Virological and serological approach to genital HSV infection.
\\n\\n
These books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\\n\\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\\n\\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
\\n\\n\\n\\n\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'
IntechOpen and Knowledge Unlatched formed a partnership to support researchers working in engineering sciences by enabling an easier approach to publishing Open Access content. Using the Knowledge Unlatched crowdfunding model to raise the publishing costs through libraries around the world, Open Access Publishing Fee (OAPF) was not required from the authors.
\n\nInitially, the partnership supported engineering research, but it soon grew to include physical and life sciences, attracting more researchers to the advantages of Open Access publishing.
\n\n\n\nThese books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\n\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\n\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
\n\n\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"7141",leadTitle:null,fullTitle:"Carotid Artery - Gender and Health",title:"Carotid Artery",subtitle:"Gender and Health",reviewType:"peer-reviewed",abstract:"This book collects recent experimental and clinical studies on gender influence in carotid artery compliance in health and pathological states, discussing also the usefulness and appropriateness of specific and personal medical therapy. Additionally, it provides an overview of the growing importance of ongoing studies on the benefit and risk of gender-specific therapy.",isbn:"978-1-83962-189-5",printIsbn:"978-1-78984-981-3",pdfIsbn:"978-1-83962-190-1",doi:"10.5772/intechopen.73939",price:119,priceEur:129,priceUsd:155,slug:"carotid-artery-gender-and-health",numberOfPages:126,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"191250d58c3cf7c8496de3525f1106e7",bookSignature:"Rita Rezzani and Luigi Fabrizio Rodella",publishedDate:"September 18th 2019",coverURL:"https://cdn.intechopen.com/books/images_new/7141.jpg",numberOfDownloads:7022,numberOfWosCitations:0,numberOfCrossrefCitations:4,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:7,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:11,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 12th 2018",dateEndSecondStepPublish:"May 23rd 2018",dateEndThirdStepPublish:"July 22nd 2018",dateEndFourthStepPublish:"October 10th 2018",dateEndFifthStepPublish:"December 9th 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"175171",title:"Prof.",name:"Rita",middleName:null,surname:"Rezzani",slug:"rita-rezzani",fullName:"Rita Rezzani",profilePictureURL:"https://mts.intechopen.com/storage/users/175171/images/system/175171.jpg",biography:"Dr. Rita Rezzani is Professor of Human Anatomy and Chairman of the Anatomy and Physiopathology Division of the Department of Clinical and Experimental Sciences, University of Brescia, Italy. She is the Director of the Interdipartimental Research Center for the study of the Adaptation and Regeneration of Tissues and Organs (ARTO) and author of more than 200 full-length publications focusing mainly on oxidative stress, cardiovascular diseases, aging and natural antioxidants. Dr. Rezzani is author of books, book chapters and monographs about Systematic Anatomy, Microscopic Anatomy as well as about aging related diseases and antioxidants effects.",institutionString:"University of Brescia",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"University of Brescia",institutionURL:null,country:{name:"Italy"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"118762",title:"Prof.",name:"Luigi Fabrizio",middleName:null,surname:"Rodella",slug:"luigi-fabrizio-rodella",fullName:"Luigi Fabrizio Rodella",profilePictureURL:"https://mts.intechopen.com/storage/users/118762/images/6822_n.jpg",biography:"Dr. Luigi F. Rodella is Professor of Human Anatomy, and Head of the Gross Anatomy Centre of the Anatomy and Physiopathology Division of the Department of Clinical and Experimental Sciences, University of Brescia, Italy. He is also Deputy Director of the Interdipartimental Research Center for the study of the Adaptation and Regeneration of Tissues and Organs (ARTO) and author of more than 200 full-length publications focusing mainly on craniofacial anatomy, cardiovascular disease, tissue regeneration and pain transmission. Dr. Rodella is author of books, book chapters and monographs of Systematic Anatomy, Microscopic Anatomy, Surgical Anatomy, and Neuroscience.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Brescia",institutionURL:null,country:{name:"Italy"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1155",title:"Vascular Surgery",slug:"vascular-surgery"}],chapters:[{id:"61913",title:"Anatomical Anomalies of Carotid-Vertebral Arteries in Patients with Dizziness and Impaired Hearing",doi:"10.5772/intechopen.78621",slug:"anatomical-anomalies-of-carotid-vertebral-arteries-in-patients-with-dizziness-and-impaired-hearing",totalDownloads:1108,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Currently, Doppler ultrasound examinations are of particular importance, including continuous wave Doppler and color-coded pulsed wave Doppler. Excellent images are obtained using contrast computed tomography angiography (CTA) and magnetic resonance angiography (MRA), which give greater understanding of blood flow in the cranial and intracranial vessels under normal conditions and in pathological situations caused by both anatomical anomalies and acquired abnormalities. Our previous studies, concerning the analysis of the frequency and types of anatomical anomalies of the cranial arteries, i.e. vertebral and carotid arteries, in patients with dizziness and impaired hearing, demonstrated that hypoplasia of the right vertebral artery was the most common anatomical anomaly occurring in 58.7% of cases, of which 51.7% were women and 6.9% men; hypoplasia of the left vertebral artery, occurring in 24.7% of the study group, of which 13.8% were women and 10.3% men; hypoplasia of the right internal carotid artery found in 3.4% of women and of the left internal carotid artery in 6.8% of cases, 3.4% in women and 3.4% in men; and hypoplasia of the right common carotid artery was reported in 3.4% of men, whereas critical stenosis of the left subclavian artery with subclavian steal syndrome was observed in 3.4% of women. Although tinnitus was the most frequent symptom occurring in those patients, in this study dizziness was most common in patients admitted to the Department for the diagnosis, possibly because they found it more disturbing.",signatures:"Jurek Olszewski and Piotr Niewiadomski",downloadPdfUrl:"/chapter/pdf-download/61913",previewPdfUrl:"/chapter/pdf-preview/61913",authors:[{id:"250243",title:"Dr.",name:"Jurek",surname:"Olszewski",slug:"jurek-olszewski",fullName:"Jurek Olszewski"},{id:"254107",title:"Dr.",name:"Piotr",surname:"Niewiadomski",slug:"piotr-niewiadomski",fullName:"Piotr Niewiadomski"}],corrections:null},{id:"64811",title:"Carotid Artery Stenting in High-Risk Patients for Stenting",doi:"10.5772/intechopen.82019",slug:"carotid-artery-stenting-in-high-risk-patients-for-stenting",totalDownloads:670,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Certain subgroups of patients are at higher risk for CAS. The identification of those patients could improve the decision-making and hence the outcome. This chapter covers factors that are associated with poor outcome during CAS based on the previously reported literature: (1) CAS in female patients, (2) CAS in octogenarians, (3) CAS in patients with difficult aortic arch configuration (type II, III, and bovine arch), (4) CAS in patients who have tortuous common carotid artery (CCA), angulated internal carotid artery (ICA) origin, and/or angulated distal ICA, (5) CAS in high-grade carotid stenosis, (6) CAS for long lesions (≥15 mm), (7) CAS for ostial-centered lesions, (8) CAS in the presence of calcified aortic arch and/or heavily calcified lesions, (9) CAS in the presence of contralateral carotid occlusion, (10) CAS in the presence of vertebral artery occlusion and/or stenosis, and (11) CAS in chronic kidney disease patients.",signatures:"Mohamed Khaled Elewa",downloadPdfUrl:"/chapter/pdf-download/64811",previewPdfUrl:"/chapter/pdf-preview/64811",authors:[{id:"250377",title:"M.D.",name:"Mohamed Khaled",surname:"Elewa",slug:"mohamed-khaled-elewa",fullName:"Mohamed Khaled Elewa"}],corrections:null},{id:"62807",title:"Diagnostic Imaging of Carotid Artery",doi:"10.5772/intechopen.79762",slug:"diagnostic-imaging-of-carotid-artery",totalDownloads:1170,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In the study of carotid arteries, the different imaging techniques allow to analyze various diseases like stenoses, aneurysms, thromboses, dissections, diseases caused by atherosclerotic plaques or congenital abnormalities. The diagnostic modalities that are used to image the carotid artery diseases are digital subtraction angiography (DSA), duplex ultrasound (DUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). The goal of the diagnostic imaging is to provide screening and to detect diseases at its earliest and most treatable stage. As initial screening study, the radiologists recommend DUS. It is a safe and painless way to produce pictures of the inside of the body using sound waves. It assesses blood flow in the carotid arteries, measures the speed of the blood flow, and estimates the diameter of a blood vessel and degree of obstruction. Digital subtraction angiography (DSA) has assumed a major role in the evaluation of occlusive cerebrovascular disease. While digital subtraction angiography (DSA) is still considered the gold standard, it has increasingly been replaced by computed tomography angiography (CTA) or magnetic resonance angiography (MRA) during the last years. Modern imaging studies like CTA and MRI allow to obtain three-dimensional reconstruction of anatomic structures and pathological abnormalities. Computed tomography angiography (CTA) of carotid arteries is a standardized procedure with excellent image quality but related with high radiation exposure. The rapid technical evolution in hardware and software allows even smaller imaging centers to perform high-quality vessel imaging. During the last decade, CTA came up with substantial progress in terms of accuracy in stenosis and aneurysm detection. Magnetic resonance angiography (MRA) is increasingly used as a noninvasive method to assess carotid arteries. Diseases like carotid artery dissections could be detected by using MRA or CTA.",signatures:"Lachezar Manchev",downloadPdfUrl:"/chapter/pdf-download/62807",previewPdfUrl:"/chapter/pdf-preview/62807",authors:[{id:"252432",title:"Associate Prof.",name:"Lachezar",surname:"Manchev",slug:"lachezar-manchev",fullName:"Lachezar Manchev"}],corrections:null},{id:"64260",title:"Flow Velocity in Common Carotid Artery",doi:"10.5772/intechopen.80712",slug:"flow-velocity-in-common-carotid-artery",totalDownloads:1387,totalCrossrefCites:3,totalDimensionsCites:4,hasAltmetrics:0,abstract:"A significant blood flow disruption as seen in cardiovascular diseases and disorders is related to hemodynamic dysfunction. Gender influences the arterial hemodynamic functions. Understanding of gender-related differences in blood flow and pressure is crucial in the prevalence and burden of cardiovascular disease. This chapter presents about characteristic profile of carotid flow velocities to extend the fundamental understanding of arterial hemodynamic functions in gender differences. Comparison of both synchronized carotid blood flow velocity and blood pressures at normodynamics state are introduced to contribute to targeted therapeutic goal based on gender. Gender-related differences in body size has influenced on arterial hemodynamics in carotid artery. Body height has influenced on systolic blood pressure, pulse pressure, wave reflection, pulse wave velocity in carotid artery. Carotid blood flow velocities are largely accounted for not only body height but also body weight. The predictors for modulating blood flow velocities were not only limited to age, but also influenced by several body compositions that largely accounted for the gender-related differences including visceral fat, muscle mass and total body fat. These data may useful to effective prevention and management of cardiovascular disease by considering the gender-difference.",signatures:"A. Rahman Rasyada and Azran Azhim",downloadPdfUrl:"/chapter/pdf-download/64260",previewPdfUrl:"/chapter/pdf-preview/64260",authors:[{id:"184934",title:"Prof.",name:"Azran",surname:"Azhim",slug:"azran-azhim",fullName:"Azran Azhim"},{id:"265179",title:"MSc.",name:"A Rahman",surname:"Rasyada",slug:"a-rahman-rasyada",fullName:"A Rahman Rasyada"}],corrections:null},{id:"62429",title:"Do Women Have a Higher Risk of Adverse Events after Carotid Revascularization?",doi:"10.5772/intechopen.79527",slug:"do-women-have-a-higher-risk-of-adverse-events-after-carotid-revascularization-",totalDownloads:718,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Carotid artery stenosis is thought to cause up to 10% of ischemic strokes. Till now, the optimal treatment between carotid endarterectomy (CEA) and carotid artery stenting (CAS) remains debated, in particular for specific subgroups of patients. Available data suggest that female have higher risk of perioperative adverse events, but conflicting results comparing CEA and CAS regarding the benefit for male or female are present in the literature. A systematic review of recent publications on gender-related differences in operative risks is reported. Moreover, a consecutive cohort of 912 symptomatic and asymptomatic patients undergoing CEA (407, 44.6%) or CAS (505, 55.4%) in a single institution has been evaluated to determine the influence of gender (59.7% male vs. 40.3% female) on the outcomes after both revascularization procedures at 30 days and during 3 years of follow-up. Our experience seems to confirm literature data as regarding female higher risk of restenosis. Female patients had higher periprocedural (2.7% female vs. 0.9% male; p < 0.05) and long-term (11.4% female vs. 4.6% male; p < 0.05) restenosis rate. In conclusion, female anatomic and pathologic parameters should be taken into account for an accurate diagnosis of carotid stenosis and guidelines should be adjusted consequently.",signatures:"Renato Casana, Chiara Malloggi, Valerio Stefano Tolva, Andrea Odero Jr, Richard Bulbulia, Alison Halliday, Vincenzo Silani and Gianfranco Parati",downloadPdfUrl:"/chapter/pdf-download/62429",previewPdfUrl:"/chapter/pdf-preview/62429",authors:[{id:"181434",title:"Prof.",name:"Vincenzo",surname:"Silani",slug:"vincenzo-silani",fullName:"Vincenzo Silani"},{id:"250947",title:"Dr.",name:"Renato",surname:"Casana",slug:"renato-casana",fullName:"Renato Casana"},{id:"251306",title:"Dr.",name:"Chiara",surname:"Malloggi",slug:"chiara-malloggi",fullName:"Chiara Malloggi"},{id:"251307",title:"Dr.",name:"Valerio Stefano",surname:"Tolva",slug:"valerio-stefano-tolva",fullName:"Valerio Stefano Tolva"},{id:"251308",title:"Dr.",name:"Andrea",surname:"Odero Jr",slug:"andrea-odero-jr",fullName:"Andrea Odero Jr"},{id:"259009",title:"Prof.",name:"Gianfranco",surname:"Parati",slug:"gianfranco-parati",fullName:"Gianfranco Parati"},{id:"259010",title:"Dr.",name:"Richard",surname:"Bulbulia",slug:"richard-bulbulia",fullName:"Richard Bulbulia"},{id:"259011",title:"Prof.",name:"Alison",surname:"Halliday",slug:"alison-halliday",fullName:"Alison Halliday"}],corrections:null},{id:"63573",title:"Gender-Associated Biomarkers in Metabolic Syndrome",doi:"10.5772/intechopen.81103",slug:"gender-associated-biomarkers-in-metabolic-syndrome",totalDownloads:981,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Metabolic syndrome (MetS) is a cluster of risk factors for atherosclerosis, including abdominal obesity, hypertension, insulin resistance, dyslipidemia with high triglycerides, and low high-density lipoprotein cholesterol. Affected patients have a significantly increased risk of developing cardiovascular disorders (CVD), that are the leading cause of death in the Western countries. Several epidemiological studies have investigated the evolution of CVD hypothesizing the presence of a gender difference in the pathogenetic and progression determinants detectable in men and women. In this chapter, we will examine new gender-associated bioindicators of possible diagnostic or prognostic value in the MetS. Moreover, we will provide an overview on current knowledge on sex-associated cardiovascular determinants with the aim to improve CVD diagnostic and prognostic clinical courses and to develop new and gender-biased prevention strategies.",signatures:"Rosa Vona, Lucrezia Gambardella and Elisabetta Straface",downloadPdfUrl:"/chapter/pdf-download/63573",previewPdfUrl:"/chapter/pdf-preview/63573",authors:[{id:"262499",title:"Dr.",name:"Elisabetta",surname:"Straface",slug:"elisabetta-straface",fullName:"Elisabetta Straface"},{id:"262957",title:"Dr.",name:"Rosa",surname:"Vona",slug:"rosa-vona",fullName:"Rosa Vona"},{id:"262958",title:"Dr.",name:"Lucrezia",surname:"Gambardella",slug:"lucrezia-gambardella",fullName:"Lucrezia Gambardella"}],corrections:null},{id:"66945",title:"Carotid Intern Aneurysms",doi:"10.5772/intechopen.81400",slug:"carotid-intern-aneurysms",totalDownloads:988,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Cerebral aneurysms (CA) are acquired lesions, affecting 5–10% of the population, being about three times more common in women than in men. The absolute majority of CA is asymptomatic. However, in symptomatic cases, cerebral aneurysms present without about 80% of cases with severe intracranial hemorrhage, with mortality up to 50% and severe morbidity of up to 80%. At this point, the carotid siphon is particularly important because it is the blood gateway to the anterior cerebral circulation, being the most sinuous portion of the internal carotid artery, and because it houses about 30% of the intracranial aneurysm. The constant interactions of blood flow with carotid siphon curvatures are apparently intrinsically related to the epidemiology of these lesions in the various locations of the intracranial circulation and their presentation form. It is well established that a greater anterior knee angle has a significant independent relation with intracranial aneurysms located after carotid siphon, larger aneurysms, and greater risk of rupture. These findings may be associated with the hemodynamic interactions of blood flow and the curvature of carotid siphon. Little is known about the anatomical changes in carotid siphon and, consequently, the repercussions of the hemodynamic changes that the neurosurgical interventions mechanisms could entail. Devices such as intracranial stents, detachable coils, and even clips of aneurysms can modify the morphology of carotid siphon, and the knowledge of these consequences could be used to obtain better therapeutic results. In the last 10 years, a new device for the treatment of intracranial aneurysms has been presenting promising results, flow diverters stents (FDS), and its use to treat aneurysms in carotid siphon appears to cause morphological changes characterized by increased anterior and posterior angles. Specifically, the anterior angle increase was associated with better angiographic results. Aneurysms of the extracranial carotid artery (ECAA) are rare and little is known about its natural history. The etiology is diverse and most ECAA are asymptomatic, but they may progress to a pulsatile mass, cranial nerve compression, or cause a stroke. ECAA treatment is still controversial and a better insight into natural history and risk of complications of the different treatments is needed in order to get the consensus.",signatures:"Eduardo Waihrich, Bruno Parente, Paulo Gonçalves, Fabio Fernandes, Carlos Ontiveros, Camila Ribeiro and Elias Rabahi",downloadPdfUrl:"/chapter/pdf-download/66945",previewPdfUrl:"/chapter/pdf-preview/66945",authors:[{id:"257283",title:"Ph.D.",name:"Eduardo",surname:"Waihrich",slug:"eduardo-waihrich",fullName:"Eduardo Waihrich"},{id:"268844",title:"Dr.",name:"Bruno",surname:"Parente",slug:"bruno-parente",fullName:"Bruno Parente"},{id:"268845",title:"Dr.",name:"Paulo",surname:"Gonçalves",slug:"paulo-goncalves",fullName:"Paulo Gonçalves"},{id:"268846",title:"Ms.",name:"Camila",surname:"Damasceno",slug:"camila-damasceno",fullName:"Camila Damasceno"},{id:"268847",title:"Dr.",name:"Elias",surname:"Rabahi",slug:"elias-rabahi",fullName:"Elias Rabahi"},{id:"268848",title:"Dr.",name:"Carlo",surname:"Ontiveros",slug:"carlo-ontiveros",fullName:"Carlo Ontiveros"},{id:"268849",title:"Dr.",name:"Fabio",surname:"Fernades",slug:"fabio-fernades",fullName:"Fabio Fernades"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"980",title:"Organ Donation and Transplantation",subtitle:"Public Policy and Clinical Perspectives",isOpenForSubmission:!1,hash:"591607d84f802684beb4660893273004",slug:"organ-donation-and-transplantation-public-policy-and-clinical-perspectives",bookSignature:"Gurch Randhawa",coverURL:"https://cdn.intechopen.com/books/images_new/980.jpg",editedByType:"Edited by",editors:[{id:"83650",title:"Dr.",name:"Gurch",surname:"Randhawa",slug:"gurch-randhawa",fullName:"Gurch Randhawa"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"363",title:"Gangrene",subtitle:"Current Concepts and Management Options",isOpenForSubmission:!1,hash:"b66b0835c5a8c7c89c0daaf4e7dc0644",slug:"gangrene-current-concepts-and-management-options",bookSignature:"Alexander Vitin",coverURL:"https://cdn.intechopen.com/books/images_new/363.jpg",editedByType:"Edited by",editors:[{id:"46555",title:"Dr.",name:"Alexander",surname:"Vitin",slug:"alexander-vitin",fullName:"Alexander Vitin"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2703",title:"Vascular Surgery",subtitle:"Principles and Practice",isOpenForSubmission:!1,hash:"7e1d45158df7b8e62946961a0e551e0f",slug:"vascular-surgery-principles-and-practice",bookSignature:"Dai Yamanouchi",coverURL:"https://cdn.intechopen.com/books/images_new/2703.jpg",editedByType:"Edited by",editors:[{id:"68673",title:"Dr.",name:"Dai",surname:"Yamanouchi",slug:"dai-yamanouchi",fullName:"Dai Yamanouchi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5155",title:"Frontiers in Transplantology",subtitle:null,isOpenForSubmission:!1,hash:"f358194cd9d33671b03808b346f354dc",slug:"frontiers-in-transplantology",bookSignature:"Hesham Abdeldayem, Ahmed F. El-Kased and Ahmed El-Shaarawy",coverURL:"https://cdn.intechopen.com/books/images_new/5155.jpg",editedByType:"Edited by",editors:[{id:"72383",title:"Prof.",name:"Hesham",surname:"Abdeldayem",slug:"hesham-abdeldayem",fullName:"Hesham Abdeldayem"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1002",title:"Vascular Surgery",subtitle:null,isOpenForSubmission:!1,hash:"1b12f3c85c6e19555f03e8c53e2af7fa",slug:"vascular-surgery",bookSignature:"Dai Yamanouchi",coverURL:"https://cdn.intechopen.com/books/images_new/1002.jpg",editedByType:"Edited by",editors:[{id:"68673",title:"Dr.",name:"Dai",surname:"Yamanouchi",slug:"dai-yamanouchi",fullName:"Dai Yamanouchi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3282",title:"Gangrene Management",subtitle:"New Advancements and Current Trends",isOpenForSubmission:!1,hash:"2addd66f1300faca3348977f1a1916ef",slug:"gangrene-management-new-advancements-and-current-trends",bookSignature:"Alexander Vitin",coverURL:"https://cdn.intechopen.com/books/images_new/3282.jpg",editedByType:"Edited by",editors:[{id:"46555",title:"Dr.",name:"Alexander",surname:"Vitin",slug:"alexander-vitin",fullName:"Alexander Vitin"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1165",title:"Novel Strategies in Lymphedema",subtitle:null,isOpenForSubmission:!1,hash:"8d219d4509ab19a62d7dc15b39ac8ec9",slug:"novel-strategies-in-lymphedema",bookSignature:"Alberto Vannelli",coverURL:"https://cdn.intechopen.com/books/images_new/1165.jpg",editedByType:"Edited by",editors:[{id:"34524",title:"Dr.",name:"Alberto",surname:"Vannelli",slug:"alberto-vannelli",fullName:"Alberto Vannelli"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10302",title:"Aortic Aneurysm",subtitle:"Clinical Findings, Diagnostic, Treatment and Special Situations",isOpenForSubmission:!1,hash:"edb4662797c08616dc42b7796f1d17fe",slug:"aortic-aneurysm-clinical-findings-diagnostic-treatment-and-special-situations",bookSignature:"Ana Terezinha Guillaumon and Daniel Emilio Dalledone Siqueira",coverURL:"https://cdn.intechopen.com/books/images_new/10302.jpg",editedByType:"Edited by",editors:[{id:"251226",title:"Prof.",name:"Ana Terezinha",surname:"Guillaumon",slug:"ana-terezinha-guillaumon",fullName:"Ana Terezinha Guillaumon"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9585",title:"Advances in Complex Valvular Disease",subtitle:null,isOpenForSubmission:!1,hash:"ef64f11e211621ecfe69c46e60e7ca3d",slug:"advances-in-complex-valvular-disease",bookSignature:"Michael S. Firstenberg and Imran Khan",coverURL:"https://cdn.intechopen.com/books/images_new/9585.jpg",editedByType:"Edited by",editors:[{id:"64343",title:"Dr.",name:"Michael S.",surname:"Firstenberg",slug:"michael-s.-firstenberg",fullName:"Michael S. Firstenberg"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7925",title:"Embolic Disease",subtitle:"Evolving Diagnostic and Management Approaches",isOpenForSubmission:!1,hash:"70a90d1a07cc875f7eda4641fbf32339",slug:"embolic-diseases-evolving-diagnostic-and-management-approaches",bookSignature:"Stanislaw P. Stawicki, Michael S. Firstenberg and Mamta Swaroop",coverURL:"https://cdn.intechopen.com/books/images_new/7925.jpg",editedByType:"Edited by",editors:[{id:"181694",title:"Dr.",name:"Stanislaw P.",surname:"Stawicki",slug:"stanislaw-p.-stawicki",fullName:"Stanislaw P. Stawicki"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],ofsBooks:[]},correction:{item:{id:"79356",slug:"corrigendum-the-contribution-and-prospects-of-the-technical-development-on-implementation-of-electri",title:"Corrigendum: The Contribution and Prospects of the Technical Development on Implementation of Electric and Hybrid Vehicles",doi:null,correctionPDFUrl:"https://cdn.intechopen.com/pdfs/79044.pdf",downloadPdfUrl:"/chapter/pdf-download/79044",previewPdfUrl:"/chapter/pdf-preview/79044",totalDownloads:null,totalCrossrefCites:null,bibtexUrl:"/chapter/bibtex/79044",risUrl:"/chapter/ris/79044",chapter:{id:"41483",slug:"the-contribution-and-prospects-of-the-technical-development-on-implementation-of-electric-and-hybrid",signatures:"Zoran Nikolić and Zlatomir Živanovic",dateSubmitted:"April 4th 2012",dateReviewed:"July 21st 2012",datePrePublished:null,datePublished:"December 19th 2012",book:{id:"3196",title:"New Generation of Electric Vehicles",subtitle:null,fullTitle:"New Generation of Electric Vehicles",slug:"new-generation-of-electric-vehicles",publishedDate:"December 19th 2012",bookSignature:"Zoran Stevic",coverURL:"https://cdn.intechopen.com/books/images_new/3196.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"30692",title:"Dr.",name:"Zoran",middleName:"M.",surname:"Stevic",slug:"zoran-stevic",fullName:"Zoran Stevic"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"154555",title:"Dr.",name:"Zoran",middleName:null,surname:"Nikolic",fullName:"Zoran Nikolic",slug:"zoran-nikolic",email:"zoran.nikolic@itn.sanu.ac.rs",position:null,institution:{name:"Institute of Technical Sciences",institutionURL:null,country:{name:"Serbia"}}},{id:"165922",title:"Dr.",name:"Zlatomir",middleName:null,surname:"Zivanovic",fullName:"Zlatomir Zivanovic",slug:"zlatomir-zivanovic",email:"zzivanovic@vin.bg.ac.rs",position:null,institution:null}]}},chapter:{id:"41483",slug:"the-contribution-and-prospects-of-the-technical-development-on-implementation-of-electric-and-hybrid",signatures:"Zoran Nikolić and Zlatomir Živanovic",dateSubmitted:"April 4th 2012",dateReviewed:"July 21st 2012",datePrePublished:null,datePublished:"December 19th 2012",book:{id:"3196",title:"New Generation of Electric Vehicles",subtitle:null,fullTitle:"New Generation of Electric Vehicles",slug:"new-generation-of-electric-vehicles",publishedDate:"December 19th 2012",bookSignature:"Zoran Stevic",coverURL:"https://cdn.intechopen.com/books/images_new/3196.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"30692",title:"Dr.",name:"Zoran",middleName:"M.",surname:"Stevic",slug:"zoran-stevic",fullName:"Zoran Stevic"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"154555",title:"Dr.",name:"Zoran",middleName:null,surname:"Nikolic",fullName:"Zoran Nikolic",slug:"zoran-nikolic",email:"zoran.nikolic@itn.sanu.ac.rs",position:null,institution:{name:"Institute of Technical Sciences",institutionURL:null,country:{name:"Serbia"}}},{id:"165922",title:"Dr.",name:"Zlatomir",middleName:null,surname:"Zivanovic",fullName:"Zlatomir Zivanovic",slug:"zlatomir-zivanovic",email:"zzivanovic@vin.bg.ac.rs",position:null,institution:null}]},book:{id:"3196",title:"New Generation of Electric Vehicles",subtitle:null,fullTitle:"New Generation of Electric Vehicles",slug:"new-generation-of-electric-vehicles",publishedDate:"December 19th 2012",bookSignature:"Zoran Stevic",coverURL:"https://cdn.intechopen.com/books/images_new/3196.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"30692",title:"Dr.",name:"Zoran",middleName:"M.",surname:"Stevic",slug:"zoran-stevic",fullName:"Zoran Stevic"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"11507",leadTitle:null,title:"New Generation of Sustainable Smart Cities",subtitle:null,reviewType:"peer-reviewed",abstract:"
\r\n\tThe book will discuss the form and function of a sustainable smart city, which represents a new generation of cities, where many aspects come across. Smart cities refer to the use of various information technology or innovative ideas to integrate the system and services to the town to improve resource utilization efficiency, optimize urban management and services, and enhance citizens' quality of life. It fully utilizes the new generation of information technology in all walks of life in the city. It is an advanced form of urban informatization based on the next generation of innovation in the knowledge society. It realizes the deep integration of informatization, industrialization, and urbanization, which helps alleviate "Big city disease", improve the quality of urbanization, achieve refined and dynamic management, enhance the effectiveness of urban governance and improve citizens' quality of life. These types of cities promote sustainable economic growth and high quality of life through investment in human and social capital, as well as in transportation and information communication infrastructure, and through participatory management of the above resources and natural resources for scientific management. The book will take the modern tendinitis towards an intelligent concept of cities, where all aspects related to human beings, urban functions, and outer spaces will be analyzed.
