Derivation of Nottingham hip fracture score (NHFS). Reproduced with kind permission of AAGBI [2]. Copyright ©2000-2018 by John Wiley & sons.
\r\n\tb. The growth of digital environments which can educate and empower as well as exploit and destroy (mobile learning, STEM education, tablets, etc.).
\r\n\tc. Social, racial, class, and gender-based discriminations that restrict the developmental potential and the prosperity perspectives
\r\n\td. Health hazards and illnesses such as the laters COVID-19 pandemic.
\r\n\te. Armed conflicts with casualties and displacements of populations seeking refuge
\r\n\tf. Lack of physical spaces that will support and nourish development and learning, etc.
\r\n\tEducation in the post-modern era strives to address the above issues and develop policies, curricula, methodologies, and strategies to contribute to an environmentally and socially sustainable future. It embraces multiple perspectives and worldviews and seeks to touch on inequalities and discriminations in favor of equity. In this direction, children’s s agency lies at the heart of democratic approaches. Educational processes adopt forms of interactions that actualize learning as “becoming” and place it in a continuum between past, present, and future. This book intends to feature innovative approaches that employ transformative elements (targets, methods, materials, ideas, etc.) and embrace the concept of child development as “becoming” in an ever-changing and challenging world.
\r\n\r\n\tWe invite authors to contribute original research or research review papers that present innovative approaches addressing personal and social transformation. All aspects of early childhood education will be considered, including research methodology for the early years.
",isbn:"978-1-80355-949-0",printIsbn:"978-1-80355-948-3",pdfIsbn:"978-1-80355-950-6",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"351c41dca5c8c997f15e758f2e035178",bookSignature:"Dr. Maria Ampartzaki and Associate Prof. Michail Kalogiannakis",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11281.jpg",keywords:"Early Childhood Education, Preschool, STEAM, Environmental Sustainability, Social Sciences, Social Sustainability, ICT, Digital Devices, Education for Equity, Gender Issues, Post-modern Epistemology, Social Constructivism",numberOfDownloads:65,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 16th 2021",dateEndSecondStepPublish:"December 14th 2021",dateEndThirdStepPublish:"February 12th 2022",dateEndFourthStepPublish:"May 3rd 2022",dateEndFifthStepPublish:"July 2nd 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"8 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:"Dr. Maria Ampartzaki is an Assistant Professor in Early Childhood Education in the Department of Preschool Education at the University of Crete. Her research interests include ICT in education, science education in the early years, inquiry-based and art-based learning, teachers’ professional development, action research, and the Pedagogy of Multiliteracies, among others. She has run and participated in several funded and non-funded projects on the teaching of Science, Social Sciences, and ICT in education.",coeditorOneBiosketch:"Michail Kalogiannakis is an Associate Professor of the Department of Preschool\r\nEducation, University of Crete in Greece. He graduated from the Physics Department\r\nof the University of Crete and continued his post-graduate studies at the University\r\nParis-7 and University Paris-5 and received his Ph.D. degree at the University Paris 5.\r\nHis research interests include science education in early childhood, science teaching\r\nand learning, e-learning, the use of ICT in science education, and games simulations.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"422488",title:"Dr.",name:"Maria",middleName:null,surname:"Ampartzaki",slug:"maria-ampartzaki",fullName:"Maria Ampartzaki",profilePictureURL:"https://mts.intechopen.com/storage/users/422488/images/system/422488.jpg",biography:"Dr Maria Ampartzaki is an Assistant Professor in Early Childhood Education in the Department of Preschool Education at the University of Crete. Her research interests include ICT in education, science education in the early years, inquiry-based and art-based learning, teachers’ professional development, action research, and the Pedagogy of Multiliteracies, among others. She has run and participated in several funded and non-funded projects on the teaching of Science, Social Sciences, and ICT in education. She also has the experience of participating in five Erasmus+ projects.",institutionString:"University of Crete",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Crete",institutionURL:null,country:{name:"Greece"}}}],coeditorOne:{id:"260066",title:"Associate Prof.",name:"Michail",middleName:null,surname:"Kalogiannakis",slug:"michail-kalogiannakis",fullName:"Michail Kalogiannakis",profilePictureURL:"https://mts.intechopen.com/storage/users/260066/images/system/260066.jpg",biography:"Michail Kalogiannakis is an Associate Professor of the Department of Preschool Education, University of Crete, and an Associate Tutor at School of Humanities at the Hellenic Open University. He graduated from the Physics Department of the University of Crete and continued his post-graduate studies at the University Paris 7-Denis Diderot (D.E.A. in Didactic of Physics), University Paris 5-René Descartes-Sorbonne (D.E.A. in Science Education) and received his Ph.D. degree at the University Paris 5-René Descartes-Sorbonne (PhD in Science Education). His research interests include science education in early childhood, science teaching and learning, e-learning, the use of ICT in science education, games simulations, and mobile learning. He has published over 120 articles in international conferences and journals and has served on the program committees of numerous international conferences.",institutionString:"University of Crete",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Crete",institutionURL:null,country:{name:"Greece"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"23",title:"Social Sciences",slug:"social-sciences"}],chapters:[{id:"81575",title:"Caring about Early Childhood Education",slug:"caring-about-early-childhood-education",totalDownloads:15,totalCrossrefCites:0,authors:[null]},{id:"80874",title:"Postmodernist Ideas and Their Translation into a Critical Pedagogy for Young Children",slug:"postmodernist-ideas-and-their-translation-into-a-critical-pedagogy-for-young-children",totalDownloads:38,totalCrossrefCites:0,authors:[{id:"338161",title:"Dr.",name:"John",surname:"Wilkinson",slug:"john-wilkinson",fullName:"John Wilkinson"}]},{id:"82431",title:"Next-Generation Science and Engineering Teaching Practices in a Preschool Classroom",slug:"next-generation-science-and-engineering-teaching-practices-in-a-preschool-classroom",totalDownloads:12,totalCrossrefCites:0,authors:[null]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"440212",firstName:"Elena",lastName:"Vracaric",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/440212/images/20007_n.jpg",email:"elena@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"6942",title:"Global Social Work",subtitle:"Cutting Edge Issues and Critical Reflections",isOpenForSubmission:!1,hash:"222c8a66edfc7a4a6537af7565bcb3de",slug:"global-social-work-cutting-edge-issues-and-critical-reflections",bookSignature:"Bala Raju Nikku",coverURL:"https://cdn.intechopen.com/books/images_new/6942.jpg",editedByType:"Edited by",editors:[{id:"263576",title:"Dr.",name:"Bala",surname:"Nikku",slug:"bala-nikku",fullName:"Bala Nikku"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6926",title:"Biological Anthropology",subtitle:"Applications and Case Studies",isOpenForSubmission:!1,hash:"5bbb192dffd37a257febf4acfde73bb8",slug:"biological-anthropology-applications-and-case-studies",bookSignature:"Alessio Vovlas",coverURL:"https://cdn.intechopen.com/books/images_new/6926.jpg",editedByType:"Edited by",editors:[{id:"313084",title:"Dr.",name:"Alessio",surname:"Vovlas",slug:"alessio-vovlas",fullName:"Alessio Vovlas"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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Rates of morbidity and mortality are high in these patients and also there is decline in function and loss of independence. NICE, AAGBI, and SIGN have provided guidelines to help improve outcomes in these patients [1, 2, 3]. New approaches to treatment aim to improve outcomes. In older adults, hemiarthroplasty (or ‘partial’ hip replacement) has largely replaced internal fixation for displaced intracapsular hip fractures and this is associated with lower rates of revision surgery and better overall outcomes. Lately, in this population, there has been a thrust to enhance the use of total hip replacement (THR) because there are better chances of returning to functional mobility and, therefore, independence. THR is used more commonly for arthritis of the hip.
NICE guidelines [1] recommend total hip replacement (THR) rather than hemiarthroplasty to patients with a displaced intracapsular hip fracture if they were:
able to walk independently out of doors with no more than the use of a stick;
are not cognitively impaired; and
are medically fit for anaesthesia and the procedure.
