Selected features of Mavic 2 Enterprise drone.
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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\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:"952",leadTitle:null,fullTitle:"Cesarean Delivery",title:"Cesarean Delivery",subtitle:null,reviewType:"peer-reviewed",abstract:"This book provides broad, science-based information regarding the most common major surgical procedure performed, i.e. Cesarean Delivery. 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Orbital cellulites is an uncommon infectious process in which patient may present with pain, reduced visual acuity, compromised ocular motility and significant proptosis. [1]- [3] In the modern era of relatively early access to the health care facilities, complete loss of vision from orbital cellulitis is rare. In the vast majority of cases, a history of upper respiratory tract infection prior to the onset is very common especially in children. [4], [5] Chandler et al, [6] for simplicity has classified the disease into 5 categories and emphasized the possibility of fatal outcome due to the extension of the abscess to cavernous sinus in the form of thrombosis and intracranial spread. In addition to the loss of vision, orbital cellulitis can be associated with a number of other serious complications that may include intracranial complications in the form of cavernous sinus thrombosis, meningitis, frontal abscess and even death. Historically, since the wide spread use of effective antibiotics, the serious complications of orbital cellulitis have become much less frequent. In the past, loss of vision was a relatively more common outcome of orbital cellulitis. [2] In the recent years, only few case reports of loss of vision following orbital cellulitis has been reported in the literature. For example, Connel et al, [3] reported case of a 69-year-old man who presented with no light perception vision, proptosis and significant ophthalmoplegia. In their case, despite emergent drainage of the abscess and systemic antibiotics, no improvement in vision was noted despite the return of the full ocular motility and disappearance of proptosis. Connel et al, [3] postulated Streptococcal-related ischemic necrosis of the optic nerve as a possible mechanism of loss of vision in their patient. In one of the recent survey of 52 patients treated for orbital cellulitis, over 35% had decreased vision and on their last follow-up, only 4% had decreased visual acuity. [1] Our own experience in treating 218 patients with orbital complications of cellulitis revealed that visual acuity improved in 16.1% and worsened in 6.2%, including 4.3% that sustained complete loss of vision. [8] We attributed the permanent loss of vision to the delay in diagnosis and intervention. Further, there were 9 cases of intracranial orbital abscess extension that required either extended treatment with systemic antibiotics alone or in combination with neurosurgical intervention. [3]
Patients with orbital cellulitis may present with signs of eyelid swelling, conjunctival chemosis, diplopia and proptosis which may not be prominent in cases of preseptal cellulitis. [1], [8], [9] These patients may present with corneal infections resulting from exposure keratopathy due to their inability to close their eyes. Many of these patients come with local symptoms in the form of eyelid edema, redness, chemosis, decreased ocular motility and proptosis (Figure 1). Patients having superficial signs of swelling (preseptal cellulitis) should be differentiated from deeper infection resulting in orbital cellulitis, in which case, signs and symptoms resulting from inflammation may be helpful. [9] In particular, external ophthalmoloplegia, proptosis and decreased visual acuity are associated with orbital cellulitis rather than preseptal cellulitis. [8], [9] Temperature greater than 37.5℃ and leukocytosis resulting in fever may be more prominent feature of the pediatric orbital cellulitis. [4], [5] In children, external ophthalmoplegia and proptosis may be the most common features, while decreased visual acuity and chemosis may be less frequent signs in both the pediatric as well as in the adult patients. In cases of the optic nerve involvement, disc edema or neuritis with rapidly progressing atrophy resulting in blindness may occur. Mechanical pressure on the optic nerve and possibly compression of the central retinal and other feeding arteries results in optic nerve atrophy. [10] Also orbital inflammation itself may spread directly into the substance of the optic nerve causing small necrotic areas or abscesses. [2] Compression of the feeding vessels as well as inflammation may result in the infarction of the optic nerve, infarction of the sclera, choroids as well as the retina. Inflammation may result in septic uveitis, iridocyclitis or choroiditis with a cloudiness of the vitreous, including septic pan ophthalmitis. A less common complication of orbital cellulitis is glaucoma that can cause decreased vision, reduced visual field or even enlarged blind spot on presentation. On occasion, one may not find any fundus abnormalities. Among our patients presenting to a tertiary eye care center in the developing country, presenting signs of 218 patients with orbital cellulitis included, eyelid swelling in 71.5%, proptosis in 68.3%, motility restriction in 59.2%, pain in 52.3%, and decreased visual acuity in 14.2% of cases. [8]
A child with left sided eyelid erythema, swelling and proptosis following a bout of upper respiratory infection.
Some of the differential diagnosis for patients presenting with orbital cellulitis may include, allergic reaction to topical or systemic medication, edema from hypo-proteinemia due to variety of systemic causes, orbital wall infarction and subperiosteal hematoma due to unrecognized trauma or due to blood coagulation disorders. Differential diagnosis may also include orbital pseudotumor (Figure 2), retinoblastoma, metastatic carcinoma and unilateral or bilateral exophthalmos secondary to thyroid related orbitopathy. [11] In all cases, careful history, thorough physical examination along with carefully selected imaging studies may help in differentiating orbital cellulitis from other causes of proptosis.
A 25-year-old male with bilateral eyelid swelling, proptosis and painful diplopia was found to have evidence of bilateral orbital pseudotumor and treated with systemic corticosteroids after imaging studies failed to show evidence of any infectious cause of his symptoms.
In the most reported series, the most common predisposing factor for orbital cellulitis is sinus disease, especially in children. [1], [4], [8] Usually, the infection originates from sinusitis. It can originate from face or eyelids after a recent or past trauma, dental abscess or from a distant source by hematogenous spread. [1], [8], [11-13] For simplification purposes, Chandler et al, [6] grouped complication of sinus inflammation into 5 classes. In the group 1, eyelids may be swollen alongwith presence of orbital content edema (preseptal cellulitis). Swelling may reflect impedance of drainage through ethmoidal vessels. Group II reflects evidence of orbital cellulitis in which inflammatory cells diffusely infiltrate orbital tissues. In Group II, the eyelids may be swollen along with conjunctival chemosis as well as some degree of proptosis. Visual loss may be present in Group II patients. Purulent material may be collecting as subperiosteal abscess between the periorbita and the bony walls of the orbit in Group III. These patients may have significant conjunctival chemosis, eyelid edema, along with tenderness in the involved areas with variable degree of proptosis, and decreased ocular motility. The abscess may be anywhere in the vicinity of the orbit. Patients in group IV (orbital abscess), may present with their abscess being inside or outside the muscle cone following untreated orbital cellulitis. These patients may have significantly more pain, proptosis, decreased ocular motility and variable degree of severe visual loss. Patients in group V may present with bilateral eyelid edema along with involvement of third, fifth and sixth cranial nerves which is thought to be due to the extension of the infectious process into the cavernous sinus with formation of thrombosis. These patients may have nausea, vomiting along with signs of nervous system involvement which could also be due to septicemia. Signs of proptosis, eyelid edema, optic neuritis, frozen globe, decreased supra-orbital nerve conduction may be hallmarks of orbital apex syndrome which is thought to be due to the sinusitis in the area of the superior orbital fissure and optic foramen. [14]
External photographs of a young male child who suffered trauma over his right brow area after which he developed orbital cellulitis and formation of an abscess that required drainage.
Our own experience in treating orbital cellulitis from a developing country confirmed previous observations from the Western countries in which sinusitis has been implicated as the cause of orbital cellulitis in most of the cases. [8] Specifically in children, vast majority of cases with orbital cellulitis had pre-existing sinusitis, and significant number of them had multiple sinuses involved. Our experience revealed that unlike patients from the Western countries, most patients with sinusitis and orbital cellulitis in the developing countries had sought treatment later in the course of their disease. Unlike Western countries, in our patients, prior history of periocular trauma or ocular/ periocular surgery were also very common cause of orbital cellulitis. (Figure 3). [1], [10] Although less common, dacryocystitis, dental infection and endophthalmitis, were also found to be the cause of orbital cellulitis in our patients (Figure 4). [8] Patients with prior history of sinusitis may also develop osteomyelitis and intracranial infection. In these cases, osteomyelitis, commonly involve the frontal bone which is due to a direct extension of frontal infection or septic thrombophlebitis via the valveless sinus of Breschet. [15] Less common cause of osteomyelitis results from the ethmoidal sinusitis because from this location, infection can rapidly spread through the thin lamina papyracea into the orbit or maxilla, where arterial anastomoses are sufficient to prevent necrosis due to septic thrombosis of a single artery. Although meningitis may be the most common intracranial complication of sinus disease, epidural, subdural and brain parenchymal abscess can also develop. [15]
External photograph and U/S of right eye of an 83-years-old male who suffered right eye trauma and then developed panophthalmitis resulting in total loss of his vision.
Usually, orbital cellulitis occurs in the childhood years which has been attributed to the relatively incomplete development of immunity in this age group. [1], [4], [5], [16], [17] In these patients, sinus disease has been found to be the most common predisposing factor. Over 90% of these patients have radiologically confirmed sinusitis, the most common being ethmoidal and maxillary. [1], [8] In the reported series, ethmoidal sinusitis has been demonstrated to be the source of infection in significantly large number of cases. [18], [19]
Anterior and sagittal view of the frontal, ehtmoidal, sphenoid and maxillary sinuses and their close relationship with orbital anatomy.
