstruction, etc.), and patient-specific factors.
For soft-tissue procedures, the knee is initially immobilized in extension, and weight-bearing with the brace locked in extension is typically allowed. The brace is continued for 6-8 weeks or until quadriceps control is regained. Typically, after MPFL reconstruction, especially with secure graft fixation in bone tunnels, limited passive range of motion of the knee can be initiated immediately after surgery. In cases of MPFL avulsion repairs with suture anchors the authors prefer to immobilize the knee for 3-4 weeks prior to initiating any range of motion, to allow some healing of the repair.
The majority of bony procedures performed for patellofemoral instability are tibial tubercle osteotomies, and the goal of early rehabilitation after this type of surgery is to prevent excessive traction on the patella tendon. Therefore, an extension brace is worn, weight-bearing is typically protected for 4-6 weeks, while passive range of motion may be allowed to a limited degree, as long as fixation of the osteotomy is secure. Active knee extension is typically restricted for at least 6 weeks, or until the osteotomy is healed.
The postoperative physical therapy protocol after patellofemoral stabilization is typically divided into 3 phases. (Table 4) Phase I (0-6 weeks) focuses on controlling the inflammatory process, protecting the bony or soft tissue fixation, and regaining quadriceps and VMO control, typically with isometric strengthening. Phase II (6-12 weeks) involves exercises to regain full range of motion, patella mobilization and continued VMO strengthening to stabilize patellar tracking, and return to a normal gait pattern. Phase III (after 12 weeks) progresses with strengthening and endurance exercises to regain full quadriceps strength and proprioception. Return to sporting activity is allowed only when the patient has no pain, no sensation of instability, regains full range of motion, andhas normal or near normal quadriceps strength. For tibial tubercle transfers healing of the osteotomy on radiographs should be confirmed prior to allowing sports participation. Return to full athletic activity typically takes 4-6 months after surgery.
Phase I (0-6 weeks) | \n\t\tDecrease inflammation Protect surgical fixation Regain quadriceps/VMO control (isometric strengthening) | \n\t
Phase II (6-12 weeks) | \n\t\tRegain full range of motion Mobilize the patella Continue quadriceps/VMO strengthening Normalize gait | \n\t
Phase III (>12 weeks) | \nAchieve full strength Build up endurance Regain proprioception | \n
Phase IV - Return to sports | \n\tNo pain No sensation of instability Full range of motion Normal or near normal quadriceps strength Radiographic healing of osteotomy (if done) | \n
Postoperative Rehabilitation Protocol After Patellofemoral Stabilization Surgery
Patellofemoral instability typically affects the young and athletic patient population. Initial trial of non-operative treatment is warranted for patients after a first-time dislocation, and without intraarticular osteochondral fragments, severe injury to the medial stabilizers, significant malalignment or patellofemoral dysplasia. When surgical treatment is contemplated, the focus should be on restoring integrity of the MFPL and optimizing the alignment of the lower extremity and specifically of the patellofemoral articulation. MPFL reconstruction has produced the best results in patients with mild or no dysplasia and malalignment, while tibial tubercle osteotomies are indicated in patients with abnormally high Q-angle and increased TT-TG distance.
The natural history of acute patellofemoral instability is that of a relatively high rate of recurrence as well as long-term functional limitations and inability to return to baseline level of activity, and thus surgery often plays a role in management of these patients. Prospective randomized trials comparing different surgical techniques are needed to determine which treatment options provide optimal restoration of function, minimize recurrence, and decrease the risk of arthritic degeneration.
The ecosystem classification of land is about the theory and design of the ECL framework and implements and practices in different nations, continents, and global scales. Bailey had made his primary studies and contributions on ecological classification framework and application, representing his scientific collections of mapping on ecosystem classification of land for the United States, North America, and global continents in [1, 2]. The ecological sites were studied and monitored with environmental conditions, biological characters, and ecosystem services [3, 4, 5, 6]. Ecologists and geographers had proposed and classified the land into simplified ecosystems where the different plants, animals, and bacteria populations lived together. By processing into different scales, geographers and ecologists designed ECL framework, theory, and applications to depict the ecosystem as systemically organized, nested, and multiple layers in [7, 8, 9]. They are so complex and adapted a cycle crossing a threshold from one stable state to another depending on the seasonality, time, landscapes, and disturbances in Refs. [10, 11], which results in the academic argument where to draw a line based on prior selected criteria, how to identify ecological sites and classify the ecoregions in Refs. [1, 3, 8, 12, 13, 14]. Afterward, do we achieve our research goal?
From a philosophical perspective, ecological regionalization could be concerned as an objective that has a form with a perceptive logic; at other times, it is an inductive and subjective art that reflects a management consideration, which is dependent on the application of the ecoregion. However, with the ecological regionalization, the contributions of existing ecoregion schemes are inconsistent. In other words, it is getting study complete with errors remaining in [11, 15].
A large amount of vector or raster formats data made the quantitative and spatial analysis more useful and practical in the last two decades. The tree technique was used to explore the analysis of complex ecological data with nonlinear relationships and high-order interaction in 2000 [16]. Many studies and attempts to analyze the complex system of nature as dynamically organized and structured within and across the scales of space and seasonality had assisted ecological researchers to solve population richness and dynamics in [17], vegetation distributions in [18, 19], and ecosystem classification framework in Refs. [1, 2, 9, 14, 20, 21, 22, 23, 24]. Understanding how environmental variables influenced the vegetation pattern and distribution and successional order, many research works demonstrated a hierarchical paradigm in Refs. [1, 11, 15, 25].
From 1976 to 1998, Bailey started to identify the ecoregion boundaries and generated the ecoregions of the United States, North America, and the world’s continents. He published his research works and had made significant progress in the 1990s. In 1993, Bailey classified the ecoregion into the top three level classes: Domain, Division, and Province. Then, applying the Köppen climate system of classification, he depicted the Domains with the synthetic description of the land surface form, climate, vegetation, soils, and fauna, seeing in [1, 2, 3]. Since Federal Geographic Data Committee (FGDC) in the United States accepted the National Hierarchy of Ecological Units (NHEU), ECOMAP in [26] was created with eight levels hierarchical approach to study the ecosystem classification of Land (ECL).
Bailey and Jensen published their work on the design and ecological mapping units with nine levels [27]. The Subregions below the Domain, Division, and Province were divided into Sections, Landtype Association, Landtype, Landtype Phase, and Ecological Site. Thus, NHEU and Bailey had driven a classified Ecosystem Classification of Land into the nested hierarchies at various scales, depending on management needs.