",isbn:"978-1-80356-765-5",printIsbn:"978-1-80356-764-8",pdfIsbn:"978-1-80356-766-2",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"dc693757b86ab8742367a38cda6cb622",bookSignature:"Prof. Amjad Almusaed and Associate Prof. Asaad Almssad",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11507.jpg",keywords:"The First Generation of Smart Cities, ARCHIGRAM Movement and Smart Cities, FUTURISM and New Cities Conception, Energy Crises and Smart Cities, the Green Context in Smart Cites, Biophilic Smart City, Smart Cities Between the Form and the Functions, Sustainability and Smart Cities, Digital City, Grid City, Electronic Cities, Inflammable Cities",numberOfDownloads:13,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 25th 2022",dateEndSecondStepPublish:"June 2nd 2022",dateEndThirdStepPublish:"August 1st 2022",dateEndFourthStepPublish:"October 20th 2022",dateEndFifthStepPublish:"December 19th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"2 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr.Almusaed completed postdoctoral research in 2004 on sustainable and bioclimatic houses from the School of Architecture in Aarhus, Denmark. He has edited many international books and is an active member of many worldwide architectural associations. He has published more than 170 international academic works (papers, research, books, and book chapters) in different languages.",coeditorOneBiosketch:"Dr. Almssad is a docent at Karlstad University, Sweden. He has more than 28 years of experience in the industry as well as teaching and research in European and non-European, institutions. He has authored and co-authored more than 30 research papers and many books. His research focuses on building structures, materials, sustainable building, and energy efficiency in building systems.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"446856",title:"Prof.",name:"Amjad",middleName:null,surname:"Almusaed",slug:"amjad-almusaed",fullName:"Amjad Almusaed",profilePictureURL:"https://mts.intechopen.com/storage/users/446856/images/system/446856.png",biography:"Prof. Amjad Almusaed has a Ph.D. in Architecture (Environmental Design) from Ion Mincu University, Bucharest, Romania. He completed postdoctoral research in 2004 on sustainable and bioclimatic houses at the School of Architecture, Aarhus, Denmark. His research expertise is sustainability in architecture and urban planning and design. He has carried out a great deal of research and technical survey work and has performed several studies in these areas. He has edited many international books and is an active member of many worldwide architectural associations. He has published more than 170 international academic works (papers, research, books, and book chapters) in different languages.",institutionString:"Jönköping University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Jönköping University",institutionURL:null,country:{name:"Sweden"}}}],coeditorOne:{id:"194040",title:"Associate Prof.",name:"Asaad",middleName:null,surname:"Almssad",slug:"asaad-almssad",fullName:"Asaad Almssad",profilePictureURL:"https://mts.intechopen.com/storage/users/194040/images/system/194040.jpg",biography:"Associate Prof. Asaad Almssad has more than thirty years of experience in industry, academia, and research at Umeå University, Sweden; Karlstad University, Sweden; and various European and non-European institutions. His research focuses on building structures, materials, sustainable building, and energy efficiency in building systems. He has authored and co-authored more than fifty research papers and many books. Currently, he is employed as a docent at Karlstad University.",institutionString:null,position:null,outsideEditionCount:null,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"11",title:"Engineering",slug:"engineering"}],chapters:[{id:"82818",title:"Analysis of Solution Diversity in Topic Models for Smart City Applications",slug:"analysis-of-solution-diversity-in-topic-models-for-smart-city-applications",totalDownloads:1,totalCrossrefCites:0,authors:[{id:"69561",title:"Dr.",name:"Tsukasa",surname:"Hokimoto",slug:"tsukasa-hokimoto",fullName:"Tsukasa Hokimoto"},{id:"190504",title:"Dr.",name:"Toshio",surname:"Uchiyama",slug:"toshio-uchiyama",fullName:"Toshio Uchiyama"}]},{id:"82138",title:"Smart City Serious Game Based on Features Selection",slug:"smart-city-serious-game-based-on-features-selection",totalDownloads:12,totalCrossrefCites:0,authors:[null]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"453624",firstName:"Martina",lastName:"Scerbe",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/453624/images/20399_n.jpg",email:"martina.s@intechopen.com",biography:null}},relatedBooks:[{type:"book",id:"10198",title:"Response Surface Methodology in Engineering Science",subtitle:null,isOpenForSubmission:!1,hash:"1942bec30d40572f519327ca7a6d7aae",slug:"response-surface-methodology-in-engineering-science",bookSignature:"Palanikumar Kayaroganam",coverURL:"https://cdn.intechopen.com/books/images_new/10198.jpg",editedByType:"Edited by",editors:[{id:"321730",title:"Prof.",name:"Palanikumar",surname:"Kayaroganam",slug:"palanikumar-kayaroganam",fullName:"Palanikumar Kayaroganam"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"117",title:"Artificial Neural Networks",subtitle:"Methodological Advances and Biomedical Applications",isOpenForSubmission:!1,hash:null,slug:"artificial-neural-networks-methodological-advances-and-biomedical-applications",bookSignature:"Kenji Suzuki",coverURL:"https://cdn.intechopen.com/books/images_new/117.jpg",editedByType:"Edited by",editors:[{id:"3095",title:"Prof.",name:"Kenji",surname:"Suzuki",slug:"kenji-suzuki",fullName:"Kenji Suzuki"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3828",title:"Application of Nanotechnology in Drug Delivery",subtitle:null,isOpenForSubmission:!1,hash:"51a27e7adbfafcfedb6e9683f209cba4",slug:"application-of-nanotechnology-in-drug-delivery",bookSignature:"Ali Demir Sezer",coverURL:"https://cdn.intechopen.com/books/images_new/3828.jpg",editedByType:"Edited by",editors:[{id:"62389",title:"PhD.",name:"Ali Demir",surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"872",title:"Organic Pollutants Ten Years After the Stockholm Convention",subtitle:"Environmental and Analytical Update",isOpenForSubmission:!1,hash:"f01dc7077e1d23f3d8f5454985cafa0a",slug:"organic-pollutants-ten-years-after-the-stockholm-convention-environmental-and-analytical-update",bookSignature:"Tomasz Puzyn and Aleksandra Mostrag-Szlichtyng",coverURL:"https://cdn.intechopen.com/books/images_new/872.jpg",editedByType:"Edited by",editors:[{id:"84887",title:"Dr.",name:"Tomasz",surname:"Puzyn",slug:"tomasz-puzyn",fullName:"Tomasz Puzyn"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"56376",title:"Genital Herpes",doi:"10.5772/intechopen.70105",slug:"genital-herpes",body:'Genital herpes is a sexually transmitted infection which is seen throughout the world and continues through life. It is the most common cause of diseases accompanied by genital ulceration. Genital herpes is a serious health problem because the infection continues through life with remissions and relapses, it causes recurring painful ulcers, the virus transmitted from mother to infant causes serious neonatal infections, and there is no known cure for it [1, 2].
Herpes simplex viruses (HSV) are the most common human pathogens causing infections in orofacial and genital regions. Genital herpes infection is caused by herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). HSV-1 mainly causes infection in oral, facial, and ocular regions and in the central nervous system (CNS) and is transmitted during childhood. While in the past genital herpes infections were mostly caused by HSV-2 and orofacial infections were mostly caused by HSV-1, HSV-1 is reported to cause genital herpes at an increasing rate today, particularly in developed countries [3, 4]. One of the important reasons behind the increase in HSV-1-induced genital herpes cases in developed countries is decreased seroprevalence of HSV-1 and the fact that the host has not encountered with the virus prior to the onset of sexual activity. Another important reason is suggested to be changing sexual behaviors among the youth such as oral sex. HSV-2 is usually transmitted through sexual contact and causes genital infection. HSV-2 may cause orofacial infections as well, which cannot be clinically distinguished from HSV-1-induced infections. However, HSV-2-induced orofacial infections are very rare [5, 6].
Herpes simplex viruses stay with infected individuals latently for lifetime. Their presentation is quite variable depending on the immune condition of the host, site of entry of the virus, and whether the disease is primary or secondary [7]. Genital herpes infection has some serious results. First of all, HSVs transmitted from the mother to the neonatal cause serious mortality and morbidity. The second serious risk is the fact that genital herpes infections facilitate human immunodeficiency virus (HIV) and play a role in the spread of HIV [8].
Genital HSV infections are among the most commonly seen sexually transmitted infections in the world. The real prevalence of the genital herpes infection is unknown due to asymptomatic cases. The most common cause of the genital herpes infection is HSV-2, but the number of primary genital herpes cases induced by HSV-1 is on the rise. The prevalence of infections induced by HSV-1 and HSV-2 varies between countries. While HSV-1 prevalence is about 60–80% worldwide, its prevalence in developing countries varies between 70 and 100%. HSV-2 prevalence is reported to vary between 7 and 80% depending on the country, age group, and sexual life characteristics. More than 500 million people are estimated to be infected with HSV-2 worldwide, which corresponds to 16% of the world population in between the ages of 15–49. It is also estimated that 20 million new cases occur every year [5, 6, 9].
HSV-1 seroprevalence is associated with age, race, geographical location, and socioeconomic status. HSV-2 is associated with age, race, geographical location, socioeconomic status, sexually transmitted disease history, onset of sexual activity, and number of the sexual partner. The most significant determining factor in genital HSV infections is lifetime sexual partner count. It was found in a study conducted in the United States that HSV-2 infection and HSV1/HSV2 co-infection are closely associated with lifetime sexual activity, smoking status, and recreational drug use [1, 10].
HSV-1 is typically transmitted during childhood and with non-sexual contact. While HSV-1-induced genital herpes prevalence varies between geographical regions, almost half of all new genital herpes cases are caused by HSV-1 in European countries [12]. HSV-1 seropositivity is estimated to be 40–63% in the United States, while HSV-2 seropositivity is estimated to be 16–18% [10]. While HSV-1 prevalence was 62% in the United States between 1988 and 1994, it dropped to 57.7% between 1999 and 2004. However, HSV-1 seroprevalence was found to increase in those who were diagnosed with genital herpes only [3]. Having orofacial HSV-1 infection during childhood may protect against genital HSV-1 infection in later years and silent HSV-2 seroconversion occurs more frequently in individuals with HSV-1 immunity. In other words, the transmission rate, duration of disease, and severity of disease are decreased in those who have immunity against a HSV type due to cross-immunity. The presence of HSV-1 antibodies does not prevent HSV-2 transmission. However, HSV-2 infection may be milder or asymptomatic in those with positive HSV-1 antibodies [7, 10, 11].
HSV-2 positivity occurs in adolescence when sexual activity begins and prevalence rate consistently increases toward adult ages. HSV-2 seroprevalence during pregnancy is reported to be 7–40% in different parts of the world. It is reported in rates varying between 60 and 95% in those infected with HIV and female sex workers [5]. The region with the highest HSV-2 prevalence and incidence is sub-Saharan Africa. Prevalence goes as high as 80% for men and over the age of 35 for women. HSV-2 seroprevalence is lower in European countries and reports vary greatly between countries. In cross-sectional studies for Europe between 1989 and 2000, HSV-2 seroprevalence was found to be 4% in Great Britain and Wales, whereas it was found to be 24% in Bulgaria. While it was 20–30% in Germany and Switzerland, it went as high as 40% in Turkey. The lowest prevalence is reported in Asian countries with 10–30% [12–14].
HSV-2 seroprevalence was found to be 17.2% in the United States in 1999–2000 and 14% between 2005 and 2010. It is believed that behaviors reducing sexual risk factors improved hygiene and life conditions, improved socioeconomic conditions, and shrinking families might have had effective in the decrease in HSV-1 and HSV-2 prevalence [3, 10].
More than 80 virus types were identified in the herpesvirus family. However, only eight herpesviruses cause diseases in humans. Herpesviruses, which are human pathogens, are HSV-1 (HHV-1), HSV-2 (HHV-2), varicella zoster virus (VZV, HHV-3), Epstein-Barr virus (EBV, HHV-4), cytomegalovirus (CMV, HHV-5), human herpesvirus 6 (HHV-6), human herpesvirus 7 (HHV-7), and human herpesvirus 8 (HHV-8). Herpesviruses, which are the first two types of HHVs and responsible for genital herpes infections, are referred to as herpes simplex viruses [15].
HSVs are members of the alpha herpesviridea subfamily of the herpesvirus family and have a large double-stranded DNA genome. The diameter of the viral nucleocapsid is approximately 100 nm and the diameter of the virus is approximately 250 nm. The structure of the virus consists of a nucleus containing the DNA in the center, an icosahedral capsid surrounding the nucleus, a tegument consisting of an amorphous protein layer surrounding the capsid, and an envelope surrounding all of these [7, 12]. The envelope is a glycoprotein outer cover and is typically derived from the host cell membrane while the DNA-containing capsid passes through the nuclear membrane of the host cell. These glycoproteins play an important role during entry into the host cell. Even though DNA sequences of HSV-1 and HSV-2 are very similar, they have different antigenic structures due to differences in envelope proteins [16].
HSVs are required to attach to at least three different cell surface receptors to start the infection. As a result of this attachment, the plasma membrane and the virus envelope join and the virus enters into the cell as a result. The viral envelope contains at least 12 different glycoproteins involved in the virus’ entry into and exit from the cell (gB, gC, gD, gE, gH, gI, gK, gL, and gM) [17]. Five different envelope proteins are involved in the virus entry process. Surface glycoproteins of HSVs mediate attachment to and entry into host cell surface and also stimulate the host’s immune system [12]. Heparan sulfate proteoglycans (HSPGs) on the cell surface are attachment regions for HSVs. gB and gC bind HSPGs and are necessary for attachment. Fırst, gD binds cell surface receptor and starts changes which allow for membrane fusion of other glycoproteins. Nectin-1 is a cell adhesion molecule, which gD binds and also the main HSV receptor found in epithelial cells and neurons [12, 17, 18].
The viral genome is required to pass through the cell surface and cytoplasm and reach the nucleus for the replication of the virus. Entry of the virus into nucleus occurs in three stages. The first stage is the absorption of the virion to the cell surface, the second stage is passing through nuclear pores after passing through the plasma membrane, and the third stage is the introduction of the viral DNA from the capsid [16]. HSVs mostly use their own DNA synthesis mechanisms for genome replication; however, they are dependent on the host’s RNA polymerase II for transcription of viral genes. Viral DNA synthesize requires at least seven viral proteins. At least six viral proteins allow for robust expression of viral genes and mobilize cellular proteins for effective synthesis of the viral DNA and proteins. Other viral proteins, mainly thymidine kinase (TK), ribonucleotide reductase, dUTPase, and uracyl DNA glycosylase, control viral nucleic acid metabolism. These proteins are potential targets of antiviral treatment [12].
Host’s immune system is the most important factor which determines the transmission, severity, and frequency of recurrence of the infection. Humoral and cellular immune systems limit the spread of the virus in immune-competent individuals. In experiments with both humans and rats, CD4+ and CD8+ T lymphocytes, macrophages, natural killer cells, and inflammatory cytokines such as interferon-γ were shown to be involved in protection against HSVs [5, 19]. While individuals with mild cellular immune deficiency experience frequent recurrences and slower resolution, individuals with severe immune deficiency are at a higher risk of disseminated, treatment-resistant, and chronic disease. More frequent and severe recurrent herpes infections in acquired immunodeficiency syndrome (AIDS) patients indicate the importance of cellular immunity, CD4+ T cells in particular [9]. Humoral immune system, on the other hand, does not affect disease severity. However, it is involved in reduction of virus titer in inoculation region and neural tissues during primary infection [5, 19]. Another cell that is primarily affected in genital herpes and involved in immune response against HSV-2 is keratinocytes. Keratinocytes infected with HSV-2 show up-regulation of antiviral cytokines such as interferon alpha, beta, tumor necrosis factor-alpha (TNF-α), colony-stimulating factors, growth factors, defensins, selectins, lymphocyte function-associated antigens, and Toll-like receptors [20].
Genital HSV infections are more common in women compared to men. Studies show that women are more vulnerable to transmission than men. This vulnerability is believed to arise from anatomic characteristics of women, the structure of the genital epithelium, longer exposure to inoculum, and a higher rate of viral reactivation among men than women. When it comes to sexual transmission, the risk of transmission from man to woman is higher than the risk of transmission from woman to man. The virus is easily deactivated with water, soap, and drying and transmission through objects is not likely [21].
The virus, which enters into the body through skin or mucosa, starts the cytolytic replication within epithelial cells. In this period, virions within epithelial cells are observed histologically as intranuclear inclusions. Cells turn into multinucleated giant cells due to cytolytic properties of HSVs. Epithelial cells break up due to cell damage, and the space between separated cells is filled with liquid. Resulting blisters contain cellular debris, inflammatory cells, and virion products [5].
HSVs are neurotropic human pathogens. Following the replication in epithelial cells, the virus is absorbed by sensory neurons that innervate these tissues. The virus travels through neuron body and to neural ganglia via retrograde microtubule-associated transport and remains latently in neural ganglia without leading to cell death in neurons. It is unknown why and how HSVs remain latently. However, after a single lytic infection, the virus gains ability to protect against host’s defense system. The latent virus genome is kept within sensory neurons in a balanced manner and all viral lytic genes are suppressed. The virus may reactivate to continue its replication due to various triggering factors and reaches epithelial cells via anterograde transport. Infected cells do not spread virus for the duration of latent infection and disease symptoms are not observed in the host. Trigeminal and sacral ganglia are the regions where HSV-1 and HSV-2 viruses most frequently remain latent. Recurrent genital herpes infection usually occurs as a result of reactivation of the virus remaining latent in sacral root ganglia [9, 17, 22]. Many factors such as traumas, inflammatory diseases, ultraviolet, menstruation, immune suppression, fatigue, and psychological stress may lead to reactivation of the latent virus. Following the virus reactivation, the virus reaches mucosa and skin once more from dorsal root ganglia through peripheral nerves. The infection maybe symptomatic or asymptomatic and seroconversion of type-specific antibodies takes 4–6 weeks [11].
There is a strong relationship between HSV-2 positivity and HIV. The risk of HIV transmission is three times higher in women and men infected with HSV-2 [23, 24]. Among HIV-positive patients in UK, HSV-1 seroprevalence was found to be 90%, HSV-2 seroprevalence was found to be 67%, and HSV-1 and HSV-2 co-incidence was found to be 64% [25]. Worldwide, more than half of individuals infected with HIV have HSV-2 infection. Genital herpes lesions are suggested to facilitate HIV acquisition due to disruptions in physical barriers of skin and mucosa. Another facilitating factor may be HIVs reaching a high number of CD4+ cells due to increased cellular inflammatory response. HSV-2 infection is believed to have played a facilitating role in HIV endemic in sub-Saharan Africa. HSV suppression treatment has not been shown to prevent HIV transmission [13, 20, 26]. In addition, HSV-2 infection is suggested to accelerate HIV disease and increase viral load. HSV treatment with acyclovir has been shown to slow down HIV progression in individuals co-infected with HIV and HSV-2. Some authors recommend that HIV-infected patients are checked for HSV-2 and co-infected individuals receive suppression treatment for HSV-2. However, this subject has not been fully illuminated. Although it is known that HSV-2 positivity facilitates HIV transmission, there is no evidence showing that it accelerates AIDS progression. On the other hand, HIV viral load has been reported to increase HSV-2 activity [26].
Genital herpes lesions are formed by both HSV-1 and HSV-2 viruses. Severity of clinical signs varies significantly. Since the majority of individuals infected with HSV do not realize a clinical symptom, they are not diagnosed with genital herpes. Therefore, they continue to spread the virus without knowing that they are infected. While mild and moderate symptoms and signs are observed in some patients, the first attack may be as severe as to require hospitalization in others. HSV-1-induced genital herpes may be milder and recur less frequently than the infection induced by HSV-2. The incubation period after the transmission of the virus is not known with certainty. The primary infection occurs 2–12 days (4 days on average) after sexual contact. In one study, based on the data obtained from patients who were aware of having the primary attack, the time between the sexual contact and the primary attack may vary from 1 to 49 days and thus it is suggested that the incubation period may be longer than expected [27].
The majority of infected individuals are not aware of the infection due to short duration of symptoms and signs or its asymptomatic nature. For this reason, genital herpes should be considered in patients with nonspecific genital symptoms. The clinical presentation of genital herpes shows certain differences in terms of the primary attack following the first encounter with the virus and recurrent attacks [28].
Although episodes in most primary genital herpes cases are asymptomatic or atypical, clinical signs are similar for both HSV-1 and HSV-2 in terms of the classical symptomatic first episode. In the prodromal period, patients may have headache, fever, anorexia, malaise, and painful inguinal and femoral lymphadenopathy. Following the prodromal period which lasts for 2–24 h, patients experience localized or regional pain and tingling and burning sensations. Constitutional symptoms are present in 80% of patients [11, 27]. Primary lesions begin about 4–7 days after sexual contact on labia minora, introitus, and urethral meatus in women and on penis shaft and glans in men as painful, erythematous, clustering vesicles, and papules in varying sizes. Painful and inflammatory vulvar edema is present in women. Other than the genital region, lesions may be seen on perineum and hips. Proctitis is one of the important initial symptoms in homosexual men. Irregular erosions and ulcers are formed due to ruptured vesicles. Since circulating antibodies are not on a sufficient level, autoinoculation may occur in other anatomical regions during or after the primary genital infection in particular. Lesions are crusted and heal without scarring after 2–3 weeks. In this period, patients may spread the virus for approximately 12 days. Atypical course may be present in women with cervical lesions, which are usually overlooked, and it is more difficult to make a diagnosis. The moist property of the genital region in women may lead to more severe clinical signs. Dysuria is also more common in women. Autonomic dysfunction and aseptic meningitis, which lead to urinary retention, are complications seen in this period. These lesions may sometimes occur without said complications. In primary genital herpes infections, aseptic meningitis is seen in 30% of women and 10% of men [7, 11]. The most common and unsettling symptom during the first episode is reported to be pain in women. In men, on the other hand, lesions are reported to be the most common and unsettling symptom. Surveys made with patients show that female patients experience more work force loss during the first genital herpes attack compared to male patients [29].
The virus remaining latent in sensory neural ganglia following the primary genital herpes reactivates and causes recurrent infections. Recurrent lesions occur more commonly in men. Recurrence is observed in 70–90% of HSV-2-positive individuals and in 20–50% of HSV-1-positive individuals who have had a symptomatic primary genital infection [5]. Recurrences are six times more frequent in HSV-2 infections compared to HSV-1 infections [1]. One to two days prior to recurrent lesions, prodromal signs such as itching, tingling, paresthesia, and pain in lumbosacral dermatomes are observed. Recurrent genital herpes lesions involve less grouped lesions compared to primary genital herpes and tend to be unilateral (Figure 1). It is usually not accompanied by systemic symptoms. Lesions are painful; however, the pain is milder compared to primary infection. Lesions usually heal within 7–8 days and viral spread lasts shorter and its concentration is lower. Recurrences may occur on thighs, lower abdomen, hips, and genital organs. Fissures, erythematous patches, excoriations, and linear ulcerations may be seen as atypical lesions [1, 11, 30]. Recurrent infections become sparse in time. That being said, recurrences have been reported in 25% of patients in the fourth year of infection [5].
Painful grouped vesicles are seen. By the courtesy of Dr. Zekayi Kutlubay.
Genital herpes infections are characterized by lifelong viral shedding after the first genital herpes attack. Viral shedding in individuals infected with genital herpes continues with both lesional and asymptomatic periods. Fifty to ninety percent of transmissions occur from infected individuals who are not aware of their infections during the asymptomatic viral shedding period. Only 25% of HSV-2-seropositive individuals have genital herpes history. The majority of infected individuals either carries the infection asymptomatically or is not aware of symptoms [1, 2]. The period with the highest risk of transmission is the active disease period which involves visible lesions. Shedding continues for 1 week after symptomatic attacks. However, viral reactivation is characterized by asymptomatic viral shedding in most patients. The asymptomatic shedding property of the virus is the most significant reason behind its spread. Viral shedding is very common in HSV-2-seropositive patients, whereas it is less common in asymptomatic HSV-1 patients. The cell shredding rate is 3–5% in cell cultures obtained from women infected with genital HSV-2 in asymptomatic period; however, this rate goes up to 28% when wipe samples are examined using the polymerase chain reaction (PCR) method.