Ethmoidal sinusitis is usually present with maxillary sinusitis on the same side of the infection. [19], [20] Frontal sinus disease has been frequently identified especially in series in which a large number of adolescents and adults have been studied (Figure 5). [10], [18], [20] Up to 38% of children may have more than one sinus involved and in the adult patients, up to 50% may have underlying sinusitis, while up to 11% may have multiple sinuses involved. [1], [8] Other etiological factors resulting in orbital cellulitis may include dacryocystitis with orbital extension (Figure 6), retained foreign body, panophthalmitis, infected tumor, Herpes Zoster, (Figure 7), and mucormycosis. [8], [21]
External photograph of a 42-years-old female who presented with left-sided orbital cellulitis and abscess formation due to the acute over chronic dacryocystitis.
External photograph of a 19-years-old male who presented with 3 day history of left-sided facial erythema, swelling, conjunctival chemosis, proptosis and eruptive skin lesions. A diagnosis of Herpes Zoster Ophthalmicus was made and patient was treated for acute Zoster infection and its complications.
As orbital cellulitis has a close relationship with sinus (Figure 5), and upper respiratory disease, a seasonal distribution paralleling that of upper respiratory infections (URI) has been documented with a bi-model seasonal distribution of cases with peak occurring in late winter and early spring season. [1], [8] Bacterial sinusitis can result in orbital cellulitis leading to a subperiosteal abscess from the accumulation of purulent material between the periorbita and the orbital bones. [6], [8], [20] Since the use of modern imaging studies in the form of computed tomography (CT-scan), the concept of subperiosteal abscess has been accepted as a separate entity. [20], [22] Because of the reports of rapidly progressive visual and intracranial complications from subperiosteal abscess, some clinicians argue for the prompt surgical drainage of the abscess and paranasal sinuses when a subperiosteal abscess is first diagnosed by a CT-scan. [15], [20], [22-26] Among our survey of 218 patients who required treatment of their orbital cellulitis, imaging studies revealed that sinus disease was the most cause in 39.4%, trauma in 19.7%, endophthalmitis in 13.3%, (Figure 8), orbital implants in 8.2%, dacryocystitis in 4.6%, retained orbital foreign body in 3.2%, dental infection in 2.7%, and scleral buckle in 2.3%.8 A history of sinusitis and recent trauma was the cause of orbital cellulitis in 4.1%, and intraocular or orbital tumors were the cause in another 4% of patients.
In diabetic and immune-compromised patients one has to rule out fungal infection as the cause of orbital cellulitis, the most common being Mucormycosis and Aspergillosis. While infection with Mucormycosis has no climatic or age restriction, Aspergillosis usually occurs in hot and humid climates in patients older than 20 years of age. Although predisposing factors for Aspergillosis are unclear multiple risk factors for Mucormycosis have been proposed, among them diabetic ketoacidosis is the most common. The course of onset for Mucromycosis infection is rapid (usually 1-7 days) as compared with slow infection due to Aspergillosis which can take a month to a year. Otolaryngologic findings in patients with Mucormycosis may include nasal and palatal necrosis along with paranasal sinusitis. In Aspergillosis, one may find evidence of chronic fibrosis and non-necrotizing granulomatous reaction of the involved structures. In cases of Mucromycosis infections there is evidence of ischemic necrosis along with thrombosed arteries
External photographs and U/S of the right eye of a 73-years-old male who developed panophthalmitis after cataract surgery.
Orbital complications of sinusitis have been reported to range anywhere between 0.5 to 3.9%. [1], [17], [27] However, the incidence of abscess formation vary considerably from 0-25% in the reported series. [15] No cases of abscess formation was reported in the published series from the Children’s Memorial Hospital in Chicago including 87 patients with orbital cellulitis and from Children’s Hospital in Pittsburgh including 104 orbital celulitis cases. [28], [29] On the other hand, a larger study of 6,770 patients from the Hospital for Sick Children in Toronto revealed that 2.3% developed orbital complications; of which 10.7% had abscess formation. [19] Another study reported 20.8% incidence of abscess formation among the 158 patients admitted for orbital cellulitis. There was a 20.8% incidence of abscess formation. [30] Among other series which has reported orbital complications of sinus disease, the incidence of abscess formation had varied from 6.25 to 20 % to as high as 78.6%. [18], [31], [32] One may attribute differences among these studies due to the inclusion criteria, age group and the severity of the complications studied by these authors. The incidence of major complications following sinusitis may be low, however such complications may be associated with considerable morbidity and mortality. [8], [15] According to the published report, in the pre-antibiotic era, orbital cellulitis resulted in death from meningitis in 17% of cases and blindness in 20%. [6] However, in the antibiotic era, incidence of menengitis was reported as 1.9% in patients with orbital cellulitis, despite prompt treatment with systemic antibiotics. [33]
External photographs as well as CT-scan (axial and coronal views) of a 7-year-old boy who presented with upper respiratory infection followed by painful diplopia, left eye proptosis and decreased vision. His symptoms did not improve with a course of systemic antibiotics. This patient required drainage of his orbital abscess which resulted in immediate resolution of his symptoms.
In-spite of systemic antibiotics and surgical intervention, orbital abscesses may have devastating outcome. [15] According to the series in which final visual results have been reported, a significant percentage of patients have been left with non-seeing eyes ranging anywhere from 7.1% to as high as 23.6%. [10] Visual loss in these cases have been attributed to optic atrophy, central retinal artery occlusion, or exposure keratopathy with corneal ulcer formation. [8], [10], [19] Some of the other hypothesized mechanisms of vision loss are septic optic neuritis, embolic or thrombotic lesions in the vascular supply of the optic nerve, choroid or retina. It has been postulated that delayed medical and surgical intervention may produce unacceptable visual outcome. [19], [20], [22]- [25] Among our 218 patients with diagnosis of orbital cellulitis, there were 116 cases of radiologically confirmed subperiosteal abscess, (Figure 9), 87% of them required drainage, and the remaining 13% were observed closely until their resolution while those patients were being treated with systemic antibiotics. [8] Thirty-nine eyes (17.8%) had endophthalmitis causing orbital cellulitis which required evisceration (9.6%) or enucleation (8.2%). Seven orbits required exenteration and 6 infected orbital implants had to be removed. Six patients had dacryocystitis that required a dacryocystorhinostomy to treat orbital cellulitis in addition to the administration of systemic antibiotics. [8]
On orbital ultrasonography (U/S), abscess may show low internal reflectivity and therefore, U/S can be useful as a screening office procedure for patients suspected of having orbital abscess. [8], [27] Computed tomography scan may be necessary to assess the evidence of sinusitis and orbital processes. On CT-scan, orbital abscess may appear as localized, generally homogenous elevation of the periorbita adjacent to an opacified sinus, (Figure 9). On imaging studies, there may be evidence of inflammatory or infective changes in the sinus areas as well as orbital structures. In children, more patients may have subperiosteal abscess as compared to the adult group at the time of their initial presentation. [4] In the series reported by Ferguson and McNab, [1] among children, 29% had inflammatory changes only, while 62% had evidence of a subperiosteal abscess, only 9% had orbital abscesses, compared with 72%, 5% and 22%, respectively, in their adult group. Computed tomography scan may influence the initial therapeutic plan by demonstrating the size and location of the abscess and the specific sinuses involved, features that may be necessary in the approach of surgical drainage. [8], [20], [27] Experience however have shown that the CT-scan characteristics of the subperiosteal collection may not always be predictive of the clinical course. For example, in reports from the patients who recovered with systemic antibiotics alone, findings were similar to the findings in patients who underwent surgical drainage. [22] The imaging studies have shown that the size of an orbital abscess may increase over the first few days of intravenous antibiotics regardless of the bacteriological response to the treatment in these patients. [22] In some patients, the identification of an orbital abscess may be a diagnostic challenge. The reliability of some of the imaging modalities such as CT-scan in demonstrating some orbital abscesses has been questioned. For example from a series of 25 cases of orbital infection, all 15 orbital abscesses were satisfactorily demonstrated only when the CT-scan examination included coronal sections. [34] According to this study, one-third of abscesses would have been missed if coronal sections had not been performed. Magnetic resonance imaging studies have been found to be necessary in some cases where CT-scan have not satisfactorily addressed clinician’s concerns.