In the global context of ecosystem classification of land, we need to understand the landscape-scale processes more generally. The issue focuses on generalizing ecoregions, the landscape-scale variation, and the combination of abiotic and biotic factors. It had been extended to identify the circumstances in which generalizations can be made, where there are limits, and find a solution in Refs. [9, 10, 14, 24, 28, 29]. It was valuable to examine the hierarchies of ecosystem classification of Land {ECL} globally when we had working experiences and research cooperation that can be related in different countries or continents in Refs. [12, 14, 19, 30]. More recently, the ecosystem services and values have been concerned with the wise use of biodiversity and natural resources [6].
In this chapter, we tried to compare the current two national ecosystem classification frameworks and assess any Domain related issue when it existed. We tried to find suitable abiotic and biotic factors, topographic features, climatic, and ecosystem services to generate deliverable lower-level ecosystem classification when these related research works were reported and published. However, this inconsistency in terminology is often confusing because similar terms may have different meanings or apply to different scales, and different terms may have the same meaning in [15]. Therefore, we will stick to our current references and literature for reviewing and discussing.
Two sets of ecoregions data of Western Utah of the United States, Yukon Territory of Canada were analyzed and validated. The Biogeoclimatic Ecosystem Classification (BEC) approach was referred to as an additional assessment in the discussion. Our focus was tried to explore lower level ecosystem classification in the different ecoregions of North America in Refs. [1, 2, 31, 32, 33, 34, 35, 36, 37, 38, 39].
The ecosystem can be a complex system more than we thought, which is changed and varied along with longitude, latitude, and elevation on the earth’s surface, and constantly adapted to the slope, aspect, environmental variables in macroscales [1, 2, 7, 9, 15, 17, 24]. Bailey had contributed to the ecological classification framework and application, which represented his scientific collections of mapping on ecosystem classification of the United States (Figure 1A).
(A) Upper level ecoregions of the United State.
Theoretically, Bailey’s Ecosystem Classification of Land had explained the ecoregions and their nested structures in the upper levels of Domain, Division, and province. However, these advantages had not been fully applied and examined as ECL’s bases for Terrestrial Ecozones and Ecoregions of Canada in [31, 36, 37, 38, 39], even though technically Bailey’s ECL polygons in the upper three levels can be easily retrieved in GIS spatial model in [14] when the ECL project was conducted.
The Ecological Framework from Canada Ecological Stratification Working Group in 1996 defined four upper levels of ecosystems as a nested hierarchy. Definitions and the number of map units for the four levels of generalization are outlined in Table 1 in Ref. [39] and Figure 1B and updated by Statistics Canada in 2018.
Canada Ecozones on a sub-continental scale is defined and represented an area of the earth’s surface of large ecological units classified by interactive and adjusting abiotic and biotic factors. Canada is divided into 15 terrestrial Ecozones. | |
A subdivision of an Ecozone was classified by major assemblages of structural or surface forms, faunal realms, and vegetation, hydrology, soil, and macro climate. | |
A subdivision of an Ecoprovince was classified by distinctive regional ecological factors, including climate, physiography, vegetation, soil, water, and fauna. | |
A subdivision of an ecoregion was classified by a distinctive assemblages of relief, landforms, geology, soil, vegetation, water bodies and fauna. |
In brief, Bailey’s 100 Polar Domain only included an area with short summer and low temperature throughout the year, which had been divided into three major Divisions, Icecap Division, Tundra Division, and Subarctic Division, furthermore had been recognized and delimited into 13 Provinces (124,125,126, M121, M125, M126, M127,131,135,139, M131, M135, M139). Bailey also extended Humid Temperate Domain (200) to Canadian Territorial and classified Warn Continental Division (210), Hot Continental Division (220), Marine Division (240), Prairie Division (250), and Dry Domain (300) overlaying with Canada subcontinent. However, the Provinces’ descriptions had very little content about Canadian Territory (242, 244,245,251, 331, 332, etc.).
Bailey’s 100 Polar Domain overlays the area of Canadian eight Ecozones of Arctic Cordillera (covers Ecoregion 1–7), Northern Arctic (Ecoregion 8–31), Southern Arctic (Ecoregion 32–49), Taiga Plains (Ecoregion 50–67), Taiga Shield (Ecoregion 68–86), Boreal Shield (Ecoregion 87–116), Atlantic Maritime (Ecoregion 117–131), Taiga Cordillera (Ecoregion 165–171) in Figure 1B. Furthermore, Bailey’s 200 Humid Temperate Domain covers the area of Canadian six Ecozones of Mixedwood Plains (covers Ecoregion132–135), Boreal Plains (Ecoregion 136–155), Prairies (Ecoregion 156–164), Boreal Cordillera (Ecoregion 172–183), Pacific Maritime (Ecoregion 184–197), Montane Cordillera (Ecoregion 198–214). In addition, the Prairies in Canada is extended from 200 Humid Temperate Domain to 300 Dry Domain.
Early pioneering works in North America evolved from forest and climate classifications and were often climate-driven, referred to in [1, 2, 13, 31, 32]. The use of more holistic classifications was recent from 1980′ to 1990′. The holistic approaches were recognized and considered the importance of a broad range of physical and biotic characteristics for identifying ecosystem regionalization and classification. They recognized that ecosystems of any size or level were not always dominated by one particular factor. In describing the ecoregion framework of Canada in [13], Wiken indicated, “The Ecological land classification is a process of delineating and classifying ecologically distinctive areas of the Earth’s surface, which can be viewed as a discrete system that has resulted from the mesh and interplay of the geologic, landform, soil, vegetative, climatic, wildlife, water, and human factors”. Therefore, land classification can be applied incrementally on a scale-related basis from site-specific to broad ecosystems.
Because of underlying dynamics of the ecosystems, the multiple patterns of correlation among the biotic, abiotic, and human factors produced the complex; these approaches were apt to produce a converging depiction of regions and significant ecosystem boundary overlapping between Canada and the United States in Refs. [1, 34, 35, 38, 39]. Thus, Canada’s continental upper level ecoregion framework defined the ecological Mozaic on a sub-continental scale, representing an area of the Earth’s ecological units characterized by interactive and adjusting abiotic and biotic factors. It is not possible to equate Canada and US classification systems directly in [31].
At Domain, Division, and Province levels, Ecoregions of the United States had been examined by Bailey. The first case study we used for the lower level was accomplished with the upper four levels for the project in a 4.5-million-hectare area centered in western Utah of the United States. National Hierarchy of Ecological Unit (NHEU) had been referenced as the coarsest boundaries in Utah, the United States. This study area was on 300 Dry dominant divisions and had bounders intersecting with 340 Temperate Desert Division and M340 Temperate Desert Regime Mountains Divisions. Three interesting provinces are 342 Intermountain Semi-Desert Province, M341 Nevada-Utah Mountains Semi-desert Coniferous Forest Alpine Province, and 341 Intermountain Semi-Desert and Desert Province. In addition, four sections were intersected in the study area: Bonneville Basin Section, Central Great Basin Section and Northeastern Great Basin Section, and Northwestern Basin and Range Section, shown in Figure 2, Table 2 in [14].