Outcomes after THR for displaced fractures of hip are similar to those after THR for elective surgery. Careful selection of patients is essential to achieve this success.
Perioperative care of patients with proximal femoral fractures can be challenging, as it involves care of large numbers of older patients with significant comorbidities. Risk of significant morbidity and mortality in these patients can be reduced by early surgical fixation of the fracture and early, effective rehabilitation.
The Department of Health has suggested the following targets for patients with hip fracture [4]:
All patients should be admitted within 4 h of arrival in the emergency department; and
Patients should be operated on by an experienced clinical team within 24 h of a decision that the patient is fit for surgery.
Multidisciplinary care improves the quality and efficiency of hip fracture care. The multidisciplinary team includes trauma co-ordinators, general practitioners, nurses, emergency staff, bed managers, orthopaedic nursing staff and surgeons, anaesthetists, orthogeriatricians, physio- and occupational therapists, social workers and rehabilitation services.
‘Fast-track’ triage systems should be in place as most of these patients are admitted via the emergency department. These will enable early clinical recognition of hip fracture with early radiography and diagnosis, allowing rapid ward admission. The use of a care pathway pro forma ensures basic quality standards are met and helps in patient care.
Patients who have a clinical suspicion or confirmation of a hip fracture should have the ‘Big Six’ interventions/treatments before leaving the Emergency Department [5].
A literature review to identify relevant evidence supporting the use of blood resuscitation in adult patients aged 65 years and over who have presented within 24 h of sustaining a fracture of the proximal femur when compared with crystalloid or colloid resuscitation did not yield any articles [6].
The assessment by anaesthetist allows pre-optimisation, planning of anaesthetic techniques and communication of perioperative risks to the patient and relatives.
Early involvement of orthogeriatrician has been shown to be useful in many ways such as medical pre-optimisation of patients, early rehabilitation and discharge planning.
One-fourth of these patients have moderate cognitive impairment and therefore tools such as abbreviated mental test score (AMTS) should be used to assess for cognitive impairment. Capacity assessment is vital for informed consent. Treatment may be provided according to the Mental Capacity Act 2005, if the patient lacks capacity and should be undertaken in the best interests of patients.
Nottingham hip fracture score (NHFS),a risk prediction tool [7], has been developed to predict postoperative mortality. It is summative score of seven variables—comorbidities and other factors (age, male sex, malignancy, preoperative cognitive function, place of residence and anaemia). NHFS is used to predict mortality at 30 days and it provides the information about outcome which may be discussed with the patient or their relatives (Tables 1 and 2).
Variable | Points |
---|---|
Age 66–85 years | 3 |
Age 86 ≥ older | 4 |
Male | 1 |
Haemoglobin concentration ≤ 10 g.dl−1 on admission to hospital | 1 |
Abbreviated mental test score ≤ 6/10 on admission to hospital | 1 |
Living in an institution | 1 |
More than one co-morbidity | 1 |
Active malignancy within last 20 years | 1 |
Derivation of Nottingham hip fracture score (NHFS). Reproduced with kind permission of AAGBI [2]. Copyright ©2000-2018 by John Wiley & sons.
Score | Predicted 30-day postoperative mortality |
---|---|
0 | 0 |
1 | 1% |
2 | 2% |
3 | 4% |
4 | 6% |
5 | 10% |
6 | 15% |
7 | 23% |
8 | 22% |
9 | 45% |
10 | 57% |
Predicted 30-day mortality as per NHFS. Reproduced with kind permission of AAGB [2]. Copyright ©2000-2018 by John Wiley & sons.
Full blood count, urea, electrolytes and ECG should be done in all patients. Anaemia is common in these patients due to various reasons and a lower threshold for blood transfusion should be considered in this group of patients.
All patients in AF should have ventricular rate less than 100 per min. Reversible causes such as electrolyte imbalance and hypovolemia should be corrected if rate is faster. Pharmacological treatment will be required if still remains high [8].
INR should be less than 2 for surgery and less than 1.5 for neuroaxial anaesthesia. Patients having warfarin should have vitamin K to reverse the effect.
If a patient is on clopidogrel, surgery should be done with expectation of higher blood loss.
Platelets should not be given prophylactically. The haematologist’s opinion should be taken if required.
Patients with chest infection should have their surgery done under regional anaesthesia which will give the benefit of analgesia and help in early mobilisation and chest physiotherapy.
The management of patients with hip fracture in whom a systolic murmur (indicating aortic stenosis) is heard remains debatable. If aortic stenosis is suspected and echo has not been done preoperatively, then the patient should be managed as having aortic stenosis.
Preoperative evaluation by cardiologist is necessary to know the type of device.
Resuscitation may not be in the best interests of the patient or not desired by the patients. DNA-CPR should be discussed with the patients where appropriate. Patients with pre-existing DNA-CPR orders must have perioperative modifications to that process prior to coming to theatre for having surgery [9] (As per recommendations from Resuscitation Council UK and Association of Anaesthetist of Great Britain & Ireland).
They can be broadly classified into extracapsular and intracapsular fractures.
Intracapsular fractures are further classified as subcapital, transcervical and basicervical fractures depending on the site of fracture. These may be displaced or undisplaced (Table 3).
Intracapsular | Extracapsular |
---|---|
Undisplaced fracture - internal fixation with multiple screws or a sliding hip screw. | Intertrochanteric fractures - a sliding hip screw |
Displaced fractures - hemiarthroplasty or total hip replacement | Subtrochanteric fractures - proximal femoral intramedullary nail |
Surgical management of proximal hip fractures.
Cemented arthroplasty as compared to uncemented arthroplasty improves hip function and is associated with lower residual pain postoperatively.
Both audit and meta-analysis of anaesthetic practice have not shown any great difference in outcome between general and regional (spinal) anaesthesia.
Parker and colleagues [10] in Cochrane review of 2004 analysed 22 trials (all of which were found to be methodologically flawed and many do not reflect current anaesthetic practice), involving 2567 patients, and concluded that regional anaesthesia may reduce the prevalence of acute postoperative confusion (9%
A meta-analysis [11] of 34 randomised controlled trials, 14 observational studies, and 8 meta-analyses, involving 18,715 patients, concluded that spinal anaesthesia is associated with significantly reduced early mortality, fewer incidents of deep vein thrombosis, less acute postoperative confusion, a tendency to fewer myocardial infarctions and fewer cases of pneumonia, fatal pulmonary embolism and post-operative hypoxia.
A further recent meta-analysis [12] of 47 clinical trials and 35 reviews/meta-analyses in geriatric patients undergoing non-cardiac surgery concluded that regional anaesthesia is associated with reduced early mortality and morbidity, for example, fewer incidents of deep vein thrombosis and less acute postoperative confusion, as well as a tendency towards fewer myocardial infarctions and fatal pulmonary embolisms.
Large observational studies in UK [13, 14] and US [15, 16, 17] show there is no difference in 30-day mortality between general and spinal anaesthesia.
NICE support the use of either spinal or general anaesthesia, + nerve block.
There are various problems attempting to perform the definitive outcome comparison study between general and regional anaesthesia, including, but not restricted to, definition of the primary endpoint.
For the time being, the AAGBI recommends that either method of anaesthesia (but not both together) may be used, but most importantly that they are administered with care to any patient, using reduced doses of anaesthetic agent combined with multimodal analgesia with an aim to minimise rapid fluctuations in arterial pressure and resultant changes in cerebral and coronary perfusion pressures. This is supported by a recent retrospective study of 1131 patients which showed that a reduced volume of intrathecal 0.5% hyperbaric bupivacaine was associated with a reduction in intraoperative hypotension, and therefore less reactive fluid administration avoiding consequent haemodilution [18].
Small doses of intravenous induction agents should be used. Alternatively, inhalational induction can be done. The advantages of inhalational induction are that it is well tolerated by the elderly patients and also allows for maintenance of spontaneous ventilation. The choice of using mechanical ventilation versus spontaneous ventilation remains controversial. The benefit of using mechanical ventilation is that there is reduced risk of aspiration and better control of carbon dioxide levels. On the other hand, there is greater physiological derangement with paralysis and tracheal intubation as compared to spontaneous ventilation.