Studies show that the highest shedding rates are seen within the first year following the onset of the infection. In a study involving 377 adults with genital herpes, viral shedding was examined by applying the PCR method to anogenital swab and found to be 33.6% within the first year after the first attack, 20.6% between 1 and 9 years, and 16.7% over 10 years. Subclinical viral shedding was shown to be similar in both men and women.
A rare yet serious complication of genital herpes in the mother during pregnancy, neonatal herpes, has a mortality risk of 60% if not treated. It may lead to mortality and permanent sequels in 30% of cases in spite of antiviral treatment. Neonatal herpes is estimated to be about 10 in 100,000 live births worldwide. This corresponds to approximately 14,000 neonatal herpes (4000 HSV-1 and 10,000 HSV-2) cases every year. The highest number of neonatal herpes cases belongs to Africa due to high HSV-2 positivity rate among women and high birth rate. HSV-1 infections cause more neonatal herpes cases than HSV-2 infections in the United States, Europe, and the West of the Pacific [31].
Transmission from the mother to the infant mostly (85%) occurs during vaginal birth due to viral shedding. Intrauterine (5%) and postnatal (10%) transmission cases are less common [2, 8]. Its clinical manifestation involves eye, mouth, and skin infection, central nervous system disease, or disseminated disease which starts within the first 28 days of life. Eye, mouth, and skin infection is present in 45% of cases and characterized by vesicular lesions without CNS involvement or disseminated disease. CNS disease is observed in about 30% of cases and characterized by lethargy, feeding difficulty, and seizures. CNS disease may be accompanied by skin lesions. The mortality is 6% and permanent moderate and severe neurological damage is 50% with intravenous (IV) acyclovir treatment. Disseminated disease consists of the remaining 25% of cases and presents multiple organ involvement with clinical sepsis. The mortality is 30% in spite of acyclovir treatment [20].
Although genital herpes can be diagnosed via patient history and examination, herpes diagnosis may not always be easy. There may be atypical localizations such as hip and thigh or atypical presentations such as vulvar/penile/perianal fissures, recurrent erythema, recurrent pain, cystitis, urethritis, and genital discharge without lesions. On the other hand, various diseases causing ulcers in the genital region such as Behcet’s disease, Crohn’s disease, other sexually transmitted diseases, and fixed drug eruption may mimic herpes. In such cases, the patient may be subjected to unnecessary antiviral treatments and experience negative social and psychosocial effects due to the diagnosis. For a thorough infection management, the clinical diagnosis must be supported with laboratory confirmation. Supporting the diagnosis is also important for detection of possible cases, further consulting services, and prevention of serious complications such as neonatal herpes [32–34].
It refers to displaying the viral genome on the skin or mucosal membrane. The best test sample is vesicle content. Samples must be sent to the laboratory in saline or virus transport medium [30]. Virus detection methods are mainly divided into four groups: cell culture, molecular methods (nucleic acid amplification tests (NAATs)), direct viral antigen detection, and cytological examinations [34]. The most commonly preferred methods are cell culture and PCR, which is a NAAT method. It is possible to distinguish between HSV-1 and HSV-2 using these two methods. It is absolutely necessary to distinguish between HSV-1 and HSV-2 in newly diagnosed genital herpes cases [35]. Because viral shedding is intermittent, the fact that no infected cell is detected does not mean that the HSV infection is not present [36].
Cell culture has lost its previous significance since it has low sensitivity in cases of healing lesions and ulcerative lesions and requires more time compared to PCR. NAAT methods such as PCR are accepted as the reference test by many centers due to their high sensitivity [30, 34, 36, 37]. Other advantages of NAAT methods include reproducibility, speed, and labor efficiency [38]. Direct viral antigen detection is a good alternative since it results in a matter of hours and is a commercially accessible method. However, it has certain disadvantages such as low specificity and sensitivity values and inability to distinguish types. Cytological methods based on detection of cellular changes such as Tzanck are not recommended due to lack of specificity and sensitivity. Similarly, these methods do not allow for distinguishing types as well [34].
Immunoglobulin M (IgM) antibodies can be detected in blood 7–10 days after encountering the infectious agent. They remain detectable for about 1–2 weeks, while they remain positive for about 6 weeks in some individuals. They become positive again within a short time frame in recurrent infections [39]. Detection of IgG antibodies may require 2 weeks to 3 months following the transmission of the virus and they remain positive for lifetime [5]. Although IgM detection in IgG negativity during the window period in the first infection in particular may be important for primary infection diagnosis, it is not recommended for routine practice [34, 40].
HSV-1 IgG antibodies do not allow for distinguishing between genital and oropharyngeal infections, HSV-2 IgG antibodies can be used to confirm genital herpes infection diagnosis. For this reason, detection of type-specific HSV IgG antibodies, especially HSV-2, is very important to use type-specific serological tests for an accurate and effective genital herpes management [6, 34].
Detection of type-specific HSV IgG antibodies is a rapid, effective, and reliable method in infection diagnosis. Although it does not provide information related to infection time, it is possible to support primary infection diagnosis in individuals who are believed to have
HSV-1 detection by direct method | HSV-2 detection by direct method | HSV-1-specific IgG | HSV-2-specific IgG | Interpretation | |
---|---|---|---|---|---|
First assessment of genital lesions | Positive | Negative | Negative | Positive or negative | Acute HSV-1 infection. Repeat HSV-1-specific serology within 15–30 days |
Negative | Positive | Positive or negative | Negative | Acute HSV-2 infection. Repeat HSV-2-specific serology within 15–30 days | |
Recurrent genital lesions | Positive | Negative | Positive | Positive or negative | Recurrent HSV-1 infection |
Negative | Positive | Positive or negative | Positive | Recurrent HSV-2 infection | |
Negative | Negative | Negative | Positive | Possible recurrent HSV-2 infection. Other potential causes of genital ulcerative disease should be considered | |
Negative | Negative | Positive | Negative | Possible recurrent HSV-1 infection. Other potential causes of genital ulcerative disease should be considered |
Virological and serological approach to genital HSV infection.
Type-specific serological tests are commercially available and the enzyme-linked immunosorbent assay (ELISA) method is widely used. They depend on detection of HSV-specific glycoprotein G1 or C1 (HSV-1) and glycoprotein G2 (HSV-2) as antigen [36]. These tests have a sensitivity of 97–100% and a specificity of 94–98% [5, 41]. Although there are multiple tests used for confirmation, the Western Blot test is accepted as the gold standard and can be found in only a number of reference centers [34].
Systemic antiviral use is the essential point of genital herpes treatment. Studies have shown that systemic antiviral treatment limits the severity and duration of the genital herpes attack [42, 43]. The important point to keep in mind is that antiviral treatment does not eliminate latent infection and does not affect posttreatment recurrence risk and severity [36].
In treatment of HSV-1- and HSV-2-induced genital herpes, it is recommended to use acyclovir, valacyclovir, and famciclovir as the standard primary care [30, 36]. These are nucleoside analogs which inhibit herpesvirus DNA polymerase specifically. While acyclovir is available in IV and oral forms, valacyclovir and famciclovir are available in oral form only. These three agents have similar activities in terms of reducing disease severity, duration, and recurrence [44]. Acyclovir is the prototype drug since it is the first molecule used. It is safe and has high tolerability. Gastrointestinal system complaints, eruption, and temporary neurotoxic effects are possible. Nephrotoxicity may develop in insufficiently hydrated cases. Concurrent nephrotoxic drug use should be avoided, liver and kidney functions should be followed closely, and the dose should be adjusted in case of renal failure [45]. Valacyclovir is the prodrug form of acyclovir. Valacyclovir is converted to acyclovir by hepatic valacyclovir hydrolase. It has higher oral bioavailability. Its use is not licensed for children, adolescents, and pregnant women. Its side effect profile is similar to that of acyclovir. Famciclovir is the prodrug form of penciclovir, which is only available in topical form. It has a quite high oral bioavailability. Similar to valacyclovir, its use is not licensed for children, adolescents, and pregnant women. Possible side effects include headache, nausea, and diarrhea [30].
The effect of topical agents is weaker than systemic agents and they do not contribute to combined treatment. They are not recommended for use in case of genital herpes since they lead to an increase in resistance. Intravenous treatment should be considered only when oral agents cannot be tolerated and in complicated cases [35]. Washing with serum physiologic and using analgesic and topical anesthetic agents are additional approaches which may be beneficial.
Primary infections are usually more severe and longer compared to recurrent attacks. Therefore, guides recommend systemic antiviral use in all primary genital herpes cases. It is recommended that treatment is started within the first 5 days. If new lesion formation continues, treatment should be started in cases older than 5 days as well. The patient should be followed up closely in terms of systemic symptoms, complications, and new lesion formation. In such cases, it may be necessary to prolong the standard treatment [35, 36, 46]. Table 2 shows recommended doses in detail.
First episode for genital herpes (adult, pregnant, immunosuppressive patients) | Oral dosesa |
---|---|
Acyclovirb | 400 mg three times a day for 5–10 days or 200 mg five times a day for 5–10 days |
Valacyclovir | 500–1000 mg twice a day for 5–10 days |
Famciclovir | 250 mg three times a day for 5–10 days |
Suppressive therapy for recurrent genital herpes | |
Acyclovirb | 400 mg twice a dayd 200 mg four times dailyc |
Valacyclovir | 500 mg once a day or 1 g once a dayd |
Famciclovir | 250 mg twice a day 500 mg twice a dayd |
Episodic therapy for recurrent genital herpes | |
Acyclovirb | 400 mg three times a day for 5 daysd or 800 mg twice a day for 5 days or 800 mg three times a day for 2 days |
Valacyclovir | 500 mg twice a day for 3 days or 1 g once a day for 5 daysd |
Famciclovir | 125–250 mg twice a day for 5 days or 1 g twice a day for 1 day or 500 mg for 1 dose followed by 250 mg twice a day for 2 days 500 mg twice a day for 5 daysd |
Treatment of genital herpes.
aFirst episode oral doses vary according to guidelines.
bRecommended as the first choice in the WHO STI guideline.
cHas a usage difficulty although it is found more efficient than the usage of 400 mg twice a day.
dThe recommended dose for the people HIV+ and have more than 10 episodes a year.
Recurrent genital herpes attacks are usually self-limiting and not so irritating compared to the first attack. However, attacks may sometimes be very frequent (four to six times a year or more) and severe and reduced the individual’s life quality. In such cases, two different regimens are used: the suppressive treatment and the intermittent treatment. Patient compliance and cost should be considered when choosing a treatment regimen. Table 2 shows recommended doses in detail. Acyclovir is low in cost compared to the other two agents. Intermittent treatment seems to be more advantageous than suppressive treatment in terms of both patient compliance and cost. Although studies show that both treatment regimens are effective and safe, suppressive treatment is more effective [47]. Thus, the World Health Organization (WHO) recommends suppressive treatment at first and to stop the treatment after 1 year to reassess recurrence frequency [46]. Since the patient usually experiences an attack after stopping the treatment, it is recommended to wait at least for the second attack. The treatment may be restarted after reassessment for patients who have unacceptable attack frequency and symptoms [35].
Complications such as urinary retention, meningoencephalitis, disseminated disease, pneumonia, and hepatitis, which are usually observed during the first attack and in immunosuppressive individuals, should be treated by hospitalizing the patient. The patient should be administered acyclovir 5–10 mg/kg IV every 8 h for 2–7 days or until clinical recovery is observed. The initial intervention should be followed up with oral antiviral treatment and the process should be completed in a total of 10 days. The treatment should be 21 days in case of HSV encephalitis [36].
Neonatal herpes during pregnancy is a serious health problem with high mortality and morbidity. Herpes must be managed carefully during pregnancy to minimize the risk of transmission to fetus. Primary/recurrent character of the maternal infection, presence of transplacental neutralizing antibodies, presence of premature rupture of membranes, fetal scalp electrode use, and labor method are factors which affect transmission [48]. Maximum risk occurs with the primary infection acquired during the third trimester.
Treatment should not be delayed in case of primary attack. Oral acyclovir administration in standard dose (400 mg/three times/day) is recommended as primary care. If the maternal infection is disseminated, IV use should be considered [49]. Although all three agents are accepted to be safe, valacyclovir and famciclovir are not recommended for primary care due to insufficient data [49–51]. If the attack occurs during the first or the second trimester, suppressive treatment with acyclovir may be started again from the 36th week until labor [52, 53]. If the attack occurs during the third trimester, acyclovir administration should be continued until labor. Detection of type-specific HSV antibodies is recommended for pregnant women who apply due to primary attack during the third trimester. Detection of the same antibody type with the type isolated on genital swab usually indicates recurrent attack rather than primary attack. There is no elective C-section indication in such cases. Otherwise, if there is also any doubt, attacks in the third trimester should be treated as primary attack and elective C-section should be used [49].
Existing protective antibodies of the pregnant woman with recurrent attack protect the fetus against transplacental transmission. Thus, neonatal herpes is not common in recurrent herpes cases. While antiviral treatment is not recommended for recurrent attacks before the 36th week, standard treatment may be considered in severe cases [54, 55]. It has been shown that suppressive treatment with acyclovir from the 36th week until labor reduces viral shedding, clinical herpes lesions, and requirement for C-section [56]. Vaginal birth should be preferred if there is no other obstetric contraindication. Even though vaginal birth is recommended in case of lesion presence during birth, the final decision should be made by the mother due to low neonatal herpes risk [49].
HSV is a condition that requires careful assessment in HIV+ patients. Similar to immunocompetent individuals, reactivation is subclinical in most cases [57]. However, the form of reactivation is closely related with the rate of immunosuppression and ulcerate, necrotic, painful, massive, multiple, and atypical lesions may be observed especially in patients with low CD4+ cell count [58]. Resistance is a high possibility in HIV+ patients. Antiviral treatment has been shown to be effective in HIV+ patients as well [59, 60]. However, antiviral treatment has not been found to be effective in preventing the transmission of HIV or HSV to the possible partner [61, 62]. Table 2 shows doses for HIV+ patients.
Drug resistance should always be considered in cases where lesions become chronic or new attacks occur under antiviral treatment. Development of drug resistance against acyclovir and derivatives has been increasing due to high prevalence of herpes and frequent and prolonged use of accessible agents. There is a vast difference between immunocompetent and immunosuppressive cases in terms of drug resistance. Immunocompetent individuals rarely develop drug resistance, while drug resistance rates up to 36% have been reported for immunosuppressive cases in the literature. In a clinical study on patients with genital herpes, the acyclovir resistance rate has been found to be 0.18% for HIV-negative cases and 5.3% for HIV-positive cases [63–65].
Acyclovir resistance occurs through HSV thymidine kinase gene mutations. Phenotypically, it is observed as loss in TK activity, reduced TK production, or reduced affinity for substrate [66]. Acyclovir resistance is accompanied by cross-resistance against other nucleoside analogs such as valacyclovir, famciclovir, ganciclovir, and penciclovir since they share the same mechanism. While treatment with high doses of acyclovir and analogs is possible in cases of partial resistance, other treatment methods, which do not depend on TK, should be considered in cases of complete resistance [35, 67]. An oral agent other than acyclovir and analogs is not available. Foscarnet (40–80 mg/kg IV every 8 h) administration is the first choice after high doses of acyclovir in case of non-response to nucleoside analogs. Non-response to foscarnet is also possible, albeit rare. In such cases, IV cidofovir administration (5 mg/kg/week) may be considered [68]. Topical imiquimod is a good alternative in cases where IV treatment is not possible [69–71]. Although it is effective in resistant cases, topical cidofovir is disadvantaged due to lack of a commercially available preparation [72].
The first and most important approach is to inform asymptomatic partners and detection of possible asymptomatic carriers by assessing type-specific HSV-2 antibodies. Although it is not possible to fully protect HSV-2-seronegative partners from transmission, it is possible to minimize the risk. The primary reason behind sexual transmission is asymptomatic viral shedding. Both HSV-1- and HSV-2-induced genital herpes cases may involve asymptomatic viral shedding. Viral shedding is more common in individuals with frequent and severe attacks in particular. The first step to protection is to encourage condom use. It has been shown to have quite high effectiveness in regular use and higher effectiveness in transmission from man to woman [73]. Sexual intercourse should be avoided during active attack periods. Asymptomatic viral shedding responsible for transmission can be suppressed with all systemic antiviral treatments [74, 75]. A reverse transcriptase inhibitor analog also approved for HIV, gel form of tenofovir, has been shown to protect HSV-seronegative women against transmission when used 12 h prior to intercourse [76]. SPL7013 gel (VivaGel®) is a microbicide developed to protect against HIV and HSV. It has been found to have strong antiviral activity when used 3 h before intercourse [77].
Efforts to develop a vaccine for HSV-1 and HSV-2 are among the priorities of WHO. Although there is no licensed HSV vaccine available as of now, there are numerous vaccines at clinical and preclinical study stages. Studies have gained pace, thanks to a better understanding of immune response against HSV [78]. Vaccines generally have two different purposes: reduction of disease activity and viral shedding (therapeutic) and prevention of infection occurrence (prophylactic). The most common HSV vaccines used in human clinical studies are glycoprotein subunit (gp D2) vaccines. A HSV subunit vaccine, HerpeVac, is a prophylactic vaccine and has the most intensive clinical study. In a study on HSV-1- and HSV-2-seronegative women, it has been found that the vaccine provides 58% protection against HSV-1; however, it has no protective effect against HSV-2 [79]. Clinical phase II studies of four prospective vaccines with therapeutic indications still continue today. First results of studies on GEN-003, a gD2/ICP4 protein subunit vaccine with Matrix M adjuvant, indicate that the vaccine reduces viral shedding by about 50% [80]. HerpV, a peptide vaccine with 32 peptides complexed with heat shock proteins and Q-21 adjuvant, is another therapeutic vaccine and reduces viral shedding by 15%. The other two vaccines (codon-optimized polynucleotide vaccine and VCL-HB01/HM01) are DNA vaccines and research results are awaited for these vaccines. Phase I studies for HSV529, a replication-defective HSV-2 vaccine, have started with both therapeutic and prophylactic indications [81].
It is very important to inform herpes-seropositive individuals and their partners accurately and completely and eliminate their concerns. Because it is possible to improve their life quality through the right consultancy, transmission can be minimized and cases such as neonatal herpes may be prevented. It is not an accurate and complete approach to provide medical services only. Patients should be provided consultancy in the first visit. A healthy consultancy and information should involve the following:
The uterus is an organ with a particular anatomic situation localized with the uterine body intraperitoneally, the isthmus extra-peritoneally, and the cervix can be considered visible intravaginal organs. The uterine body is coated by the visceral peritoneum, which intimately adheres to its sides. In front, the visceral peritoneum reflects it on the bladder and in the back to the rectum. On the lateral side, the visceral uterine peritoneum detaches from the two sides of the uterus into two sheets that are joined to each other but are anatomically distinct and surgically separable, forming
The uterus is maintained in anatomical position inside the pelvis by two systems: a
The suspension and orientation system of the uterus consists of
The
The supporting system reunites all the elements that work together to maintain the uterus in its intrapelvic anatomical position and resist the descending tendency generated by the weight of the intestines at rest or under effort.
Biomechanical studies show that the support of the uterus and the upper part of the vagina are provided by the
The supporting system anchors the uterus and vagina to the pelvic brim: the
The cardinal ligament consists of three segments: Proximal and intermediate segments containing the mesenteric elements and the terminal ureter and a common segment with the homologous uterosacral ligament, which is the main support element of the pericervical ring.
Cardinal ligaments provide reliable support for the vascular and lymphatic axes that converge or emerge in the uterus. Their fibers dissipate in the pubocervicovesical fascia towards the cervix uteri and superior vagina at the level of the cervical ring, and the fascial and areolar structures towards the pelvic walls, structures that cover the pelvic diaphragm, the obturator pelvic fascia, and the tendinous arch of the pelvis (arcus taendineus fascia pelvis-ATFP). (Campbell).
Like the cardinal ligaments, the uterosacral ligaments defined three segments: a proximal segment that merges with the cardinal ligament, an intermediate segment that represents the structure that can be used as a suspension element, and a distal segment that merges with the presacral fascia. Sacrouterine ligaments contain nervous fibers from the superior hypogastric plexus. Those innervating the urinary bladder are of particular importance in nerve-sparing surgery for cervical cancer (Figure 3).
Definition of three segments of uterosacral ligaments. MRI reconstruction -spatial disposition of posteriorly oriented uterosacral ligaments (in green) and cardinal ligaments oriented vertically (in beige yellow), P = pubis arch, Isch = ischion, Il = ilion, S = sacrum.
Vaginal hysterectomy consists of disconnection from below of all elements that maintain the uterus in anatomical position.
From the vaginal point of view, the uterus suspension-supporting system consists of three main connective-vascular pedicles; lower, middle, and upper pedicles.
like abdominal hysterectomy, where the lower pedicle is most difficult to approach, vaginal hysterectomy solves this operative step as the first maneuver of the disconnection of the uterus.
Lower Pedicle
On the caudal side, the cervix and uterine isthmus provide insertion for two fibrous-connective structures: anteriorly,
The juxta vesical ureter, surrounded by fatty tissue, is located in the thickness of each pillar. The
The
The uterosacral ligaments on the lateral sides, towards their sacral insertion, are flanked by the hypogastric nerve, which, along with the pelvic nerves, will be part of the inferior hypogastric plexus. For this reason, sectioning the uterosacral ligaments in radical vaginal hysterectomy as close as possible to the sacral insertion bears the risk of urinary disorders occurring through bladder denervation. Laterally and caudally, the uterosacral ligaments continue with the superior paracolpium, and a division of them achieves the upper level of suspension of the vagina (Delancey).
Campbell identified three distinct histologic regions of the uterosacral ligament. At the cervical attachment, the ligament was made up of carefully packed bundles of smooth muscle, abundant medium-sized and small blood vessels, and small nerve bundles. The intermediate third of the ligament was composed of predominantly connective tissue and only a few scattered smooth muscle fibers, nerve elements, and blood vessels. The sacral third was almost entirely composed of loose strands of connective tissue and intermingled fat, few vessels, nerves, and lymphatics.
The mechanical strength of the uterosacral ligaments is remarkable. The cervical and intermediate portions of the uterosacral ligament supported more than 17 kg of weight before failure. (Nichols) (Figure 4).
Middle Pedicle
The middle connective-vascular pedicle consists of the cardinal ligaments and a variable contingent of fibers that are part of the uterosacral ligaments. Vaginally, each cardinal ligament has a fibrous-connective segment consisting of inferior fibers of the uterosacral ligament and a cranially located vascular segment, which consists of the superior bundle of the cardinal ligament and uterine vascular pedicle. The two segments can be surgically treated as a single pedicle or as separate depending on the thickness and insertion area of the uterine edge (Shiff).
On its cranial aspect, the cardinal ligament is crossed by the ureter under the crossing-point with the uterine artery. The distance between the lateral side of the cervix and isthmus and the wall of the pelvis is approximately 4–5 cm. The ureter crosses the cardinal ligament halfway, approximately 2–2.5 cm from the cervix. The ureteral risk is reduced in vaginal hysterectomy because, once the lower pedicle is cut, the cardinal ligament is elongated, removing the ureter from the operator’s field. (Kovak) (Figure 5).
Upper Pedicle
The upper pedicle consists of
The primary vascular element of the upper pedicle is the
A. Lower connective-vascular pedicle (cardinal uterosacral complex -CUSC the first pedicle in vaginal hysterectomy). 1 = cervicovesical ligament, 2 = uterosacral ligaments, 3 = cardinal ligament. Redline mark where the same pedicle might secure bladder pillar, uterosacral ligaments, and cardinal ligaments. B. Lower connective pedicle at vaginal hysterectomy with distinct uterosacral ligament (USL) and cardinal ligament (CL) in the same pedicle.
Middle pedicle. 1 = uterine artery, 2 = cardinal ligament, 3 = inferior pedicle cut, 4 = parametrial ureter. Once cut, the uterosacral ligament’s traction on the cervix makes the cardinal ligament elongated and removes the ureter from the surgical field.
The uterus is a highly vascular organ with two arterial and two venous systems intertwined.
The primary arterial system is composed of the
Between the
The venous system is composed of the
The arterial blood supply is provided by three different sources: the
The origin of the uterine artery can be encountered most often in a common trunk with the umbilical artery, which arises as to the terminal branch from the previous division of the hypogastric artery. However, there is also the anatomic variant of direct origin from the hypogastric artery. From its origin, the uterine artery follows a 3–5 cm intrapelvic trajectory, approaching the cervix at a constant distance of approximately 2–2.5 cm without coming into contact.
The level where the uterine artery enters the uterine body, regardless of the shape or size of the uterus, corresponds to the level of the internal cervical orifice (Figure 6).
The point where the uterine artery reaches the uterus is constant at the level of the internal cervical orifice. ICO = internal cervical orifice, UP = uterine point. 1 = main uterine artery, 2 = ascending branch of the uterine artery, three = descending branches of the uterine artery. 4 = Beliaeva triangle.
In its trajectory, the uterine artery has three distinct segments:
In the
The
The uterine artery reaches the uterus in a triangular zone near the isthmus (Beliaeva triangle) situated at the base of the broad ligaments at three o clock for the right side and nine o clock for the left side (from the vaginal point of view). The descending uterine artery supplies the isthmus, cervix, and upper vagina. The ascending uterine artery supplies the body of the uterus. The ascending uterine artery is tortuous and gives rise to 10–12 arcuate arteries that course between the outer and middle thirds of the myometrium.
The crossing point of the uterine artery with the ureter is located sideways, approximately 20 mm away from the cervix and 10–12 mm cranially from the lateral vaginal fornix. At this level, there are two venous currents, one in front and another in the back of the ureter, which is predisposed to bleed during maneuvers to unroof the parametrial ureter (Figure 7).
Arterial supply of uterus and vagina. 1 = arterial trunk of hypogastric artery, 2 = Main trunk of the uterine artery, 3 = the ascending branch of the uterine artery, 4 = the descending branch of uterine artery (superior vaginal artery), five = inferior vaginal artery, 6 = umbilical vesical artery, 7 = ureteral branches from the uterine artery, 8 = middle hemorrhoidal artery, nine = ovarian artery, ten = ovarian arch between ovarian and uterine branches, 11 = tubal arch between ovarian and uterine branches, 12 = fundal branch of the uterine artery, 13 = arcuate arteries from right side, 14 = anastomotic branch between the uterine artery and ovarian arch, 15 = funicular branch (round ligament) artery.
The
Between the right and left sides of the uterine body, the arcuate arteries are anastomosed by collateral and small, direct branches. At the uterine fundus, approximately 15 mm away from the insertion of the tube, the ascending uterine artery divides into two branches:
A branch from the uterine artery.
The vaginal artery.
The middle hemorrhoidal artery.