Upper four levels of ECLs overlaid and intersected in the study area.
Level | ECOMAP name | Example name | Main environmental characters | Scales |
---|---|---|---|---|
1 | Domain | 300 Dry | Climate/ Köppen Bsk | Ecoregion |
2 | Division | 340 Dry Temperate | Climate | Ecoregion |
3 | Province | 342 Intermountain Semi-Desert | Climate | Ecoregion |
4 | Section | Central Great Basin | Topography/Terrain | Segment |
5 | Subsection | Erosional Landscape | Intermediate Scale Terrain Segment | Landscape Mosaic |
6 | Landtype Association | Hard Erosional Landscape | Macroterrain Units, | Landscape Mosaic |
7 | Landtype | Eolian Sediments | Mesottrain Units | Landscape Mosaic |
8 | Landtype Phase | Sedimentary (ridge, slope etc) | Microterrain Units | Zone/Subzone |
9 | Ecological Site | Desert gravelly Loam | Objectively Defined Land Unit | Site |
10 | Vegetation Stand | Sagebrush | Homogeneous Vegetation | Stand |
Summaries of the implemented ecosystem classification in western Utah.
“Bolson” is used as a term in the lower level of ecosystem classification, described the terrain, having entire area from surrounding mountains to mountain slopes, reduced with distance from ridgelines, to the centre of either a river valley or terminal lake basins, or reaching nearly all the study area. DEM data (30 m) was used in the model (Figure 3A and B) and generated 60 bolson segments.
(A) DEM landscape layout of study area. (B) The 60 bolson segments of the subsection.
In the study area, the 60 bolson segments were subdivided into different macroterrain units. The algorithm to determine macroterrain units employed elevation and relative change in apparent elevation (slope) from adjacent 30 m DEM cells. It had classified the cells as upslope of equal or higher slope position. Thus, most “mixed” macroterrain unit cells will have “erosional” cells upslope and “depositional” cells downslope depended on their positions. This principle of “superposition” was enforced by the application of the macroterrain class using watershed functions.
With available data of geologic formation or sediments at 1:50,000 scale, the computer algorism was used to identify and delineate the polygons with name attributes for example the metamorphic or moderately hard sedimentary rock, basalt, alluvium, and eolian sediments. By a rationale based on probability, the exposed bedrock units were identified by steeper slope classes, and the presence of rock outcrop as the mapping units.
The mesoterrain units were divided into subdivisions called microterrain units. Microterrain units were further nested subdivisions of mesoterrain units, which were based mainly on landforms for the erosion-dominated surfaces and landforms plus soils condition. The protocols repeatedly identified landscape units. And two additional levels below the 8th level (NHEU) were added. The 9th level of Ecological sites (ESs) was designed and implemented by using important data on ESs, nested to ECOMAP; the 10th and finest-grain level of vegetation stands were subdivisions of individual polygons of ESs based on differences in disturbance histories (fire, grazing, and human activities) (Table 2). The vegetation stands were studied and described by vegetation characteristics, representing fine-scale variations in regional climate, site-specific moisture, nutrient regimes, and disturbance histories (Figure 4A and B).
(A) Flow diagram of ecosystem classification of land from bolson segments to vegetation stands. (B) Map of the ecological sites in sampling area.
The major Canadian publications about territorial ecosystem classification or ecoregion classification were designed and generalized as a hierarchical, nested framework with systematic, nested hierarchical layers in the upper four layers (Table 1) in [38, 39].
In second case analysis, we validated the Environment Yukon’s data and documental report [40, 41, 42, 43] with our field observation. The territory of Yukon is approximately 483,450 km2, about 2.2 times that of Utah State in the US, and intersects with Southern Arctic, Taiga Plain, Taiga Cordillera, Boreal Cordillera, and Pacific Maritime Ecozone. Yukon’s 23 Ecoregions
(A) Yukon ecozones and ecoregions. Data source from Ecological Stratification Working Group and Smith et al. editors [
The research and field work focused on displaying and describing bioclimate features such as the horizontal distribution from south to north and vertical distribution from lower to high (Figure 5B). The study was characterized the broad areas influenced by similar climates into a hierarchy of bioclimate zone to lower level classification. Thus, Boreal Low (BOL), Boreal High (BOH), Subalpine (SUB), Taiga Wooded (TAW), Taiga Shrub (TAS), Tundra (TUN), Alpine (ALP) were identified as Bioclimate Zones. The broad ecosystem types by slope position and the phases by plant community dominant species were identified in the nested multiple layers and simplified in Table 3 in Refs. [41, 42, 43]. Field survey and road investigation were carried out at the eleven observation points in 2021 summer (Figure 5B). The broad ecosystem types were classified by relative moisture regime as dry, moist, and wet, which can be functionally represented and retrieved the relationship by the generalized the Edatopic Grid as Figure 6, and using indexes of Hydrodynamic, aquatic and actual moisture, PH, similarly to it in report [43].
Level | Yukon nested ECLs | Classification I | II | III | Equivelent to |
---|---|---|---|---|---|
1 | 100 Domain | Domain | Bailey’s Top Level | ||
2 | 12 Ecozone | Boreal Cordilera | Canada’s Top level | ||
3 | 12.2 Ecoprovince | Northern Boreal Cordilera | Bioclimatic Zone | ||
4 | 12.2.176 Ecoregion | Yukon Plateau-North | Bioclimatic Subzone | ||
5 | 12.2.176.0898 Ecodistrict | Elsa | Canada ECL’s unit | ||
6 | Board Ecosystem | H. Wetland | B. Ridge | D. Plains | Bioclimatic/ Slope Position |
7 | Board Ecosystem Phase | Shrub and salix grasses | Herb | White Spruce | Bioclimatic/ Plants |
8 | Ecological site/Ecosite | Lodgepole Pine Spruce-Grass-Lichen | Ledium / Salix | Mixedwood/Boardleaf Forest | Objective or Bioclimatic |
Yukon’s board ecosystem classification and nested lower levels’ ECL.
Note: bioclimatic Zone: TAW- Taiga Wooded, BOL-Boreal Low, BOH-Boreal High, SUB-Subalpine, TUN- Tundra, ALP- Alpine.
Bioclimatic subzones: Yukon Plateau North, Eagle Plains, North Ogilvie Mountains etc.