Sedation should be used cautiously in elderly patients with spinal anaesthesia. If necessary for patient comfort, sedation should be restricted to propofol. Ketamine can cause postop confusion and delirium.
The rational being, co-administration of a nerve block, reduces age-adjusted maintenance doses of general anaesthesia, helps in positioning of patient for spinal anaesthesia, enables the use of low-dose spinal anaesthesia as it provides analgesia during skin closure even if spinal starts wearing off and it helps in providing opioid sparing analgesia in early postoperative period.
Blockade of the three nerves—femoral, obturator and lateral cutaneous nerve of the thigh—can provide adequate analgesia. The most reliable method of blocking all three nerves is the psoas compartment block. The fascia iliaca block/femoral nerve blocks do not reliably block all three nerves but do provide some pain relief. Ultrasound guidance can be used for performing these nerve blocks.
As recommended by AAGBI, minimum standards for monitoring as for any other surgery include the continual presence of the anaesthetist, pulse oximetry, capnography, ECG and non-invasive blood pressure monitoring.
As elderly patients are prone to hypothermia, core temperature monitoring should be used routinely.
Further monitoring should be considered depending on the risk. This may include invasive blood pressure monitoring, central venous pressure (CVP) monitoring and cardiac output monitoring. Transoesophageal Doppler, Transthoracic Doppler or LIDCO can be used for cardiac output monitoring.
Bispectral index (BIS) monitors may be used to monitor the depth of anaesthesia as it will allow for dose reduction and hence avoid potential hypotension. Initial BIS levels may be abnormally low in alcoholic patients and patients with dementia.
Cerebral oxygen saturation: Postoperative cognitive dysfunction is associated with reduced cerebral oxygen saturation.
AAGBI emphasises the finding in the NCEPOD reports ‘
Antibiotic prophylaxis significantly reduces overall wound infections. Antibiotics should be administered within 1 h of skin incision according to AAGBI recommendations. Hospital antibiotic protocols should be followed.
Perioperative optimisation of fluid management helps to reduce morbidity. Cardiac output-guided fluid administration in this group of patients could reduce hospital stay and improve outcome [19].
The following strategies will help reduce the risk of deep vein thrombosis-thromboprophylactic stockings or intraop usage of intermittent calf compressors, regional anaesthesia, early surgery and early mobilisation.
Active warming techniques like body warmers and warm IV fluids should be used as elderly patients are prone to intraoperative hypothermia.
Patients with hip fractures can have significant blood loss. The rate of blood transfusion in the perioperative period for hip fracture patients is reported between 20 and 60%.These patients have multiple comorbidities making them more susceptible to adverse events from blood loss.
Antifibrinolytics, such as tranexamic acid (TXA), have been used to limit bleeding in orthopaedic surgery and prevent the need for blood transfusion.
It acts as a competitive inhibitor in the activation of plasminogen to plasmin, therefore preventing the degradation of fibrin. Despite its proven efficacy in patients undergoing elective orthopaedic surgery, including total joint replacement and spine surgery, there is clinical uncertainty and a lack of high-quality evidence regarding the use of TXA in hip fracture patients.
Four of five studies [20, 21, 22, 23, 24] identified a significant decrease in rate of transfusion in patients who received TXA compared to those that did not. Some of these studies were underpowered for detecting significant differences in thromboembolic events. Also, patients were only followed perioperatively, and differences in 6-month and 1-year mortality rates and late-onset complications were not assessed.
A systematic review of tranexamic acid in hip fracture surgery showed moderate quality evidence that TXA reduces blood transfusion in hip fracture surgery and low-quality evidence suggesting no increased risk of thrombotic events. A randomised controlled trial on the efficacy of tranexamic acid in reducing blood loss in hip fracture patients is being done. The immediate goal of this trial is to provide high-quality evidence that can be used to develop clinical guidelines for use of TXA in patients with hip fractures [25].
This is characterised by hypoxia, hypotension, or both, and/or unexpected loss of consciousness [26]. This occurs at the time of cementation, prosthesis insertion and reduction of the joint or, occasionally, limb tourniquet deflation in a patient undergoing cemented bone surgery. Several mechanisms may contribute to a multimodal aetiology, including fat/platelet/fibrin/marrow emboli and stimulated release of vasoactive mediators. The treatment of BCIS includes delivery of 100% oxygen, fluid resuscitation (guided by CVP measurement) and vasoactive/inotropic support. AAGBI [27] has made several recommendations to reduce the risk of developing BCIS from cemented arthroplasty. They advocate a three-step check process to ensure we are prepared for such events and we are able to manage them in a proactive manner.
AAGBI recommends use of point-of-care Hb analysers (e.g., Hemocue or similar) routinely at the end of surgery to assess the degree of anaemia and guide blood transfusion. Haemoglobin and electrolytes need to be monitored postoperatively. An analysis of postoperative haemoglobin levels in patients with a fractured neck of femur demonstrated that a haemoglobin value taken on D2 postoperatively represents the largest drop in a patient’s circulating haemoglobin with statistical and also clinical significance [28]. Certain groups will require close daily monitoring of haemoglobin levels such as patients with chronic renal, cardiac disease and patients taking any form of anticoagulation.
Good nursing care with regular input from orthogeriatricians, adequate analgesia, hydration and nutrition are all important for good postoperative outcomes.
Early rehabilitation helps return the patient to their pre-morbid level of activity.
This is common in this group of patients. Management includes adequate analgesia, nutrition and hydration, electrolyte balance, appropriate medication, optimising bowel habit, mobilisation and also identifying and treating any infection or silent myocardial ischaemia. Drugs such as haloperidol or lorazepam should only be used for short-term control of symptoms.
Patients with a hip fracture have a relatively high risk of perioperative morbidity and mortality.
High-quality care of these patients requires multidisciplinary care and protocol-driven care pathways
Early surgery aids in providing analgesia and allows early mobilisation, and is associated with reduced morbidity and mortality.
The mode of anaesthesia provided is less important than the manner with which it is delivered with regard to the age and pathophysiological status of the individual patient.
Surgery and anaesthesia must be undertaken by appropriately experienced surgeons and anaesthetists.
None declared.
Optimization problems are common in engineering, and the problem must be optimized regarding one function (usually called as cost function). The cost function has several parameters used to model the optimization problem. Several methods have been proposed in the literature to optimize functions, and the method is selected according the cost function and parameters characteristics.
Deterministic methods usually have an initial point, called as seed. Using the gradient of the cost function, the optimization method starts on the initial point and converges to the optimal parameter value. The parameters are usually continuous [1]. However, engineering problems have problems which cannot be solved by this approach.
Some cost functions have several minimum, and the convergence strongly depends on the seed (or initial point). To overcome this issue, several meta-heuristics were proposed, like Genetic Algorithms (GA) [2, 3], Particle Swarm Optimization (PSO) [4], Simulated Annealing (SA) [5], and others. Optimization methods based on meta-heuristics do not need the gradient information. For some problems, it is very hard to determine the gradient. This is particularly true for problems with discrete cost function. The existing meta-heuristics, usually, are focused on some specific type of parameters. For example, PSO can be applied to engineering problems with continuous parameters. GA can be applied to engineering problems with integer or fixed precision parameters.
SA was first proposed to solve combinatorial problems [5]. Later on, Corana et al. [6] extended the SA to incorporate continuous parameters. It was shown that the proposal made by Corana et al. [6] only converged to the global optimum in specific problems. Ingber [7] improved the SA to overcome this issue, however he used the cost function gradient for some calculations. Martins and Tsuzuki [8] proposed the SA with crystallization heuristic which does not use any gradient information.
This chapter shows the versatility of the SA with crystallization heuristic. Initially, the SA with crystallization heuristic is explained in Section 2. It was used to solve different problems related to Cutting and Packing, particularly the case with discrete cost function and cyclic continuous parameters [8, 9, 10] will be explained in Section 3. A third application is Topological Optimization (TO), it has a large number of parameters, like the EIT problem. This application is explained in Section 4. The curve interpolation problem, explained in Section 5, has two different types of parameters: continuous and integer. It is relevant to point that the SA with crystallization heuristic has been applied with success to interval based objective function evaluation [11, 12, 13]. The conclusions are in Section 6.