The source of the uterine artery is composed of vesicovaginal and cervicovaginal branches and ensures the blood flow for the upper part of the vagina. The correct vaginal artery (lower vaginal artery or large vaginal artery) originates from the hypogastric artery. The artery from both sides anastomose in the midline and forms the longitudinal artery from the cervix to the vulva named the
The
The
The bilateral ligature of the anterior trunk of hypogastric arteries cannot stop the blood flow into the pelvis. Two primary sources ensure arterial collateral circulation of the pelvis:
Iliolumbar arteries
Lateral sacral arteries
Middle hemorrhoidal arteries
Lumbar arteries
Middle sacral artery
Superior hemorrhoidal arteries
Venous blood from the uterine body comes from the veins located in the thickness of the myometrium, which is venous sinuses with reduced endothelial cover. Venous blood drains into two collecting veins on each side of the uterus, with anastomoses in between. The collateral venous blood supply is significant concerning the alternative route for blood flow in case of significant obstruction of main venous branches.
Collateral venous circulation of the uterus can be done in three main ways:
The
The
The
The venous blood supply of the vagina consists of veins that come from each side of the vagina and anastomose on the median line on the same path as the azygos arteries. The blood flow is oriented to uterine veins at the level of the cervix.
Veins are mainly located on the sides of the vagina and anastomose each other at the extremities of the vaginal canal. In the middle region of the vagina, anastomoses are carried out in the azygous arteries draining the blood to the uterine veins at the level of the cervix. The uterine veins are anastomosis with the average hemorrhoidal veins, which, in turn, communicate with the upper hemorrhoids, forming at this level a porta-cave anastomose. The
Vaginal hysterectomy has as its first step the disconnection of the upper vagina from the cervix and uterine body. As a result, the anastomotic flow between the uterus and vagina is interrupted.
After the middle pedicles are cut, due to caudal traction of the cervix in the vaginal canal, the transversal segment of the uterine artery elongates, and it can be secured by occluding both the ascending and descending branch. After that, all the maneuverers in the uterus, until the upper pedicles, are bloodless.
If the diameter of the uterus exceeds the lower pelvic brim, as the uterus is released, the bleeding is stopped by compressing the vessels on the hard plane of the pelvis.
After extracting a large uterus, important bleeding may occur, caused by either ligature sliding or from the tearing of veins in the broad ligament.
Many vaginal hysterectomies may result in insignificant bleeding as compared to those in abdominal hysterectomies.
Unlike abdominal hysterectomy, regardless of the method, open or laparoscopic, vaginal hysterectomy produces a particularly favorable effect by reducing bleeding, especially in the case of large uteri due to special hemodynamic conditions. During a vaginal hysterectomy, a series of hemodynamic events occur concerning the uterine circulation, especially for a large uterus:
Traction exerts on the cervix of a large uterus almost throughout the operation, so that blood flow is significantly diminished. After the bilateral ligature of the uterine arteries, which can affect both the ascending and the descending branches, the blood flow is completely stopped, allowing maneuvers for dimensional reduction of the uterus with no risk of significant bleeding.
During the vaginal hysterectomy, after the ligature of uterine arteries, visible bleeding does not come from vascular pedicles but from blood stored in the myometer.
In cases where labia minora are hypertrophic and hinder access to the vaginal introit, they are anchored laterally by suture or by using the Richter retractor. The surgical area is bounded by a set of fields isolating the anterior vulval-perineal region (Figure 8).
Pericervical infiltration with saline solution. The cervix is grasped with 2 Pozzi clamps, and a magenta dye marks the limit of the anterior and posterior incision. Infiltrating is strictly submucosal.
The course of the future colpotomy is infiltrated submucosally with a vasoconstrictive solution. (1/200,000 epinephrine, 4 ml of ropivacaine, and up to 20 ml of saline solution). When there are contraindications for administering the epinephrine, saline solution alone may be used. Through infiltration with saline solution, a hydric dissection of the tissues is achieved, which determines the opening of the cleavage spaces, and the local anesthesia blocks the nervous transmission from the receptor level.
Accidental intravascular injection should be avoided.
The incision of the vaginal wall can be done with a cold or electric scalpel.
The incision of the vagina around the cervix is circular, with the anterior limit in the first transversal fold of the vaginal mucosa from its insertion into the cervix (
The incision includes the entire thickness of the vaginal wall, anteriorly and posteriorly. Laterally only the epithelium is interested. In this way, with the ligature of the first pedicle, the vagina will remain anchored sideways to the uterosacral ligaments, ensuring the prevention of the vaginal vault prolapse (Figure 9).
The incision of the anterior wall of the vagina 1.5–2 cm away from the external cervical orifice includes the entire thickness of the vaginal wall. Posteriorly, the incision is placed at the level of the first posterior rugae of the vaginal wall.
Entry into the anterior cleavage space starts with opening the vesicouterine space by cutting the
To expose the cervico-vesical septum, the cervix is pulling down and the cutting edge of the vaginal wall in the opposite direction. The sectioning of the cervicovesical septum is done with scissors facing the mass of the cervix.
The anterior cleavage space is open. Bladder pillars delineate the spatial side of anterior cleavage space. The dissection of the vesicouterine space is done by the progression of the index on the median line.
The peritoneal vesicouterine fold remains up as long as the uterus keeps its connections with the superior connective vascular pedicle. For this reason, its opening is not an immediate objective once the bladder has been detached from the uterus.
In our basic technique, opening the vesicouterine pouch becomes extremely simple after the disconnection of the inferior pedicle if the uterus is not enlarged or deformed. After sectioning the inferior pedicle, the uterus descends 3–4 cm, where the white-pearly transversal fold of the peritoneal vesicouterine fold can be observed. It is grasped with a clamp and cut where it enters the pelvis. The surgeon digitally explores the anterior side of the uterus and inserts a Briesky-Navratil retractor in this space, discharging the bladder upward (Figure 12).
A. Identifying and opening the real vesicovaginal fold (white arrow). The black arrow marks the cervical insertion of the peritoneal fold (false fold). B. the vesicovaginal fold opens.
Unlike with anterior colpoceliotomy, entering the rectovaginal cleavage space and opening the pouch of Douglas can be done at the same time. The level of posterior vaginal incision described above is significant to ensure a good entry into the rectovaginal space. The edge of the posterior vaginal wall incision is grasped with Allis clamps, and the rectovaginal space is entered by sharp or blunt dissection. After entering the rectovaginal space and pressing the rectum down, the peritoneal cul-de-sac may be observed swelling when the cervix is moved in or out. After opening the pouch of Douglas, the posterior side of the uterus, uterosacral ligaments, and the posterior leaf of the broad ligaments can be explored digitally (Figures 13 and 14).
Developing rectovaginal cleavage space. Allis clamps grasp the vaginal cutting edge, and the space is open by sharp dissection. The posterior aspect of the cervix is pulled upward, and the dissection is carried out using a Sims retractor.
The rectovaginal fold is open, and the posterior side of the uterus is visible. (arrow).
In difficult cases, a particular variant can be used to avoid the creation of an excessively sizeable retroperitoneal space between the vagina and the rectum. (see Chapter 6).
The lower pedicle is represented by the uterosacral ligament posteriorly and the vesicouterine ligament anteriorly. For the disconnection of the inferior pedicle, it is not mandatory to open the rectouterine pouch, and the maneuver can be done extra-peritoneally.
The bladder is removed cranially with a Briesky-Navratil retractor, placing the two vesical pillars under tension, and the rectum is depressed with a posterior Sims retractor (Figures 15 and 16).
Right lower pedicle. A dotted line separates the bladder pillar (blue arrow) from the uterosacral ligament (blue light arrow). Clamping the inferior part of the bladder pillar and uterosacral ligament together form the right lower pedicle.
A. Right lower pedicle secured by Vicryl 2/0. B. the left lower pedicle is clamped prepared to cut.
Using a Wertheim clamp, one of the uterosacral ligaments and the homologous bladder pillar are loaded together, after which, the pedicle is cut and ligated. The maneuver is repeated on the opposite side. In many situations, after cutting the pedicle, the pouch of Douglas opens spontaneously near the uterine edge.
The middle pedicle is represented by the cardinal ligament that contains the main uterine vascular supply for the uterus and cervix. By caudal traction on the cervix, the vascular pedicle has a parallel direction on the uterine edge, removing the ureters from the surgical field (Figure 17).
Right middle pedicle formed by cardinal ligament and uterine artery and veins clamped and cut. Left middle pedicle clamped. Arrow mark the uterine artery. In our technique, the pediculisation of uterine vessels is not useful as long as the clamping of the pedicle is done strictly parallel to the uterine side. The risk to the ureter’s damage is reduced if the lower pedicle is previously sectioned. (see chapter 2).
For this reason, during the vaginal hysterectomy, the urethral risk is lower than with the abdominal approach. After clamping, the pedicle is cut and ligated with 2–0 Vicryl.
In some situations, the cardinal ligament can be well represented and cannot be clamped at a single time. In this case, a second clamping and cutting should be cautiously be done. There is the risk of clamping and cutting a part of the superior pedicle and, in the maneuver, tilting the uterus. If so, the latter might break, causing some unwanted bleeding.
For vaginally delivering the uterus, securing the superior connective vascular pedicle is the most important and sometimes the most difficult step of vaginal hysterectomy.
In most cases, the superior pedicle can be brought into the surgical field by tilting the uterus. The uterus can be tilted anteriorly (Doderlain-Kronig maneuver) or posteriorly (Heaney maneuver).
When the uterus is highly mobile and small, its release from the pelvis can also be done without tilting.
For the uterus weighing up to 200–280 g, access to the superior pedicle is done by tilting, a maneuver that brings the superior pedicle into the surgical field, which consists in anatomical order of the round ligament, fallopian tube, and homologous utero-ovarian ligament. This pedicle includes the anastomotic branch of the uterine artery and the tubo-ovarian vascular arch.
The main disadvantage of the tilting maneuvers is that it forces the vaginal opening through which the uterus is pulled, which can lead to the slipping of ligatures placed on the anteriorly cut and ligated connective vascular pedicles (Figures 18–20).
Disconnection of upper pedicle by posterior tilting (Heaney maneuver).
Disconnection of the superior pedicle. In this case, the uterus is hemisected previously. The pedicle is hooked by the index finger and then clamped.
Clamped left upper pedicle. We can see what it is made of 1 = round ligament, 2 = utero-ovarian ligament, 3 = tube.
Anterior tilting (Doderlain-Kronig maneuver). After anterior colpoceliotomy, the anterior side of the uterus is evident. Using Pozzi forceps, the uterine fundus is extracted, and the superior pedicle can be clamped and cut.
The cervix is forcefully pulled caudally to expose as much as possible the anterior side of the uterus. Using a Pozzi clamp, the mass of the uterine body is clamped on the median line as high up as possible. It is gradually pulled, without sudden moves that lead to the rupture of the myometrium. At the same time, the cervix is left free without traction or pushed cranially and posteriorly with the Pozzi clamp. Along with the uterus’s progress into the surgical field, using another Pozzi clamp, the mass of the uterine tissue is escalated as high up as possible until the uterine fundus and one or two superior pedicles appear in the surgical field. At this time, the cervix is pulled cranially to place the pedicle under tension. The index finger of the surgeon’s left hand cranially and caudally loads the superior uterine pedicle, while the right-hand loads the pedicle into the arms of the Wertheim clamp.
After clamping and cutting, the pedicle is ligated, and the ends of the threads are kept as benchmarks. For the contralateral side, the maneuver for clamping the pedicle simplifies because, by pulling onto the cervix, the pedicle will be well exposed. Cutting and ligating the pedicles gives rise to the extraction of the uterus. The pedicle can be completely clamped or the round ligament isolated when one aims to perform the adnexectomy.
Posterior tilting (Heaney maneuver) is the most frequently used maneuver to access the superior pedicle for non-prolapsed uteruses weighing more than 180 g. Posterior tilting has the main advantage of being able to rotate the uterus in a much larger space, represented by the sacral concavity.
The cervix is forcefully pulled cranially while the assistant depresses the rectum using a Sims retractor to reveal as much as possible of the posterior side of the uterus. The surgeon places a Pozzi clamp on the dorsal middle bottom of the uterus, as close as possible to the uterine pouch. Relaxing the tension exerted on the cervix, it is pulled progressively by the clamp while the assistant tries to extract the uterus using the posterior retractor. When uterus progression is observed, the position of the uterus pulling clamp is changed to become as cranial as possible, and the releasing maneuvers are continued until the uterine fundus appears in the surgical field (Figures 22 and 23).
Posterior tilting (Heaney maneuver). Clamping the left superior pedicle. The cervix is pulled cranially at the same time that the uterine fundus is pulled hard caudally.
The Heaney maneuver. The right pedicle is clamped ˝a la Vue easily. ˝.
Unlike anterior tilting, the superior pedicle does not become visible. To be able to identify it, the surgeon places a Briesky retractor in the area between the lateral wall of the vagina and the uterine horn, usually on the left side, where access is more accessible. As an aiding maneuver, the clamp anchoring the uterine fundus is repositioned as close as possible to the externalized uterine horn. Thus, by simultaneously pulling the cervix and uterine fundus and maneuvering the Briesky-Navratil retractor laterally, the superior pedicle is revealed at its insertion into the uterus. With the medius of the left hand, the surgeon loads the pedicle in a cranial position to clamp the pedicle in a caudal place with the right hand using a Wertheim clamp.
In certain situations (early endometrial cancer, interventions under local anesthesia), it is necessary to release the uterus with minimum trauma, without tilting or morcellation. Direct access to the superior pedicle is possible mainly in multiparous women with perineal relaxation and small uteruses with a weakly represented bearing system. In these cases, clamping and section of the pedicle are done without any difficulties. Clamping the superior pedicle can be done safely by successively escalating the elements included in the utero-adnexal pedicle.
After extracting the uterus, gauze is inserted through the vaginal opening and into the pelvic cavity, pushing the bowels and leaving the pelvic-subperitoneal space open to view. The posterior wall of the vagina is retracted with an auto-static retractor. The vesicouterine peritoneum is revealed using a Briesky-Navratil retractor. The basis of the parameter is shown on the appropriate side, pulling the thread locating the superior pedicle. Bleeding at the end of the intervention is usually profuse, and its primary source is the vaginal cutting edges. In the case of active arterial bleeding from parameters, the surgical field is flooded, and the primary sources, such as the uterine arteries or the utero-ovarian arches, are to be found immediately.
At the end of a vaginal hysterectomy, the surgical field is rarely “dry” until the vaginal cuff is closed.
In the technique we used for a vaginal hysterectomy for a non-prolapsed uterus, we adopted the Wertheim manner of closing the peritoneal cavity and the remaining vaginal edges. The main drawback of this maneuver is the closing of the surgical field without controlling the hemostasis until the end of the operation. We modified the technique, closing down the pelvic-peritoneal space and anchoring the superior vagina to the remaining cuffs of the inferior pedicle containing the most substantial elements of suspension – the uterosacral ligaments. With this procedure, the prevention of vaginal vault prolapse is done like the McCall procedure.
The manner we proposed is done in three distinct times:
Closure of the pelvic-subperitoneal posterior space
Closure of the pelvic-subperitoneal anterior space
Full closure of the vaginal cuff
Closure of the pelvic-subperitoneal posterior space
Closing down the pelvic-subperitoneal space is done by running a suture with Vicryl nr. 0 to close the edge of the vagina and the posterior visceral peritoneum, starting from the lower pedicle on one side to the similar pedicle on the other side (Figure 24).
Closure of the pelvic-subperitoneal anterior space
This step usually is not necessary, but when the dissection of the bladder wall is difficult or in the case of an inadvertent wound, closing the space between the bladder and vagina is the best alternative. By joining the wall of the vagina with the visceral vesical peritoneum using a running suture, space is closed down.
Full closure of the vaginal cuff
The vaginal cuff can be fully closed by sutures with separate suture points. The closure of the vaginal cuff is done with Vicryl 0 and with suture points in a figure of eight that starts at the center of the section and goes out towards each lateral vaginal commissure (Figure 25).
Prophylactic apical support
The technique described above refers to the unprolapsed uterus where post-hysterectomy vault prolapse occurs very rarely. For this reason, we do not include in the operative procedure an appropriate step addressed for it. The prevention of vaginal vault prolapse is necessary in case of an association of early forms of uterovaginal prolapse. By the technique described by us, the means of suspension of the upper vagina are preserved as long as the circular (Figure 26).
Closing the posterior pelvic-subperitoneal space by running suture. The edge of the vagina (green arrow) is sutured together with the visceral posterior peritoneum (yellow arrow).
The final closing of the vaginal vault by separate suture points, from middle to lateral.
Superficial incision of the lateral aspect of the vagina allows the section of the lower connective vascular pedicle to anchor the vaginal wall to uterosacral ligaments making prophylaxis of vaginal vault prolapse. (yellow arrows – Vaginal wall).
The incision in the cervix is of interest only to the vaginal mucosa. For cases where early apical prolapse is present, McCall culdoplasty is an excellent way to resuspend the upper vagina at the first level (DeLancey).
The presented technique of vaginal hysterectomy resulted from combining several variants tried by authors over the years of more than 4500 vaginal hysterectomies. From each variant of the technique, we chose the most efficient and safe method to achieve each operator time as a confirmation of the validity of the succession of operating times proposed by us, the International Society of Endoscopic Surgery (ISGE) published in 2020 a set of recommendations on the technique of vaginal hysterectomy on the unprolapsed uterus.
Six recommendations were established similar to the standard technique proposed by us:
Circular incision at the level of the cervical-vagina junction is recommended (grade IC).
Posterior peritoneum should be opened first (grade IC).
Clamping and cutting the uterosacral and cardinal ligaments before or after getting access to the anterior peritoneum are recommended (grade IC).
Routine closure of the peritoneum during vaginal hysterectomy is not recommended (grade IB).
Vertical or horizontal closure of the vaginal vault following vaginal hysterectomy is recommended (grade IC).
To insert the vaginal plug following vaginal hysterectomy is not recommended (grade IB).
..,
There is no standard technique for vaginal hysterectomies. Every case poses different strategical problems. It is not necessary to follow every step of the operation in order as described elsewhere in literature or even in this chapter. The surgeon can treat every operation as a distinct one with a specific strategy.
The disconnection of the leading vascular pedicles causes fewer problems than delivering the uterus from the upper connective vascular pedicle. For large uteri, this operative step is time-consuming and challenging to work for the surgeon.
If during the first steps of the operation, incidental bleeding begins that cannot be managed, the surgeon should not hesitate to convert the vaginal operation to an open abdominal or laparoscopic one. Every minute lost means 250 ml of blood lost from each uterine artery.
In many cases, there is significant blood loss until the uterus is released, and after that, the drama begins. In some cases, the abrupt withdrawal of the uterus from the pelvis causes the sliding of ligatures from a uterine artery. If the bleeding seems to be to one side, you have to look for it on the opposite side.
The most important thing is to finish this partially blind operation without any doubt regarding the safety of the patient.
We believe financial barriers should not prevent researchers from publishing their findings. With the need to make scientific research more publicly available and support the benefits of Open Access, more and more institutions and funders are dedicating resources to assist faculty members and researchers cover Open Access Publishing Fees (OAPFs). In addition, IntechOpen provides several further options presented below, all of which are available to researchers, and could secure the financing of your Open Access publication.
",metaTitle:"Waiver Policy",metaDescription:"We feel that financial barriers should never prevent researchers from publishing their research. With the need to make scientific research more publically available and support the benefits of Open Access, more institutions and funders have dedicated funds to assist their faculty members and researchers cover the APCs associated with publishing in Open Access. Below we have outlined several options available to secure financing for your Open Access publication.",metaKeywords:null,canonicalURL:"/page/waiver-policy",contentRaw:'[{"type":"htmlEditorComponent","content":"At IntechOpen, the majority of OAPFs are paid by an Author’s institution or funding agency - Institutions (73%) vs. Authors (23%).
\\n\\nThe first step in obtaining funds for your Open Access publication begins with your institution or library. IntechOpen’s publishing standards align with most institutional funding programs. Our advice is to petition your institution for help in financing your Open Access publication.
\\n\\nHowever, as Open Access becomes a more commonly used publishing option for the dissemination of scientific and scholarly content, in addition to institutions, there are a growing number of funders who allow the use of grants for covering OA publication costs, or have established separate funds for the same purpose.
\\n\\nPlease consult our Open Access Funding page to explore some of these funding opportunities and learn more about how you could finance your IntechOpen publication. Keep in mind that this list is not definitive, and while we are constantly updating and informing our Authors of new funding opportunities, we recommend that you always check with your institution first.
\\n\\nFor Authors who are unable to obtain funding from their institution or research funding bodies and still need help in covering publication costs, IntechOpen offers the possibility of applying for a Waiver.
\\n\\nOur mission is to support Authors in publishing their research and making an impact within the scientific community. Currently, 14% of Authors receive full waivers and 6% receive partial waivers.
\\n\\nWhile providing support and advice to all our international Authors, waiver priority will be given to those Authors who reside in countries that are classified by the World Bank as low-income economies. In this way, we can help ensure that the scientific work being carried out can make an impact within the worldwide scientific community, no matter where an Author might live.
\\n\\nThe application process is open after your submitted manuscript has been accepted for publication. To apply, please fill out a Waiver Request Form and send it to your Author Service Manager. If you have an official letter from your university or institution showing that funds for your OA publication are unavailable, please attach that as well. The Waiver Request will normally be addressed within one week from the application date. All chapters that receive waivers or partial waivers will be designated as such online.
\\n\\nDownload Waiver Request Form
\\n\\nFeel free to contact us at funders@intechopen.com if you have any questions about Funding options or our Waiver program. If you have already begun the process and require further assistance, please contact your Author Service Manager, who is there to assist you!
\\n\\nNote: All data represented above was collected by IntechOpen from 2013 to 2017.
\\n"}]'},components:[{type:"htmlEditorComponent",content:'At IntechOpen, the majority of OAPFs are paid by an Author’s institution or funding agency - Institutions (73%) vs. Authors (23%).
\n\nThe first step in obtaining funds for your Open Access publication begins with your institution or library. IntechOpen’s publishing standards align with most institutional funding programs. Our advice is to petition your institution for help in financing your Open Access publication.
\n\nHowever, as Open Access becomes a more commonly used publishing option for the dissemination of scientific and scholarly content, in addition to institutions, there are a growing number of funders who allow the use of grants for covering OA publication costs, or have established separate funds for the same purpose.
\n\nPlease consult our Open Access Funding page to explore some of these funding opportunities and learn more about how you could finance your IntechOpen publication. Keep in mind that this list is not definitive, and while we are constantly updating and informing our Authors of new funding opportunities, we recommend that you always check with your institution first.
\n\nFor Authors who are unable to obtain funding from their institution or research funding bodies and still need help in covering publication costs, IntechOpen offers the possibility of applying for a Waiver.
\n\nOur mission is to support Authors in publishing their research and making an impact within the scientific community. Currently, 14% of Authors receive full waivers and 6% receive partial waivers.
\n\nWhile providing support and advice to all our international Authors, waiver priority will be given to those Authors who reside in countries that are classified by the World Bank as low-income economies. In this way, we can help ensure that the scientific work being carried out can make an impact within the worldwide scientific community, no matter where an Author might live.
\n\nThe application process is open after your submitted manuscript has been accepted for publication. To apply, please fill out a Waiver Request Form and send it to your Author Service Manager. If you have an official letter from your university or institution showing that funds for your OA publication are unavailable, please attach that as well. The Waiver Request will normally be addressed within one week from the application date. All chapters that receive waivers or partial waivers will be designated as such online.
\n\nDownload Waiver Request Form
\n\nFeel free to contact us at funders@intechopen.com if you have any questions about Funding options or our Waiver program. If you have already begun the process and require further assistance, please contact your Author Service Manager, who is there to assist you!
\n\nNote: All data represented above was collected by IntechOpen from 2013 to 2017.