Canada ecodistrit can be searched and viewed https://databasin.org/maps/new/#datasets=8dca767690af48e6ae5581b34612a19d
Broad ecosystem gernerated with edaptopic grid scheme and slope position. The board ecosystem types can be identfied in a lanform position.
A DEM is a derivative product of the CanVec topographic data set. In Yukon, DEM is available for the entire territory. The generalized GIS model in Keno town area was established to generalize the lower level’s bioclimate board ecosystem classification. Predictive ecosystem mapping relayed on digital elevation models (DEM) to represent landform slope and aspect conditions. These conditions provided and informed soil moisture, a primary determinant of ecosystem pattern. A demonstration was the slope survey completed near Keno city up to Monument hill (Figure 7). Subalpine shrub appeared above elevation 1530 m, and Salix + Carex shrub grasses from 1600 m to 1730 m. Homogenous Carex + Litchen alpine vegetation located at 1780 m become biological indicator where was near the ice valley or cold environment. Gravels + Carex + gravels belt located at 1825 m indicated that the seasonal frozen condition was occurred constantly.
Vegetation distribution along Keno Hill slope, Yukon.
By analyzing the upper level of ECLs in the United States and Canada, we realized that the ecosystem classification of land was a special methodology to explore and classify the ecoregions in the different countries. Bailey classified upper-level Ecosystem Classification of Land (Domain, Division, and Province), in which Domain was based on Köppen climate system classification [1, 2, 3]. Bailey, in Ref. [34], indicated that the differences in the climatic regime distinguish the natural ecosystems. The principle is that climate, as a source of energy and moisture, acts as the primary control for the ecosystem. Whether or not using Bailey’s Domain as the top level of Canada’s territorial Domain remained a further comparison between the United States and Canada. At least, the upper four levels’ ecosystem classification and detail descriptions of Canada (see Table 1) would be the best fulfillment and data source. Technically, the vector and raster data can be retrieved and integrated into GIS software [14, 44, 45, 46].
The Ecological Framework of Canada in Refs. [37, 38, 39] used different classification schemes and presented the upper four levels of ecosystem classification with features of hierarchy structure in a subcontinent scale. Canada’s top-level fifteen Ecozones have overlaid and intersected with Bailey’s 100 Polar Domain, 200 Humid Temperate Domain, and 300 Dry Domain. For instance, Bailey’s 100 Polar Domain overlays the area of Canadian eight Ecozones, Bailey’s 200 Humid Temperate Domain covers the area of Canadian six Ecozones. In addition, the Prairies in Canada is extended from 200 Humid Temperate Domain to 300 Dry Domain in the US.
ECOMAP defined by the National Hierarchy of Ecological Unit (NHEU), had presented the “top-down” approach of Ecosystem Classification of Land in the United States. Western Utah’s project had proved that it was a cost matter through a complete ECL’s field survey. Another consequence of the strictly top-down nested hierarchical design of ECOMAP is that progressively smaller and unique polygons are created for each level. In other words, the ECOMAP process applied so far prevents one from easily relating features at one location to those within other landform units or bolson segments. Thus, ECOMAP is a top-down regionalization with hierarchically nested features for an explicitly geographic area. At the same time, these futures allow the ecosystem classification units to be used for various needs, from local to national. These features in the NHEU are the perimeters of outer polygons created at lower levels have to be vertically integrated with the delineation of polygons occurring at upper levels.
The limitation is for this “top-down” process; if the lowest levels are produced independently from higher levels, we still cannot answer whether the similarity of the same label polygon or unit is the same until a field survey is conducted or references available.
Much information for local managers and management companies, not all information very useful for Ecological land of classification. We did not expect any ecological research had funding to complete for mapping as to details. The project in a dry domain area with a 10 level classification would be more theoretical than practical management.
While network linked rather than nested hierarchically could be employed, we propose a simpler, more straightforward solution. Our actions were carried out a complete hierarchical land classification from a top-down approach. Ideally, we treated the ecosystem like an “organism” and separated it into components, following a top-down nested hierarchy to its finest subdivisions, and countered in common sense and practicality. Thus, a terrestrial ecosystem is considered as a volume of earth space with organic contents. We separated it from its neighbors by reasonable divisions by the empirical observation and knowledge in climatology, geography, ecology, soil, and physiography in [47, 48, 49, 50, 51].
While it is recognized that the National Ecological Framework with the terrestrial ecoregions in Table 1 is a referential part of the Yukon ELC Framework, maintaining these layers for Yukon as attributive layers and data in the GIS model that is recommended in [40, 41, 42, 43]. Specially, using 100 Domain as a top level ELC. Canada’s Ecozone was considered as second level ELC. Canada’s Ecoprovince in Yukon Territory was equivalent to the Bioclimate Zone, and Ecoregion was equivalent to the Bioclimate Subzones. Canada’s Ecodistrict was established and can be used as identical fifth ELC layer. The sixth and seventh ELCs were related to Bioclimatic Board Ecosystem in terms of slope position and plant population important index. Canada’s eight ELC was objectively defined Ecological Site or bioclimatic Ecosite. Thus, we established a complete ELC in Yukon Territory (Table 3).
The management approach and applications for the broad ecosystem classification and mapping are listed in Table 4.
Mapping level and scales | Applications | Context |
---|---|---|
Bioclimate (1:100,000 to 1,000,000) | Climate Change Studies | Plant species shifting and community succession |
Board Ecosystem 1:50,000 1:250,000 | Regional land use planning | Land use changes and management policy |
Local Ecosystems 1:10,000 to 1:50,000 | Environmental Impact assessments | Land Degradation, recovery and restoration |
Varies | Ecosystem Services | Ecosystem Assessment, Supporting, provisional, regulating and cultural services |
Broad ecosystem classification mapping and applications.
Practically, the lower level cases of Canada territorial Ecosystem Classification had preferred more practice and objective. The researchers can use GIS technology and Spatial Analysis Modeling to efficiently produce the different maps for the landowner, management companies, and government agencies. In addition, plant ecologists had sophistical experiences in [18, 30, 33, 44, 52, 53, 54, 55, 56, 57] to develop the vegetation classification and ecoregion map with a nested structure using biogeoclimatic principles. The map products were delivered by the scaled-based ecosystem classification and represented them with a high relation among the long-term climate condition, climax vegetation, and dominant plant species.
In addition to Bioclimatic Board Ecosystem Classification, Biogeoclimatic Ecosystem Classification (BEC) approach was often demonstrated as a quick approach and identified as an ecological framework for vegetation classification, mapping, and monitoring vegetation dynamics in [33, 44, 53, 54, 55, 58]. BEC approach has been used in many provinces in Canada, and the association-based ecological units of BEC are the fundamental units, for example, that the boreal vegetation association was integrated for its boundary justification. Also, the BEC approach delineated ecologically equivalent climatic regions and displayed the site conditions in the Edatopic Grid with a relationship between soil nutrient regime and soil moisture regime in [53, 54].