The SA is an optimization algorithm that uses a random local search and is able to find the global optimum solution. It was proposed by [5, 14], and it was inspired by the metal annealing process, which starts with a high temperature and reduces the temperature in small increments until reaching the minimum temperature. In each step, the new solution is accepted if it improves the current solution. Otherwise, it is only accepted if a probability factor
where
Algorithm 1 describes a possible implementation of a conventional SA. It initializes with a random solution and an initial temperature, which is an important parameter. There are two loops. The external loop controls the temperature. The temperature decreases according to a geometric cooling schedule with factor
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The random search in the SA algorithm can use different strategies to improve finding a new solution. One of them is the SA with crystallization heuristic proposed by [9, 16]. The SA has two phases when the search is performed: exploration and refinement. Figure 1 shows the two phases and their connection with the crystallization factor. The exploration of the domain space, usually happens in higher temperatures. The refinement of the solution happens in lower temperatures. There is no clear interface between the two phases.
The crystallization heuristic represented by SA controlling each parameter crystallization factor.
For problems with combinatorial and integer parameters, the generation of the new candidate can be easily performed. In the case of combinatorial parameters, the algorithm exchanges the position of two parameters. In the case of integer parameters, the algorithm increments, decrements or keeps the current value. There are possibilities, considering that integer parameters have lower and upper bounds, it is possible to generate a new value performing a random selection in the range.
The control of continuous parameters is challenging. The crystallization heuristic proposed by [9, 16] considers a fixed maximum step, and the SA controls the probability density. Figure 1 shows that wider probability density allows larger jumps with higher probability. While, thinner probability density allows smaller jumps with higher probability. However, a larger jump still possible to happen with very small probability. This feature allows the SA to escape from local minima.
Each continuous parameter has a crystallization factor, which is represented by
where
It remains to explain the procedure in which the SA controls the crystallization factor for each parameter. The SA modifies only one parameter at a time, and according the decision of accepting or rejecting the new candidate, an action is performed. The procedure is represented in Figure 2. If the new candidate is rejected, it is assumed that the SA is performing exploration and to increase accepted solutions the crystallization factor associated with this parameter is increased. The increase in the crystallization factor will reduce the probability of larger jumps for this parameter. On the other hand, if the new candidate is accepted, it is assumed that the SA is performing refinement and to increase exploration the crystallization factor associated with this parameter is reduced. The reduction of the crystallization factor will enlarge the probability of larger jumps for this parameter.
During the optimization process, the SA has phases: exploration and refinement. In the exploration phase, the parameters have low crystallization and can perform larger jumps. The inverse happens in the refinement phase where the parameters have high crystallization.
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Algorithm 2 describes the implementation of SA with crystallization heuristic. In this algorithm, the crystallization heuristic adjusts the modification to increase the acceptance of new solutions. The crystallization factor
The field of operations research concentrates many real world applications of optimization techniques in engineering, as it essentially e aims to increase the efficiency of industry operations [8, 9, 16, 17, 18, 19]. Interest in this area has grown recently due to advances in optimization algorithms and the importance of the waste and pollution reduction, which is usually an effect of an improved solution.
Among operations research subjects, cutting and packing (C&P) problems can be highlighted due to its importance and singular combination of geometry and optimization. These characterises are even more prominent in irregular packing problems, which involves simple polygonal items. Essentially, C&P problems consists of assigning a set of small items to a set of set of large containers, maintaining some geometric restrictions, while minimizing an objective function.
In this section, a SA based solution for the irregular packing problem is proposed. It adopts a discrete objective function, as it is related to the number of items in the container, while using continuous parameter for items rotations.
In the 2D irregular single bin packing problem, given a collection of items, one must place a subset of these inside a rectangular container with the aim of minimizing the unused space inside the bin. Each item is represented by a simple polygon and may be rotated by any angle. The main geometric restrictions dictates that no two items may overlap and there should be no protrusion from the container.
Consider a set of items
where
One of the main challenges in irregular packing is the complexity of managing the geometric constraint, which results in fewer proposed solutions in the literature [20]. In order to optimize the layout without compromising the geometric feasibility, two main strategies are often employed. The first is to define a constructive heuristic, which places one item at a time, usually at the bottom-left position. In this approach, the optimization algorithm only controls the placement order; a popular solution is to employ genetic algorithms [2, 21]. The alternative is to allow the items to move freely inside the container while applying penalization on the item overlaps [22, 23, 24].
In [9], however, a different approach was adopted: a SA based algorithm was employed to directly control the placement order, as well as the position and rotation of each item. Items were placed sequentially, using the parameters given by the SA, until no more items fitted the container. Then, the objective function, which was the unoccupied area of the container, which is directly related to the subset of placed items, was evaluated.
The main difficulty was the definition of the item position parameter, which should always correspond to a valid placement, i.e., without overlap or protrusion from the container. It was given by the collision free region (CFR), a polygon describing the allowed placement region, as shown in Figure 3. The CFR can be obtained using modified Boolean operations on polygons, described in [25]. A continuous parameter evaluated to a position along the perimeter of the CFR, and the closest vertex was chosen as the placement position of the item. The rotation was defined by a second controlled variable, and it had to be applied prior to the determination of the CFR.
Example of collision free region for item
Therefore, the solution optimization basically consisted of a SA controlling the placement and rotation parameter of each item in the layout. At each iteration, one parameter for a single item was changed, or two items were swapped in the placement order. Then, the cost was evaluated and the new solution was accepted according to (1). The crystallization factor described in Section 2 was applied to the rotation parameters.
Six broken glass puzzle instances were created to evaluate the performance of the algorithm. These instances have a known optimal solution, which are displayed in Figure 4. Therefore, the effectiveness of the algorithm can be measure by its success rate, which relates to the number of executions converging to the optimal solution.
Instances for the irregular bin packing problem.
The tests were executed on a Phenom 9550 2.21GHz and the convergence condition for the SA was that (1) the cost variation for the final temperature was zero, and (2) the final solution has the lowest cost found. The initial temperature was adjusted by admitting initial 50% acceptance and a geometric cooling schedule was adopted with
Table 1 shows the results data obtained for 30 executions of each instance. Results show that only very simple problems were solved optimally in every executions. This indicates that the SA algorithm should be complemented with heuristics approaches to increase the convergence rate. Nevertheless, given the complexity of the problem with free rotations, the fact that it found the optimal solutions for all instances is important, as some could not be achieved by enforcing simple heuristics such as bottom-left or larger first.
Instance | ||||
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Tangram | 7 | 130,169 | 722.83 | 58.8% |
Hole | 7 | 12,847 | 28.89 | 93.5% |
Simple | 4 | 24,604 | 49.58 | 100.0% |
Concave | 5 | 17,912 | 43.96 | 86.7% |
LF Fails | 5 | 4,426 | 10.61 | 63.6% |
BL Fails | 5 | 117 | 0.16 | 100.0% |
The results for the SA based irregular bin packing solution.
One important characteristic of the irregular bin packing problem with free rotations is that the objective function is discrete and some of the parameters are continuous. This is illustrated in Figure 5, which shows discrete cost values for different values for the leftmost item rotation. The SA solution was not affected by this issue, as the results show, it can handle both continuous and discrete parameters and objective function. Moreover, the continuous rotation convergence for each item was improved by adopting the crystallization factor.
Discrete cost behaviour with single continuous parameter variation.
TO is a mathematical approach to determine distribution of material in a design domain such that the performance becomes maximized. The definition of performance could be different in each application. The physic of problem and desired application determines the objective function and the constraints. Depending on the problem, different methods have been developed in the literature [26, 27].