\n'}]},successStories:{items:[]},authorsAndEditors:{filterParams:{},profiles:[{id:"396",title:"Dr.",name:"Vedran",middleName:null,surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/396/images/7281_n.png",biography:"After obtaining his Master's degree in Mechanical Engineering he continued his education at the Vienna University of Technology where he obtained his PhD degree in 2004. He worked as a researcher at the Automation and Control Institute, Faculty of Electrical Engineering, Vienna University of Technology until 2008. His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. He has contributed in stochastic estimation of control area especially, in the Multiple Target Tracking and Interactive Multiple Model (IMM) research, Ball & Beam Control Problem, Robotics, Levitation Control. He has contributed in developing Algorithms for Fingerprint Matching, Computer Vision and Face Recognition. He has been supervising Pattern Recognition, Formal Languages and Distributed Processing projects for several years. He has reviewed many books on Management, Computer Science. Currently, he is an active and permanent reviewer for many international conferences and symposia and the program committee member for many international conferences.\nIn teaching he has taught the core computer science subjects like, Digital Design, Real Time Embedded System Programming, Operating Systems, Software Engineering, Data Structures, Databases, Compiler Construction. In the Engineering side, Digital Signal Processing, Computer Architecture, Electronics Devices, Digital Filtering and Engineering Management.\nApart from his Academic Interest and activities he loves sport especially, Cricket, Football, Snooker and Squash. He plays cricket for Esbjerg city in the second division team as an opener wicket keeper batsman. He is a very good player of squash but has not played squash since his arrival in Denmark.",institutionString:null,institution:null},{id:"611",title:"Prof.",name:"T",middleName:null,surname:"Nagarajan",slug:"t-nagarajan",fullName:"T Nagarajan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universiti Teknologi Petronas",country:{name:"Malaysia"}}}],filtersByRegion:[{group:"region",caption:"North America",value:1,count:13389},{group:"region",caption:"Middle and South America",value:2,count:11658},{group:"region",caption:"Africa",value:3,count:4168},{group:"region",caption:"Asia",value:4,count:22334},{group:"region",caption:"Australia and Oceania",value:5,count:2019},{group:"region",caption:"Europe",value:6,count:33642}],offset:12,limit:12,total:135272},chapterEmbeded:{data:{}},editorApplication:{success:null,errors:{}},ofsBooks:{filterParams:{hasNoEditors:"0",sort:"dateEndThirdStepPublish",topicId:"8,9,10,11,14,15,20,22,24"},books:[{type:"book",id:"11124",title:"Next-Generation Textiles",subtitle:null,isOpenForSubmission:!0,hash:"093f9e26bb829b8d414d13626aea1086",slug:null,bookSignature:"Dr. Hassan Ibrahim",coverURL:"https://cdn.intechopen.com/books/images_new/11124.jpg",editedByType:null,editors:[{id:"90645",title:"Dr.",name:"Hassan",surname:"Ibrahim",slug:"hassan-ibrahim",fullName:"Hassan Ibrahim"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11561",title:"Zeolite From Wastes - New Perspectives on Innovative Resources and Their Valorization Process",subtitle:null,isOpenForSubmission:!0,hash:"3ed0dfd842de9cd1143212415903e6ad",slug:null,bookSignature:"Dr. Claudia Belviso",coverURL:"https://cdn.intechopen.com/books/images_new/11561.jpg",editedByType:null,editors:[{id:"61457",title:"Dr.",name:"Claudia",surname:"Belviso",slug:"claudia-belviso",fullName:"Claudia Belviso"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11533",title:"Advances in Green Electronics Technologies",subtitle:null,isOpenForSubmission:!0,hash:"209fb1d781e97e58e1b2098b8976e2c3",slug:null,bookSignature:"Dr. Albert Sabban",coverURL:"https://cdn.intechopen.com/books/images_new/11533.jpg",editedByType:null,editors:[{id:"16889",title:"Dr.",name:"Albert",surname:"Sabban",slug:"albert-sabban",fullName:"Albert Sabban"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11521",title:"Internal Combustion Engines - Recent Advances",subtitle:null,isOpenForSubmission:!0,hash:"99cc881bcb3efe05085f2728ccbeab6b",slug:null,bookSignature:"Prof. Akaehomen Akii Ibhadode",coverURL:"https://cdn.intechopen.com/books/images_new/11521.jpg",editedByType:null,editors:[{id:"253342",title:"Prof.",name:"Akaehomen",surname:"Ibhadode",slug:"akaehomen-ibhadode",fullName:"Akaehomen Ibhadode"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11828",title:"Lubrication - Thermal Management and Friction Reduction",subtitle:null,isOpenForSubmission:!0,hash:"b900201d5e8a4b13100f49e7c1019447",slug:null,bookSignature:"Dr. Hafiz Muhammad Ali",coverURL:"https://cdn.intechopen.com/books/images_new/11828.jpg",editedByType:null,editors:[{id:"187624",title:"Dr.",name:"Hafiz Muhammad",surname:"Ali",slug:"hafiz-muhammad-ali",fullName:"Hafiz Muhammad Ali"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11499",title:"Nonlinear Systems - Recent Developments and Advances",subtitle:null,isOpenForSubmission:!0,hash:"22a4fb880337aaa9899a7bddcdde52eb",slug:null,bookSignature:"Dr. Bo Yang",coverURL:"https://cdn.intechopen.com/books/images_new/11499.jpg",editedByType:null,editors:[{id:"234525",title:"Dr.",name:"Bo",surname:"Yang",slug:"bo-yang",fullName:"Bo Yang"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11947",title:"Power Converter Technology - Recent Advances, Design and Applications",subtitle:null,isOpenForSubmission:!0,hash:"1f5c85b127faa05e07e46c646dcb4540",slug:null,bookSignature:"Dr. Raul Gregor",coverURL:"https://cdn.intechopen.com/books/images_new/11947.jpg",editedByType:null,editors:[{id:"175676",title:"Dr.",name:"Raul",surname:"Gregor",slug:"raul-gregor",fullName:"Raul Gregor"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11535",title:"Recent Research Trends in Sustainable Energy Conversion",subtitle:null,isOpenForSubmission:!0,hash:"8a29db15e41fcfcb6d49fa1ecc670318",slug:null,bookSignature:"Prof. Arunkumar Chandrasekhar",coverURL:"https://cdn.intechopen.com/books/images_new/11535.jpg",editedByType:null,editors:[{id:"226215",title:"Prof.",name:"Arunkumar",surname:"Chandrasekhar",slug:"arunkumar-chandrasekhar",fullName:"Arunkumar Chandrasekhar"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11830",title:"Rubber Materials",subtitle:null,isOpenForSubmission:!0,hash:"6cf0b844f6881c758c61cca10dc8b134",slug:null,bookSignature:"Associate Prof. Gülşen Akın Evingür and Dr. Önder Pekcan",coverURL:"https://cdn.intechopen.com/books/images_new/11830.jpg",editedByType:null,editors:[{id:"180256",title:"Associate Prof.",name:"Gülşen",surname:"Akın Evingür",slug:"gulsen-akin-evingur",fullName:"Gülşen Akın Evingür"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11453",title:"Biomimetics - Bridging the Gap",subtitle:null,isOpenForSubmission:!0,hash:"173e62fa4d7bf5508cec3bdd8e3cb32d",slug:null,bookSignature:"Prof. Ziyad S. Haidar",coverURL:"https://cdn.intechopen.com/books/images_new/11453.jpg",editedByType:null,editors:[{id:"222709",title:"Prof.",name:"Ziyad S.",surname:"Haidar",slug:"ziyad-s.-haidar",fullName:"Ziyad S. Haidar"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"12081",title:"Dyes and Pigments - Insights and Applications",subtitle:null,isOpenForSubmission:!0,hash:"fcd069956c2e931195925b19a74ce9a3",slug:null,bookSignature:"Dr. Brajesh Kumar",coverURL:"https://cdn.intechopen.com/books/images_new/12081.jpg",editedByType:null,editors:[{id:"176093",title:"Dr.",name:"Brajesh",surname:"Kumar",slug:"brajesh-kumar",fullName:"Brajesh Kumar"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"12019",title:"Chaos Theory - Recent Advances, New Perspectives and Applications",subtitle:null,isOpenForSubmission:!0,hash:"38f0946fe1dd3314939e670799f88426",slug:null,bookSignature:"Dr. Mykhaylo I. Andriychuk",coverURL:"https://cdn.intechopen.com/books/images_new/12019.jpg",editedByType:null,editors:[{id:"57755",title:"Dr.",name:"Mykhaylo",surname:"Andriychuk",slug:"mykhaylo-andriychuk",fullName:"Mykhaylo Andriychuk"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],filtersByTopic:[{group:"topic",caption:"Agricultural and Biological Sciences",value:5,count:28},{group:"topic",caption:"Biochemistry, Genetics and Molecular Biology",value:6,count:8},{group:"topic",caption:"Business, Management and Economics",value:7,count:4},{group:"topic",caption:"Chemistry",value:8,count:16},{group:"topic",caption:"Computer and Information Science",value:9,count:18},{group:"topic",caption:"Earth and Planetary Sciences",value:10,count:8},{group:"topic",caption:"Engineering",value:11,count:43},{group:"topic",caption:"Environmental Sciences",value:12,count:6},{group:"topic",caption:"Immunology and Microbiology",value:13,count:9},{group:"topic",caption:"Materials Science",value:14,count:17},{group:"topic",caption:"Mathematics",value:15,count:9},{group:"topic",caption:"Medicine",value:16,count:73},{group:"topic",caption:"Nanotechnology and Nanomaterials",value:17,count:3},{group:"topic",caption:"Neuroscience",value:18,count:3},{group:"topic",caption:"Pharmacology, Toxicology and Pharmaceutical Science",value:19,count:6},{group:"topic",caption:"Physics",value:20,count:6},{group:"topic",caption:"Psychology",value:21,count:5},{group:"topic",caption:"Robotics",value:22,count:2},{group:"topic",caption:"Social Sciences",value:23,count:7},{group:"topic",caption:"Veterinary Medicine and Science",value:25,count:2}],offset:12,limit:12,total:119},popularBooks:{featuredBooks:[{type:"book",id:"7827",title:"Interpersonal Relationships",subtitle:null,isOpenForSubmission:!1,hash:"ebf41f4d17c75010eb3294cc8cac3d47",slug:"interpersonal-relationships",bookSignature:"Martha Peaslee Levine",coverURL:"https://cdn.intechopen.com/books/images_new/7827.jpg",editors:[{id:"186919",title:"Dr.",name:"Martha",middleName:null,surname:"Peaslee Levine",slug:"martha-peaslee-levine",fullName:"Martha Peaslee Levine"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10808",title:"Current Concepts in Dental Implantology",subtitle:"From Science to Clinical Research",isOpenForSubmission:!1,hash:"4af8830e463f89c57515c2da2b9777b0",slug:"current-concepts-in-dental-implantology-from-science-to-clinical-research",bookSignature:"Dragana Gabrić and Marko Vuletić",coverURL:"https://cdn.intechopen.com/books/images_new/10808.jpg",editors:[{id:"26946",title:"Prof.",name:"Dragana",middleName:null,surname:"Gabrić",slug:"dragana-gabric",fullName:"Dragana Gabrić"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10908",title:"Advances in Decision Making",subtitle:null,isOpenForSubmission:!1,hash:"126486f7f91e18e2e3539a32c38be7b1",slug:"advances-in-decision-making",bookSignature:"Fausto Pedro García Márquez",coverURL:"https://cdn.intechopen.com/books/images_new/10908.jpg",editors:[{id:"22844",title:"Prof.",name:"Fausto Pedro",middleName:null,surname:"García Márquez",slug:"fausto-pedro-garcia-marquez",fullName:"Fausto Pedro García Márquez"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10796",title:"Extracellular Vesicles",subtitle:"Role in Diseases, Pathogenesis and Therapy",isOpenForSubmission:!1,hash:"eb5407fcf93baff7bca3fae5640153a2",slug:"extracellular-vesicles-role-in-diseases-pathogenesis-and-therapy",bookSignature:"Manash K. Paul",coverURL:"https://cdn.intechopen.com/books/images_new/10796.jpg",editors:[{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"11263",title:"Supply Chain",subtitle:"Recent Advances and New Perspectives in the Industry 4.0 Era",isOpenForSubmission:!1,hash:"aab634c9c1f9a692c1e9881d18e9c9b7",slug:"supply-chain-recent-advances-and-new-perspectives-in-the-industry-4-0-era",bookSignature:"Tamás Bányai, Ágota Bányai and Ireneusz Kaczmar",coverURL:"https://cdn.intechopen.com/books/images_new/11263.jpg",editors:[{id:"201248",title:"Dr.",name:"Tamás",middleName:null,surname:"Bányai",slug:"tamas-banyai",fullName:"Tamás Bányai"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10739",title:"Global Decline of Insects",subtitle:null,isOpenForSubmission:!1,hash:"543783652b9092962a8fa4bed38eeb17",slug:"global-decline-of-insects",bookSignature:"Hamadttu Abdel Farag El-Shafie",coverURL:"https://cdn.intechopen.com/books/images_new/10739.jpg",editors:[{id:"192142",title:"Dr.",name:"Hamadttu",middleName:null,surname:"Abdel Farag El-Shafie",slug:"hamadttu-abdel-farag-el-shafie",fullName:"Hamadttu Abdel Farag El-Shafie"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10911",title:"Higher Education",subtitle:"New Approaches to Accreditation, Digitalization, and Globalization in the Age of Covid",isOpenForSubmission:!1,hash:"223a02337498e535e967174c1f648fbc",slug:"higher-education-new-approaches-to-accreditation-digitalization-and-globalization-in-the-age-of-covid",bookSignature:"Lee Waller and Sharon Waller",coverURL:"https://cdn.intechopen.com/books/images_new/10911.jpg",editors:[{id:"263301",title:"Dr.",name:"Lee",middleName:null,surname:"Waller",slug:"lee-waller",fullName:"Lee Waller"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10669",title:"Corrosion",subtitle:"Fundamentals and Protection Mechanisms",isOpenForSubmission:!1,hash:"4a76d54f8a40fc2e7002a8d13fd617c1",slug:"corrosion-fundamentals-and-protection-mechanisms",bookSignature:"Fahmina Zafar, Anujit Ghosal and Eram Sharmin",coverURL:"https://cdn.intechopen.com/books/images_new/10669.jpg",editors:[{id:"89672",title:"Dr.",name:"Fahmina",middleName:null,surname:"Zafar",slug:"fahmina-zafar",fullName:"Fahmina Zafar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"95",title:"Applications and Experiences of Quality Control",subtitle:null,isOpenForSubmission:!1,hash:"4bcb22b1eee68210a977a97d5a0f363a",slug:"applications-and-experiences-of-quality-control",bookSignature:"Ognyan Ivanov",coverURL:"https://cdn.intechopen.com/books/images_new/95.jpg",editors:[{id:"22230",title:"Prof.",name:"Ognyan",middleName:null,surname:"Ivanov",slug:"ognyan-ivanov",fullName:"Ognyan Ivanov"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"2160",title:"MATLAB",subtitle:"A Fundamental Tool for Scientific Computing and Engineering Applications - Volume 1",isOpenForSubmission:!1,hash:"dd9c658341fbd264ed4f8d9e6aa8ca29",slug:"matlab-a-fundamental-tool-for-scientific-computing-and-engineering-applications-volume-1",bookSignature:"Vasilios N. Katsikis",coverURL:"https://cdn.intechopen.com/books/images_new/2160.jpg",editors:[{id:"12289",title:"Prof.",name:"Vasilios",middleName:"N.",surname:"Katsikis",slug:"vasilios-katsikis",fullName:"Vasilios Katsikis"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"3560",title:"Advances in Landscape Architecture",subtitle:null,isOpenForSubmission:!1,hash:"a20614517ec5f7e91188fe8e42832138",slug:"advances-in-landscape-architecture",bookSignature:"Murat Özyavuz",coverURL:"https://cdn.intechopen.com/books/images_new/3560.jpg",editors:[{id:"93073",title:"Dr.",name:"Murat",middleName:null,surname:"Ozyavuz",slug:"murat-ozyavuz",fullName:"Murat Ozyavuz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"3568",title:"Recent Advances in Plant in vitro Culture",subtitle:null,isOpenForSubmission:!1,hash:"830bbb601742c85a3fb0eeafe1454c43",slug:"recent-advances-in-plant-in-vitro-culture",bookSignature:"Annarita Leva and Laura M. R. Rinaldi",coverURL:"https://cdn.intechopen.com/books/images_new/3568.jpg",editors:[{id:"142145",title:"Dr.",name:"Annarita",middleName:null,surname:"Leva",slug:"annarita-leva",fullName:"Annarita Leva"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],offset:12,limit:12,total:4805},hotBookTopics:{hotBooks:[],offset:0,limit:12,total:null},publish:{},publishingProposal:{success:null,errors:{}},books:{featuredBooks:[{type:"book",id:"7827",title:"Interpersonal Relationships",subtitle:null,isOpenForSubmission:!1,hash:"ebf41f4d17c75010eb3294cc8cac3d47",slug:"interpersonal-relationships",bookSignature:"Martha Peaslee Levine",coverURL:"https://cdn.intechopen.com/books/images_new/7827.jpg",publishedDate:"July 27th 2022",numberOfDownloads:7107,editors:[{id:"186919",title:"Dr.",name:"Martha",middleName:null,surname:"Peaslee Levine",slug:"martha-peaslee-levine",fullName:"Martha Peaslee Levine"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10808",title:"Current Concepts in Dental Implantology",subtitle:"From Science to Clinical Research",isOpenForSubmission:!1,hash:"4af8830e463f89c57515c2da2b9777b0",slug:"current-concepts-in-dental-implantology-from-science-to-clinical-research",bookSignature:"Dragana Gabrić and Marko Vuletić",coverURL:"https://cdn.intechopen.com/books/images_new/10808.jpg",publishedDate:"July 27th 2022",numberOfDownloads:1955,editors:[{id:"26946",title:"Prof.",name:"Dragana",middleName:null,surname:"Gabrić",slug:"dragana-gabric",fullName:"Dragana Gabrić"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10908",title:"Advances in Decision Making",subtitle:null,isOpenForSubmission:!1,hash:"126486f7f91e18e2e3539a32c38be7b1",slug:"advances-in-decision-making",bookSignature:"Fausto Pedro García Márquez",coverURL:"https://cdn.intechopen.com/books/images_new/10908.jpg",publishedDate:"July 27th 2022",numberOfDownloads:1452,editors:[{id:"22844",title:"Prof.",name:"Fausto Pedro",middleName:null,surname:"García Márquez",slug:"fausto-pedro-garcia-marquez",fullName:"Fausto Pedro García Márquez"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10796",title:"Extracellular Vesicles",subtitle:"Role in Diseases, Pathogenesis and Therapy",isOpenForSubmission:!1,hash:"eb5407fcf93baff7bca3fae5640153a2",slug:"extracellular-vesicles-role-in-diseases-pathogenesis-and-therapy",bookSignature:"Manash K. Paul",coverURL:"https://cdn.intechopen.com/books/images_new/10796.jpg",publishedDate:"July 20th 2022",numberOfDownloads:2289,editors:[{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"11263",title:"Supply Chain",subtitle:"Recent Advances and New Perspectives in the Industry 4.0 Era",isOpenForSubmission:!1,hash:"aab634c9c1f9a692c1e9881d18e9c9b7",slug:"supply-chain-recent-advances-and-new-perspectives-in-the-industry-4-0-era",bookSignature:"Tamás Bányai, Ágota Bányai and Ireneusz Kaczmar",coverURL:"https://cdn.intechopen.com/books/images_new/11263.jpg",publishedDate:"July 27th 2022",numberOfDownloads:888,editors:[{id:"201248",title:"Dr.",name:"Tamás",middleName:null,surname:"Bányai",slug:"tamas-banyai",fullName:"Tamás Bányai"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10739",title:"Global Decline of Insects",subtitle:null,isOpenForSubmission:!1,hash:"543783652b9092962a8fa4bed38eeb17",slug:"global-decline-of-insects",bookSignature:"Hamadttu Abdel Farag El-Shafie",coverURL:"https://cdn.intechopen.com/books/images_new/10739.jpg",publishedDate:"July 20th 2022",numberOfDownloads:1566,editors:[{id:"192142",title:"Dr.",name:"Hamadttu",middleName:null,surname:"Abdel Farag El-Shafie",slug:"hamadttu-abdel-farag-el-shafie",fullName:"Hamadttu Abdel Farag El-Shafie"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10911",title:"Higher Education",subtitle:"New Approaches to Accreditation, Digitalization, and Globalization in the Age of Covid",isOpenForSubmission:!1,hash:"223a02337498e535e967174c1f648fbc",slug:"higher-education-new-approaches-to-accreditation-digitalization-and-globalization-in-the-age-of-covid",bookSignature:"Lee Waller and Sharon Waller",coverURL:"https://cdn.intechopen.com/books/images_new/10911.jpg",publishedDate:"July 13th 2022",numberOfDownloads:2054,editors:[{id:"263301",title:"Dr.",name:"Lee",middleName:null,surname:"Waller",slug:"lee-waller",fullName:"Lee Waller"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10669",title:"Corrosion",subtitle:"Fundamentals and Protection Mechanisms",isOpenForSubmission:!1,hash:"4a76d54f8a40fc2e7002a8d13fd617c1",slug:"corrosion-fundamentals-and-protection-mechanisms",bookSignature:"Fahmina Zafar, Anujit Ghosal and Eram Sharmin",coverURL:"https://cdn.intechopen.com/books/images_new/10669.jpg",publishedDate:"July 27th 2022",numberOfDownloads:780,editors:[{id:"89672",title:"Dr.",name:"Fahmina",middleName:null,surname:"Zafar",slug:"fahmina-zafar",fullName:"Fahmina Zafar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"95",title:"Applications and Experiences of Quality Control",subtitle:null,isOpenForSubmission:!1,hash:"4bcb22b1eee68210a977a97d5a0f363a",slug:"applications-and-experiences-of-quality-control",bookSignature:"Ognyan Ivanov",coverURL:"https://cdn.intechopen.com/books/images_new/95.jpg",publishedDate:"April 26th 2011",numberOfDownloads:318480,editors:[{id:"22230",title:"Prof.",name:"Ognyan",middleName:null,surname:"Ivanov",slug:"ognyan-ivanov",fullName:"Ognyan Ivanov"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"2160",title:"MATLAB",subtitle:"A Fundamental Tool for Scientific Computing and Engineering Applications - Volume 1",isOpenForSubmission:!1,hash:"dd9c658341fbd264ed4f8d9e6aa8ca29",slug:"matlab-a-fundamental-tool-for-scientific-computing-and-engineering-applications-volume-1",bookSignature:"Vasilios N. Katsikis",coverURL:"https://cdn.intechopen.com/books/images_new/2160.jpg",publishedDate:"September 26th 2012",numberOfDownloads:271760,editors:[{id:"12289",title:"Prof.",name:"Vasilios",middleName:"N.",surname:"Katsikis",slug:"vasilios-katsikis",fullName:"Vasilios Katsikis"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],latestBooks:[{type:"book",id:"10808",title:"Current Concepts in Dental Implantology",subtitle:"From Science to Clinical Research",isOpenForSubmission:!1,hash:"4af8830e463f89c57515c2da2b9777b0",slug:"current-concepts-in-dental-implantology-from-science-to-clinical-research",bookSignature:"Dragana Gabrić and Marko Vuletić",coverURL:"https://cdn.intechopen.com/books/images_new/10808.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"26946",title:"Prof.",name:"Dragana",middleName:null,surname:"Gabrić",slug:"dragana-gabric",fullName:"Dragana Gabrić"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11328",title:"Botulinum Toxin",subtitle:"Recent Topics and Applications",isOpenForSubmission:!1,hash:"7dd05a316001cef143e209eda51387a7",slug:"botulinum-toxin-recent-topics-and-applications",bookSignature:"Suna Sabuncuoglu",coverURL:"https://cdn.intechopen.com/books/images_new/11328.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"270856",title:"Associate Prof.",name:"Suna",middleName:null,surname:"Sabuncuoglu",slug:"suna-sabuncuoglu",fullName:"Suna Sabuncuoglu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11085",title:"Polycystic Ovary Syndrome",subtitle:"Functional Investigation and Clinical Application",isOpenForSubmission:!1,hash:"3066dd3ff29e1fac072fd60b08d4d3e7",slug:"polycystic-ovary-syndrome-functional-investigation-and-clinical-application",bookSignature:"Zhengchao Wang",coverURL:"https://cdn.intechopen.com/books/images_new/11085.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"204883",title:"Dr.",name:"Zhengchao",middleName:null,surname:"Wang",slug:"zhengchao-wang",fullName:"Zhengchao Wang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10833",title:"Tumor Angiogenesis and Modulators",subtitle:null,isOpenForSubmission:!1,hash:"f29b575c46128b2da061ef7f9bd1070b",slug:"tumor-angiogenesis-and-modulators",bookSignature:"Ke Xu",coverURL:"https://cdn.intechopen.com/books/images_new/10833.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"59529",title:"Dr.",name:"Ke",middleName:null,surname:"Xu",slug:"ke-xu",fullName:"Ke Xu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11356",title:"Molecular Cloning",subtitle:null,isOpenForSubmission:!1,hash:"671c629dd86e97f0fb467b9e70e92296",slug:"molecular-cloning",bookSignature:"Sadık Dincer, Hatice Aysun Mercimek Takcı and Melis Sumengen Ozdenef",coverURL:"https://cdn.intechopen.com/books/images_new/11356.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"188141",title:"Prof.",name:"Sadik",middleName:null,surname:"Dincer",slug:"sadik-dincer",fullName:"Sadik Dincer"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7827",title:"Interpersonal Relationships",subtitle:null,isOpenForSubmission:!1,hash:"ebf41f4d17c75010eb3294cc8cac3d47",slug:"interpersonal-relationships",bookSignature:"Martha Peaslee Levine",coverURL:"https://cdn.intechopen.com/books/images_new/7827.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"186919",title:"Dr.",name:"Martha",middleName:null,surname:"Peaslee Levine",slug:"martha-peaslee-levine",fullName:"Martha Peaslee Levine"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10908",title:"Advances in Decision Making",subtitle:null,isOpenForSubmission:!1,hash:"126486f7f91e18e2e3539a32c38be7b1",slug:"advances-in-decision-making",bookSignature:"Fausto Pedro García Márquez",coverURL:"https://cdn.intechopen.com/books/images_new/10908.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"22844",title:"Prof.",name:"Fausto Pedro",middleName:null,surname:"García Márquez",slug:"fausto-pedro-garcia-marquez",fullName:"Fausto Pedro García Márquez"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10669",title:"Corrosion",subtitle:"Fundamentals and Protection Mechanisms",isOpenForSubmission:!1,hash:"4a76d54f8a40fc2e7002a8d13fd617c1",slug:"corrosion-fundamentals-and-protection-mechanisms",bookSignature:"Fahmina Zafar, Anujit Ghosal and Eram Sharmin",coverURL:"https://cdn.intechopen.com/books/images_new/10669.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"89672",title:"Dr.",name:"Fahmina",middleName:null,surname:"Zafar",slug:"fahmina-zafar",fullName:"Fahmina Zafar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10677",title:"Advanced Topics of Topology",subtitle:null,isOpenForSubmission:!1,hash:"bf964c52f9e653fac20a7fcab58070e5",slug:"advanced-topics-of-topology",bookSignature:"Francisco Bulnes",coverURL:"https://cdn.intechopen.com/books/images_new/10677.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"92918",title:"Dr.",name:"Francisco",middleName:null,surname:"Bulnes",slug:"francisco-bulnes",fullName:"Francisco Bulnes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11195",title:"Recent Advances in Biometrics",subtitle:null,isOpenForSubmission:!1,hash:"2d32e33e0f499cb5241734bb75dd2a83",slug:"recent-advances-in-biometrics",bookSignature:"Muhammad Sarfraz",coverURL:"https://cdn.intechopen.com/books/images_new/11195.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"148",title:"Applied Microbiology",slug:"immunology-and-microbiology-applied-microbiology",parent:{id:"13",title:"Immunology and Microbiology",slug:"immunology-and-microbiology"},numberOfBooks:27,numberOfSeries:0,numberOfAuthorsAndEditors:878,numberOfWosCitations:955,numberOfCrossrefCitations:921,numberOfDimensionsCitations:1980,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicId:"148",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"11328",title:"Botulinum Toxin",subtitle:"Recent Topics and Applications",isOpenForSubmission:!1,hash:"7dd05a316001cef143e209eda51387a7",slug:"botulinum-toxin-recent-topics-and-applications",bookSignature:"Suna Sabuncuoglu",coverURL:"https://cdn.intechopen.com/books/images_new/11328.jpg",editedByType:"Edited by",editors:[{id:"270856",title:"Associate Prof.",name:"Suna",middleName:null,surname:"Sabuncuoglu",slug:"suna-sabuncuoglu",fullName:"Suna Sabuncuoglu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11006",title:"Disinfection of Viruses",subtitle:null,isOpenForSubmission:!1,hash:"d7f3f66e22e16c3751989918a43b3210",slug:"disinfection-of-viruses",bookSignature:"Raymond W. Nims and M. Khalid Ijaz",coverURL:"https://cdn.intechopen.com/books/images_new/11006.jpg",editedByType:"Edited by",editors:[{id:"104702",title:"Dr.",name:"Raymond W.",middleName:null,surname:"Nims",slug:"raymond-w.-nims",fullName:"Raymond W. Nims"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9614",title:"Advances in Candida albicans",subtitle:null,isOpenForSubmission:!1,hash:"31d6882518ca749b12715266eed0a018",slug:"advances-in-candida-albicans",bookSignature:"Xinhui Wang",coverURL:"https://cdn.intechopen.com/books/images_new/9614.jpg",editedByType:"Edited by",editors:[{id:"296531",title:"Dr.",name:"Xinhui",middleName:null,surname:"Wang",slug:"xinhui-wang",fullName:"Xinhui Wang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9403",title:"Human Microbiome",subtitle:null,isOpenForSubmission:!1,hash:"c31366ba82585ba3ac91d21eb1cf0a4d",slug:"human-microbiome",bookSignature:"Natalia V. Beloborodova and Andrey V. Grechko",coverURL:"https://cdn.intechopen.com/books/images_new/9403.jpg",editedByType:"Edited by",editors:[{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9521",title:"Antimicrobial Resistance",subtitle:"A One Health Perspective",isOpenForSubmission:!1,hash:"30949e78832e1afba5606634b52056ab",slug:"antimicrobial-resistance-a-one-health-perspective",bookSignature:"Mihai Mareș, Swee Hua Erin Lim, Kok-Song Lai and Romeo-Teodor Cristina",coverURL:"https://cdn.intechopen.com/books/images_new/9521.jpg",editedByType:"Edited by",editors:[{id:"88785",title:"Prof.",name:"Mihai",middleName:null,surname:"Mares",slug:"mihai-mares",fullName:"Mihai Mares"}],equalEditorOne:{id:"190224",title:"Dr.",name:"Swee Hua Erin",middleName:null,surname:"Lim",slug:"swee-hua-erin-lim",fullName:"Swee Hua Erin Lim",profilePictureURL:"https://mts.intechopen.com/storage/users/190224/images/system/190224.png",biography:"Dr. Erin Lim is presently working as an Assistant Professor in the Division of Health Sciences, Abu Dhabi Women\\'s College, Higher Colleges of Technology in Abu Dhabi, United Arab Emirates and is affiliated as an Associate Professor to Perdana University-Royal College of Surgeons in Ireland, Selangor, Malaysia. She obtained her Ph.D. from Universiti Putra Malaysia in 2010 with a National Science Fellowship awarded from the Ministry of Science, Technology and Innovation Malaysia and has been actively involved in research ever since. Her main research interests include analysis of carriage and transmission of multidrug resistant bacteria in non-conventional settings, besides an interest in natural products for antimicrobial testing. She is heavily involved in the elucidation of mechanisms of reversal of resistance in bacteria in addition to investigating the immunological analyses of diseases, development of vaccination and treatment models in animals. She hopes her work will support the discovery of therapeutics in the clinical setting and assist in the combat against the burden of antibiotic resistance.",institutionString:"Higher Colleges of Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Perdana University",institutionURL:null,country:{name:"Malaysia"}}},equalEditorTwo:{id:"221544",title:"Dr.",name:"Kok-Song",middleName:null,surname:"Lai",slug:"kok-song-lai",fullName:"Kok-Song Lai",profilePictureURL:"https://mts.intechopen.com/storage/users/221544/images/system/221544.jpeg",biography:"Dr. Lai Kok Song is an Assistant Professor in the Division of Health Sciences, Abu Dhabi Women\\'s College, Higher Colleges of Technology in Abu Dhabi, United Arab Emirates. He obtained his Ph.D. in Biological Sciences from Nara Institute of Science and Technology, Japan in 2012. Prior to his academic appointment, Dr. Lai worked as a Senior Scientist at the Ministry of Science, Technology and Innovation, Malaysia. His current research areas include antimicrobial resistance and plant-pathogen interaction. His particular interest lies in the study of the antimicrobial mechanism via membrane disruption of essential oils against multi-drug resistance bacteria through various biochemical, molecular and proteomic approaches. Ultimately, he hopes to uncover and determine novel biomarkers related to antibiotic resistance that can be developed into new therapeutic strategies.",institutionString:"Higher Colleges of Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"8",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Higher Colleges of Technology",institutionURL:null,country:{name:"United Arab Emirates"}}},equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8415",title:"Extremophilic Microbes and Metabolites",subtitle:"Diversity, Bioprospecting and Biotechnological Applications",isOpenForSubmission:!1,hash:"93e0321bc93b89ff73730157738f8f97",slug:"extremophilic-microbes-and-metabolites-diversity-bioprospecting-and-biotechnological-applications",bookSignature:"Afef Najjari, Ameur Cherif, Haïtham Sghaier and Hadda Imene Ouzari",coverURL:"https://cdn.intechopen.com/books/images_new/8415.jpg",editedByType:"Edited by",editors:[{id:"196823",title:"Dr.",name:"Afef",middleName:null,surname:"Najjari",slug:"afef-najjari",fullName:"Afef Najjari"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8967",title:"Bacterial Biofilms",subtitle:null,isOpenForSubmission:!1,hash:"e692b520263526cca2b37092c3e8d0b4",slug:"bacterial-biofilms",bookSignature:"Sadik Dincer, Melis Sümengen Özdenefe and Afet Arkut",coverURL:"https://cdn.intechopen.com/books/images_new/8967.jpg",editedByType:"Edited by",editors:[{id:"188141",title:"Prof.",name:"Sadik",middleName:null,surname:"Dincer",slug:"sadik-dincer",fullName:"Sadik Dincer"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9294",title:"Fluorescence Methods for Investigation of Living Cells and Microorganisms",subtitle:null,isOpenForSubmission:!1,hash:"a97a566a3a19eb9e0c9ba61042bb06c5",slug:"fluorescence-methods-for-investigation-of-living-cells-and-microorganisms",bookSignature:"Natalia Grigoryeva",coverURL:"https://cdn.intechopen.com/books/images_new/9294.jpg",editedByType:"Edited by",editors:[{id:"239430",title:"Dr.",name:"Natalia",middleName:"Yu.",surname:"Grigoryeva",slug:"natalia-grigoryeva",fullName:"Natalia Grigoryeva"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8422",title:"Metagenomics",subtitle:"Basics, Methods and Applications",isOpenForSubmission:!1,hash:"82c6409553747ffccd6075f9420e3175",slug:"metagenomics-basics-methods-and-applications",bookSignature:"Wael N. Hozzein",coverURL:"https://cdn.intechopen.com/books/images_new/8422.jpg",editedByType:"Edited by",editors:[{id:"189233",title:"Prof.",name:"Wael N.",middleName:"Nabil",surname:"Hozzein",slug:"wael-n.