Ecologists studied different computational models in ecological classification such as LeNet, AlexNet, VGG models, residual neural network, and inception models in Refs. [16, 17, 24, 28]. The biggest challenge was faced in the need for an extensive training dataset to achieve high accuracy. Examples trained algorithms and the machine can only detect what criteria have been previously shown and selected. Deep learning, or machine learning algorithms, was going on method for analyzing nonlinear data with complex interactions. Moreover, they can achieve remarkable accuracy for identification and classification tasks. As a result, achieving proper ecological predictions is more feasible now. Increasing data availability is highly related to using GIS, remote sensing, and international research networks in Refs. [45, 46, 56, 57]. Furthermore, a fundamental change in research culture is towards making ecological data open access publically. All of these developments are important factors behind deep learning and development in ecology.
With further understanding, the ecosystem classification approaches and ecological modeling experiences in [14, 44, 46, 56, 57, 59] and objectively defined ecosystem classification can be integrated by using a computer algorithm to develop efficient tools and affordable applications (Figure 8) without losing hierarchical structure feature in [30]. The ECL menu had input data function by getting upper-level Domain, Division, Province, and Section digital format data, and carried out a deliverable application associated with a scaled lower level ECLs. The objective analysis generated internal function outputs and combined them in the Deep Learning Algorism. The slope model, landform model, was running based on objective needs; vegetation, soil, and geology data could be considered attribute data sources depending on the study area.
Objectively defined ecosystem classification.
We did not discuss landscape-scale changes and boundary issues that influenced ecosystem classification, which authors already presented in Refs. [1, 2, 11, 15, 25, 31, 48, 49]. Second study case demonstrated that a full ECL generally included three components: Bailey’s upper level ECL, Broad Ecosystem classification, and bottom level Ecological site. With assessment, justification, and testing, we completed a full Ecosystem Classification in a Yukon ecoregion.
Why do we use western Utah’s ECL to compare with Yukon’s? The direct reason is that these two ecoregions had fewer human activities and had more broad original nature ecosystems in North America. In the meantime, the climate conditions are between a Dry Domain and a Polar Domain in these two ecoregions. Our study cases led the research and study with a complete ELC in Bailey’s 300 Dry Domain and 100 Polar Domain.
Canada’s continental upper level ecoregion framework defined the ecological Mozaic on a sub-continental scale, representing an area of the earth’s ecological units characterized by interactive and adjusting abiotic and biotic factors. Therefore, using Bailey’s Domain as the top level of Canada’s territorial ecoregion was recommended. Similarly, many users suggested that they examined the popularity and characteristics in a study area linked to the continental and global scales in [1, 8, 59, 60, 61, 62] whenever necessary and integrated to delineate and identify the regional ecosystem. Ecological regionalization is an abstraction from global to a local site-level, contributing to understanding nature and providing differentiated guidance to sustainable environmental management. It recommended that using the global ecoregion scheme offers the guidelines for biodiversity conservation, but it still faces obstacles in improving ecosystem services and substantial uses. We had reviewed and analyzed the regionalization process, implements in two ecoregions, and some practices. With the critical consideration of ecosystem services, global environmental change and human activities should be followed in functionalized ecological regionalization. Ecosystem regionalization is a scale-based approach to classifying land surfaces, combined with regional and continental data. We should have understood more about taking geology, landform, soils, vegetation, and climate into account to classify the regionalization in different scales and ecosystem levels for a global-wide scheme when the ecosystem studies and services have grown in the research, publication and practice.
Correspondence author collaborated in USU’s ECL project with Prof. Neil West (Referred West et al., 2005), and conducted the Yukon Ecosystem Classification Project. The final study was supported by Instant Calling Spatial Arch Lab, Burnaby, BC, Canada. Thanks to Prof. Neil West for his past advice. Thanks to Simon Fraser University Library funds for eligible open access publication.
Authors declare that there are no competing interests.
Authors have contributed a lot to this manuscript and approved the final manuscript.
Final stage’s research fund was supported by Instant Calling Spatial Arch lab, Burnaby, B.C. Canada, and Simon Fraser University Library Open Access Fund.
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Tenreiro Machado",authors:null},{id:"135",doi:"10.5772/4771",title:"Vision Based Tactile Sensor Using Transparent Elastic Fingertip for Dexterous Handling",slug:"vision_based_tactile_sensor_using_transparent_elastic_fingertip_for_dexterous_handling",totalDownloads:2999,totalCrossrefCites:13,totalDimensionsCites:26,abstract:null,book:{id:"6109",slug:"mobile_robots_perception_navigation",title:"Mobile Robots",fullTitle:"Mobile Robots: Perception & Navigation"},signatures:"Goro Obinata, Ashish Dutta, Norinao Watanabe and Nobuhiko Moriyama",authors:null},{id:"10091",doi:"10.5772/8838",title:"In Situ Self-Reconfiguration of Hexapod Robot OSCAR Using Biologically Inspired Approaches",slug:"in-situ-self-reconfiguration-of-hexapod-robot-oscar-using-biologically-inspired-approaches",totalDownloads:2865,totalCrossrefCites:14,totalDimensionsCites:16,abstract:null,book:{id:"3622",slug:"climbing-and-walking-robots",title:"Climbing and Walking Robots",fullTitle:"Climbing and Walking Robots"},signatures:"Bojan Jakimovski and Erik Maehle",authors:null}],mostDownloadedChaptersLast30Days:[{id:"10095",title:"Gait Based Directional Bias Detection of Four-Legged Walking Robots",slug:"gait-based-directional-bias-detection-of-four-legged-walking-robots",totalDownloads:2861,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"3622",slug:"climbing-and-walking-robots",title:"Climbing and Walking Robots",fullTitle:"Climbing and Walking Robots"},signatures:"Wei-Chung Teng and Ding-Jie Huang",authors:null},{id:"58561",title:"Search-Based Planning and Replanning in Robotics and Autonomous Systems",slug:"search-based-planning-and-replanning-in-robotics-and-autonomous-systems",totalDownloads:1146,totalCrossrefCites:3,totalDimensionsCites:2,abstract:"In this chapter, we present one of the most crucial branches in motion planning: search-based planning and replanning algorithms. This research branch involves two key points: first, representing traverse environment information as discrete graph form, in particular, occupancy grid cost map at arbitrary resolution, and, second, path planning algorithms calculate paths on these graphs from start to goal by propagating cost associated with each vertex in graph. The chapter will guide researcher through the foundation of motion planning concept, the history of search-based path planning and then focus on the evolution of state-of-the-art incremental, heuristic, anytime algorithm families that are currently applied on practical robot rover. The comparison experiment