For the TO problems with well defined objective functions and constraints, the gradient based algorithms have been widely used [28, 29, 30]. The sensitivity information converges the final results to the optimized topology. This method shows fast convergence and low computational costs. The gradient based TO methods use Optimality Criteria (OC), Method of Moving Asymptotes (MMA), Sequential Linear Programming (SLP), etc. to optimize the objective functions [31, 32]. In the cases that the objective function or its derivatives are not mathematically modeled or hard to calculate, using the non-gradient based algorithms are more advantages [33, 34]. In the non-gradient based TO methods, GA and SA are the two most popular algorithms of optimization [3, 35, 36, 37]. Even these methods have high computational costs, but can optimize the topology without need to calculation of the derivatives and sensitivity information.
Using the SA method in the non-gradient based TO is beneficial because of reaching global minimum as well as provide the information of convergence. The information of convergence such as the number of accepted and rejected solutions could be used in the evaluation of TO results. The available SA for TO uses random search to generate new solutions, while by using SA with crystallization heuristic [10], the search for new accepted solutions has been improved. After finishing the optimization process, a density filter can reduce gray area and discontinued regions.
The structural TO to minimize compliance in beams is a classic problem. This problem has been solved with gradient based methods in the literature [38] and the results have been used to verify TO with crystallization heuristic SA (as described in Section 2). The problem of minimizing compliance can be represented as the problem of minimizing strain energy, modeled as
where
where
A new heuristic is included, after reaching the thermal equilibrium, the domain is regularized by filtering. The new density of each element after filtering gets some effects from the adjacent elements, as
where
The design domain and loading for cantilever beam (left) and half-MBB beam (right).
Volume fraction | Cantilever in [38] | Cantilever in SA | Half-MBB in [38] | Half-MBB in SA |
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0.5 | 75.05 | 79.87 | 82.37 | 89.65 |
0.6 | 62.89 | 65.70 | 69.19 | 73.36 |
0.7 | 55.27 | 57.10 | 60.61 | 63.39 |
0.8 | 49.89 | 51.29 | 54.85 | 56.63 |
0.9 | 46.29 | 47.36 | 50.57 | 51.79 |
The results for compliance of cantilever and half-MBB beam for different volume fractions.
As shown in Table 2, the results from this non-gradient based TO method are very close to the gradient based results. The main advantage of the proposed method is that there is no need to calculate derivatives of the objective function.
The TO objective function can be complex and combine two or more objective functions. In such situations, the solution is not necessarily unique and comes with a set of optimum solutions called Pareto Front. The Pareto Front curve shows the solutions where none of the objective functions can be improved without degrading the other objective functions. The Pareto Front curve can be used for trade-off the suitable solution within this set instead of considering the full range of every parameter. The traditional TO usually optimizes one objective function while considering the other objective functions fixed or as a constraint [39]. The SA showed also this ability to incorporate multiple objective functions, like the one presented by the CoAnnealing [40] and AMOSA [41].
The CoAnnealing was used to solve TO problems and the Pareto Front was obtained; particularly, compliance and volume fraction as considered as cost functions in a cantilever beam, as shown in Figure 7. The points on the curve showed a good agreement with the results for that volume fraction and compliance [42]. The results shows that Coannealing can be used for the multiple objective TO problems.
The Pareto Front curve for minimization of compliance and weight in cantilever problem.
The problem of curve fitting is an essential Computer Aided Design (CAD) problem with applications in various engineering fields including but not limited to digital metrology, robotics, path planning, and data modeling. The problem consists of constructing a curve from a set of discrete points, as shown in Figure 8. The two main types of curve fitting can be defined, as an approximating curve fitting, when the constructed curve approximates the location of the points in the dataset, and an interpolating curve fitting, when the curve passes exactly through the set of points. The curve approximation has application in many engineering problems when a certain level of uncertainty exists in the dataset. This always can be expected in data points collected by an experimental process, when sources of uncertainties including the equipment errors, environmental effects, human errors, measurement resolution, etc., represent a combined level of uncertainty [43]. Due to the non-systematic nature of the uncertainties in the data, the approximating curve fitting process aims to recognise the true pattern in the data points instead of exactly passing through them [44]. The three major computation tasks to complete the approximating curve fitting include Point Measurement Planning (PMP), Substitute Geometry Estimation (SGE), and Deviation Zone Evaluation (DZE). Reducing or controlling the level of uncertainty in the constructed curve have been studied comprehensively at PMP by proper selection of the datapoints [45]. It is also addressed in SGE by improving the curve or surface fitting algorithms, using an enhanced optimization processes to avoid trapping in local minima, and by using iterative fitting approaches with monitoring some indicators for the level of uncertainty [46]. Various approaches have been also presented to measure and monitor the level of uncertainty typically at DZE stage by modeling the pattern and nature of the resulting deviations of the processed data points from the approximated curves or surfaces [47].
Approximating curve (dashed) versus the interpolating curve (red).
On the contrary, the curve interpolation is applicable when the datapoints are known to be fairly accurate and are conducted with no accommodation for any level of uncertainty in the datapoints. Figure 8 presents a set of datapoints with its corresponding approximating and interpolating curves. The set of datapoints is shown by blue dots, the interpolating curve is presented by solid red line, and the approximating curve is presented by black dashed line.
Since a certain level of uncertainty typically exists in the most of the engineering problems, developing methodologies to control or reduce the level of uncertainty in the finally constructed curve is highly important. In this section, a SA approach is proposed to determine an approximation curve from a sequence of points. In this approach, the control points are continuous parameters and index corresponding points of the sequence are discrete parameters. All these parameters are adjusted by SA. This study was started by Ueda et al. [48]. The developed methodology employs piece-wise Bézier curve structure to solve the problem, as explained in the followings.
There are several curve structures that can be used for the purpose of solving a curve fitting problem. However, each one has it own advantages and drawbacks. In a Bézier curve, the control points influence the entire curve globally including the regions that the curve is already fitted. On the other hand, the control points in a B-spline have only a local influence, i.e., by changing a group of control points only a certain region of the curve is modified. One feature of the Bézier curve structure that is beneficial in the presented fitting approach here is that the resulting Bézier curve always interpolates the first and last control point, while in the B-spline curve structure, these points usually are not interpolated. It is possible to interpolates these points in a B-spline. However, a higher number of optimization parameters is needed to achieve such feature, compared to the Bézier curve.
A piece-wise Bézier curve overcome the problem of the global influence of the control point. This curve is a sequence of cubic Bézier curves as shown in Figure 9, in which the last control point of curve
Piece-wise cubic Bézier curve with
with
Using a piece-wise Bézier curve has a advantage in two aspects. First, the curve is divided in several pieces, in which each curve segment approximates only part of the sequence. Second, it is known that a Bézier curve always interpolates its end points. The used cost function is
with
SA needs to adjust the parameters defining a piece-wise Bézier curve that minimizes (8). Each piece-wise Bézier curve has two internal control points (as shown in Figure 9). The coordinates for each of these control points are continuous parameters and they are controlled using the crystallization heuristic. The connection point between two piece-wise Bézier curves (as point
Consider the example from Figure 10, the continuous parameters are the coordinate of control points
Each Bézier curve segment approximates just one part of the sequence of points.
The continuous parameters are controlled by the crystallization heuristic. The discrete parameters have specific operator, a random value is picked from a uniform distribution between
A curve is defined and sampled, and a random noise is added to each sampled point creating an artificial example to be tested by the proposed algorithm. Two example were tested, shown in Figure 11. Figure 11(a) is sampled with
Two artificial created examples tested by the proposed algorithm. Black points are the noisy sampled points, each curve segment is in a different color with its respective control points represented as squares.
Table 3 show the result of these two test examples. The objective function is higher in the second example, once
Example | Cost | |||
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1 | 101 | 4 | 508,404 | 10.37 |
2 | 300 | 5 | 473,680 | 134.97 |
The results for the SA based curve interpolation solution.
The proposed interpolation algorithm was applied in different applications showing its versatility and robustness. Ueda et al. [51] proposed an algorithm to determine the curves which interpolates the boundary of a point cloud in space. Ueda et al. [52] proposed an algorithm to determine the defect zone from a 3D scanned turbine blade. Ueda et al. [53] also proposed an algorithm to determine open boundaries in point clouds with symmetry (like injuries in a skull).