The development of an orbital abscess does not correlate specifically with visual acuity, proptosis, chemosis, or any other signs. [15], [27] Therefore diagnostic procedures are essential in evaluating the patient with orbital cellulitis and possible abscess or retained orbital foreign bodies. Although sinus X-ray may demonstrate an air-fluid level when present in an abscess cavity, gas-free abscesses may not be readily visible. [15] Ultrasound may detect an abscess of the anterior orbit or the medial wall with 90% accuracy, [25] although an acute abscess may be poorly delineated. Currently, the investigative procedure of choice to diagnose an orbital infection is the CT-scan, although MRI can be utilized when there is a contra-indications for CT-scan. [8], [27], [35] By CT-scan, orbital walls, extraocular muscles, optic nerve, intraconal area and adipose tissue can be seen clearly. An orbital abscess can be seen as a homogenous, a ring-like, or a heterogenous mass. In these studies, the site of origin, orbital or subperiosteal, and extent of abscess are readily visible. [8], [22] When administered, contrast-media can enhance the surrounding wall of an abscess. Computed tomography scan will not differentiate between preseptal cellulitis and eyelid edema but will differentiate between preseptal and orbital cellulitis. [15] Beside foreign bodies, sinus disease and intracranial complications may also be visible on the CT-scan. [8] Our experience has shown that CT-scan may be the most comprehensive source of information about orbital infections and the most sensitive means of monitoring resolving orbital or intracranial lesions. [8], [27] Computed tomography scan is indicated in all patients with periorbital inflammation in whom proptosis, ophthalmoplegia, or a decrease in visual acuity develop, in whom a foreign body or an abscess is suspected, severe eyelid edema prevents an adequate examination, or surgery is contemplated. [8], [15], [20], [22], [35] In our study of the 218 patients with orbital cellulitis, diagnosis was made clinically and confirmed by CT-scans or U/S in 90.4% and 36.2% orbits, respectively. [8] Orbital abscesses were identified in 53.2% of orbits. In all cases of orbital cellulitis, there was evidence of inflammatory or infective changes of the orbital structures. Abscess location was found to be medial in 35%, superior in 33%, intraconal in 13%, superomedial in 6%, inferomedial in 6% and lateral in 2% of orbits. [8]
In the reported series, the bacteriology of orbital abscesses has received little attention. In series in which the contents of the abscess cavity have been cultured, a wide range of organisms have been reported. [8], [36] Most commonly reported bacterial species from the abscesses of the orbit and periorbital area include Staphylococcus aureus, Staphylococcus epidermidis, Streptococci, Diphtheroids, Haemophilus influenzae, Escherichia Coli, multiple species of aerobes and anaerobes. There was no growth in up to 25% of abscesses. [15], [17] Microbiological results from Ferguson and McNab, [1] series varied, with differences in the rate of testing between the pediatric age group and the older age group. In their series, some forms of cultures were performed in 93% of their patients. Fifty percent of their patiens had blood cultures none of which yielded positive results. According to their study, cultures taken from abscesses were more likely to yield positive results. The authors noted that there was no correlation between cultures taken from conjunctival swab and the etiological organisms recovered from the abscesses of those patients with positive cultures. In their study, Staphylococcus aureus was the most common micro-organism recovered. In their pediatric age group various species of Streptococcus predominated. Among their pediatric patients, 4 patients had anaerobic Streptococcus isolates, two had mixed anaerobes and one had Clostridium bifermentans. In Ferguson and McNab’s, [1] series, orbital cellulitis due to anaerobes was much less common in adults, with only one case of mixed anaerobes identified. In their series, only 5 adults and 4 pediatric patients had multiple organisms isolated from the abscesses. No pathogenic organisms were isolated from their 6 adult and 15 pediatric patients in whom the cultures were performed. [1] Although in the past, H influenza was a major pathogenic bacteria responsible for orbital cellulitis in the pediatric age group, [8], [15] in the series reported by Ferguson and McNab,1 no cases of H. influenza were identified in the pediatric age group and only one case was found in an adult patient. This observation has been attributed to the general immunization of children with H. influenza type B vaccine since the early 1990s. [1], [27] Schramm et al,5 reported 32 cases of orbital abscesses, the predominant microorganisms being Staphylococci, Streptococci and Bacteroids species.
The role of anaerobes, not usually considered pathogens in the sinus disease is unclear, although considerable number of cultures in adult patients have yielded anaerobes. [8], [20], [23] In general, patients during their first decade of life may have infection caused by a single aerobic pathogen which may be responsive to the medical therapy alone. On the other hand, patients older than 15 years of age may have complex infections caused by multiple aerobic and anaerobic organisms that may be slow to clear despite medical and surgical intervention. [23] The virulence of pathogens and responsiveness to anti-microbial agents appear to be age-related. [20], [37] With enlarging of the size of the sinus cavities, the ostia gets narrow creating optimal condition for anaerobic bacterial growth. As the person ages, there is a trend towards appearance of more complex infections. In mixed infections, aerobes utilize oxygen which encourage growth of more anaerobic microorganisms. On the other hand anaerobes produce B-Lactamase which makes antibiotics less effective. Harris, [20] reviewed microbiology results of 37 patients with orbital abscesses in which one-third were younger than 9 years, 58% were culture negative and the rest had single aerobic pathogen. From his series, 16 patients between ages 9-14 years showed transition towards more complex infections. Among these, 9 patients which were older than 15 years had positive cultures despite being on systemic antibiotics for 3 days. In Harris’s, [20] study, older group had more often polymicrobial infections and anaerobes were found in all cases. According to our study the most common microorganisms isolated from the drained abscesses were the most common microorganisms isolated from the drained abscesses were Staphylococci and Streptococci species; less common organisms included Propionibacterium acnes, Haemophilus influenzae, Bacillus, and fungi. [8]
Medical management depends on the patient’s appearance, ability to take oral medications, compliance and clinical progression of the disease. Patients presenting with signs and symptoms of eyelid edema, diplopia, reduced visual acuity, abnormal light reflexes, ophthalmoplegia and proptosis need admission (Figure 10). Further, if a patient appears toxic and eye exam is difficult to be completely performed, along with signs of CNS involvement as evident by lethargy, vomiting, seizures, headache or cranial nerve deficit, admission is needed for further evaluation and proper treatment. Intravenous antibiotics are usually started once the diagnosis of orbital cellulitis is suspected, broad-spectrum antibiotics that cover most gram positive and gram negative bacteria are considered initially. The recommendations for antibiotics are usually based on the microorganisms most frequently suspected from abscesses; Staphylococcus aureus, Staphylococcus epidermidis, Streptococci, and Hemophilus species. [15] Empiric antibiotics should cover methicillin-resistant Staph.aureus if suspected. [38], [39] One should suspect mixed infections including aerobic and anaerobic species in the abscesses. [20] Warm compresses over the involved area may help to improve the softening of the tissues to bring in more blood circulation in the area where blood supply is already abundant. If no improvement occurs in 24-48 hours of systemic antibiotics, one may consider Infectious Disease, Ear, Nose and Throat and/or Neurosurgery consultations. [27]
Historically, cultures from the conjunctiva, nose and throat are usually not representative of the pathogens cultured from the abscesses and blood cultures may frequently be negative and are not usually helpful. [15] Most patients in the reported series, had received a combination of a third-generation cephalosporin and flucloxacillin. [1], [8] According to those reports, most patients had received oral antibiotics on discharge for varying periods of time. [40] For example, all patients in the Ferguson and McNab’s [1], series had received intravenous antibiotic treatment during their admission and most of these patients had received multidrug therapy with up to 5 different antibiotics at some point. In these cases treatment regimens were empirically based and instituted prior to the identification of responsible organisms. [1] In our experience, most of our patients also had multiple antibiotic regimens administered during their stay in the hospital and most of them were discharged on at least one antibiotic therapy. [8] In our study of 218 patients having orbital cellulitis and abscess, all patients received systemic antibiotic treatment, and in all patients, treatment regimens were empirically based and were instituted before the identification of any responsible organisms. [8] In our study, the most common antibiotic regimen included cephalosporins in 90%, and aminoglycosides in 66% with a combination of other antibiotics. These antibiotics included flucloxacillin in 15%, vancomycin in 13%, ampicillin in 6%, metronidazole in 4%, and penicillin in 3% of patients. In our study, most patients received oral antibiotics on their discharge for varying periods, ranging from 3 days to 3 weeks. [8]
Patient from
From the reported series, patient age has been identified as a factor in the bacteriology and the response of these patients to treatment for their orbital abscesses. [16], [17], [20] In general, children aged <9 years have been found to have simpler, more responsive infections, primarily caused by single aerobic pathogen. Older children and adults have been found to harbor more complex infections caused by multiple aerobic and anaerobic organisms, resistant to both medical and surgical treatment. [20] In addition to starting systemic antibiotics, emergent drainage of the orbital abscesses may be necessary in patients with compromised vision regardless of patient age. Urgent drainage (within 24 hour of presentation) has been recommended for large abscesses, for extensive superior or inferior orbital abscesses, for patients with central nervous system complications and for infections following dental work in which anaerobes might be expected. [20] These patients require surgical option if improvement does not occur as expected. In these patients, careful monitoring of the clinical course is mandatory and comparison of serial CT-scan may be necessary as an adjunct to clinical judgment. In Harris’s series 27 of 29 patients which were younger than 9 years old recovered with antibiotic treatment alone with a good clinical outcome. [20] He described “sliding scale” of risk associated with increasing age and argued that patients in the older age group who present with orbital process should undergo prompt sinus surgery even before orbital or intracranial abscesses develop. Once sinus infection in older children or adults has extended into the orbit as an abscess, urgent drainage may include the orbit along with the infected sinuses. [20] Computed tomography scan may not be accurate in assessing clinical course in some of these patients. In a review of 37 cases of orbital abscesses, Harris, found that subperiosteal material could not be predicted from the size or relative radiodensity of the collections from the CT-scans. [22] Initial scans were not as predictive of the clinical course. In fact the serial scans showed enlargement of abscesses during the first few days of systemic antibiotic therapy regardless of the final outcome of the response to treatment. He concluded that expansion of orbital abscess on the serial CT-scans during the initial treatment may not be equated to failure of the infection to respond to the medical management in the form of antibiotics alone. [22]
From their vast experience with the management of orbital abscesses, Garcia and Harris [23], concluded that surgical therapy for orbital abscesses may be contemplated based on several factors, including the sinuses involved, the presumed pathogens, the anticipated bacterial response to administered antibiotic, visual status, the size and location of the orbital abscess and potential intracranial complications. They recommended emergency drainage of the orbital abscesses and sinuses of patients of any age whose optic nerve or retinal function is compromised. Urgent drainage for large abscesses, in cases of extensive superior or inferior abscesses that might not quickly resolve despite clearance of sinusitis by medical treatment has been recommended, (Figure 11). In cases of intracranial complications at the time of presentation and in frontal sinusitis, in which the risk of intracranial extension is increased, and when complex infections that include anaerobes are suspected, urgent drainage of an abscess is recommended. [23] Again, expectant approach has been recommended for patients younger than 9 years of age in whom simple infections may be suspected. Surgical option may still be exercised if clinical improvement does not occur in a timely manner and if relative afferent pupillary defect develops at any time. Further, surgical option should be considered in cases of fever not abating within 36 hours of systemic antibiotic treatment suggesting that the infection may not be responding to the choice of antibiotics being administered. Surgery should also be considered when there has been deterioration of vision despite 48 hours of appropriate antibiotic therapy and no improvement despite 72 hours of such treatment. Usually, CT-scan improvement should be expected to lag behind the clinical picture. In fact, the CT findings may worsen during the first few days of hospitalization despite successful treatment with antibiotics alone. [23]
External photograph of an 8-year-old boy who required drainage of his right orbital abscess after failing 3 days of by systemic antibiotic treatment. CT-scan (axial and saggital cuts) showed an evidence of maxillary sinusitis and an abscess formation in the superior orbit.