-hozzein",fullName:"Wael N. Hozzein"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6967",title:"Prebiotics and Probiotics",subtitle:"Potential Benefits in Nutrition and Health",isOpenForSubmission:!1,hash:"11781d6b1c070edcf204518e632033be",slug:"prebiotics-and-probiotics-potential-benefits-in-nutrition-and-health",bookSignature:"Elena Franco-Robles and Joel Ramírez-Emiliano",coverURL:"https://cdn.intechopen.com/books/images_new/6967.jpg",editedByType:"Edited by",editors:[{id:"219102",title:"Dr.",name:"Elena",middleName:null,surname:"Franco-Robles",slug:"elena-franco-robles",fullName:"Elena Franco-Robles"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8019",title:"Alginates",subtitle:"Recent Uses of This Natural Polymer",isOpenForSubmission:!1,hash:"61ea5c1aef462684a3b2215631b7dbf2",slug:"alginates-recent-uses-of-this-natural-polymer",bookSignature:"Leonel Pereira",coverURL:"https://cdn.intechopen.com/books/images_new/8019.jpg",editedByType:"Edited by",editors:[{id:"279788",title:"Dr.",name:"Leonel",middleName:null,surname:"Pereira",slug:"leonel-pereira",fullName:"Leonel Pereira"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8292",title:"Oral Health by Using Probiotic Products",subtitle:null,isOpenForSubmission:!1,hash:"327e750e83634800ace02fe62607c21e",slug:"oral-health-by-using-probiotic-products",bookSignature:"Razzagh Mahmoudi",coverURL:"https://cdn.intechopen.com/books/images_new/8292.jpg",editedByType:"Edited by",editors:[{id:"245925",title:"Dr.",name:"Razzagh",middleName:null,surname:"Mahmoudi",slug:"razzagh-mahmoudi",fullName:"Razzagh Mahmoudi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:27,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"62553",doi:"10.5772/intechopen.79371",title:"Antibiotic Use in Poultry Production and Its Effects on Bacterial Resistance",slug:"antibiotic-use-in-poultry-production-and-its-effects-on-bacterial-resistance",totalDownloads:7315,totalCrossrefCites:42,totalDimensionsCites:89,abstract:"A surge in the development and spread of antibiotic resistance has become a major cause for concern. Over the past few decades, no major new types of antibiotics have been produced and almost all known antibiotics are increasingly losing their activity against pathogenic microorganisms. The levels of multi-drug resistant bacteria have also increased. It is known that worldwide, more than 60% of all antibiotics that are produced find their use in animal production for both therapeutic and non-therapeutic purposes. The use of antimicrobial agents in animal husbandry has been linked to the development and spread of resistant bacteria. Poultry products are among the highest consumed products worldwide but a lot of essential antibiotics are employed during poultry production in several countries; threatening the safety of such products (through antimicrobial residues) and the increased possibility of development and spread of microbial resistance in poultry settings. This chapter documents some of the studies on antibiotic usage in poultry farming; with specific focus on some selected bacterial species, their economic importance to poultry farming and reports of resistances of isolated species from poultry settings (farms and poultry products) to essential antibiotics.",book:{id:"6978",slug:"antimicrobial-resistance-a-global-threat",title:"Antimicrobial Resistance",fullTitle:"Antimicrobial Resistance - A Global Threat"},signatures:"Christian Agyare, Vivian Etsiapa Boamah, Crystal Ngofi Zumbi and\nFrank Boateng Osei",authors:[{id:"182058",title:"Dr.",name:"Christian",middleName:null,surname:"Agyare",slug:"christian-agyare",fullName:"Christian Agyare"},{id:"261271",title:"MSc.",name:"Crystal Ngofi",middleName:null,surname:"Zumbi",slug:"crystal-ngofi-zumbi",fullName:"Crystal Ngofi Zumbi"},{id:"261272",title:"MSc.",name:"Frank Boateng",middleName:null,surname:"Osei",slug:"frank-boateng-osei",fullName:"Frank Boateng Osei"},{id:"261273",title:"Dr.",name:"Vivian Etsiapa",middleName:null,surname:"Boamah",slug:"vivian-etsiapa-boamah",fullName:"Vivian Etsiapa Boamah"}]},{id:"39599",doi:"10.5772/50046",title:"Encapsulation Technology to Protect Probiotic Bacteria",slug:"encapsulation-technology-to-protect-probiotic-bacteria",totalDownloads:12448,totalCrossrefCites:45,totalDimensionsCites:87,abstract:null,book:{id:"3145",slug:"probiotics",title:"Probiotics",fullTitle:"Probiotics"},signatures:"María Chávarri, Izaskun Marañón and María Carmen Villarán",authors:[{id:"150285",title:"Dr.",name:"María",middleName:null,surname:"Chávarri Hueda",slug:"maria-chavarri-hueda",fullName:"María Chávarri Hueda"},{id:"151613",title:"MSc.",name:"Izaskun",middleName:null,surname:"Marañon",slug:"izaskun-maranon",fullName:"Izaskun Marañon"},{id:"151621",title:"Dr.",name:"Mª Carmen",middleName:null,surname:"Villarán",slug:"ma-carmen-villaran",fullName:"Mª Carmen Villarán"}]},{id:"39607",doi:"10.5772/50121",title:"Recent Application of Probiotics in Food and Agricultural Science",slug:"recent-application-of-probiotics-in-food-and-agricultural-science",totalDownloads:10168,totalCrossrefCites:32,totalDimensionsCites:77,abstract:null,book:{id:"3145",slug:"probiotics",title:"Probiotics",fullTitle:"Probiotics"},signatures:"Danfeng Song, Salam Ibrahim and Saeed Hayek",authors:[{id:"107905",title:"Prof.",name:"Salam",middleName:null,surname:"Ibrahim",slug:"salam-ibrahim",fullName:"Salam Ibrahim"},{id:"150202",title:"Dr.",name:"Danfeng",middleName:null,surname:"Song",slug:"danfeng-song",fullName:"Danfeng Song"},{id:"151025",title:"MSc.",name:"Saeed",middleName:null,surname:"Hayek",slug:"saeed-hayek",fullName:"Saeed Hayek"}]},{id:"49246",doi:"10.5772/61300",title:"Chitosan as a Biomaterial — Structure, Properties, and Electrospun Nanofibers",slug:"chitosan-as-a-biomaterial-structure-properties-and-electrospun-nanofibers",totalDownloads:4720,totalCrossrefCites:27,totalDimensionsCites:63,abstract:"Chitosan is a polysaccharide derived from chitin; chitin is the second most abundant polysaccharide in the world, after cellulose. Chitosan is biocompatible, biodegradable and non-toxic, so that it can be usedin medicalapplications such as antimicrobial and wound healing biomaterials. It also used as chelating agent due to its ability to bind with cholesterol, fats, proteins and metal ions.",book:{id:"4648",slug:"concepts-compounds-and-the-alternatives-of-antibacterials",title:"Concepts, Compounds and the Alternatives of Antibacterials",fullTitle:"Concepts, Compounds and the Alternatives of Antibacterials"},signatures:"H. M. Ibrahim and E.M.R. El- Zairy",authors:[{id:"90645",title:"Dr.",name:"Hassan",middleName:null,surname:"Ibrahim",slug:"hassan-ibrahim",fullName:"Hassan Ibrahim"},{id:"175694",title:"Dr.",name:"Enas",middleName:null,surname:"El- Zairy",slug:"enas-el-zairy",fullName:"Enas El- Zairy"}]},{id:"51065",doi:"10.5772/63499",title:"Role of the Biofilms in Wastewater Treatment",slug:"role-of-the-biofilms-in-wastewater-treatment",totalDownloads:6849,totalCrossrefCites:28,totalDimensionsCites:61,abstract:"Biological wastewater treatment systems play an important role in improving water quality and human health. This chapter thus briefly discusses different biological methods, specially biofilm technologies, the development of biofilms on different filter media, factors affecting their development as well as their structure and function. It also tackles various conventional and modern molecular techniques for detailed exploration of the composition, diversity and dynamics of biofilms. These data are crucial to improve the performance, robustness and stability of biofilm-based wastewater treatment technologies.",book:{id:"5197",slug:"microbial-biofilms-importance-and-applications",title:"Microbial Biofilms",fullTitle:"Microbial Biofilms - Importance and Applications"},signatures:"Shama Sehar and Iffat Naz",authors:[{id:"180364",title:"Dr.",name:"Iffat",middleName:null,surname:"Naz",slug:"iffat-naz",fullName:"Iffat Naz"},{id:"183345",title:"Dr.",name:"Shama",middleName:null,surname:"Sehar",slug:"shama-sehar",fullName:"Shama Sehar"}]}],mostDownloadedChaptersLast30Days:[{id:"65613",title:"The Methods for Detection of Biofilm and Screening Antibiofilm Activity of Agents",slug:"the-methods-for-detection-of-biofilm-and-screening-antibiofilm-activity-of-agents",totalDownloads:9277,totalCrossrefCites:15,totalDimensionsCites:26,abstract:"Biofilm producer microorganisms cause nosocomial and recurrent infections. Biofilm that is a sticky exopolysaccharide is the main virulence factor causing biofilm-related infections. Biofilm formation begins with attachment of bacteria to biotic surface such as host cell or abiotic surface such as prosthetic devices. After attachment, aggregation of bacteria is started by cell-cell adhesion. Aggregation continues with the maturation of biofilm. Dispersion is started by certain conditions such as phenol-soluble modulins (PSMs). By this way, sessile bacteria turn back into planktonic form. Bacteria embedded in biofilm (sessile form) are more resistant to antimicrobials than planktonic bacteria. So it is hard to treat biofilm-embedded bacteria than planktonic forms. For this reason, it is important to detect biofilm. There are a few biofilm detection and biofilm production methods on prosthetics, methods for screening antibacterial effect of agents against biofilm-embedded microorganism and antibiofilm effect of agents against biofilm production and mature biofilm. The aim of this chapter is to overview direct and indirect methods such as microscopy, fluorescent in situ hybridization, and Congo red agar, tube method, microtiter plate assay, checkerboard assay, plate counting, polymerase chain reaction, mass spectrometry, MALDI-TOF, and biological assays used by antibiofilm researches.",book:{id:"8427",slug:"antimicrobials-antibiotic-resistance-antibiofilm-strategies-and-activity-methods",title:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods",fullTitle:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods"},signatures:"Sahra Kırmusaoğlu",authors:[{id:"179460",title:"Associate Prof.",name:"Sahra",middleName:null,surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu"}]},{id:"62553",title:"Antibiotic Use in Poultry Production and Its Effects on Bacterial Resistance",slug:"antibiotic-use-in-poultry-production-and-its-effects-on-bacterial-resistance",totalDownloads:7327,totalCrossrefCites:43,totalDimensionsCites:92,abstract:"A surge in the development and spread of antibiotic resistance has become a major cause for concern. Over the past few decades, no major new types of antibiotics have been produced and almost all known antibiotics are increasingly losing their activity against pathogenic microorganisms. The levels of multi-drug resistant bacteria have also increased. It is known that worldwide, more than 60% of all antibiotics that are produced find their use in animal production for both therapeutic and non-therapeutic purposes. The use of antimicrobial agents in animal husbandry has been linked to the development and spread of resistant bacteria. Poultry products are among the highest consumed products worldwide but a lot of essential antibiotics are employed during poultry production in several countries; threatening the safety of such products (through antimicrobial residues) and the increased possibility of development and spread of microbial resistance in poultry settings. This chapter documents some of the studies on antibiotic usage in poultry farming; with specific focus on some selected bacterial species, their economic importance to poultry farming and reports of resistances of isolated species from poultry settings (farms and poultry products) to essential antibiotics.",book:{id:"6978",slug:"antimicrobial-resistance-a-global-threat",title:"Antimicrobial Resistance",fullTitle:"Antimicrobial Resistance - A Global Threat"},signatures:"Christian Agyare, Vivian Etsiapa Boamah, Crystal Ngofi Zumbi and\nFrank Boateng Osei",authors:[{id:"182058",title:"Dr.",name:"Christian",middleName:null,surname:"Agyare",slug:"christian-agyare",fullName:"Christian Agyare"},{id:"261271",title:"MSc.",name:"Crystal Ngofi",middleName:null,surname:"Zumbi",slug:"crystal-ngofi-zumbi",fullName:"Crystal Ngofi Zumbi"},{id:"261272",title:"MSc.",name:"Frank Boateng",middleName:null,surname:"Osei",slug:"frank-boateng-osei",fullName:"Frank Boateng Osei"},{id:"261273",title:"Dr.",name:"Vivian Etsiapa",middleName:null,surname:"Boamah",slug:"vivian-etsiapa-boamah",fullName:"Vivian Etsiapa Boamah"}]},{id:"65914",title:"Introductory Chapter: The Action Mechanisms of Antibiotics and Antibiotic Resistance",slug:"introductory-chapter-the-action-mechanisms-of-antibiotics-and-antibiotic-resistance",totalDownloads:4428,totalCrossrefCites:6,totalDimensionsCites:10,abstract:null,book:{id:"8427",slug:"antimicrobials-antibiotic-resistance-antibiofilm-strategies-and-activity-methods",title:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods",fullTitle:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods"},signatures:"Sahra Kırmusaoğlu, Nesrin Gareayaghi and Bekir S. Kocazeybek",authors:[{id:"179460",title:"Associate Prof.",name:"Sahra",middleName:null,surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu"},{id:"248288",title:"Prof.",name:"Bekir",middleName:null,surname:"Kocazeybek",slug:"bekir-kocazeybek",fullName:"Bekir Kocazeybek"},{id:"406463",title:"Dr.",name:"Nesrin",middleName:null,surname:"Gareayaghi",slug:"nesrin-gareayaghi",fullName:"Nesrin Gareayaghi"}]},{id:"50992",title:"Probiotics: A Comprehensive Review of Their Classification, Mode of Action and Role in Human Nutrition",slug:"probiotics-a-comprehensive-review-of-their-classification-mode-of-action-and-role-in-human-nutrition",totalDownloads:5429,totalCrossrefCites:16,totalDimensionsCites:28,abstract:"Probiotics are live microorganisms that live in gastrointestinal (GI) tract and are beneficial for their hosts and prevent certain diseases. In this chapter, after a complete introduction to probiotics, definition, mechanism of action, and their classification, currently used organisms will be discussed in detail. Moreover, different kinds of nutritional synthetic products of probiotics along with their safety and drug interaction will be noticed. This chapter mentions all clinical trial studies that have been done to evaluate probiotic efficacy with a focus on gastrointestinal diseases.",book:{id:"5193",slug:"probiotics-and-prebiotics-in-human-nutrition-and-health",title:"Probiotics and Prebiotics in Human Nutrition and Health",fullTitle:"Probiotics and Prebiotics in Human Nutrition and Health"},signatures:"Amirreza Khalighi, Reza Behdani and Shabnam Kouhestani",authors:[{id:"179560",title:"Dr.",name:"Amirreza",middleName:null,surname:"Khalighi",slug:"amirreza-khalighi",fullName:"Amirreza Khalighi"},{id:"185238",title:"Dr.",name:"Reza",middleName:null,surname:"Behdani",slug:"reza-behdani",fullName:"Reza Behdani"},{id:"185239",title:"Dr.",name:"Shabnam",middleName:null,surname:"Kouhestani",slug:"shabnam-kouhestani",fullName:"Shabnam Kouhestani"}]},{id:"72109",title:"Antibiotic Resistance in Biofilm",slug:"antibiotic-resistance-in-biofilm",totalDownloads:1479,totalCrossrefCites:11,totalDimensionsCites:20,abstract:"Biofilms can be found on several living and nonliving surfaces, which are formed by a group of microorganisms, complex assembly of proteins, polysaccharides, and DNAs in an extracellular polymeric matrix. By forming a biofilm, bacteria protect themselves from host defense, disinfectants, and antibiotics. Bacteria inside biofilm are much more resistant to antimicrobial agents than planktonic forms since bacteria that are unresisting to antimicrobial agents in any way can turn resistant after forming a biofilm. Low penetration of antibiotics into the biofilm, slow reproduction, and the existence of adaptive stress response constitute the multiphased defense of the bacterium. This antibiotic resistance, which is provided by biofilm, makes the treatments, which use effective antibiotic doses on the bacterium in planktonic shape, difficult. Biofilm formation potential of bacteria appears as an important virulence factor in ensuring the colonization on the living tissues or medical devices and makes the treatment difficult. The aim of this chapter is to overview the current knowledge of antimicrobial resistance mechanisms in biofilms.",book:{id:"8967",slug:"bacterial-biofilms",title:"Bacterial Biofilms",fullTitle:"Bacterial Biofilms"},signatures:"Sadık Dincer, Fatima Masume Uslu and Anil Delik",authors:[{id:"188141",title:"Prof.",name:"Sadik",middleName:null,surname:"Dincer",slug:"sadik-dincer",fullName:"Sadik Dincer"},{id:"315992",title:"MSc.",name:"Fatıma Masume",middleName:null,surname:"Uslu",slug:"fatima-masume-uslu",fullName:"Fatıma Masume Uslu"},{id:"315993",title:"MSc.",name:"Anıl",middleName:null,surname:"Delik",slug:"anil-delik",fullName:"Anıl Delik"}]}],onlineFirstChaptersFilter:{topicId:"148",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"81704",title:"Quorum Sensing Inhibition Based Drugs to Conquer Antimicrobial Resistance",slug:"quorum-sensing-inhibition-based-drugs-to-conquer-antimicrobial-resistance",totalDownloads:22,totalDimensionsCites:0,doi:"10.5772/intechopen.104125",abstract:"Quorum sensing is the cell to cell communication mechanism in microorganism through signalling molecules. Regulation of virulence factor, sporulation, proteolytic enzymes production, biofilm formation, auto-inducers, cell population density are key physiological process mediated through quorum-sensing (QS) signalling. Elevation of innate immune system and antibiotic tolerance of pathogens is highly increased with perspective of quorum-sensing (QS) activity. Development of novel drugs is highly attractive scenario against cell-cell communication of microbes. Design of synthetic drugs and natural compounds against QS signal molecules is vital combat system to attenuate microbial pathogenicity. Quorum sensing inhibitors (QSIs), quorum quenchers (QQs), efflux pump inhibitors (EPIs) act against multi-drug resistance strains (MDR) and other pathogenic microbes through regulation of auto-inducers and signal molecule with perceptive to growth arrest both in-vitro and in-vivo. QQs, QSIs and EPIs compounds has been validated with various animal models for high selection pressure on therapeutics arsenal against microbe’s growth inhibition. Promising QSI are phytochemicals and secondary metabolites includes polyacetylenes, alkaloids, polyphenols, terpenoids, quinones.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Kothandapani Sundar, Ramachandira Prabu and Gopal Jayalakshmi"},{id:"82372",title:"Unlocking the Potential of Ghost Probiotics in Combating Antimicrobial Resistance",slug:"unlocking-the-potential-of-ghost-probiotics-in-combating-antimicrobial-resistance",totalDownloads:20,totalDimensionsCites:0,doi:"10.5772/intechopen.104126",abstract:"Antimicrobial resistance is a global concern that requires immediate attention. Major causes of development of antimicrobial resistance in microbial cells are overuse of antimicrobials along the food chain especially in livestock, in preventing infections as well as misuse of antimicrobials by patients. Probiotics could be a viable alternative to antibiotics in the fight against antimicrobial resistance. Probiotic strains can act as a complement to antimicrobial therapy, improving antimicrobial function and enhancing immunity. However, there are safety concerns regarding the extensive use of live microbial cells especially in immunocompromised individuals; these include microbial translocation, inhibition of other beneficial microorganisms and development of antimicrobial resistance, among other concerns. Inevitably, ghost probiotics have become the favored alternative as they eliminate the safety and shelf-life problems associated with use of probiotics. Ghost probiotics are non-viable microbial cells (intact or broken) or metabolic products from microorganisms, which when administered in adequate amounts have biologic activity in the host and confer health benefits. Ghost probiotics exert biological effects similar to probiotics. However, the major drawback of using ghost probiotics is that the mechanism of action of these is currently unknown, hence more research is required and regulatory instruments are needed to assure the safety of consumers.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Abigarl Ndudzo, Sakhile Ndlovu, Nesisa Nyathi and Angela Sibanda Makuvise"},{id:"82178",title:"Managing Antimicrobial Resistance beyond the Hospital Antimicrobial Stewardship: The Role of One Health",slug:"managing-antimicrobial-resistance-beyond-the-hospital-antimicrobial-stewardship-the-role-of-one-heal",totalDownloads:16,totalDimensionsCites:0,doi:"10.5772/intechopen.104170",abstract:"Infections caused by micro-organisms affect the health of people and animals, causing morbidity and mortality, with Asia and Africa as the epicenters. Some of the infectious diseases are emerging and re-emerging in nature. Examples include viral hepatitis, Lassa fever, Ebola, yellow fever, tuberculosis, covid-19, measles, and malaria, among others. Antimicrobials have been playing an important role in the treatment of infections by these microbes. However, there has been a development of resistance to these antimicrobials as a result of many drivers. This write-up used secondary data to explore the management of antimicrobial resistance (AMR) beyond the hospital antimicrobial resistance steward using the one health concept. The findings showed AMR to be a transboundary, multifaceted ecosystem problem affecting both the developed and developing countries. It is also one of the top ten global public health threats facing mankind. Globally, AMR will cost over US$100 trillion in output loss by 2050, about 700,000 deaths a year, and 4,150,000 deaths in Africa by 2050. About 2.4 million people could die in high-income countries between 2015 and 2050 without a sustained effort to contain AMR. The drivers of AMR are beyond the hospital and hospital AMR stewardship. Therefore, the need for one health concept to manage it.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Istifanus Anekoson Joshua, Mathew Bobai and Clement Sokfa Woje"},{id:"81918",title:"Machine Learning for Antimicrobial Resistance Research and Drug Development",slug:"machine-learning-for-antimicrobial-resistance-research-and-drug-development",totalDownloads:52,totalDimensionsCites:0,doi:"10.5772/intechopen.104841",abstract:"Machine learning is a subfield of artificial intelligence which combines sophisticated algorithms and data to develop predictive models with minimal human interference. This chapter focuses on research that trains machine learning models to study antimicrobial resistance and to discover antimicrobial drugs. An emphasis is placed on applying machine learning models to detect drug resistance among bacterial and fungal pathogens. The role of machine learning in antibacterial and antifungal drug discovery and design is explored. Finally, the challenges and prospects of applying machine learning to advance basic research on and treatment of antimicrobial resistance are discussed. Overall, machine learning promises to advance antimicrobial resistance research and to facilitate the development of antibacterial and antifungal drugs.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Shamanth A. Shankarnarayan, Joshua D. Guthrie and Daniel A. Charlebois"},{id:"81891",title:"Alternatives to Antibiotics in Semen Extenders Used in Artificial Insemination",slug:"alternatives-to-antibiotics-in-semen-extenders-used-in-artificial-insemination",totalDownloads:27,totalDimensionsCites:0,doi:"10.5772/intechopen.104226",abstract:"Antimicrobial resistance is a serious global threat requiring a widespread response. Both veterinarians and medical doctors should restrict antibiotic usage to therapeutic use only, after determining the sensitivity of the causal organism. However, the addition of antibiotics to semen extenders for animal artificial insemination represents a hidden, non-therapeutic use of antimicrobial substances. Artificial insemination for livestock breeding is a huge global enterprise with hundreds of million sperm doses prepared annually. However, reporting of antimicrobial resistance in semen is increasing. This review discusses the consequences of bacteria in semen samples, as well as the effect of antimicrobial substances in semen extenders on bacteria in the environment and even on personnel. Alternatives to antibiotics have been reported in the scientific literature and are reviewed here. The most promising of these, removal of the majority of bacteria by colloid centrifugation, is considered in detail, especially results from an artificial insemination study in pigs. In conclusion, colloid centrifugation is a practical method of physically removing bacteria from semen, which does not induce antibiotic resistance. Sperm quality in stored semen samples may be improved at the same time.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Jane M. Morrell, Pongpreecha Malaluang, Aleksandar Cojkic and Ingrid Hansson"},{id:"81699",title:"Efflux Pumps among Urinary E. coli and K. pneumoniae Local Isolates in Hilla City, Iraq",slug:"efflux-pumps-among-urinary-e-coli-and-k-pneumoniae-local-isolates-in-hilla-city-iraq",totalDownloads:10,totalDimensionsCites:0,doi:"10.5772/intechopen.104408",abstract:"Urinary tract infections (UTI) are the most common bacterial infections affecting humans. Escherichia coli and Klebsiella pneumoniae were common enterobacteria engaged with community-acquired UTIs. Efflux pumps were vital resistance mechanisms for antibiotics, especially among enterobacteria. Overexpression of an efflux system, which results in a decrease in antibiotic accumulation, is an effective mechanism for drug resistance. The ATP-binding cassette (ABC) transporters, small multidrug resistance (SMR), and multidrug and toxic compound extrusion (MATE) families, the major facilitator superfamily (MFS), and the resistance-nodulation- cell division (RND) family are the five superfamilies of efflux systems linked to drug resistance. This chapter highlights the results of studying the prevalence of efflux pump genes among local isolates of E. coli and K. pneumoniae in Hilla City, Iraq. class RND AcrAB-TolC, AcrAD-TolC, and AcrFE-TolC genes detected by conventional PCR of E. coli and K. pneumoniae respectively. The result revealed approximately all studied efflux transporter were found in both E. coli and K. pneumoniae in different percentages. Biofilm formation were observed in 50(100%) of K. pneumoniae and 49(98%) of E. coli isolates were biofilm former and follow: 30(60%), 20(40%) were weak, 12(24%), 22(44%) were moderate and 7(14%) and 8(16%) were Strong biofilm former for E. coli and K. pneumoniae, respectively.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Hussein Al-Dahmoshi, Sahar A. Ali and Noor Al-Khafaji"}],onlineFirstChaptersTotal:13},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"3",title:"Dentistry",doi:"10.5772/intechopen.71199",issn:"2631-6218",scope:"\r\n\tThis book series will offer a comprehensive overview of recent research trends as well as clinical applications within different specialties of dentistry. Topics will include overviews of the health of the oral cavity, from prevention and care to different treatments for the rehabilitation of problems that may affect the organs and/or tissues present. The different areas of dentistry will be explored, with the aim of disseminating knowledge and providing readers with new tools for the comprehensive treatment of their patients with greater safety and with current techniques. Ongoing issues, recent advances, and future diagnostic approaches and therapeutic strategies will also be discussed. This series of books will focus on various aspects of the properties and results obtained by the various treatments available, whether preventive or curative.