This chapter describes the SA with crystallization heuristic and three different applications: cutting and packing, topology optimization and curve interpolation. The cutting and packing problem determines the layout for a set of items to be placed inside a container with fixed dimensions. The cost function is the unused area inside the container. The items can be translated and rotated in the process of determining the layout. This cost function is discrete and the parameters are continuous. As there is no need of any gradient information, it can optimize discrete cost functions.
The topology optimization problem has continuous parameters. The number of parameters is much larger when compared with the cutting and packing problem. Usually, the cost function is one of the two possibilities: volume fraction and compliance. As there are two possibilities for cost function, it is considered the application of the CoAnnealing, which is a multi-objective version of the SA with crystallization heuristic. The last application is the curve interpolation. It has two different types of parameters: continuous and integer. The objective function is composed of two parts: the error between the the given points and the interpolating curve, and the length of the curve. The length of the curve is a regularization to force the curve to be shorter and smoother. The curve interpolation algorithm was used in different applications.
These examples show that the SA with crystallization heuristic is very generic, versatile and easy to implement.
G. C. Duran is supported by CNPq (process 140.299/2020-3). H. R. Najafabadi is supported by FAPESP (grant 2019/03453-2). M. S. G Tsuzuki is partially supported by CNPq (process 311.195/2019-9). A. K. Sato is supported by FUSP/Petrobras.
Temperature Geometric Cooling Parameter
Function Area
Proportional Factor to Ensure Weak-G1 continuity
Rectangular Conteiner
Crystallization Factor
Energy Variation
Step Variation for Variable
Position Vector for Variable
External Force
Objective Function
Stiffness for Element
Interior of the Item
Length of Curve
Stiffness
Number of Square Elements
Penalization Parameter
Control Point
Set of Items
Item
Item Rotated by
Item Translated by
Piece-wise Bézier Curve
Projection of Point
Space of Continuous Numbers
Rotation
Strain Energy
Translation
Assigned Set of Items
Temperature at iteration
Elastic Deformation
Elastic Deformation for Element
Current Solution
Solution Candidate
Density of Element
Weighting Function
Weight Used in the Approximation Curve
Archived Multiobjective Simulated Annealing
Computer-Aided Design
Collision Free Region
Cutting & Packing
Electrical Impedance Tomography
Finite Element Method
Genetic Algorithm
Maximum a Posteriori
Method of Moving Asymptotes
Optimality Criteria
Probability Density Function
Particle Swarm Optimization
Random Sample Consensus
Simulated Annealing
Solid Isotropic Material with Penalization
Sequential Linear Programming
Topology Optimization
Authors are listed below with their open access chapters linked via author name:
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\n\n\n\n\n\n\n\n\n\nJocelyn Chanussot (chapter to be published soon...)
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Over the past few decades, no major new types of antibiotics have been produced and almost all known antibiotics are increasingly losing their activity against pathogenic microorganisms. The levels of multi-drug resistant bacteria have also increased. It is known that worldwide, more than 60% of all antibiotics that are produced find their use in animal production for both therapeutic and non-therapeutic purposes. The use of antimicrobial agents in animal husbandry has been linked to the development and spread of resistant bacteria. Poultry products are among the highest consumed products worldwide but a lot of essential antibiotics are employed during poultry production in several countries; threatening the safety of such products (through antimicrobial residues) and the increased possibility of development and spread of microbial resistance in poultry settings. This chapter documents some of the studies on antibiotic usage in poultry farming; with specific focus on some selected bacterial species, their economic importance to poultry farming and reports of resistances of isolated species from poultry settings (farms and poultry products) to essential antibiotics.",book:{id:"6978",slug:"antimicrobial-resistance-a-global-threat",title:"Antimicrobial Resistance",fullTitle:"Antimicrobial Resistance - A Global Threat"},signatures:"Christian Agyare, Vivian Etsiapa Boamah, Crystal Ngofi Zumbi and\nFrank Boateng Osei",authors:[{id:"182058",title:"Dr.",name:"Christian",middleName:null,surname:"Agyare",slug:"christian-agyare",fullName:"Christian Agyare"},{id:"261271",title:"MSc.",name:"Crystal Ngofi",middleName:null,surname:"Zumbi",slug:"crystal-ngofi-zumbi",fullName:"Crystal Ngofi Zumbi"},{id:"261272",title:"MSc.",name:"Frank Boateng",middleName:null,surname:"Osei",slug:"frank-boateng-osei",fullName:"Frank Boateng Osei"},{id:"261273",title:"Dr.",name:"Vivian Etsiapa",middleName:null,surname:"Boamah",slug:"vivian-etsiapa-boamah",fullName:"Vivian Etsiapa Boamah"}]},{id:"49246",doi:"10.5772/61300",title:"Chitosan as a Biomaterial — Structure, Properties, and Electrospun Nanofibers",slug:"chitosan-as-a-biomaterial-structure-properties-and-electrospun-nanofibers",totalDownloads:4727,totalCrossrefCites:27,totalDimensionsCites:63,abstract:"Chitosan is a polysaccharide derived from chitin; chitin is the second most abundant polysaccharide in the world, after cellulose. Chitosan is biocompatible, biodegradable and non-toxic, so that it can be usedin medicalapplications such as antimicrobial and wound healing biomaterials. It also used as chelating agent due to its ability to bind with cholesterol, fats, proteins and metal ions.",book:{id:"4648",slug:"concepts-compounds-and-the-alternatives-of-antibacterials",title:"Concepts, Compounds and the Alternatives of Antibacterials",fullTitle:"Concepts, Compounds and the Alternatives of Antibacterials"},signatures:"H. M. Ibrahim and E.M.R. 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Specifically, titanium dioxide (TiO2) has been considered as an attractive antimicrobial compound due to its photocatalytic nature and because it is a chemically stable, non-toxic, inexpensive, and Generally Recognized as Safe (GRAS) substance. Several studies have revealed this metal oxide demonstrates excellent antifungal and antibacterial properties against a broad range of both Gram-positive and Gram-negative bacteria. These properties were significantly improved by titanium dioxide nanoparticles (TiO2 NPs) synthesis. In this chapter, latest developments on routes of synthesis of TiO2 NPs and antimicrobial activity of these nanostructures are presented. Furthermore, TiO2 NPs favor the inactivation of microorganisms due to their strong oxidizing power by free radical generation, such as hydroxyl and superoxide anion radicals, showing reductions growth against several microorganisms, such as Escherichia coli and Staphylococcus aureus. Understanding the main mechanisms of antimicrobial action of these nanoparticles was the second main purpose of this chapter.",book:{id:"9521",slug:"antimicrobial-resistance-a-one-health-perspective",title:"Antimicrobial Resistance",fullTitle:"Antimicrobial Resistance - A One Health Perspective"},signatures:"Carol López de Dicastillo, Matias Guerrero Correa, Fernanda B. Martínez, Camilo Streitt and Maria José Galotto",authors:[{id:"244902",title:"Dr.",name:"Carol",middleName:null,surname:"Lopez De Dicastillo",slug:"carol-lopez-de-dicastillo",fullName:"Carol Lopez De Dicastillo"},{id:"315494",title:"Mr.",name:"Matias",middleName:null,surname:"Guerrero Correa",slug:"matias-guerrero-correa",fullName:"Matias Guerrero Correa"},{id:"315495",title:"Ms.",name:"Fernanda",middleName:null,surname:"B. Martínez",slug:"fernanda-b.