In majority of the cases, surgical intervention is indicated for significant underlying sinus disease, orbital or subperiosteal abscess, or both in the children, (Figure 11). [1], [5], [8], [17] For older patients, sinus surgery remains the most common surgical intervention. Recent literature suggests that the volume of subperiosteal abscess seems to be the most important criterion in determining medical versus surgical management; the volumes of abscesses needing surgery appears to be larger than the volumes of abscesses not needing surgery. In general, volumes of <1,250 mm may not need surgical intervention. [41], [42] There may be an argument regarding early drainage of an orbital abscess to prevent complications whereas early surgical intervention has the possibility of seeding the infection. [20] For practical purposes, Harris, has outlined a useful approach in the management of an orbital abscess. [20] He emphasizes on the emergent drainage for patients of any age whose visual function may be compromised. Also for the patients in whom a large orbital abscess causes discomfort, presence of superior or inferior orbital abscess, evidence of intracranial extension, involvement of frontal sinuses, and a known dental source of the infection in patients older than 9 years, urgent drainage usually within 24 hours has been recommended. [20] Wait and see approach may be indicated for patients younger than 9 years of age having medial subperiosteal abscess of modest size, for patients having no visual compromise and in those having no intracranial or frontal sinus involvement. In these patients, careful evaluation and close monitoring of their optic nerve function and the level of consciousness and mental state are necessary. When indicated, one may consider making an incision approximately 2-inch down to the periosteum at the inner quadrant of the orbit to drain these orbital abscesses. [27] Patients with suspected fungal orbital cellulitis (especially Mucormycosis), need to be treated with intravenous Amphotericin B and predisposing factors such as diabetes, acidosis and other medical conditions need to be addressed. Wide excision along with debridement of the necrotic tissue is desired. If necessary, a drain may be inserted and tissues may not need to be sutured and may be left for granulation. One may consider removal of drain when no further drainage occurs. In some cases, endoscopic approach may be utilized and has been found to be effective for the treatment subperiosteal abscess as a result of sinus infection. Some of the advantages of endoscopic surgical drainage may be the avoidance of external ethmoidectomy and associated external facial scar and an early drainage of the affected sinuses and subperosteal abscess at the same time. [27], [43] In our study [8], among the 116 radiologically confirmed orbital abscesses, 87% required drainage, and the remaining 13% required close observation until their resolution while on systemic antibiotics. Thirty-nine eyes (17.8%) had endophthalmitis causing orbital cellulitis and required evisceration or enucleation. Seven orbits required exenteration and 6 infected orbital implants had to be removed. Other 6 patients had dacryocystitis that required a dacryocystorhinostomy to treat orbital cellulitis in addition to the administration of systemic antibiotics. Combined endoscopic sinus surgery with transnasal orbital abscess drainage was carried out in some of our patients with sinusitis and orbital abscess, especially in the medial orbit. [8]
Although less common, major complications related to orbital cellulitis and abscess can occur. Even after the successful treatment of such infections, permanent visual loss or loss of function of the vital structures may remain. Ferguson [1] reported no visual function loss among their patients after resolution of their infections. Only one of their patients from the pediatric age group had proptosis on follow-up; one had ophthalmoplegia and one had recollection of the abscess. One of their adult patients developed presumed meningitis and another adult patient required enucleation. In rare circumstances, the microorganism may cause necrotizing eyelid disease often referred as necrotizing fasciitis. [3], [44]- [46] This may progress to systemic manifestations including the potentially fatal toxic streptococcus syndrome, characterized by multi-organ failure. [44], [46] These complications can occur in the absence of antecedent health problems or history of trauma. [3], [45], [46] The virulence of this organism is related to the production of M proteins and exotoxins A and B. [47] These proteins act as super-antigens in vitro and mediate tissue necrosis by causing massive release of cytokines such as tumor necrosis factor and interleukins.
Permanent loss of vision has been noted as a complication of orbital infection and up to one fifth of patients with orbital inflammation had blindness in the pre-antibiotic era. [2] Now, although permanent loss of vision resulting from orbital inflammation is unusual it can still occur, (Figure 12). [8], [25], [26] Patt [26] reported 38 patients with orbital cellulitis and resultant permanent vision loss one of which progressed to no light perception vision. Loss of vision with orbital inflammation may result from optic neuritis as a reaction to adjacent or nearby infection, ischemia due to thrombophlebitis along valveless orbital veins, or compressive/pressure ischemia possibly resulting in central artery/occlusion, (Figure 12). [22], [26] Permanent irreversible visual loss may occur in cases with orbital and subperiosteal abscess despite early intervention. In a survey of 46 cases with confirmed diagnosis of orbital and subperiosteal abscess in which visual results were reported, permanent loss of vision occurred in 15% of the cases. [48] Blindness was attributed to the central retinal artery occlusion in 4, optic atrophy in 2 of hese patients. Permanent visual loss in orbital cellulitis probably has a vascular cause, whereas partial vision loss that respond to antibiotic therapy and drainage procedures may be due to inflammatory infiltrates or presence of compressive optic neuropathy. [21] It is believed that the confinement of the optic nerve in the orbital apex area and within its bony canal along with its proximity to the posterior ethmoid and sphenoid sinuses may further highlight the importance of the these factors in the exacerbation of posterior orbital celluliltis. Physcians need to be aware that patients with sinusitis and associated orbital cellulitis may be at risk for developing severe vision deficit requiring timely intervention. In a review of 148 patients with orbital abscess from 13 series reported by Hornblass [15], 3 patients had evidence of no light perception vision.
Clinical examination by itself may not exactly delineate the nature of orbital inflammatory processes, clinicians may have to rely on imaging studies to select potential surgical candidates. Despite availability of modern CT-Scan and MRI studies, the physician stil needs to rely on the clinical progression of the inflammation based on vision, pupillary fuction, and assessment of ocular motility. Patt and Manning [26], reported 4 patients with vision loss due to orbital cellulitis and in each of these cases had CT-scan readings of “no definite abscess” contributing to the delay in diagnosis of orbital abscess, with a resultant delay in surgical drainage.
Ethmoidal sinuses are separated from the orbital cavity by the lamina papyracea and anterior and posterior ethmoidal foramina serve as additional connections that may allow infection to gain access from ethmoidal air cells to the orbital cavity, (Figure 5). Periorbita in this area is loosely attached to bone and may be elevated by a purulent collection, resulting in subperiosteal abscess. Acute visual loss due to sinusitis may either be secondary to complications of orbital cellulitis or may be seen as a part of orbital apex syndrome. orbital cellulitis or as a part of the orbital apex syndrome. [27] Two cases of acute visual loss have been reported by El-Sayed and Muhaimeid [49], as a complication of orbital cellulitis due to sinusitis. One of these patients had dramatic improvement in vision from hand motion to normal vision after systemic antibiotic treatment of pansinusitis and associated orbital cellulitis. The second patient, (a 10-year old girl), achieved normal visual acuity from no light perception after only surgical intervention by exploration of sphenoid and ethmoid sinuses along-with intravenous antibiotic administration. Three cases of sphenoethmoiditis with minimal signs of orbital inflammation causing permanent loss of vision have been reported by Slavin and Glaser. [48] These authors suggested the use of term “posterior orbital cellulitis” for such cases and defined it as a clinical syndrome in which early severe visual loss overshadows or precedes accompanying inflammatory orbital signs. Acute blindness may also result from orbital infarction syndrome.
External photographs, CT-scan (coronal view) and right eye fundus photograph of a 70-year-old female who presented late in the course of her right-sided orbital cellulitis/abscess which required surgical drainage. She had complete loss of vision in the right eye which was attributed to central retinal artery occlusion due to orbital infectious process. Fundus photo reveals evidence of a pale optic nerve.
Orbital infarction syndrome is a disorder that may take place secondary to different mechanisms which may include acute perfusion failure like common carotid artery occlusion, systemic vasculitis such as giant-cell arteritis, or as a result of orbital cellulitis with vasculitis such as Mucormycosis. In some of these cases, vision loss can be permanent due to retinal or optic nerve damag. [50] According to our experience in a developing country, most patients with sinusitis and orbital abscess presented late in the course of their disease. [8] Most patients with refractory or complicated subperiosteal abscesses have been older children or adults. In one of the largest studies reported, among the 159 patients with orbital complications of sinusitis, 4 had permanent blindness. [26] All 4 had surgically confirmed subperiosteal abscess, and all were older than 15 years of age. In another study, among the 13 patients with intracranial abscess extension from sinusitis or orbital abscesses, 2 patients were 9 to 14 years of age and 11 were older than 15 years of age. [7] In our study of orbital cellulitis, visual acuity improved in 16.1% and worsened in 6.2%, including 4.3% that sustained complete loss of vision. We attributed the permanent loss of vision to the delay in diagnosis and intervention. [8]
In the pre-antibiotic era, Birch-Hirschfeld reported that 19% of 275 cases of orbital cellultis reported in the studies from 1907-1930 died mostly due to the intracranial complications of orbital cellulitis. [2] More recently, Hartstein et al, [51], reported case-studies of 3 patients who were found to have pansinusitis which progressed to subperiosteal abscess of the orbit and subsequent intracranial extension. All 3 patients had been treated with systemic antibiotics and surgical drainage of the orbital abscesses as well as sinuses. Two of the 3 patients required surgical drainage of their intracranial abscesses.