between algorithm families is demonstrated in terms of performance and optimality. The future of search-based path planning and motion planning in general is also discussed.",book:{id:"6322",slug:"advanced-path-planning-for-mobile-entities",title:"Advanced Path Planning for Mobile Entities",fullTitle:"Advanced Path Planning for Mobile Entities"},signatures:"An T. Le and Than D. Le",authors:[{id:"211542",title:"Mr.",name:"Than",middleName:null,surname:"Le",slug:"than-le",fullName:"Than Le"},{id:"211558",title:"Mr.",name:"An",middleName:"T.",surname:"Le",slug:"an-le",fullName:"An Le"}]},{id:"58361",title:"Path Planning on Quadric Surfaces and Its Application",slug:"path-planning-on-quadric-surfaces-and-its-application",totalDownloads:867,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"In this chapter, recent near-shortest path-planning algorithms with O(nlog n) in the quadric plane based on the Delaunay triangulation, Ahuja-Dijkstra algorithm, and ridge points are reviewed. The shortest path planning in the general three-dimensional situation is an NP-hard problem. The optimal solution can be approached under the assumption that the number of Steiner points is infinite. The state-the-art method has at most 2.81% difference on the shortest path length, but the computation time is 4216 times faster. Compared to the other O(nlog n) time near-shortest path approach (Kanai and Suzuki, KS’s algorithm), the path length of the Delaunay triangulation method is 0.28% longer than the KS’s algorithm with three Steiner points, but the computation is about 31.71 times faster. This, however, has only a few path length differences, which promises a good result, but the best computing time. Notably, these methods based on Delaunay triangulation concept are ideal for being extended to solve the path-planning problem on the Quadric surface or even the cruise missile mission planning and Mars rover.",book:{id:"6322",slug:"advanced-path-planning-for-mobile-entities",title:"Advanced Path Planning for Mobile Entities",fullTitle:"Advanced Path Planning for Mobile Entities"},signatures:"Chi-Chia Sun, Gene Eu Jan, Chaomin Lu and Kai-Chieh Yang",authors:[{id:"36311",title:"Dr.",name:"Chaomin",middleName:null,surname:"Luo",slug:"chaomin-luo",fullName:"Chaomin Luo"},{id:"220894",title:"Prof.",name:"Gene Eu (Ching Yuh)",middleName:"Eu",surname:"Jan",slug:"gene-eu-(ching-yuh)-jan",fullName:"Gene Eu (Ching Yuh) Jan"},{id:"221450",title:"Dr.",name:"Chi-Chia",middleName:null,surname:"Sun",slug:"chi-chia-sun",fullName:"Chi-Chia Sun"},{id:"221451",title:"MSc.",name:"Kai-Chieh",middleName:null,surname:"Yang",slug:"kai-chieh-yang",fullName:"Kai-Chieh Yang"}]},{id:"58388",title:"Path Planning Based on Parametric Curves",slug:"path-planning-based-on-parametric-curves",totalDownloads:1216,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"Parametric curves are extensively used in engineering. The most commonly used parametric curves are, Bézier, B-splines, (NURBSs), and rational Bézier. Each and every one of them has special features, being the main difference between them the complexity of their mathematical definition. While Bézier curves are the simplest ones, B-splines or NURBSs are more complex. In mobile robotics, two main problems have been addressed with parametric curves. The first one is the definition of an initial trajectory for a mobile robot from a start location to a goal. The path has to be a continuous curve, smooth and easy to manipulate, and the properties of the parametric curves meet these requirements. The second one is the modification of the initial trajectory in real time attending to the dynamic properties of the environment. Parametric curves are capable of enhancing the trajectories produced by path planning algorithms adapting them to the kinematic properties of the robot. In order to avoid obstacles, the shape modification of parametric curves is required. In this chapter, an algorithm is proposed for computing an initial Bézier trajectory of a mobile robot and subsequently modifies it in real time in order to avoid obstacles in a dynamic environment.",book:{id:"6322",slug:"advanced-path-planning-for-mobile-entities",title:"Advanced Path Planning for Mobile Entities",fullTitle:"Advanced Path Planning for Mobile Entities"},signatures:"Lucía Hilario Pérez, Marta Covadonga Mora Aguilar, Nicolás Montés\nSánchez and Antonio Falcó Montesinos",authors:[{id:"213131",title:"Dr.",name:"Lucía",middleName:null,surname:"Hilario Pérez",slug:"lucia-hilario-perez",fullName:"Lucía Hilario Pérez"},{id:"213132",title:"Dr.",name:"Marta Covadonga",middleName:null,surname:"Mora",slug:"marta-covadonga-mora",fullName:"Marta Covadonga Mora"},{id:"213144",title:"Dr.",name:"Nicolás",middleName:null,surname:"Montés Sánchez",slug:"nicolas-montes-sanchez",fullName:"Nicolás Montés Sánchez"},{id:"221922",title:"Dr.",name:"Antonio",middleName:null,surname:"Falcó Montesinos",slug:"antonio-falco-montesinos",fullName:"Antonio Falcó Montesinos"}]},{id:"63374",title:"Motion Planning for Mobile Robots",slug:"motion-planning-for-mobile-robots",totalDownloads:1181,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"This chapter introduces two kinds of motion path planning algorithms for mobile robots or unmanned ground vehicles (UGV). First, we present an approach of trajectory planning for UGV or mobile robot under the existence of moving obstacles by using improved artificial potential field method. Then, we propose an I-RRT* algorithm for motion planning, which combines the environment with obstacle constraints, vehicle constraints, and kinematic constraints. All the simulation results and the experiments show that two kinds of algorithm are effective for practical use.",book:{id:"6322",slug:"advanced-path-planning-for-mobile-entities",title:"Advanced Path Planning for Mobile Entities",fullTitle:"Advanced Path Planning for Mobile Entities"},signatures:"Xiangrong Xu, Yang Yang and Siyu Pan",authors:[{id:"217380",title:"Prof.",name:"Xiangrong",middleName:null,surname:"Xu",slug:"xiangrong-xu",fullName:"Xiangrong Xu"}]}],onlineFirstChaptersFilter:{topicId:"258",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:99,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:290,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:10,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:1,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"10",title:"Physiology",doi:"10.5772/intechopen.72796",issn:"2631-8261",scope:"Modern physiology requires a comprehensive understanding of the integration of tissues and organs throughout the mammalian body, including the cooperation between structure and function at the cellular and molecular levels governed by gene and protein expression. While a daunting task, learning is facilitated by identifying common and effective signaling pathways mediated by a variety of factors employed by nature to preserve and sustain homeostatic life. \r\nAs a leading example, the cellular interaction between intracellular concentration of Ca+2 increases, and changes in plasma membrane potential is integral for coordinating blood flow, governing the exocytosis of neurotransmitters, and modulating gene expression and cell effector secretory functions. 