-martinez",fullName:"Fernanda B. Martínez"},{id:"315496",title:"Mr.",name:"Camilo",middleName:null,surname:"Zuñiga",slug:"camilo-zuniga",fullName:"Camilo Zuñiga"},{id:"315497",title:"Dr.",name:"Maria José",middleName:null,surname:"Galotto",slug:"maria-jose-galotto",fullName:"Maria José Galotto"}]},{id:"65613",doi:"10.5772/intechopen.84411",title:"The Methods for Detection of Biofilm and Screening Antibiofilm Activity of Agents",slug:"the-methods-for-detection-of-biofilm-and-screening-antibiofilm-activity-of-agents",totalDownloads:9283,totalCrossrefCites:15,totalDimensionsCites:26,abstract:"Biofilm producer microorganisms cause nosocomial and recurrent infections. Biofilm that is a sticky exopolysaccharide is the main virulence factor causing biofilm-related infections. Biofilm formation begins with attachment of bacteria to biotic surface such as host cell or abiotic surface such as prosthetic devices. After attachment, aggregation of bacteria is started by cell-cell adhesion. Aggregation continues with the maturation of biofilm. Dispersion is started by certain conditions such as phenol-soluble modulins (PSMs). By this way, sessile bacteria turn back into planktonic form. Bacteria embedded in biofilm (sessile form) are more resistant to antimicrobials than planktonic bacteria. So it is hard to treat biofilm-embedded bacteria than planktonic forms. For this reason, it is important to detect biofilm. There are a few biofilm detection and biofilm production methods on prosthetics, methods for screening antibacterial effect of agents against biofilm-embedded microorganism and antibiofilm effect of agents against biofilm production and mature biofilm. The aim of this chapter is to overview direct and indirect methods such as microscopy, fluorescent in situ hybridization, and Congo red agar, tube method, microtiter plate assay, checkerboard assay, plate counting, polymerase chain reaction, mass spectrometry, MALDI-TOF, and biological assays used by antibiofilm researches.",book:{id:"8427",slug:"antimicrobials-antibiotic-resistance-antibiofilm-strategies-and-activity-methods",title:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods",fullTitle:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods"},signatures:"Sahra Kırmusaoğlu",authors:[{id:"179460",title:"Associate Prof.",name:"Sahra",middleName:null,surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu"}]},{id:"63397",doi:"10.5772/intechopen.80624",title:"Antibiotic Resistance in Lactic Acid Bacteria",slug:"antibiotic-resistance-in-lactic-acid-bacteria",totalDownloads:2486,totalCrossrefCites:12,totalDimensionsCites:21,abstract:"Most starter cultures belong to the lactic acid bacteria group (LAB) and recognized as safe by the US Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA). However, LAB may act as intrinsic or extrinsic reservoirs for antibiotic resistance (AR) genes. This fact may not constitute a safety concern itself, as the resistance gene transfer is vertical. Nevertheless, external genetic elements may induce changes that favor the horizontal transfer transmission of resistance from pathogens as well as from the human intestinal microbiota, which represents a severe safety issue. Some genus of AR LAB includes Enterococcus, Lactobacillus, Lactococcus, Leuconostoc, Pediococcus, and Streptococcus isolated from fermented meat and milk products. Currently, the WHO recommends that LAB used in the food industry should be free of resistance. Therefore, the objective of this chapter is to present an overview of the LAB antibiotic resistance and some methods to determine the same.",book:{id:"6978",slug:"antimicrobial-resistance-a-global-threat",title:"Antimicrobial Resistance",fullTitle:"Antimicrobial Resistance - A Global Threat"},signatures:"Yenizey M. Álvarez-Cisneros and Edith Ponce-Alquicira",authors:[{id:"256345",title:"Dr.",name:"Yenizey Merit",middleName:null,surname:"Alvarez Cisneros",slug:"yenizey-merit-alvarez-cisneros",fullName:"Yenizey Merit Alvarez Cisneros"},{id:"256347",title:"Dr.",name:"Edith",middleName:null,surname:"Ponce-Alquicira",slug:"edith-ponce-alquicira",fullName:"Edith Ponce-Alquicira"}]}],mostDownloadedChaptersLast30Days:[{id:"65613",title:"The Methods for Detection of Biofilm and Screening Antibiofilm Activity of Agents",slug:"the-methods-for-detection-of-biofilm-and-screening-antibiofilm-activity-of-agents",totalDownloads:9277,totalCrossrefCites:15,totalDimensionsCites:26,abstract:"Biofilm producer microorganisms cause nosocomial and recurrent infections. Biofilm that is a sticky exopolysaccharide is the main virulence factor causing biofilm-related infections. Biofilm formation begins with attachment of bacteria to biotic surface such as host cell or abiotic surface such as prosthetic devices. After attachment, aggregation of bacteria is started by cell-cell adhesion. Aggregation continues with the maturation of biofilm. Dispersion is started by certain conditions such as phenol-soluble modulins (PSMs). By this way, sessile bacteria turn back into planktonic form. Bacteria embedded in biofilm (sessile form) are more resistant to antimicrobials than planktonic bacteria. So it is hard to treat biofilm-embedded bacteria than planktonic forms. For this reason, it is important to detect biofilm. There are a few biofilm detection and biofilm production methods on prosthetics, methods for screening antibacterial effect of agents against biofilm-embedded microorganism and antibiofilm effect of agents against biofilm production and mature biofilm. The aim of this chapter is to overview direct and indirect methods such as microscopy, fluorescent in situ hybridization, and Congo red agar, tube method, microtiter plate assay, checkerboard assay, plate counting, polymerase chain reaction, mass spectrometry, MALDI-TOF, and biological assays used by antibiofilm researches.",book:{id:"8427",slug:"antimicrobials-antibiotic-resistance-antibiofilm-strategies-and-activity-methods",title:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods",fullTitle:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods"},signatures:"Sahra Kırmusaoğlu",authors:[{id:"179460",title:"Associate Prof.",name:"Sahra",middleName:null,surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu"}]},{id:"62553",title:"Antibiotic Use in Poultry Production and Its Effects on Bacterial Resistance",slug:"antibiotic-use-in-poultry-production-and-its-effects-on-bacterial-resistance",totalDownloads:7327,totalCrossrefCites:43,totalDimensionsCites:92,abstract:"A surge in the development and spread of antibiotic resistance has become a major cause for concern. Over the past few decades, no major new types of antibiotics have been produced and almost all known antibiotics are increasingly losing their activity against pathogenic microorganisms. The levels of multi-drug resistant bacteria have also increased. It is known that worldwide, more than 60% of all antibiotics that are produced find their use in animal production for both therapeutic and non-therapeutic purposes. The use of antimicrobial agents in animal husbandry has been linked to the development and spread of resistant bacteria. Poultry products are among the highest consumed products worldwide but a lot of essential antibiotics are employed during poultry production in several countries; threatening the safety of such products (through antimicrobial residues) and the increased possibility of development and spread of microbial resistance in poultry settings. This chapter documents some of the studies on antibiotic usage in poultry farming; with specific focus on some selected bacterial species, their economic importance to poultry farming and reports of resistances of isolated species from poultry settings (farms and poultry products) to essential antibiotics.",book:{id:"6978",slug:"antimicrobial-resistance-a-global-threat",title:"Antimicrobial Resistance",fullTitle:"Antimicrobial Resistance - A Global Threat"},signatures:"Christian Agyare, Vivian Etsiapa Boamah, Crystal Ngofi Zumbi and\nFrank Boateng Osei",authors:[{id:"182058",title:"Dr.",name:"Christian",middleName:null,surname:"Agyare",slug:"christian-agyare",fullName:"Christian Agyare"},{id:"261271",title:"MSc.",name:"Crystal Ngofi",middleName:null,surname:"Zumbi",slug:"crystal-ngofi-zumbi",fullName:"Crystal Ngofi Zumbi"},{id:"261272",title:"MSc.",name:"Frank Boateng",middleName:null,surname:"Osei",slug:"frank-boateng-osei",fullName:"Frank Boateng Osei"},{id:"261273",title:"Dr.",name:"Vivian Etsiapa",middleName:null,surname:"Boamah",slug:"vivian-etsiapa-boamah",fullName:"Vivian Etsiapa Boamah"}]},{id:"65914",title:"Introductory Chapter: The Action Mechanisms of Antibiotics and Antibiotic Resistance",slug:"introductory-chapter-the-action-mechanisms-of-antibiotics-and-antibiotic-resistance",totalDownloads:4428,totalCrossrefCites:6,totalDimensionsCites:10,abstract:null,book:{id:"8427",slug:"antimicrobials-antibiotic-resistance-antibiofilm-strategies-and-activity-methods",title:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods",fullTitle:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods"},signatures:"Sahra