In our series of 218 patients with orbital cellulitis, there were 9 cases of intracranial extension of orbital abscesses that required either extended treatment with systemic antibiotics alone or in combination with neurosurgical intervention. [8] Nineteen cases of intracranial abscesses due to mid-face infection had been reported by Maniglia et al, [7] anaerobic organisms were the most common cause of their abscesses. Most of these intracranial complications were due to the nasal, sinus and orbital disease while cavernous sinus thrombosis occurred in only one of these patients. Intracranial abscesses were mostly located in frontal lobe, epidural or subdural. Handler et al [52], recommend surgical drainage for those with deterioration of ocular motility and vision. Ethmoidal sinusitis was overwhelming predisposing cause in their study of orbital cellulitis and intracranial spread occurred in 6 of their 65 patients with orbital cellulitis. Sinus infections appear to be more common cause of intracranial abscess, the most common being frontal sinus, followed by ethmoid and maxillary sinuses. While the superior ophthalmic vein drains into the cavernous sinus, the inferior ophthalmic vein may drain either into the cavernous sinus through the superior orbital fissure or into the pterigoid plexus through the inferior orbital fissure (Figure 13). [15]
In the past, intracranial abscess formation had a poor prognosis with a significant mortality rate. The valveless veins interconnect the orbit with sinuses, eyelids and the cavernous sinus, (Figure 13). Since intracranial abscess may be a life-threatening complication of orbital processes, it may require aggressive intervention by multidisciplinary team. Undesirable complications of intracranial abscess may result from cavernous sinus thrombosis as well as intracranial rupture of the abscess. Patient with intracranial abscess may be asymptomatic or present with nausea, vomiting, seizures and change of their mental status. [27] Among other signs, neurological signs of intracranial abscess may include fever or altered mental status. The classic neurological presentation of intracranial abscess seen in adults may be typical, while in children these symptoms may be minimal or even absent, (Figure 14). [27] Cavernous sinus thrombosis may represent the most severe form of orbital cellulitis. The condition may be suspected clinically by the presence of bilateral orbital process along with ophthalmoplegia and loss of vision. [53], [54] Repeat imaging studies may be necessary when there is evidence of neurologic deficit, to rule out presence of epidural or subdural empyema, brain abscess, or cavernous sinus thrombosis. [55]- [57] In such cases, successful management of orbital and/or intracranial abscesses may require timely recognition of the infectious process, administration of systemic antibiotics, serial head and orbital imaging studies, early surgical management of orbit disease and often the intracranial process, (Figure 14). Computed tomography scan of the orbit and sinuses with fine cuts is the recommended imaging study of choice. [8], [51], [57] Magnetic resonance imaging studies with fat suppression has been found to be useful for visualizing the intracranial abscesses in suspected cases. The cause of most of the intracranial infectious complications of sinusitis are polymicrobial organisms, with anaerobes being the most common pathogens. [38], [51]- [54] Although no specific species or combination of bacterial microorganisms is found to be predominant; Streptococcus, Staphylococcus, Bacteriodes, and Fusobacterium species are frequently encountered. Hartstein et al. reported 3 cases of intracranial abscess all of which had evidence of polymicrobial infection with no predominance of any one particular organism. [51] Initial treatment of such patients requires broad-spectrum antibiotics including beta-lactamase resistant antibiotics that have good anaerobic coverage, as well as good central nervous system penetration. [20], [23], [27], [51] Routine follow-up imaging studies may be indicated based on the clinical examination. Proper management of these patients may require a multidisciplinary team that includes an orbital surgeon, otolaryngologists, neurosurgeon, and an infectious disease specialist.
Lateral view of the schematic drawing showing extensive venous drainage of the facial structures along with orbital veins and their direct connections with cavernous sinus.
External photograph and MRI (axial view) of the orbits and brain of an infant with bilateral orbital cellulitis/abscesses and its extension to the brain requiring broad-spectrum systemic antibiotics along with drainage of right orbital abscess.
Digitization has become an ongoing goal on the agenda of economic development and social transformation. It offers a broad perspective on the very near future of humanity embodied in current paradigms such as the web-driven economy, e-government, e-society, or e-communities that are based on digital democracy and promote it at the same time. Digitization is a priority all over the world and is seen as a strategy for the profound development of all sectors of human activity. One of the most relevant examples is the program promoted by the European Commission under the slogan “A Europe fit for the digital age”, which guides how digital technology is changing people’s lives by empowering people with a new generation of technologies [1]. Several concepts are now circulating such as big data and cloud computing and a number of technologies such as data mining, data analytics, data fusions, and deep learning are currently used and are constantly improving to keep up with the huge production of data in all fields.
Cultural heritage is a part of data production and has been contributing to the informational treasure of humanity for millennia. The digitization of cultural heritage is only a step in collecting and manipulating data with two major purposes: storage for information preservation, respectively data analysis for the study, and advanced research. A recent European Commission report on shaping Europe’s digital future focuses on 3D digitization of cultural heritage [2]. This is a roadmap for the digitization of tangible cultural heritage that highlights that the integration of data obtained through different scanning techniques is the right approach for the future. Knowledge of technologies for transforming tangible heritage objectives into data by scanning across different spectral bands and dimensional measurements, including software components for data analysis and presentation, is very important. The digitization of tangible cultural heritage is not only a fashionable technology but a tool that tends to become a standard for the collection, preservation, and dissemination efforts of arts and cultural heritage worldwide [3]. All in all, digitization is a necessity for a better knowledge and interpretation of things, so research becomes much more efficient using data instead of physical artifacts, especially in the case of tangible real estate. Sometimes access to the physical object is impossible, or very expensive, and then, a set of data captured with the right sensors is very useful. On the other hand, data become more democratic and thus can reach the general public through the media or virtual products in the service of knowledge of cultural heritage. In fact, through digitization, tangible cultural heritage becomes digital heritage, which is a subcategory of intangible cultural heritage.
In the last decade, drones have been used in many industries such as construction and infrastructure, agriculture, environmental monitoring, mining, GIS, and so on. For all these areas, drones provide imaging data of various types: single aerial pictures, thermal and multispectral images, stereoscopic images, video content, data from laser scanning, and remote sensing. A significant number of bibliographic sources report on drone technology and airborne sensors and their specific applications and services. Most case studies are presented even by professional drone manufacturers, and a wide collection of information can be found on their websites, for example, [4, 5, 6]. A recent report on the leading manufacturers of drone technology, including their applications, can be found in the reference [7].
At present, drones have begun to be part of the arsenal of means of investigating cultural heritage, offering the possibility to fly over and supervise heritage objectives from the air, with low operating costs. In principle, they offer photogrammetry services but the applications are open to possible remote exploration and sensing tasks in archeological sites, instead of humans. An extensive and recent synthesis of the use of drones in the service of cultural heritage, including examples of applications and case studies conducted around the world, can be found in [8].
A drone is an unmanned aerial vehicle (UAV) that can be remotely controlled by a human operator in a specific area of action. This type of aircraft is an excellent platform for various scanning equipment, and sensors capable of transmitting acquired data in real time, as well as its current position. Drones can provide a wide range of services, but most applications include airborne surveillance and monitoring tasks. There are drones for military purposes and drones for civilian use, but we will discuss here drones with civilian applications.
The basic mission of drones in the service of cultural heritage is to scan various objects, artifacts, sets of objects, places built of cultural interest, and using different techniques for obtaining digital images.
Traditionally, aerial photogrammetry is the science and technology of obtaining reliable information about physical objects and the terrestrial environment through the process of recording, measuring, and interpreting photographic images captured from height. Currently, digitization has extended the field of photogrammetry to the analysis and processing of images based on mathematical and geometric models with software-implemented algorithms. Automatic image processing works with huge amounts of data that drones are able to provide by mobile scanning over areas of interest.
Aerial images can be processed and interpreted in different ways. One of the most used methods is a 3D reconstruction based on 2D images. This task defines particular uses of the drone in controlled overflight scenarios, which differ from one objective to another. Another method is orthophotography through which the objectives are mapped 2D, resulting in the digital map of the objective and the area flown over with the planimetry information. These methods include geometric models and algorithms for analytical geometry. Another category of methods aims at chromatics and image illumination, which involve extracting components and color ranges, estimating specular reflection, determining ambient lighting and its interaction with materials in order to render physical objects. This is where digital image analysis algorithms take place in the visible or multispectral domain. The combination of methods, for example, orthophotography with chromatic methods produces orthomosaic maps, and by the combination with multispectral data, various indexed maps are obtained based on normalized difference vegetation index (NDVI), optimized soil-adjusted vegetation index (OSAVI), chlorophile map, or processing CIR Composite (color infrared), or digital surface model (DSM).
This is a technique for directly obtaining 3D images using laser radiation using LiDAR (laser imaging, detection, and ranging) devices. Unlike photogrammetry, which is a passive method of capturing images, LiDAR is an active method that involves laser emission in the NIR or UV spectrum. Mobile laser scanning is also beginning to be accessible to drones through aerial LiDAR equipment that has evolved to meet the requirements of weight, size, and performance. Laser scanning involves technical conditions and additional requirements to photogrammetry. Knowing the position of the drone as accurately as possible at all times is crucial for the quality of LiDAR data and therefore, these systems have integrated inertial navigation sensors with very high accuracy. Laser scanning has several definite advantages versus classical photogrammetry, but it cannot surpass resolution performance, image realism, data accuracy, and ultimately the cost of photogrammetry equipment. In the LiDAR technique for each scan radius (direction) only two parameters are obtained: flight time—which is directly proportional to the distance and intensity of the reflected radiation. With this information about each scanned point, a synthetic image of the objects is built respecting their geometry with a certain precision, while all the chromatic characteristics are conventionally chosen. However, some advantages prevail for laser scanning technology: It can operate at night, in an atmosphere with clouds and smoke, and can reconstruct more precisely the surfaces covered by vegetation. Also, the time required for post-processing LiDAR data is much shorter than when processing photo images. In various applications, LiDAR technology is used in addition to the classic photo-video technique.