",coverUrl:"https://cdn.intechopen.com/series/covers/3.jpg",latestPublicationDate:"August 4th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:9,editor:{id:"419588",title:"Ph.D.",name:"Sergio",middleName:"Alexandre",surname:"Gehrke",slug:"sergio-gehrke",fullName:"Sergio Gehrke",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038WgMKQA0/Profile_Picture_2022-06-02T11:44:20.jpg",biography:"Dr. Sergio Alexandre Gehrke is a doctorate holder in two fields. The first is a Ph.D. in Cellular and Molecular Biology from the Pontificia Catholic University, Porto Alegre, Brazil, in 2010 and the other is an International Ph.D. in Bioengineering from the Universidad Miguel Hernandez, Elche/Alicante, Spain, obtained in 2020. In 2018, he completed a postdoctoral fellowship in Materials Engineering in the NUCLEMAT of the Pontificia Catholic University, Porto Alegre, Brazil. He is currently the Director of the Postgraduate Program in Implantology of the Bioface/UCAM/PgO (Montevideo, Uruguay), Director of the Cathedra of Biotechnology of the Catholic University of Murcia (Murcia, Spain), an Extraordinary Full Professor of the Catholic University of Murcia (Murcia, Spain) as well as the Director of the private center of research Biotecnos – Technology and Science (Montevideo, Uruguay). Applied biomaterials, cellular and molecular biology, and dental implants are among his research interests. He has published several original papers in renowned journals. In addition, he is also a Collaborating Professor in several Postgraduate programs at different universities all over the world.",institutionString:null,institution:{name:"Universidad Católica San Antonio de Murcia",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:3,paginationItems:[{id:"86",title:"Business and Management",coverUrl:"https://cdn.intechopen.com/series_topics/covers/86.jpg",isOpenForSubmission:!0,editor:{id:"128342",title:"Prof.",name:"Vito",middleName:null,surname:"Bobek",slug:"vito-bobek",fullName:"Vito Bobek",profilePictureURL:"https://mts.intechopen.com/storage/users/128342/images/system/128342.jpg",biography:"Dr. Vito Bobek works as an international management professor at the University of Applied Sciences FH Joanneum, Graz, Austria. He has published more than 400 works in his academic career and visited twenty-two universities worldwide as a visiting professor. Dr. Bobek is a member of the editorial boards of six international journals and a member of the Strategic Council of the Minister of Foreign Affairs of the Republic of Slovenia. He has a long history in academia, consulting, and entrepreneurship. His own consulting firm, Palemid, has managed twenty significant projects, such as Cooperation Program Interreg V-A (Slovenia-Austria) and Capacity Building for the Serbian Chamber of Enforcement Agents. He has also participated in many international projects in Italy, Germany, Great Britain, the United States, Spain, Turkey, France, Romania, Croatia, Montenegro, Malaysia, and China. Dr. Bobek is also a co-founder of the Academy of Regional Management in Slovenia.",institutionString:"Universities of Applied Sciences FH Joanneum, Austria",institution:{name:"Universities of Applied Sciences Joanneum",institutionURL:null,country:{name:"Austria"}}},editorTwo:{id:"293992",title:"Dr.",name:"Tatjana",middleName:null,surname:"Horvat",slug:"tatjana-horvat",fullName:"Tatjana Horvat",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hXb0hQAC/Profile_Picture_1642419002203",biography:"Tatjana Horvat works as a professor for accountant and auditing at the University of Primorska, Slovenia. She is a Certified State Internal Auditor (licensed by Ministry of Finance RS) and Certified Internal Auditor for Business Sector and Certified accountant (licensed by Slovenian Institute of Auditors). At the Ministry of Justice of Slovenia, she is a member of examination boards for court expert candidates and judicial appraisers in the following areas: economy/finance, valuation of companies, banking, and forensic investigation of economic operations/accounting. At the leading business newspaper Finance in Slovenia (Swedish ownership), she is the editor and head of the area for business, finance, tax-related articles, and educational programs.",institutionString:null,institution:{name:"University of Primorska",institutionURL:null,country:{name:"Slovenia"}}},editorThree:null},{id:"87",title:"Economics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/87.jpg",isOpenForSubmission:!0,editor:{id:"327730",title:"Prof.",name:"Jaime",middleName:null,surname:"Ortiz",slug:"jaime-ortiz",fullName:"Jaime Ortiz",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002zaOKZQA2/Profile_Picture_1642145584421",biography:"Dr. Jaime Ortiz holds degrees from Chile, the Netherlands, and the United States. He has held tenured faculty, distinguished professorship, and executive leadership appointments in several universities around the world. Dr. Ortiz has previously worked for international organizations and non-government entities in economic and business matters, and he has university-wide globalization engagement in more than thirty-six countries. He has advised, among others, the United Nations Development Program, Inter-American Development Bank, Organization of American States, Pre-investment Organization of Latin America and the Caribbean, Technical Cooperation of the Suisse Government, and the World Bank. Dr. Ortiz is the author, co-author, or editor of books, book chapters, textbooks, research monographs and technical reports, and refereed journal articles. He is listed in Who’s Who in the World, Who’s Who in America, Who’s Who in Finance and Business, Who’s Who in Business Higher Education, Who’s Who in American Education, and Who’s Who Directory of Economists. Dr. Ortiz has been a Fulbright Scholar and an MSI Leadership Fellow with the W.K. Kellogg Foundation. His teaching interests revolve around global economies and markets while his research focuses on topics related to development and growth, global business decisions, and the economics of technical innovation.",institutionString:null,institution:{name:"University of Houston",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},{id:"88",title:"Marketing",coverUrl:"https://cdn.intechopen.com/series_topics/covers/88.jpg",isOpenForSubmission:!0,editor:{id:"203609",title:"Associate Prof.",name:"Hanna",middleName:null,surname:"Gorska-Warsewicz",slug:"hanna-gorska-warsewicz",fullName:"Hanna Gorska-Warsewicz",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSD9pQAG/Profile_Picture_2022-06-14T11:58:32.jpeg",biography:"Hanna Górska-Warsewicz, Ph.D. is Associate Professor at Warsaw University of Life Sciences and Head of Department of Food Market and Consumption Research. She specializes in the subject of brands, brand equity, and brand management in production, service, and trade enterprises. She combines this subject with marketing and marketing management in both theoretical and practical aspects. Prof. Hanna Górska-Warsewicz also analyzes brands in the context of trademarks, legal regulations and the protection of intangible. She is an author or co-author of over 200 publications in this field, including 8 books. She works with the business sector and has participated in projects for the Ministry of Agriculture and Rural Development and the Ministry of Education and Science in Poland.",institutionString:null,institution:{name:"Warsaw University of Life Sciences",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null}]},overviewPageOFChapters:{paginationCount:10,paginationItems:[{id:"82858",title:"Corporate Social Responsibility a Case of the Provision of Recreational Facilities",doi:"10.5772/intechopen.105608",signatures:"Peter Musa Wash, Shida Irwana Omar, Badaruddin Mohamed and Mohd Ismail Isa",slug:"corporate-social-responsibility-a-case-of-the-provision-of-recreational-facilities",totalDownloads:5,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Corporate Social Responsibility",coverURL:"https://cdn.intechopen.com/books/images_new/11602.jpg",subseries:{id:"86",title:"Business and Management"}}},{id:"82786",title:"Discussion of Purchasing Virtual Digital Nature and Tourism",doi:"10.5772/intechopen.105869",signatures:"Hiroko Oe and Yasuyuki Yamaoka",slug:"discussion-of-purchasing-virtual-digital-nature-and-tourism",totalDownloads:6,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"A New Era of Consumer Behavior - Beyond the Pandemic",coverURL:"https://cdn.intechopen.com/books/images_new/11581.jpg",subseries:{id:"88",title:"Marketing"}}},{id:"82289",title:"Consumer Culture and Abundance of Choices: Having More, Feeling Blue",doi:"10.5772/intechopen.105607",signatures:"Ondřej Roubal",slug:"consumer-culture-and-abundance-of-choices-having-more-feeling-blue",totalDownloads:7,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"A New Era of Consumer Behavior - Beyond the Pandemic",coverURL:"https://cdn.intechopen.com/books/images_new/11581.jpg",subseries:{id:"88",title:"Marketing"}}},{id:"82405",title:"Does Board Structure Matter in CSR Spending of Commercial Banks? Empirical Evidence from an Emerging Economy",doi:"10.5772/intechopen.105589",signatures:"Bishnu Kumar Adhikary and Ranjan Kumar Mitra",slug:"does-board-structure-matter-in-csr-spending-of-commercial-banks-empirical-evidence-from-an-emerging-",totalDownloads:18,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Corporate Social Responsibility",coverURL:"https://cdn.intechopen.com/books/images_new/11602.jpg",subseries:{id:"86",title:"Business and Management"}}}]},overviewPagePublishedBooks:{paginationCount:1,paginationItems:[{type:"book",id:"11392",title:"Leadership in a Changing World",subtitle:"A Multidimensional Perspective",coverURL:"https://cdn.intechopen.com/books/images_new/11392.jpg",slug:"leadership-in-a-changing-world-a-multidimensional-perspective",publishedDate:"May 11th 2022",editedByType:"Edited by",bookSignature:"Muhammad Mohiuddin, Bilal Khalid, Md. Samim Al Azad and Slimane Ed-dafali",hash:"86a6d33cf601587e591064ce92effc02",volumeInSeries:1,fullTitle:"Leadership in a Changing World - A Multidimensional Perspective",editors:[{id:"418514",title:"Dr.",name:"Muhammad",middleName:null,surname:"Mohiuddin",slug:"muhammad-mohiuddin",fullName:"Muhammad Mohiuddin",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038UqSfQAK/Profile_Picture_2022-05-13T10:39:03.jpg",biography:"Dr. Muhammad Mohiuddin is an Associate Professor of International Business at Laval University, Canada. He has taught at Thompson Rivers University, Canada; University of Paris-Est, France; Osnabruck University of Applied Science, Germany; and Shanghai Institute of Technology and Tianjin University of Technology, China. He has published research in Research Policy, Applied Economics, Review of Economic Philosophy, Strategic Change, International Journal of Logistics, Sustainability, Journal of Environmental Management, Journal of Global Information Management, Journal of Cleaner Production, M@N@GEMENT, and more. He is a member of CEDIMES Institut (France), Academy of International Business (AIB), Strategic Management Society (SMS), Academy of Management (AOM), Administrative Science Association of Canada (ASAC), and Canadian council of small business and entrepreneurship (CCSBE). He is currently the director of the Research Group on Contemporary Asia (GERAC) at Laval University. He is also co-managing editor of Transnational Corporations Review and a guest editor for Electronic Commerce Research and Journal of Internet Technology.",institutionString:"Université Laval",institution:{name:"Université Laval",institutionURL:null,country:{name:"Canada"}}}]}]},openForSubmissionBooks:{paginationCount:1,paginationItems:[{id:"11568",title:"Staphylococcal Infections - Recent Advances and Perspectives",coverURL:"https://cdn.intechopen.com/books/images_new/11568.jpg",hash:"92c881664d1921c7f2d0fee34b78cd08",secondStepPassed:!0,currentStepOfPublishingProcess:3,submissionDeadline:"July 8th 2022",isOpenForSubmission:!0,editors:[{id:"59719",title:"Dr.",name:"Jaime",surname:"Bustos-Martínez",slug:"jaime-bustos-martinez",fullName:"Jaime Bustos-Martínez"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},onlineFirstChapters:{paginationCount:42,paginationItems:[{id:"82914",title:"Glance on the Critical Role of IL-23 Receptor Gene Variations in Inflammation-Induced Carcinogenesis",doi:"10.5772/intechopen.105049",signatures:"Mohammed El-Gedamy",slug:"glance-on-the-critical-role-of-il-23-receptor-gene-variations-in-inflammation-induced-carcinogenesis",totalDownloads:8,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Chemokines Updates",coverURL:"https://cdn.intechopen.com/books/images_new/11672.jpg",subseries:{id:"18",title:"Proteomics"}}},{id:"82875",title:"Lipidomics as a Tool in the Diagnosis and Clinical Therapy",doi:"10.5772/intechopen.105857",signatures:"María Elizbeth Alvarez Sánchez, Erick Nolasco Ontiveros, Rodrigo Arreola, Adriana Montserrat Espinosa González, Ana María García Bores, Roberto Eduardo López Urrutia, Ignacio Peñalosa Castro, María del Socorro Sánchez Correa and Edgar Antonio Estrella Parra",slug:"lipidomics-as-a-tool-in-the-diagnosis-and-clinical-therapy",totalDownloads:7,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Fatty Acids - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11669.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82440",title:"Lipid Metabolism and Associated Molecular Signaling Events in Autoimmune Disease",doi:"10.5772/intechopen.105746",signatures:"Mohan Vanditha, Sonu Das and Mathew John",slug:"lipid-metabolism-and-associated-molecular-signaling-events-in-autoimmune-disease",totalDownloads:17,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Fatty Acids - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11669.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82483",title:"Oxidative Stress in Cardiovascular Diseases",doi:"10.5772/intechopen.105891",signatures:"Laura Mourino-Alvarez, Tamara Sastre-Oliva, Nerea Corbacho-Alonso and Maria G. Barderas",slug:"oxidative-stress-in-cardiovascular-diseases",totalDownloads:9,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Importance of Oxidative Stress and Antioxidant System in Health and Disease",coverURL:"https://cdn.intechopen.com/books/images_new/11671.jpg",subseries:{id:"15",title:"Chemical Biology"}}},{id:"82751",title:"Mitochondria-Endoplasmic Reticulum Interaction in Central Neurons",doi:"10.5772/intechopen.105738",signatures:"Liliya Kushnireva and Eduard Korkotian",slug:"mitochondria-endoplasmic-reticulum-interaction-in-central-neurons",totalDownloads:6,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}},{id:"82709",title:"Fatty Acid Metabolism as a Tumor Marker",doi:"10.5772/intechopen.106072",signatures:"Gatot Nyarumenteng Adhipurnawan Winarno",slug:"fatty-acid-metabolism-as-a-tumor-marker",totalDownloads:10,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Fatty Acids - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11669.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82716",title:"Advanced glycation end product induced endothelial dysfunction through ER stress: Unravelling the role of Paraoxonase 2",doi:"10.5772/intechopen.106018",signatures:"Ramya Ravi and Bharathidevi Subramaniam Rajesh",slug:"advanced-glycation-end-product-induced-endothelial-dysfunction-through-er-stress-unravelling-the-rol",totalDownloads:12,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}},{id:"82388",title:"Epigenetics: Science of Changes without Change in DNA Sequences",doi:"10.5772/intechopen.105039",signatures:"Jayisha Dhargawe, Rita Lakkakul and Pradip Hirapure",slug:"epigenetics-science-of-changes-without-change-in-dna-sequences",totalDownloads:17,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Modifications of Biomolecules",coverURL:"https://cdn.intechopen.com/books/images_new/11098.jpg",subseries:null}},{id:"82583",title:"Leukaemia: The Purinergic System and Small Extracellular Vesicles",doi:"10.5772/intechopen.104326",signatures:"Arinzechukwu Ude and Kelechi Okeke",slug:"leukaemia-the-purinergic-system-and-small-extracellular-vesicles",totalDownloads:11,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Purinergic System",coverURL:"https://cdn.intechopen.com/books/images_new/10801.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82531",title:"Abnormal Iron Metabolism and Its Effect on Dentistry",doi:"10.5772/intechopen.104502",signatures:"Chinmayee Dahihandekar and Sweta Kale Pisulkar",slug:"abnormal-iron-metabolism-and-its-effect-on-dentistry",totalDownloads:12,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Iron Metabolism - A Double-Edged Sword",coverURL:"https://cdn.intechopen.com/books/images_new/10842.jpg",subseries:{id:"17",title:"Metabolism"}}}]},subseriesFiltersForOFChapters:[{caption:"Chemical Biology",value:15,count:2,group:"subseries"},{caption:"Proteomics",value:18,count:2,group:"subseries"},{caption:"Cell and Molecular Biology",value:14,count:17,group:"subseries"},{caption:"Metabolism",value:17,count:18,group:"subseries"}],publishedBooks:{paginationCount:9,paginationItems:[{type:"book",id:"10808",title:"Current Concepts in Dental Implantology",subtitle:"From Science to Clinical Research",coverURL:"https://cdn.intechopen.com/books/images_new/10808.jpg",slug:"current-concepts-in-dental-implantology-from-science-to-clinical-research",publishedDate:"July 27th 2022",editedByType:"Edited by",bookSignature:"Dragana Gabrić and Marko Vuletić",hash:"4af8830e463f89c57515c2da2b9777b0",volumeInSeries:11,fullTitle:"Current Concepts in Dental Implantology - From Science to Clinical Research",editors:[{id:"26946",title:"Prof.",name:"Dragana",middleName:null,surname:"Gabrić",slug:"dragana-gabric",fullName:"Dragana Gabrić",profilePictureURL:"https://mts.intechopen.com/storage/users/26946/images/system/26946.png",institutionString:"University of Zagreb",institution:{name:"University of Zagreb",institutionURL:null,country:{name:"Croatia"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9493",title:"Periodontology",subtitle:"Fundamentals and Clinical Features",coverURL:"https://cdn.intechopen.com/books/images_new/9493.jpg",slug:"periodontology-fundamentals-and-clinical-features",publishedDate:"February 16th 2022",editedByType:"Edited by",bookSignature:"Petra Surlin",hash:"dfe986c764d6c82ae820c2df5843a866",volumeInSeries:8,fullTitle:"Periodontology - Fundamentals and Clinical Features",editors:[{id:"171921",title:"Prof.",name:"Petra",middleName:null,surname:"Surlin",slug:"petra-surlin",fullName:"Petra Surlin",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institutionString:"University of Medicine and Pharmacy of Craiova",institution:{name:"University of Medicine and Pharmacy of Craiova",institutionURL:null,country:{name:"Romania"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9588",title:"Clinical Concepts and Practical Management Techniques in Dentistry",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/9588.jpg",slug:"clinical-concepts-and-practical-management-techniques-in-dentistry",publishedDate:"February 9th 2022",editedByType:"Edited by",bookSignature:"Aneesa Moolla",hash:"42deab8d3bcf3edf64d1d9028d42efd1",volumeInSeries:7,fullTitle:"Clinical Concepts and Practical Management Techniques in Dentistry",editors:[{id:"318170",title:"Dr.",name:"Aneesa",middleName:null,surname:"Moolla",slug:"aneesa-moolla",fullName:"Aneesa Moolla",profilePictureURL:"https://mts.intechopen.com/storage/users/318170/images/system/318170.png",institutionString:"University of the Witwatersrand",institution:{name:"University of the Witwatersrand",institutionURL:null,country:{name:"South Africa"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8202",title:"Periodontal Disease",subtitle:"Diagnostic and Adjunctive Non-surgical Considerations",coverURL:"https://cdn.intechopen.com/books/images_new/8202.jpg",slug:"periodontal-disease-diagnostic-and-adjunctive-non-surgical-considerations",publishedDate:"February 5th 2020",editedByType:"Edited by",bookSignature:"Nermin Mohammed Ahmed Yussif",hash:"0aee9799da7db2c732be44dd8fed16d8",volumeInSeries:6,fullTitle:"Periodontal Disease - Diagnostic and Adjunctive Non-surgical Considerations",editors:[{id:"210472",title:"Dr.",name:"Nermin",middleName:"Mohammed Ahmed",surname:"Yussif",slug:"nermin-yussif",fullName:"Nermin Yussif",profilePictureURL:"https://mts.intechopen.com/storage/users/210472/images/system/210472.jpg",institutionString:"MSA University",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8837",title:"Human Teeth",subtitle:"Key Skills and Clinical Illustrations",coverURL:"https://cdn.intechopen.com/books/images_new/8837.jpg",slug:"human-teeth-key-skills-and-clinical-illustrations",publishedDate:"January 22nd 2020",editedByType:"Edited by",bookSignature:"Zühre Akarslan and Farid Bourzgui",hash:"ac055c5801032970123e0a196c2e1d32",volumeInSeries:5,fullTitle:"Human Teeth - Key Skills and Clinical Illustrations",editors:[{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",institutionString:"Gazi University",institution:{name:"Gazi University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:{id:"52177",title:"Prof.",name:"Farid",middleName:null,surname:"Bourzgui",slug:"farid-bourzgui",fullName:"Farid Bourzgui",profilePictureURL:"https://mts.intechopen.com/storage/users/52177/images/system/52177.png",biography:"Prof. Farid Bourzgui obtained his DMD and his DNSO option in Orthodontics at the School of Dental Medicine, Casablanca Hassan II University, Morocco, in 1995 and 2000, respectively. Currently, he is a professor of Orthodontics. He holds a Certificate of Advanced Study type A in Technology of Biomaterials used in Dentistry (1995); Certificate of Advanced Study type B in Dento-Facial Orthopaedics (1997) from the Faculty of Dental Surgery, University Denis Diderot-Paris VII, France; Diploma of Advanced Study (DESA) in Biocompatibility of Biomaterials from the Faculty of Medicine and Pharmacy of Casablanca (2002); Certificate of Clinical Occlusodontics from the Faculty of Dentistry of Casablanca (2004); University Diploma of Biostatistics and Perceptual Health Measurement from the Faculty of Medicine and Pharmacy of Casablanca (2011); and a University Diploma of Pedagogy of Odontological Sciences from the Faculty of Dentistry of Casablanca (2013). He is the author of several scientific articles, book chapters, and books.",institutionString:"University of Hassan II Casablanca",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"7",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"University of Hassan II Casablanca",institutionURL:null,country:{name:"Morocco"}}},equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7060",title:"Gingival Disease",subtitle:"A Professional Approach for Treatment and Prevention",coverURL:"https://cdn.intechopen.com/books/images_new/7060.jpg",slug:"gingival-disease-a-professional-approach-for-treatment-and-prevention",publishedDate:"October 23rd 2019",editedByType:"Edited by",bookSignature:"Alaa Eddin Omar Al Ostwani",hash:"b81d39988cba3a3cf746c1616912cf41",volumeInSeries:4,fullTitle:"Gingival Disease - A Professional Approach for Treatment and Prevention",editors:[{id:"240870",title:"Ph.D.",name:"Alaa Eddin Omar",middleName:null,surname:"Al Ostwani",slug:"alaa-eddin-omar-al-ostwani",fullName:"Alaa Eddin Omar Al Ostwani",profilePictureURL:"https://mts.intechopen.com/storage/users/240870/images/system/240870.jpeg",institutionString:"International University for Science and Technology.",institution:{name:"Islamic University of Science and Technology",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7572",title:"Trauma in Dentistry",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7572.jpg",slug:"trauma-in-dentistry",publishedDate:"July 3rd 2019",editedByType:"Edited by",bookSignature:"Serdar Gözler",hash:"7cb94732cfb315f8d1e70ebf500eb8a9",volumeInSeries:3,fullTitle:"Trauma in Dentistry",editors:[{id:"204606",title:"Dr.",name:"Serdar",middleName:null,surname:"Gözler",slug:"serdar-gozler",fullName:"Serdar Gözler",profilePictureURL:"https://mts.intechopen.com/storage/users/204606/images/system/204606.jpeg",institutionString:"Istanbul Aydin University",institution:{name:"Istanbul Aydın University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7139",title:"Current Approaches in Orthodontics",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7139.jpg",slug:"current-approaches-in-orthodontics",publishedDate:"April 10th 2019",editedByType:"Edited by",bookSignature:"Belma Işık Aslan and Fatma Deniz Uzuner",hash:"2c77384eeb748cf05a898d65b9dcb48a",volumeInSeries:2,fullTitle:"Current Approaches in Orthodontics",editors:[{id:"42847",title:"Dr.",name:"Belma",middleName:null,surname:"Işik Aslan",slug:"belma-isik-aslan",fullName:"Belma Işik Aslan",profilePictureURL:"https://mts.intechopen.com/storage/users/42847/images/system/42847.jpg",institutionString:"Gazi University Dentistry Faculty Department of Orthodontics",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"6668",title:"Dental Caries",subtitle:"Diagnosis, Prevention and Management",coverURL:"https://cdn.intechopen.com/books/images_new/6668.jpg",slug:"dental-caries-diagnosis-prevention-and-management",publishedDate:"September 19th 2018",editedByType:"Edited by",bookSignature:"Zühre Akarslan",hash:"b0f7667770a391f772726c3013c1b9ba",volumeInSeries:1,fullTitle:"Dental Caries - Diagnosis, Prevention and Management",editors:[{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",institutionString:"Gazi University",institution:{name:"Gazi University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Prosthodontics and Implant Dentistry",value:2,count:3},{group:"subseries",caption:"Oral