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His primary area of interest is physiology and pathophysiology of the gastrointestinal (GI) tract, with the major focus on the mechanism of GI mucosal defense, protection, and ulcer healing. He was a postdoctoral NIH fellow at the University of California and the Gastroenterology VA Medical Center, Irvine, Long Beach, CA, USA, and at the Gastroenterology Clinics Erlangen-Nuremberg and Munster in Germany. He has published 290 original articles in some of the most prestigious scientific journals and seven book chapters on the pathophysiology of the GI tract, gastroprotection, ulcer healing, drug therapy of peptic ulcers, hormonal regulation of the gut, and inflammatory bowel disease.",institutionString:null,institution:{name:"Jagiellonian University",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:7,paginationItems:[{id:"10",title:"Animal Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/10.jpg",editor:{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",biography:"Catrin Rutland is an Associate Professor of Anatomy and Developmental Genetics at the University of Nottingham, UK. She obtained a BSc from the University of Derby, England, a master’s degree from Technische Universität München, Germany, and a Ph.D. from the University of Nottingham. She undertook a post-doctoral research fellowship in the School of Medicine before accepting tenure in Veterinary Medicine and Science. Dr. Rutland also obtained an MMedSci (Medical Education) and a Postgraduate Certificate in Higher Education (PGCHE). She is the author of more than sixty peer-reviewed journal articles, twelve books/book chapters, and more than 100 research abstracts in cardiovascular biology and oncology. She is a board member of the European Association of Veterinary Anatomists, Fellow of the Anatomical Society, and Senior Fellow of the Higher Education Academy. 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He studied \r\nchemistry at the Universidad Nacional de La Plata, Argentina, where received aPh.D. degree in chemistry (Biological Branch) in 1965. From\r\n1964 to 1974, he worked as Assistant in Biochemistry at the School of MedicineUniversidad Nacional de La Plata, Argentina. From 1974 to 1976, he was a Fellowof the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor oBiochemistry at the Universidad Nacional de La Plata, Argentina. He is Member ofthe National Research Council (CONICET), Argentina, and Argentine Society foBiochemistry and Molecular Biology (SAIB). His laboratory has been interested for manyears in the lipid peroxidation of biological membranes from various tissues and different species. Professor Catalá has directed twelve doctoral theses, publishedover 100 papers in peer reviewed journals, several chapters in books andtwelve edited books. Angel Catalá received awards at the 40th InternationaConference Biochemistry of Lipids 1999: Dijon (France). W inner of the Bimbo PanAmerican Nutrition, Food Science and Technology Award 2006 and 2012, South AmericaHuman Nutrition, Professional Category. 2006 award in pharmacology, Bernardo\r\nHoussay, in recognition of his meritorious works of research. Angel Catalá belongto the Editorial Board of Journal of lipids, International Review of Biophysical ChemistryFrontiers in Membrane Physiology and Biophysics, World Journal oExperimental Medicine and Biochemistry Research International, W orld Journal oBiological Chemistry, Oxidative Medicine and Cellular Longevity, Diabetes and thePancreas, International Journal of Chronic Diseases & Therapy, International Journal oNutrition, Co-Editor of The Open Biology Journal.",institutionString:null,institution:{name:"National University of La Plata",institutionURL:null,country:{name:"Argentina"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"186048",title:"Prof.",name:"Ines",middleName:null,surname:"Drenjančević",slug:"ines-drenjancevic",fullName:"Ines Drenjančević",profilePictureURL:"https://mts.intechopen.com/storage/users/186048/images/5818_n.jpg",institutionString:null,institution:{name:"University of Osijek",institutionURL:null,country:{name:"Croatia"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"79615",title:"Dr.",name:"Robson",middleName:null,surname:"Faria",slug:"robson-faria",fullName:"Robson Faria",profilePictureURL:"https://mts.intechopen.com/storage/users/79615/images/system/79615.png",institutionString:null,institution:{name:"Oswaldo Cruz Foundation",institutionURL:null,country:{name:"Brazil"}}},{id:"84459",title:"Prof.",name:"Valerie",middleName:null,surname:"Chappe",slug:"valerie-chappe",fullName:"Valerie Chappe",profilePictureURL:"https://mts.intechopen.com/storage/users/84459/images/system/84459.jpg",institutionString:null,institution:{name:"Dalhousie University",institutionURL:null,country:{name:"Canada"}}}]},{id:"12",title:"Human Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. His interest later turned to the molecular mechanism and attenuating strategy of sarcopenia (age-related muscle atrophy). His opinion is to attenuate sarcopenia by improving autophagic defects using nutrient- and pharmaceutical-based treatments.",institutionString:null,institution:{name:"Tokyo Institute of Technology",institutionURL:null,country:{name:"Japan"}}},editorTwo:null,editorThree:{id:"331519",title:"Dr.",name:"Kotomi",middleName:null,surname:"Sakai",slug:"kotomi-sakai",fullName:"Kotomi Sakai",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000031QtFXQA0/Profile_Picture_1637053227318",biography:"Senior researcher Kotomi Sakai, Ph.D., MPH, works at the Research Organization of Science and Technology in Ritsumeikan University. She is a researcher in the geriatric rehabilitation and public health field. She received Ph.D. from Nihon University and MPH from St.Luke’s International University. Her main research interest is sarcopenia in older adults, especially its association with nutritional status. Additionally, to understand how to maintain and improve physical function in older adults, to conduct studies about the mechanism of sarcopenia and determine when possible interventions are needed.",institutionString:null,institution:{name:"Ritsumeikan University",institutionURL:null,country:{name:"Japan"}}},editorialBoard:[{id:"213786",title:"Dr.",name:"Henrique P.",middleName:null,surname:"Neiva",slug:"henrique-p.-neiva",fullName:"Henrique P. 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Science",value:19,count:5}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:3},{group:"publicationYear",caption:"2021",value:2021,count:3},{group:"publicationYear",caption:"2020",value:2020,count:3},{group:"publicationYear",caption:"2019",value:2019,count:1},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:249,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, Kuwait. His research interests include optimization, computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, and intelligent systems. Prof. Sarfraz has been a keynote/invited speaker at various platforms around the globe. He has advised/supervised more than 110 students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He has authored and/or edited around seventy books. Prof. Sarfraz is a member of various professional societies. He is a chair and member of international advisory committees and organizing committees of numerous international conferences. He is also an editor and editor in chief for 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:"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:null},{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:"Beijing University of Technology",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:"Lakhno Igor Victorovich 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.\nPhD – 1999, Kharkiv National Medical Univesity.\nDSc – 2019, PL Shupik National Academy of Postgraduate Education \nLakhno Igor has been graduated from an international training courses on reproductive medicine and family planning held in Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor of 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 a professor of the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics and gynecology department of Kharkiv Medical Academy of Postgraduate Education . He’s an author of about 200 printed works and there are 17 of them in Scopus or Web of Science databases. Lakhno Igor is a rewiever of Journal of Obstetrics and Gynaecology (Taylor and Francis), 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 DSc degree \\'Pre-eclampsia: prediction, prevention and treatment”. 