The drone, as a system, is capable of providing raw imaging data for the above-mentioned processing, while a suite of application software programs effectively performs the appropriate processing to extract the desired information. In fact, these are stand-alone software tools that perform advanced data processing including artificial intelligence techniques.
The configuration of drones for civilian use is of a VTOL (vertical take-off and landing)-type aircraft with fixed wings or the most popular with rotary wings. Here are the main component systems (subsystems) of a professional drone for civilian use:
The structure and the propulsion engines: It constitutes a unitary assembly made of resistant and light materials in a compact and aerodynamic configuration with rotor-type propellers. The structure usually has foldable elements so that it can be stored and transported more easily.
The sensor system: It provides data for drone self-monitoring and navigation data. On the main directions of movement, there are video sensors for detecting obstacles and measuring the distance to them and also IR sensors for detecting and telemetry of obstacles up and down. For this purpose, the drones can also be equipped with additional (redundant) ultrasonic or LiDAR sensors. Navigation sensors include the compass, the global navigation system receiver (for GPS coordinates), and the inertial measurement system (IMU) consisting of a gyroscope and accelerometers.
The airborne surveillance system: It generally consists of a video camera with controllable orientation, but may also include a thermal imaging camera or multispectral cameras depending on the mission of the drone.
The communication system: It contains the airborne transceiver with separate frequency channels for the remote control of the drone flight and the airborne systems, respectively for image downlink, as well as the paired transceiver in the portable remote control unit. The communication subsystem also contains a number of interfaces for data communication such as the USB port, the micro-SD card slot, and the port for connecting additional accessories to the drone (beacon, speaker, lighting projector).
The power system: It includes the drone battery that supplies all the subsystems in the drone composition, respectively the battery of the remote control equipment.
The electronic command and control system: It represents the brain of the drone and it ensures all the functions of the onboard subsystems such as control of the propulsion system, control of sensors, control of telecommunications, and control of surveillance equipment. The control of the major subsystems of the drone includes various parallel command and real-time control tasks such as independent speed control of each engine, stabilization of surveillance cameras, battery control, and radio power control. The brain structure of the drone is based on a multiprocessor architecture with a powerful master processor and several slave processors with distinct responsibilities.
The remote control equipment: It is the user’s portable unit—an HMI (human-machine interface) that provides the graphical control interface and the effective means of command of the drone (buttons and sticks). Usually, this role can be provided with a tablet or smartphone, but professional drones come with their own dedicated remote control unit that includes the display.
Last but not the least, a special and vital component of drones is the software system that is distributed on both components: built-in drone, respectively on the portable remote control unit. The software component actually defines the drone’s brain and its so-called intelligence, effectively ensuring all the processes for its proper functioning.
Figure 1 shows an overview of the Mavic 2 Enterprise model, where the main subsystems can be identified. Full details can be found by accessing the official manufacturer’s website available from: https://www.dji.com/mavic-2-enterprise/downloads
Professional drone Mavic 2 Enterprise with native surveillance camera mounted in front of the gimbal joint.
Here, we will review the basic characteristics of drones and detail the functional parameters that are relevant to the tasks of digitizing the objectives of tangible cultural heritage.
We mainly distinguish between technical characteristics and operational characteristics, the latter depending largely on the former, and together, they determine the use class of the drone, its performance, and finally the purchase price on the market. First of all, we need to understand that drone performance is the result of a technical compromise that is reflected in their operational capabilities. Current technology manages to optimize this compromise by balancing power and speed requirements versus flight distance and height, weight and gauge versus air range (maximum flight time), data processing, and transmission capability versus sensor resolution.
In general, the mission of a drone is to acquire images with very good resolution from precisely defined and very well-controlled positions. In other words, drones must provide quality digital material for photogrammetry and image processing techniques. Thus, in addition to the general performance of maximum speed, maximum service ceiling above sea level, and maximum flight time, the following features are very important: hovering accuracy range, parameters of the camera, and gimbal of camera. In Table 1 has given selectively these characteristics for a reference model—the Mavic 2 Enterprise drone.
Technical/operational feature | Value/limits | Notes |
---|---|---|
Max takeoff weight | 1100 g | |
Max speed | 72 kph | Near sea level, no wind |
Max ascent speed | 5 m/s | |
Max descent speed | 3 m/s | |
Max service ceiling | 6000 m | Above sea level |
Max flight time (no wind) | 31 min | At a consistent speed of 25 kph |
Max hovering time (no wind) | 29 min | |
Hovering accuracy range | Vertical: | |
| With vision positioning With GPS positioning | |
Horizontal: | ||
| With vision positioning With GPS positioning | |
Parameters of camera | Effective pixels: 12 megapixels | Sensor: 1/2.3″ CMOS |
Auto focus at: 0.5 - ∞ | ||
Max image size:
| Photo format JPEG, DNG (RAW) | |
Video resolution:
| Video Format MP4/MOV (MPEG-4 AVC/H.264) | |
Gimbal | Mechanical range: Tilt: −135 to +45° Pan: −100 to +100° Controllable range: Tilt: −90 to +30° Pan: −75 to +75° Stabilization: 3-axis (tilt, roll, pan) Max control speed (tilt): 120°/s Angular vibration range: ±0.005° |
Selected features of Mavic 2 Enterprise drone.
Considerations related to the accuracy of data collected by drones are discussed in [9]. The quality of the images provided by a drone is described by three essential characteristics [10].
The pixel resolution of an image is the number of pixels that make up the image. It is expressed by the number of columns and rows, such as 4056 × 3040, or directly by the total number of pixels, such as 12.3 Mpixels (4056 × 3040 = 12,330,240). This parameter is important for data sharing and storage, image display, and digital zoom.
Ground sampling distance (GSD), in mm/pixel, is the distance between the centers of two adjacent pixels, measured on the object observed in the image. This parameter depends on the size of the camera sensor and its actual number of pixels, but also on the distance to the photographed object. For example, a GSD of 1 mm/pixel means that one pixel per image is 1 mm in the real world. A smaller GSD means that the object will appear larger and that smaller details will be visible in the image. For example, a photo image can reach one million pixels/m2, while a LiDAR image can only reach a few hundred pixels/m2. Ground sampling distance is an important measure to consider for photogrammetry and measurements in images. However, GDS does not fully describe the ability to detect and characterize an object or detail in an image.
Spatial resolution or angular resolution describes the smallest details visible in the image. Unlike theoretical GSD, spatial resolution can be expressed in a different unit, which takes into account blur, image noise, contrast, and in general the effects of image processing: compression, denoising, edge clarity, etc. Spatial resolution is therefore a correct metric to quantify the ability to detect and characterize an object in the image. Spatial resolution is often expressed in “pairs of lines per millimeter.” This unit is used to describe the spatial frequency of alternating black and white line patterns.
Finally, another photometric parameter that influences image quality is the ISO exposure value at the image sensor. Under normal lighting conditions (daylight), the exposure value is set to the lower limit of the range values and vice versa, and at lower lighting levels, the exposure value is set above. However, a high ISO value of exposure produces image noise, and a long exposure time produces motion blur when the camera moves. This reduces the image quality, and eventually the ability to distinguish small details in the image.
A survey of the latest applications of the use of mandrels for cultural heritage purposes reveals two aspects. First, there are various subdomains or particular purposes with concrete tasks where drones, as providers of digital content, prove their usefulness. Specific applications can be classified as follows:
Reproduction of virtual models, especially for architectural heritage, is the widest class of applications. HBIM (historical building information modeling) technology as part of BIM (building information modeling) technology is one of the most used digitization activities in the service of the tangible cultural heritage in which drones prove their effectiveness. Here, based on panoramic images captured by drones, 3D reconstruction is the most frequently addressed technique. A suite of cultural heritage virtualization projects can be viewed on the following websites: [https://www.3deling.com/heritage/], [https://iconem.com/en/].
Non-destructive analysis of heritage sites and objects is an area of activity that can fully exploit the drone service in data acquisition. We mention here exterior and interior photogrammetry missions on frescoes, mosaics, upholstered surfaces, decorative stucco, and bas-reliefs.
The conservation of the material patrimony requires as accurate and complete information as possible in the effective restoration activity. The reference digital models help both the restoration work and the sustainable preservation and management of the heritage.
The actual restoration action can be automated and effectively driven by data by robotic interventions and reconstruction by additive techniques, such as 3D printing technology.
Artifact authentication is another activity that can fully benefit from the digital support provided by drones in special situations when the place cannot be explored on land or the object is in dangerous or contaminated places and when there is a risk of destroying the artifact by other types of examination.
Second, the review of recent literature reporting various applications of drones in the service of cultural heritage reveals the complementarity of several digitization technologies with that of drones, as well as strengths, weaknesses, and limitations of these technologies [11, 12, 13, 14]. As the main technique for capturing images, traditional aerial photogrammetry has now become accessible through drones at a very good performance-cost ratio. Photogrammetry and laser scanning are the basic techniques applicable by various methods with distinct equipment, but for the production of digital content of cultural heritage objectives, several scanning techniques are available. The main concepts frequently used in the digitization of the material cultural heritage are based on the following methods:
Close-range photogrammetry (CRP) is considered when the subject is observed from less than 400 m either from the ground or from the air. This is a cheap and sufficiently accurate method for 3D photogrammetry based on stereoscopically associated overlapping 2D images. For aerial applications with drones, CRP is the ideal solution because the cameras have a lower weight and size, compared to laser scanners, for example.