Health",value:1,count:6}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:3},{group:"publicationYear",caption:"2020",value:2020,count:2},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:30,paginationItems:[{id:"425474",title:"Mr.",name:"Jasper",middleName:"Okoro Godwin",surname:"Okoro Godwin Elechi",slug:"jasper-okoro-godwin-elechi",fullName:"Jasper Okoro Godwin Elechi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/425474/images/19990_n.jpg",biography:"Mr. Elechi is an innovative and passionate food professional and educator who can collaborate across boundaries with an integrated aspiration of innovation to provide good, sustainable, and healthy food solutions that promote human health and conserve planetary health. He has a special interest in innovative food product development, nutrition, indigenous food products, biotechnology, bioeconmy, sustainable global food systems transformation, food safety Nanotechnology, and Nanomaterials. He has carried out independent research and publications in these areas. He possesses comprehensive knowledge and technical know-how on nutritional formulation and production of healthy and sustainable foods from locally available underutilized Cereal-Legume crops for combating food security and malnutrition in developing communities.",institutionString:null,institution:null},{id:"307387",title:"Dr.",name:"Cecilia",middleName:null,surname:"Camporeale",slug:"cecilia-camporeale",fullName:"Cecilia Camporeale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Agency For New Technologies, Energy and Sustainable Economic Development",country:{name:"Italy"}}},{id:"296882",title:"Dr.",name:"Mario",middleName:null,surname:"Jorizzo",slug:"mario-jorizzo",fullName:"Mario Jorizzo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Agency For New Technologies, Energy and Sustainable Economic Development",country:{name:"Italy"}}},{id:"307388",title:"Dr.",name:"ROBERTO",middleName:null,surname:"DEL CIELLO",slug:"roberto-del-ciello",fullName:"ROBERTO DEL CIELLO",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Agency For New Technologies, Energy and Sustainable Economic Development",country:{name:"Italy"}}},{id:"437647",title:"M.Sc.",name:"Fernando",middleName:null,surname:"Teixeira",slug:"fernando-teixeira",fullName:"Fernando Teixeira",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Évora",country:{name:"Portugal"}}},{id:"423338",title:"Dr.",name:"Harjeet",middleName:null,surname:"Singh",slug:"harjeet-singh",fullName:"Harjeet Singh",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Chitkara University",country:{name:"India"}}},{id:"443635",title:"Dr.",name:"Suruchi",middleName:null,surname:"Jindal",slug:"suruchi-jindal",fullName:"Suruchi Jindal",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Punjab Agricultural University",country:{name:"India"}}},{id:"426265",title:"Mrs.",name:"Inonge",middleName:null,surname:"Chibua",slug:"inonge-chibua",fullName:"Inonge Chibua",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Botswana",country:{name:"Botswana"}}},{id:"426266",title:"Ms.",name:"Mesha",middleName:null,surname:"Mbisana",slug:"mesha-mbisana",fullName:"Mesha Mbisana",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Botswana",country:{name:"Botswana"}}},{id:"426264",title:"Mr.",name:"Samuel",middleName:null,surname:"Raditloko",slug:"samuel-raditloko",fullName:"Samuel Raditloko",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Botswana",country:{name:"Botswana"}}},{id:"426394",title:"Dr.",name:"Mags",middleName:null,surname:"Adams",slug:"mags-adams",fullName:"Mags Adams",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Central Lancashire",country:{name:"United Kingdom"}}},{id:"441182",title:"Dr.",name:"Neil",middleName:null,surname:"Wilson",slug:"neil-wilson",fullName:"Neil Wilson",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Central Lancashire",country:{name:"United Kingdom"}}},{id:"425171",title:"Ph.D. Student",name:"Tanya",middleName:null,surname:"Zerbian",slug:"tanya-zerbian",fullName:"Tanya Zerbian",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Central Lancashire",country:{name:"Cyprus"}}},{id:"424714",title:"Prof.",name:"Elke",middleName:null,surname:"Stedefeldt",slug:"elke-stedefeldt",fullName:"Elke Stedefeldt",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Federal University of Sao Paulo",country:{name:"Brazil"}}},{id:"425244",title:"Dr.",name:"Rayane",middleName:"Stephanie Gomes",surname:"Stephanie Gomes De Freitas",slug:"rayane-stephanie-gomes-de-freitas",fullName:"Rayane Stephanie Gomes De Freitas",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Federal University of Sao Paulo",country:{name:"Brazil"}}},{id:"424688",title:"Dr.",name:"Bart",middleName:null,surname:"de Steenhuijsen Piters",slug:"bart-de-steenhuijsen-piters",fullName:"Bart de Steenhuijsen Piters",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Wageningen University & Research",country:{name:"Netherlands"}}},{id:"429404",title:"Dr.",name:"Emma",middleName:null,surname:"Termeer",slug:"emma-termeer",fullName:"Emma Termeer",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Wageningen University & Research",country:{name:"Netherlands"}}},{id:"429407",title:"Dr.",name:"Herman",middleName:null,surname:"Brouwer",slug:"herman-brouwer",fullName:"Herman Brouwer",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Wageningen University & Research",country:{name:"Netherlands"}}},{id:"429406",title:"Dr.",name:"Hubert",middleName:null,surname:"Fonteijn",slug:"hubert-fonteijn",fullName:"Hubert Fonteijn",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Wageningen University & Research",country:{name:"Netherlands"}}},{id:"427504",title:"Dr.",name:"Kriengsak",middleName:null,surname:"Chareonwongsak",slug:"kriengsak-chareonwongsak",fullName:"Kriengsak Chareonwongsak",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"423333",title:"Ph.D. Student",name:"Shivani",middleName:null,surname:"Sood",slug:"shivani-sood",fullName:"Shivani Sood",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"452297",title:"Mr.",name:"Cornelius",middleName:null,surname:"Smah Adamu",slug:"cornelius-smah-adamu",fullName:"Cornelius Smah Adamu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"452296",title:"Mr.",name:"Ikechukwu",middleName:null,surname:"U. Nwiyi",slug:"ikechukwu-u.-nwiyi",fullName:"Ikechukwu U. Nwiyi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"423395",title:"Assistant Prof.",name:"Adane",middleName:null,surname:"Atara Debessa",slug:"adane-atara-debessa",fullName:"Adane Atara Debessa",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"426267",title:"Mr.",name:"Banyaladzi",middleName:null,surname:"Paphane",slug:"banyaladzi-paphane",fullName:"Banyaladzi Paphane",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"483388",title:"Dr.",name:"Berhanu",middleName:null,surname:"Denu",slug:"berhanu-denu",fullName:"Berhanu Denu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"483387",title:"Dr.",name:"Degefa",middleName:null,surname:"Tolossa",slug:"degefa-tolossa",fullName:"Degefa Tolossa",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"426059",title:"Dr.",name:"Dikabo",middleName:null,surname:"Mogopodi",slug:"dikabo-mogopodi",fullName:"Dikabo Mogopodi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"422909",title:"Dr.",name:"Dorcas Stella",middleName:null,surname:"Shumba",slug:"dorcas-stella-shumba",fullName:"Dorcas Stella Shumba",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"429405",title:"Dr.",name:"Deborah",middleName:null,surname:"Bakker",slug:"deborah-bakker",fullName:"Deborah Bakker",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null}]}},subseries:{item:{id:"17",type:"subseries",title:"Metabolism",keywords:"Biomolecules Metabolism, Energy Metabolism, Metabolic Pathways, Key Metabolic Enzymes, Metabolic Adaptation",scope:"Metabolism is frequently defined in biochemistry textbooks as the overall process that allows living systems to acquire and use the free energy they need for their vital functions or the chemical processes that occur within a living organism to maintain life. Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. Thus all studies on metabolism will be considered for publication.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11413,editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",slug:"yannis-karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",biography:"Yannis Karamanos, born in Greece in 1953, completed his pre-graduate studies at the Université Pierre et Marie Curie, Paris, then his Masters and Doctoral degree at the Université de Lille (1983). He was associate professor at the University of Limoges (1987) before becoming full professor of biochemistry at the Université d’Artois (1996). He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. His teaching areas are energy metabolism and regulation, integration and organ specialization and metabolic adaptation.",institutionString:null,institution:{name:"Artois University",institutionURL:null,country:{name:"France"}}},editorTwo:null,editorThree:null,series:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983"},editorialBoard:[{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",slug:"anca-pantea-stoian",fullName:"Anca Pantea Stoian",profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"203824",title:"Dr.",name:"Attilio",middleName:null,surname:"Rigotti",slug:"attilio-rigotti",fullName:"Attilio Rigotti",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institutionString:null,institution:{name:"Pontifical Catholic University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"300470",title:"Dr.",name:"Yanfei (Jacob)",middleName:null,surname:"Qi",slug:"yanfei-(jacob)-qi",fullName:"Yanfei (Jacob) Qi",profilePictureURL:"https://mts.intechopen.com/storage/users/300470/images/system/300470.jpg",institutionString:null,institution:{name:"Centenary Institute of Cancer Medicine and Cell Biology",institutionURL:null,country:{name:"Australia"}}}]},onlineFirstChapters:{paginationCount:5,paginationItems:[{id:"82701",title:"Pathology of Streptococcal Infections",doi:"10.5772/intechopen.105814",signatures:"Yutaka Tsutsumi",slug:"pathology-of-streptococcal-infections",totalDownloads:8,totalCrossrefCites:0,totalDimensionsCites:0,authors:[{name:"Yutaka",surname:"Tsutsumi"}],book:{title:"Streptococcal Infections",coverURL:"https://cdn.intechopen.com/books/images_new/10828.jpg",subseries:{id:"3",title:"Bacterial Infectious Diseases"}}},{id:"82634",title:"Bacterial Sexually Transmitted Disease",doi:"10.5772/intechopen.105747",signatures:"Lebeza Alemu Tenaw",slug:"bacterial-sexually-transmitted-disease",totalDownloads:12,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Bacterial Sexually Transmitted Infections - New Findings, Diagnosis, Treatment, and Prevention",coverURL:"https://cdn.intechopen.com/books/images_new/11569.jpg",subseries:{id:"3",title:"Bacterial Infectious Diseases"}}},{id:"82193",title:"Enterococcal Infections: Recent Nomenclature and emerging trends",doi:"10.5772/intechopen.104792",signatures:"Kavita Raja",slug:"enterococcal-infections-recent-nomenclature-and-emerging-trends",totalDownloads:13,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Streptococcal Infections",coverURL:"https://cdn.intechopen.com/books/images_new/10828.jpg",subseries:{id:"3",title:"Bacterial Infectious Diseases"}}},{id:"81821",title:"Pneumococcal Carriage in Jordanian Children and the Importance of Vaccination",doi:"10.5772/intechopen.104999",signatures:"Adnan Al-Lahham",slug:"pneumococcal-carriage-in-jordanian-children-and-the-importance-of-vaccination",totalDownloads:7,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Streptococcal Infections",coverURL:"https://cdn.intechopen.com/books/images_new/10828.jpg",subseries:{id:"3",title:"Bacterial Infectious Diseases"}}},{id:"80546",title:"Streptococcal Skin and Skin-Structure Infections",doi:"10.5772/intechopen.102894",signatures:"Alwyn Rapose",slug:"streptococcal-skin-and-skin-structure-infections",totalDownloads:74,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Streptococcal Infections",coverURL:"https://cdn.intechopen.com/books/images_new/10828.jpg",subseries:{id:"3",title:"Bacterial Infectious Diseases"}}}]},publishedBooks:{paginationCount:14,paginationItems:[{type:"book",id:"10840",title:"Benzimidazole",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/10840.jpg",slug:"benzimidazole",publishedDate:"July 13th 2022",editedByType:"Edited by",bookSignature:"Pravin Kendrekar and Vinayak Adimule",hash:"e28c770013e7a8dd0fc37aea6aa9def8",volumeInSeries:34,fullTitle:"Benzimidazole",editors:[{id:"310674",title:"Dr.",name:"Pravin",middleName:null,surname:"Kendrekar",slug:"pravin-kendrekar",fullName:"Pravin Kendrekar",profilePictureURL:"https://mts.intechopen.com/storage/users/310674/images/system/310674.jpg",institutionString:"Visiting Scientist at Lipid Nanostructures Laboratory, Centre for Smart Materials, School of Natural Sciences, University of Central Lancashire",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"10798",title:"Starch",subtitle:"Evolution and Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/10798.jpg",slug:"starch-evolution-and-recent-advances",publishedDate:"June 28th 2022",editedByType:"Edited by",bookSignature:"Martins Ochubiojo Emeje",hash:"f197f6062c1574a9a90e50a369271bcf",volumeInSeries:33,fullTitle:"Starch - Evolution and Recent Advances",editors:[{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",institutionURL:null,country:{name:"Nigeria"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"11332",title:"Essential Oils",subtitle:"Advances in Extractions and Biological Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11332.jpg",slug:"essential-oils-advances-in-extractions-and-biological-applications",publishedDate:"June 23rd 2022",editedByType:"Edited by",bookSignature:"Mozaniel Santana de Oliveira and Eloisa Helena de Aguiar Andrade",hash:"742e6cae3a35686f975edc8d7f9afa94",volumeInSeries:32,fullTitle:"Essential Oils - Advances in Extractions and Biological Applications",editors:[{id:"195290",title:"Ph.D.",name:"Mozaniel",middleName:null,surname:"Santana De Oliveira",slug:"mozaniel-santana-de-oliveira",fullName:"Mozaniel Santana De Oliveira",profilePictureURL:"https://mts.intechopen.com/storage/users/195290/images/system/195290.png",institutionString:"Museu Paraense Emílio Goeldi",institution:{name:"Museu Paraense Emílio Goeldi",institutionURL:null,country:{name:"Brazil"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"10841",title:"Hydrolases",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/10841.jpg",slug:"hydrolases",publishedDate:"June 15th 2022",editedByType:"Edited by",bookSignature:"Sajjad Haider, Adnan Haider and Angel Catalá",hash:"4e868cde273d65a7ff54b1817d640629",volumeInSeries:29,fullTitle:"Hydrolases",editors:[{id:"110708",title:"Dr.",name:"Sajjad",middleName:null,surname:"Haider",slug:"sajjad-haider",fullName:"Sajjad Haider",profilePictureURL:"https://mts.intechopen.com/storage/users/110708/images/system/110708.png",institutionString:"King Saud University",institution:{name:"King Saud University",institutionURL:null,country:{name:"Saudi Arabia"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"10799",title:"Phenolic Compounds",subtitle:"Chemistry, Synthesis, Diversity, Non-Conventional Industrial, Pharmaceutical and Therapeutic Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10799.jpg",slug:"phenolic-compounds-chemistry-synthesis-diversity-non-conventional-industrial-pharmaceutical-and-therapeutic-applications",publishedDate:"February 23rd 2022",editedByType:"Edited by",bookSignature:"Farid A. Badria",hash:"339199f254d2987ef3167eef74fb8a38",volumeInSeries:26,fullTitle:"Phenolic Compounds - Chemistry, Synthesis, Diversity, Non-Conventional Industrial, Pharmaceutical and Therapeutic Applications",editors:[{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",institutionString:"Mansoura University",institution:{name:"Mansoura University",institutionURL:null,country:{name:"Egypt"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9753",title:"Terpenes and Terpenoids",subtitle:"Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/9753.jpg",slug:"terpenes-and-terpenoids-recent-advances",publishedDate:"July 28th 2021",editedByType:"Edited by",bookSignature:"Shagufta Perveen and Areej Mohammad Al-Taweel",hash:"575689df13c78bf0e6c1be40804cd010",volumeInSeries:21,fullTitle:"Terpenes and Terpenoids - Recent Advances",editors:[{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",institutionString:"King Saud University",institution:{name:"King Saud University",institutionURL:null,country:{name:"Saudi Arabia"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9731",title:"Oxidoreductase",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/9731.jpg",slug:"oxidoreductase",publishedDate:"February 17th 2021",editedByType:"Edited by",bookSignature:"Mahmoud Ahmed Mansour",hash:"852e6f862c85fc3adecdbaf822e64e6e",volumeInSeries:19,fullTitle:"Oxidoreductase",editors:[{id:"224662",title:"Prof.",name:"Mahmoud Ahmed",middleName:null,surname:"Mansour",slug:"mahmoud-ahmed-mansour",fullName:"Mahmoud Ahmed Mansour",profilePictureURL:"https://mts.intechopen.com/storage/users/224662/images/system/224662.jpg",institutionString:"King Saud bin Abdulaziz University for Health Sciences",institution:{name:"King Saud bin Abdulaziz University for Health Sciences",institutionURL:null,country:{name:"Saudi Arabia"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8094",title:"Aflatoxin B1 Occurrence, Detection and Toxicological Effects",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/8094.jpg",slug:"aflatoxin-b1-occurrence-detection-and-toxicological-effects",publishedDate:"June 3rd 2020",editedByType:"Edited by",bookSignature:"Xi-Dai Long",hash:"44f4ad52d8a8cbb22ef3d505d6b18027",volumeInSeries:14,fullTitle:"Aflatoxin B1 Occurrence, Detection and Toxicological Effects",editors:[{id:"202142",title:"Prof.",name:"Xi-Dai",middleName:null,surname:"Long",slug:"xi-dai-long",fullName:"Xi-Dai Long",profilePictureURL:"https://mts.intechopen.com/storage/users/202142/images/system/202142.jpeg",institutionString:"Youjiang Medical University for Nationalities",institution:{name:"University of Macau",institutionURL:null,country:{name:"Macau"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8004",title:"Nitrogen Fixation",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/8004.jpg",slug:"nitrogen-fixation",publishedDate:"April 8th 2020",editedByType:"Edited by",bookSignature:"Everlon Cid Rigobelo and Ademar Pereira Serra",hash:"02f39c8365ba155d1c520184c2f26976",volumeInSeries:11,fullTitle:"Nitrogen Fixation",editors:[{id:"39553",title:"Prof.",name:"Everlon",middleName:"Cid",surname:"Rigobelo",slug:"everlon-rigobelo",fullName:"Everlon Rigobelo",profilePictureURL:"https://mts.intechopen.com/storage/users/39553/images/system/39553.jpg",institutionString:"São Paulo State University",institution:{name:"Sao Paulo State University",institutionURL:null,country:{name:"Brazil"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8028",title:"Flavonoids",subtitle:"A Coloring Model for Cheering up Life",coverURL:"https://cdn.intechopen.com/books/images_new/8028.jpg",slug:"flavonoids-a-coloring-model-for-cheering-up-life",publishedDate:"March 11th 2020",editedByType:"Edited by",bookSignature:"Farid A. Badria and Anthony Ananga",hash:"6c33178a5c7d2b276d2c6af4255def64",volumeInSeries:10,fullTitle:"Flavonoids - A Coloring Model for Cheering up Life",editors:[{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",institutionString:"Mansoura University",institution:{name:"Mansoura University",institutionURL:null,country:{name:"Egypt"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8170",title:"Chemical Properties of Starch",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/8170.jpg",slug:"chemical-properties-of-starch",publishedDate:"March 11th 2020",editedByType:"Edited by",bookSignature:"Martins Emeje",hash:"0aedfdb374631bb3a33870c4ed16559a",volumeInSeries:9,fullTitle:"Chemical Properties of Starch",editors:[{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",institutionURL:null,country:{name:"Nigeria"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8019",title:"Alginates",subtitle:"Recent Uses of This Natural Polymer",coverURL:"https://cdn.intechopen.com/books/images_new/8019.jpg",slug:"alginates-recent-uses-of-this-natural-polymer",publishedDate:"February 5th 2020",editedByType:"Edited by",bookSignature:"Leonel Pereira",hash:"61ea5c1aef462684a3b2215631b7dbf2",volumeInSeries:7,fullTitle:"Alginates - Recent Uses of This Natural Polymer",editors:[{id:"279788",title:"Dr.",name:"Leonel",middleName:null,surname:"Pereira",slug:"leonel-pereira",fullName:"Leonel Pereira",profilePictureURL:"https://mts.intechopen.com/storage/users/279788/images/system/279788.jpg",institutionString:"University of Coimbra",institution:{name:"University of Coimbra",institutionURL:null,country:{name:"Portugal"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},testimonialsList:[{id:"18",text:"It was great publishing with IntechOpen, the process was straightforward and I had support all along.",author:{id:"71579",name:"Berend",surname:"Olivier",institutionString:"Utrecht University",profilePictureURL:"https://mts.intechopen.com/storage/users/71579/images/system/71579.png",slug:"berend-olivier",institution:{id:"253",name:"Utrecht University",country:{id:null,name:"Netherlands"}}}},{id:"8",text:"I work with IntechOpen for a number of reasons: their professionalism, their mission in support of Open Access publishing, and the quality of their peer-reviewed publications, but also because they believe in equality.",author:{id:"202192",name:"Catrin",surname:"Rutland",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",slug:"catrin-rutland",institution:{id:"134",name:"University of Nottingham",country:{id:null,name:"United Kingdom"}}}},{id:"27",text:"The opportunity to work with a prestigious publisher allows for the possibility to collaborate with more research groups interested in animal nutrition, leading to the development of new feeding strategies and food valuation while being more sustainable with the environment, allowing more readers to learn about the subject.",author:{id:"175967",name:"Manuel",surname:"Gonzalez Ronquillo",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/175967/images/system/175967.png",slug:"manuel-gonzalez-ronquillo",institution:{id:"6221",name:"Universidad Autónoma del Estado de México",country:{id:null,name:"Mexico"}}}}]},submityourwork:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],subseriesList:[],annualVolumeBook:{},thematicCollection:[],selectedSeries:null,selectedSubseries:null},seriesLanding:{item:{id:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343",scope:"Biomedical Engineering is one of the fastest-growing interdisciplinary branches of science and industry. The combination of electronics and computer science with biology and medicine has improved patient diagnosis, reduced rehabilitation time, and helped to facilitate a better quality of life. Nowadays, all medical imaging devices, medical instruments, or new laboratory techniques result from the cooperation of specialists in various fields. The series of Biomedical Engineering books covers such areas of knowledge as chemistry, physics, electronics, medicine, and biology. This series is intended for doctors, engineers, and scientists involved in biomedical engineering or those wanting to start working in this field.",coverUrl:"https://cdn.intechopen.com/series/covers/7.jpg",latestPublicationDate:"August 3rd, 2022",hasOnlineFirst:!0,numberOfOpenTopics:3,numberOfPublishedChapters:107,numberOfPublishedBooks:12,editor:{id:"50150",title:"Prof.",name:"Robert",middleName:null,surname:"Koprowski",fullName:"Robert Koprowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTYNQA4/Profile_Picture_1630478535317",biography:"Robert Koprowski, MD (1997), PhD (2003), Habilitation (2015), is an employee of the University of Silesia, Poland, Institute of Computer Science, Department of Biomedical Computer Systems. For 20 years, he has studied the analysis and processing of biomedical images, emphasizing the full automation of measurement for a large inter-individual variability of patients. Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},subseries:[{id:"7",title:"Bioinformatics and Medical Informatics",keywords:"Biomedical Data, Drug Discovery, Clinical Diagnostics, Decoding Human Genome, AI in Personalized Medicine, Disease-prevention Strategies, Big Data Analysis in Medicine",scope:"Bioinformatics aims to help understand the functioning of the mechanisms of living organisms through the construction and use of quantitative tools. The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",fullName:"Reda R. Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. Osma",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDv7QAG/Profile_Picture_1626602531691",institutionString:null,institution:{name:"Universidad de Los Andes",institutionURL:null,country:{name:"Colombia"}}},{id:"69697",title:"Dr.",name:"Mani T.",middleName:null,surname:"Valarmathi",fullName:"Mani T. Valarmathi",profilePictureURL:"https://mts.intechopen.com/storage/users/69697/images/system/69697.jpg",institutionString:"Religen Inc. | A Life Science Company, United States of America",institution:null},{id:"205081",title:"Dr.",name:"Marco",middleName:"Vinícius",surname:"Chaud",fullName:"Marco Chaud",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDGeQAO/Profile_Picture_1622624307737",institutionString:null,institution:{name:"Universidade de Sorocaba",institutionURL:null,country:{name:"Brazil"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"profile.detail",path:"/profiles/192869",hash:"",query:{},params:{id:"192869"},fullPath:"/profiles/192869",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()