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: obstetrics, women’s health, fetal medicine, cardiovascular medicine.",institutionString:"V.N. Karazin Kharkiv National University",institution:{name:"Kharkiv Medical Academy of Postgraduate Education",country:{name:"Ukraine"}}},{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:"243698",title:"M.D.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. Dr. Wang was awarded two research project grants focused on multimodal optical coherence tomography imaging and deep learning in cataract and retinal disease, from the National Natural Science Foundation of China. He has published around 30 peer-reviewed journal papers and four book chapters and co-edited one book.",institutionString:"Shanxi Eye Hospital",institution:{name:"Shanxi Eye Hospital",country:{name:"China"}}},{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:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRZkkQAG/Profile_Picture_2022-05-09T12:55:18.jpg",biography:null,institutionString:null,institution:null},{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:"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. RELACION DE PONENCIAS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGIA. 10/2014.",institutionString:null,institution:null},{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:null},{id:"318905",title:"Prof.",name:"Elvis",middleName:"Kwason",surname:"Tiburu",slug:"elvis-tiburu",fullName:"Elvis Tiburu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Ghana",country:{name:"Ghana"}}},{id:"336193",title:"Dr.",name:"Abdullah",middleName:null,surname:"Alamoudi",slug:"abdullah-alamoudi",fullName:"Abdullah Alamoudi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"318657",title:"MSc.",name:"Isabell",middleName:null,surname:"Steuding",slug:"isabell-steuding",fullName:"Isabell Steuding",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}},{id:"318656",title:"BSc.",name:"Peter",middleName:null,surname:"Kußmann",slug:"peter-kussmann",fullName:"Peter Kußmann",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}},{id:"338222",title:"Mrs.",name:"María José",middleName:null,surname:"Lucía Mudas",slug:"maria-jose-lucia-mudas",fullName:"María José Lucía Mudas",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Carlos III University of Madrid",country:{name:"Spain"}}},{id:"147824",title:"Mr.",name:"Pablo",middleName:null,surname:"Revuelta Sanz",slug:"pablo-revuelta-sanz",fullName:"Pablo Revuelta Sanz",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Carlos III University of Madrid",country:{name:"Spain"}}}]}},subseries:{item:{id:"12",type:"subseries",title:"Human Physiology",keywords:"Anatomy, Cells, Organs, Systems, Homeostasis, Functions",scope:"Human physiology is the scientific exploration of the various functions (physical, biochemical, and mechanical properties) of humans, their organs, and their constituent cells. 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Moreover, in the field of machine learning, evolutionary computation has carved out a significant niche both in the generation of learning models and in the automatic design and optimization of hyperparameters in deep learning models. This collection aims to include quality volumes on various topics related to evolutionary algorithms and, alternatively, other metaheuristics of interest inspired by nature. 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It has become a massive part of our daily lives, making predictions based on experience, making this a fascinating area that solves problems that otherwise would not be possible or easy to solve. This topic aims to encompass algorithms that learn from experience (supervised and unsupervised), improve their performance over time and enable machines to make data-driven decisions. It is not limited to any particular applications, but contributions are encouraged from all disciplines.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",keywords:"Intelligent Systems, Machine Learning, Data Science, Data Mining, Artificial Intelligence"},{id:"27",title:"Multi-Agent Systems",scope:"Multi-agent systems are recognised as a state of the art field in Artificial Intelligence studies, which is popular due to the usefulness in facilitation capabilities to handle real-world problem-solving in a distributed fashion. 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The search for this knowledge grows in importance as rapid increases in population and economic development intensify humans’ stresses on ecosystems. Fortunately, rapid increases in multiple scientific areas are advancing our understanding of environmental sciences. Breakthroughs in computing, molecular biology, ecology, and sustainability science are enhancing our ability to utilize environmental sciences to address real-world problems.
\r\n\tThe four topics of this book series - Pollution; Environmental Resilience and Management; Ecosystems and Biodiversity; and Water Science - will address important areas of advancement in the environmental sciences. They will represent an excellent initial grouping of published works on these critical topics.
\r\n\tPollution is caused by a wide variety of human activities and occurs in diverse forms, for example biological, chemical, et cetera. In recent years, significant efforts have been made to ensure that the environment is clean, that rigorous rules are implemented, and old laws are updated to reduce the risks towards humans and ecosystems. However, rapid industrialization and the need for more cultivable sources or habitable lands, for an increasing population, as well as fewer alternatives for waste disposal, make the pollution control tasks more challenging. Therefore, this topic will focus on assessing and managing environmental pollution. It will cover various subjects, including risk assessment due to the pollution of ecosystems, transport and fate of pollutants, restoration or remediation of polluted matrices, and efforts towards sustainable solutions to minimize environmental pollution.
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",annualVolume:11967,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/39.jpg",editor:{id:"137040",title:"Prof.",name:"Jose",middleName:null,surname:"Navarro-Pedreño",fullName:"Jose Navarro-Pedreño",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRAXrQAO/Profile_Picture_2022-03-09T15:50:19.jpg",institutionString:"Miguel Hernández University of Elche, Spain",institution:null},editorTwo:null,editorThree:null,editorialBoard:[{id:"177015",title:"Prof.",name:"Elke Jurandy",middleName:null,surname:"Bran Nogueira Cardoso",fullName:"Elke Jurandy Bran Nogueira Cardoso",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRGxzQAG/Profile_Picture_2022-03-25T08:32:33.jpg",institutionString:"Universidade de São Paulo, Brazil",institution:null},{id:"211260",title:"Dr.",name:"Sandra",middleName:null,surname:"Ricart",fullName:"Sandra Ricart",profilePictureURL:"https://mts.intechopen.com/storage/users/211260/images/system/211260.jpeg",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}}]},{id:"40",title:"Ecosystems and Biodiversity",keywords:"Ecosystems, Biodiversity, Fauna, Taxonomy, Invasive species, Destruction of habitats, Overexploitation of natural resources, Pollution, Global warming, Conservation of natural spaces, Bioremediation",scope:"