Structure from Motion (SfM) is a technique based on automated photogrammetry that facilitates the collection of moving images. This is the standard method for 3D reconstruction in the field of cultural heritage. In principle, it is applied within the CRP with the determination of the best overflight height and the establishment of the optimal spatial resolution, and the orthophotography acquisitions with an overlap of at least 60% are scheduled. The image collection is then processed with SfM software based on 3D reconstruction algorithms.
Airborne LiDAR scanning (ALS) is a complementary or alternative photogrammetry technique to create a digital terrain model (DTM) or digital elevation model (DEM). 3D reconstruction of cultural heritage objectives by laser scanning with drones is becoming an increasingly accessible technology.
Terrestrial laser scanning (TLS) is used as a basic technique or to complete the acquisition of 3D images of cultural heritage objectives with fixed ground equipment, which gives a very good data accuracy.
Mobile laser scanning (MLS) contributes to massive point-capture technology along with photogrammetry, using LiDAR equipment mounted on land vehicles, ALS, or with handheld scanning devices. The use of this equipment involves special SLAM (simultaneous localization and mapping) technology for capturing images and point clouds in motion and real time.
In specific applications for the material cultural heritage, there are some peculiarities that influence the scanning techniques used, as follows:
Objects are motionless, so there are virtually no relative dynamics and images can be considered static.
Some artifacts require photography from a short distance outdoor but also indoor.
Indoor, natural lighting is usually poor.
In inaccessible places, the real size of objects is generally not precisely known, so the exclusive photogrammetric interpretation is relative.
Interesting studies addressing the combined use of air and ground scanning technologies for cultural heritage objectives are reported in [13, 15].
We have seen that drones can be used successfully for both outdoor and indoor photogrammetry and laser scanning operations. Most applications are outdoor missions for HBIM tasks but some indoor missions are suitable for drones, in concrete situations these being the only means that can make data acquisition at reasonable cost-effectiveness. In [16], it is presented a comparative study of digitization of land surfaces, photogrammetry versus laser scanning, conducted for four types of drones. These results are interesting and useful for professionals in the field of cultural heritage. A project reported in [17] focused on HBIM for Byzantine churches in Cyprus using exclusively low-altitude outdoor photogrammetry, provides methodological details, and results obtained with a drone equipped with a 20 MP camera. In Romania, there are some important cultural heritage objectives that are being investigated by photogrammetry with the help of a drone. One of them is the large architectural monument—the medieval castle named Corvin Castle, also known as Hunyadi Castle, in Hunedoara (Figure 2). The other is the Adamclisi Fortress in Dobrogea, which is an ancient Roman architectural complex, today in ruins (Figure 3).
The Corvin castle in Hunedoara, Romania.
The Adamclisi Fortess ruins in Dobrogea, Romania.
These applications require the planning of particular flight missions with predefined itineraries for photogrammetric capture with different viewing angles on ground objectives. Usually, two gimbal angles are used for the camera: −90°, that is, vertical downward direction, called nadiral view, and oblique direction at −45°. Practically, a methodology and planning of photography are established for each objective. The goal is to best capture the elevation of objects.
The indoor missions in the field of cultural heritage are to complete the HBIM from inside when the TLS and other MLS methods are not applicable. Recent case studies with the use of drones for visual inspection in enclosed spaces such as mine galleries, cisterns, or sewers are reported in [18]. In the case of indoor scanning missions, the drone does not benefit from GNNS services, that is, GPS signal for positioning; however, piloting the drone is done in P (positioning) mode when the vision systems to locate and stabilize itself and obstacle sensing function is enabled. Other indoor scanning purposes require drones hovering over the artifacts in order to capture the best image possible. In these conditions, hovering accuracy is the feature that counts, and the best results are obtained by piloting the drone in T-mode (Tripod), which makes the aircraft more stable during the shooting. An example for this use case is the inspection of the roman mosaic arts in Constanta during the expertise for restoration. This is the subject of nondestructive analysis by evaluation of the morphological and chromatic characteristics that represent suitable metrics for making decisions based on image processing [19]. Figure 4 presents this artifact in the present condition of conservation. For a reliable analysis, quality imaging data obtained by correct photogrammetry techniques are required. Thus, for correct analysis, the images of the mosaic, as a primary source of data, must meet certain conditions from the acquisition phase, as follows: (i) to be taken orthographic shots, (ii) to be captured under uniform lighting conditions, without shadows, reflections, etc., (iii) to be taken from the same height (constant distance) for the entire interest surface, and (iv) the resolution must be as high as possible. In general, the photogrammetric method is sufficient for the inspection of artifacts such as flat decorative surfaces, so that 2D orthogonal images obtained by single shots provide all the planimetry and color information necessary for morphological and chromatic analysis. Using CRP with SfM techniques, it is possible to obtain details for DTM by estimating the deformations of the mosaic surface, the degree of degradation by erosion, and the lack of mosaic elements or the degree of intervention by adding material. ALS is not an option for scanning the decorative mosaic because an acceptable value of the GSD parameter cannot be achieved. Also, due to the restriction of access on the surface of the mosaic, scanning by terrestrial means is not possible in this case. In Figure 5, it can be seen two shots taken manually at the arbitrary angle but also the effect of non-uniform environmental lighting.
Ancient mosaic art in Constanta. (a) Indoor floor view. (b) Details of the artifact.
Different images of the artifact.
Professional drones are actually considered UAS (Unmanned Aerial Systems), which means more than an unmanned aerial vehicle. They are equipped with specific scanning systems that define their role and operational functions. The drone is a sufficiently stable platform for close-range photogrammetry (CRP) missions and is an excellent indoor scanning device due to its small size, good maneuverability, and flight qualities. We see great potential for the use of drones for interior photogrammetry on decorative artifacts where the information of interest concerns their planimetry and chromatics. The ease of use of airborne cameras in terms of gimbal stabilizer-controlled mobility, controlled focusing, and exposure function combined with the drone’s ability to hover at a short distance from the artifact gives drones high versatility for digital image acquisition. By using the auto exposure bracketing (AEB) function, for example, the camera can take several successive photos (usually three) with slightly different settings. Then, the images can be combined automatically, for example, in a single image with a high dynamic level or can be stored separately, so that the images with the most suitable appearance can be later taken from the batch.
Regarding the digitization of cultural heritage objectives, the main data are obtained through photogrammetric techniques, which in most cases cannot be exceeded in terms of accuracy and amount of data provided by LiDAR techniques. Moreover, the chromatic analysis of images can be performed exclusively by photographic techniques. Laser scanning techniques have several strengths that make them rather useful as complementary methods in digitizing cultural heritage objectives. Thus, the ALS technique generally helps in the case of infrastructures covered with vegetation and in the case of noisy photographic images when the estimation of the 3D model would be deficient.
Professional drones are becoming increasingly affordable handy tools for use in the field of material cultural heritage.
This study was supported by the grant PN-III-P1-1.2-PCCDI-2017-0476, no.51PCCDI/2018, from UEFISCDI-MEN.
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Graphene, one-atom thick, exhibits a unique chemical structure and outstanding electronic, optical, thermal, and mechanical properties that made it compelling for various engineering applications. Graphene and graphene-based materials are promising candidates for fabricating state-of-the-art nano-scale sensors and biosensors. They featured with good conductivity and large specific surface area thereby; graphene-based sensors/biosensors performed well with good accuracy, rapidness, high sensitivity and selectivity, low detection limits, and long-term stability. They are ideally used as gas sensors, electrochemical sensors for heavy metal ions, immunosensors and dihydronicotinamide dinucleotide NADH, DNA, catecholamine neurotransmitters, paracetamol, glucose, H2O2, hemoglobin, and myoglobin biosensors. This chapter reviews the applications of graphene in nanotechnology since it came to the field particularly in sensing and biosensing applications. It updates the reader with the scientific progress of the current use of graphene as sensors and biosensors. There is still much room for the scientific research and application development of graphene-based theory, materials, and devices. Despite the vast amount of research already conducted on graphene for various applications, the field is still growing and many questions remain to be answered.",book:{id:"4624",slug:"biosensors-micro-and-nanoscale-applications",title:"Biosensors",fullTitle:"Biosensors - Micro and Nanoscale Applications"},signatures:"Nada F. Atta, Ahmed Galal and Ekram H. El-Ads",authors:[{id:"30072",title:"Prof.",name:"Nada",middleName:null,surname:"F. Atta",slug:"nada-f.-atta",fullName:"Nada F. 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Here, we present the general concept and the classification of biosensors, their advantages and drawbacks, the main strategies in electrochemical biosensor technology and the materials used in electrochemical sensors, such as electrodes and supporting substrates, materials for improved sensitivity and selectivity, materials for bioreceptor immobilization, and biological recognition elements. Various nanomaterials, such as carbon-based materials (carbon nanotubes, graphene, carbon nanoparticles), inorganic and organic nanoparticles (magnetic and metal nanoparticles, nanosized clays), conductive and insulating polymers (nanosized and nanostructured polymers, molecularly imprinted polymers), and hybrid materials, etc., have been successfully applied for the enhancement of the electroanalytical performance of biosensors and for the immobilization of biorecognition elements. Among these, due to their unique physiochemical features, carbon-based materials, such as carbon nanotubes and graphenes, have received special attention in recent years, and examples of surface functionalization using various types of nanoparticles are presented. The future trends in sensor research activities and areas of development that are expected to have an impact in biosensor performance, like immobilization techniques, nanotechnology, miniaturization and multisensor array determinations, are also examined.",book:{id:"4624",slug:"biosensors-micro-and-nanoscale-applications",title:"Biosensors",fullTitle:"Biosensors - Micro and Nanoscale Applications"},signatures:"Robert Săndulescu, Mihaela Tertiş, Cecilia Cristea and Ede Bodoki",authors:[{id:"28983",title:"Prof.",name:"Robert",middleName:"Valentin",surname:"Sandulescu",slug:"robert-sandulescu",fullName:"Robert Sandulescu"}]}],mostDownloadedChaptersLast30Days:[{id:"72990",title:"Nanoprecipitation: Applications for Entrapping Active Molecules of Interest in Pharmaceutics",slug:"nanoprecipitation-applications-for-entrapping-active-molecules-of-interest-in-pharmaceutics",totalDownloads:912,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"Nanoprecipitation technique, also named solvent injection, spontaneous emulsification, solvent displacement, solvent diffusion, interfacial deposition, mixing-induced nanoprecipitation, or flash nanoprecipitation, is recognized as a useful and versatile strategy for trapping active molecules on the submicron and nanoscale levels. Thus, these particles could be intended among others, for developing innovative pharmaceutical products bearing advantages as controlled drug release, target therapeutic performance, or improved stability and organoleptic properties. On this basis, this chapter offers readers a comprehensive revision of the state of the art in research on carriers to be used for pharmaceutical applications and developed by the nanoprecipitation method. In this sense, the starting materials, the particle characteristics, and the in vitro and in vivo performances of the most representative of these carriers, i.e., polymer, lipid, and hybrid particles have been analyzed in a comparative way searching for a general view of the obtained behaviors.",book:{id:"10116",slug:"nano-and-microencapsulation-techniques-and-applications",title:"Nano- and Microencapsulation",fullTitle:"Nano- and Microencapsulation - Techniques and Applications"},signatures:"Oscar Iván Martínez-Muñoz, Luis Fernando Ospina-Giraldo and Claudia Elizabeth Mora-Huertas",authors:[{id:"320030",title:"Prof.",name:"Claudia Elizabeth",middleName:null,surname:"Mora Huertas",slug:"claudia-elizabeth-mora-huertas",fullName:"Claudia Elizabeth Mora Huertas"},{id:"326041",title:"Prof.",name:"Luis Fernando",middleName:null,surname:"Ospina Giraldo",slug:"luis-fernando-ospina-giraldo",fullName:"Luis Fernando Ospina Giraldo"},{id:"326042",title:"Mr.",name:"Oscar Iván",middleName:null,surname:"Martínez Muñoz",slug:"oscar-ivan-martinez-munoz",fullName:"Oscar Iván Martínez Muñoz"}]},{id:"71786",title:"Microemulsion Formulation of Botanical Oils as an Efficient Tool to Provide Sustainable Agricultural Pest Management",slug:"microemulsion-formulation-of-botanical-oils-as-an-efficient-tool-to-provide-sustainable-agricultural",totalDownloads:889,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"Microemulsion formulation is among the most suitable carrier for the delivery of bioactive and, therefore, has excellent potential for industrial applications. The microemulsion system is thermodynamically and kinetically stable. Due to the smaller droplet size of the microemulsion system, the bioactive covers a larger surface of the target pest. Botanicals and essential oils, in particular, are green options to control various soil and seed-borne pathogens. Each oil contains several bioactive constituents that practically avoid microbe-resistance against it. Nevertheless, to improve the handling and shelf-life of botanicals, microemulsion formulation is the best option available. The current chapter provides the insight of a microemulsion system and explores the possibility of botanical oil-based biopesticides for a sustainable agro-ecosystem. We believe that botanical oil microemulsion could be a better alternative to synthetic pesticides and opens a new corridor for the promotion of the greener way of plant protection in India and across the globe.",book:{id:"10116",slug:"nano-and-microencapsulation-techniques-and-applications",title:"Nano- and Microencapsulation",fullTitle:"Nano- and Microencapsulation - Techniques and Applications"},signatures:"Abhishek Sharma, Saurabh Dubey and Nusrat Iqbal",authors:[{id:"314853",title:"Dr.",name:"Abhishek",middleName:null,surname:"Sharma",slug:"abhishek-sharma",fullName:"Abhishek Sharma"},{id:"315502",title:"Dr.",name:"Saurabh",middleName:null,surname:"Dubey",slug:"saurabh-dubey",fullName:"Saurabh Dubey"},{id:"317856",title:"Ms.",name:"Nusrat",middleName:null,surname:"Iqbal",slug:"nusrat-iqbal",fullName:"Nusrat Iqbal"}]},{id:"48359",title:"Immunosensors",slug:"immunosensors",totalDownloads:3123,totalCrossrefCites:7,totalDimensionsCites:22,abstract:"Immunosensors are solid-state devices in which the immunochemical reaction is coupled to a transducer. They form one of the most important classes of affinity biosensors based on the specific recognition of antigens by antibodies to form a stable complex, in a similar way to immunoassay. Depending on the type of transducer there are four types of immunosensor: electrochemical, optical, microgravimetric and thermometric. The most commonly used bioelements for the development of electrochemical immunosensors are antibodies (Ab), followed by aptamers (Apt) and, in the last five years, microRNA (miRNA). In order to perform an early diagnosis, a method that is able to measure peptides and proteins directly in a sample, without any sample pre-treatment or any separation, is preferred. This direct detection can be performed with methods making use of the specific interaction of proteins with Ab, Apt and miRNA. The recent developments made in the immunosensor field, regarding the incorporation of nanomaterials for increased sensitivity, multiplexing or microfluidic-based devices, may have potential for promising use in industry and clinical analysis. Some examples of assays for several commercially available biomarkers will be presented. The main application fields, beside biomedical analysis, are drug abuse control, food analysis and environmental analysis.",book:{id:"4624",slug:"biosensors-micro-and-nanoscale-applications",title:"Biosensors",fullTitle:"Biosensors - Micro and Nanoscale Applications"},signatures:"Cecilia Cristea, Anca Florea, Mihaela Tertiș and Robert Săndulescu",authors:[{id:"28983",title:"Prof.",name:"Robert",middleName:"Valentin",surname:"Sandulescu",slug:"robert-sandulescu",fullName:"Robert Sandulescu"}]},{id:"48575",title:"Impedimetric Sensors for Bacteria Detection",slug:"impedimetric-sensors-for-bacteria-detection",totalDownloads:3715,totalCrossrefCites:6,totalDimensionsCites:20,abstract:"The application of electrochemical biosensors based on impedance detection has grown during the past years due to their high sensitivity and rapid response, making this technique extremely useful to detect biological interactions with biosensor platforms. This chapter is focused on the use of electrochemical impedance spectroscopy (EIS) for bacterial detection in two ways. On one hand, bacteria presence may be determined by the detection of metabolites produced by bacterial growth involving the media conductivity changes. On the other hand, faster and more selective bacterial detection may be achieved by the immobilization of bacteria on a sensor surface using biorecognition elements (antibodies, antimicrobial peptides, aptamers, etc.) and registering changes produced in the charge transfer resistance (faradic process) or interfacial impedance (nonfaradic process). Here we discuss different types of impedimetric biosensors for microbiological applications, making stress on their most important parameters, such as detection limits, detection times, selectivity, and sensitivity. The aim of the paper was to give a critical review of recent publications in the field and mark the future trends.",book:{id:"4624",slug:"biosensors-micro-and-nanoscale-applications",title:"Biosensors",fullTitle:"Biosensors - Micro and Nanoscale Applications"},signatures:"Sergi Brosel-Oliu, Naroa Uria, Natalia Abramova and Andrey Bratov",authors:[{id:"174122",title:"Dr.",name:"Andrey",middleName:null,surname:"Bratov",slug:"andrey-bratov",fullName:"Andrey Bratov"},{id:"175939",title:"MSc.",name:"Sergi",middleName:null,surname:"Brosel-Oliu",slug:"sergi-brosel-oliu",fullName:"Sergi Brosel-Oliu"},{id:"175940",title:"Dr.",name:"Naroa",middleName:null,surname:"Uria",slug:"naroa-uria",fullName:"Naroa Uria"},{id:"175941",title:"Dr.",name:"Natalia",middleName:null,surname:"Abramova",slug:"natalia-abramova",fullName:"Natalia Abramova"}]},{id:"58296",title:"Recent Advances in Bioimaging for Cancer Research",slug:"recent-advances-in-bioimaging-for-cancer-research",totalDownloads:1501,totalCrossrefCites:4,totalDimensionsCites:5,abstract:"Molecular imaging techniques as well as nanoparticle applicable to molecular imaging are being explored to improve the cancer detection accuracy, which help to manage efficiently at the early stage. Among the various imaging technologies, optical imaging is a highly sensitive detection technique that allows direct observation of specific molecular events, biological pathways, and disease processes in real time through imaging probes that emit light in a range of wavelengths. Recently, nanoparticles have provided significant progresses that can be simultaneously used for cancer diagnosis and therapy (cancer theranostics). Theranostics aims to provide “image-guided cancer therapy,” by integrating therapeutic and imaging agents in a single platform. In addition, molecular imaging techniques facilitate “image-guided surgery” enabling maximization of tumor excision and minimization of side effects. The optical signals generated by fluorescence nanoparticles offer the possibility to distinguish tumor sites and normal tissues during surgery by real-time guidance, thereby increasing the long-term patient survival. These techniques will considerably contribute to reducing cancer recurrence and developing more effective cures. 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Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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