Kırmusaoğlu, Nesrin Gareayaghi and Bekir S. Kocazeybek",authors:[{id:"179460",title:"Associate Prof.",name:"Sahra",middleName:null,surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu"},{id:"248288",title:"Prof.",name:"Bekir",middleName:null,surname:"Kocazeybek",slug:"bekir-kocazeybek",fullName:"Bekir Kocazeybek"},{id:"406463",title:"Dr.",name:"Nesrin",middleName:null,surname:"Gareayaghi",slug:"nesrin-gareayaghi",fullName:"Nesrin Gareayaghi"}]},{id:"63397",title:"Antibiotic Resistance in Lactic Acid Bacteria",slug:"antibiotic-resistance-in-lactic-acid-bacteria",totalDownloads:2486,totalCrossrefCites:12,totalDimensionsCites:21,abstract:"Most starter cultures belong to the lactic acid bacteria group (LAB) and recognized as safe by the US Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA). However, LAB may act as intrinsic or extrinsic reservoirs for antibiotic resistance (AR) genes. This fact may not constitute a safety concern itself, as the resistance gene transfer is vertical. Nevertheless, external genetic elements may induce changes that favor the horizontal transfer transmission of resistance from pathogens as well as from the human intestinal microbiota, which represents a severe safety issue. Some genus of AR LAB includes Enterococcus, Lactobacillus, Lactococcus, Leuconostoc, Pediococcus, and Streptococcus isolated from fermented meat and milk products. Currently, the WHO recommends that LAB used in the food industry should be free of resistance. Therefore, the objective of this chapter is to present an overview of the LAB antibiotic resistance and some methods to determine the same.",book:{id:"6978",slug:"antimicrobial-resistance-a-global-threat",title:"Antimicrobial Resistance",fullTitle:"Antimicrobial Resistance - A Global Threat"},signatures:"Yenizey M. Álvarez-Cisneros and Edith Ponce-Alquicira",authors:[{id:"256345",title:"Dr.",name:"Yenizey Merit",middleName:null,surname:"Alvarez Cisneros",slug:"yenizey-merit-alvarez-cisneros",fullName:"Yenizey Merit Alvarez Cisneros"},{id:"256347",title:"Dr.",name:"Edith",middleName:null,surname:"Ponce-Alquicira",slug:"edith-ponce-alquicira",fullName:"Edith Ponce-Alquicira"}]},{id:"49246",title:"Chitosan as a Biomaterial — Structure, Properties, and Electrospun Nanofibers",slug:"chitosan-as-a-biomaterial-structure-properties-and-electrospun-nanofibers",totalDownloads:4726,totalCrossrefCites:27,totalDimensionsCites:63,abstract:"Chitosan is a polysaccharide derived from chitin; chitin is the second most abundant polysaccharide in the world, after cellulose. Chitosan is biocompatible, biodegradable and non-toxic, so that it can be usedin medicalapplications such as antimicrobial and wound healing biomaterials. It also used as chelating agent due to its ability to bind with cholesterol, fats, proteins and metal ions.",book:{id:"4648",slug:"concepts-compounds-and-the-alternatives-of-antibacterials",title:"Concepts, Compounds and the Alternatives of Antibacterials",fullTitle:"Concepts, Compounds and the Alternatives of Antibacterials"},signatures:"H. M. Ibrahim and E.M.R. El- Zairy",authors:[{id:"90645",title:"Dr.",name:"Hassan",middleName:null,surname:"Ibrahim",slug:"hassan-ibrahim",fullName:"Hassan Ibrahim"},{id:"175694",title:"Dr.",name:"Enas",middleName:null,surname:"El- Zairy",slug:"enas-el-zairy",fullName:"Enas El- Zairy"}]}],onlineFirstChaptersFilter:{topicId:"897",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"81704",title:"Quorum Sensing Inhibition Based Drugs to Conquer Antimicrobial Resistance",slug:"quorum-sensing-inhibition-based-drugs-to-conquer-antimicrobial-resistance",totalDownloads:22,totalDimensionsCites:0,doi:"10.5772/intechopen.104125",abstract:"Quorum sensing is the cell to cell communication mechanism in microorganism through signalling molecules. Regulation of virulence factor, sporulation, proteolytic enzymes production, biofilm formation, auto-inducers, cell population density are key physiological process mediated through quorum-sensing (QS) signalling. Elevation of innate immune system and antibiotic tolerance of pathogens is highly increased with perspective of quorum-sensing (QS) activity. Development of novel drugs is highly attractive scenario against cell-cell communication of microbes. Design of synthetic drugs and natural compounds against QS signal molecules is vital combat system to attenuate microbial pathogenicity. Quorum sensing inhibitors (QSIs), quorum quenchers (QQs), efflux pump inhibitors (EPIs) act against multi-drug resistance strains (MDR) and other pathogenic microbes through regulation of auto-inducers and signal molecule with perceptive to growth arrest both in-vitro and in-vivo. QQs, QSIs and EPIs compounds has been validated with various animal models for high selection pressure on therapeutics arsenal against microbe’s growth inhibition. Promising QSI are phytochemicals and secondary metabolites includes polyacetylenes, alkaloids, polyphenols, terpenoids, quinones.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Kothandapani Sundar, Ramachandira Prabu and Gopal Jayalakshmi"},{id:"82372",title:"Unlocking the Potential of Ghost Probiotics in Combating Antimicrobial Resistance",slug:"unlocking-the-potential-of-ghost-probiotics-in-combating-antimicrobial-resistance",totalDownloads:20,totalDimensionsCites:0,doi:"10.5772/intechopen.104126",abstract:"Antimicrobial resistance is a global concern that requires immediate attention. Major causes of development of antimicrobial resistance in microbial cells are overuse of antimicrobials along the food chain especially in livestock, in preventing infections as well as misuse of antimicrobials by patients. Probiotics could be a viable alternative to antibiotics in the fight against antimicrobial resistance. Probiotic strains can act as a complement to antimicrobial therapy, improving antimicrobial function and enhancing immunity. However, there are safety concerns regarding the extensive use of live microbial cells especially in immunocompromised individuals; these include microbial translocation, inhibition of other beneficial microorganisms and development of antimicrobial resistance, among other concerns. Inevitably, ghost probiotics have become the favored alternative as they eliminate the safety and shelf-life problems associated with use of probiotics. Ghost probiotics are non-viable microbial cells (intact or broken) or metabolic products from microorganisms, which when administered in adequate amounts have biologic activity in the host and confer health benefits. Ghost probiotics exert biological effects similar to probiotics. However, the major drawback of using ghost probiotics is that the mechanism of action of these is currently unknown, hence more research is required and regulatory instruments are needed to assure the safety of consumers.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Abigarl Ndudzo, Sakhile Ndlovu, Nesisa Nyathi and Angela Sibanda Makuvise"},{id:"82178",title:"Managing Antimicrobial Resistance beyond the Hospital Antimicrobial Stewardship: The Role of One Health",slug:"managing-antimicrobial-resistance-beyond-the-hospital-antimicrobial-stewardship-the-role-of-one-heal",totalDownloads:16,totalDimensionsCites:0,doi:"10.5772/intechopen.104170",abstract:"Infections caused by micro-organisms affect the health of people and animals, causing morbidity and mortality, with Asia and Africa as the epicenters. Some of the infectious diseases are emerging and re-emerging in nature. Examples include viral hepatitis, Lassa fever, Ebola, yellow fever, tuberculosis, covid-19, measles, and malaria, among others. Antimicrobials have been playing an important role in the treatment of infections by these microbes. However, there has been a development of resistance to these antimicrobials as a result of many drivers. This write-up used secondary data to explore the management of antimicrobial resistance (AMR) beyond the hospital antimicrobial resistance steward using the one health concept. The findings showed AMR to be a transboundary, multifaceted ecosystem problem affecting both the developed and developing countries. It is also one of the top ten global public health threats facing mankind. Globally, AMR will cost over US$100 trillion in output loss by 2050, about 700,000 deaths a year, and 4,150,000 deaths in Africa by 2050. About 2.4 million people could die in high-income countries between 2015 and 2050 without a sustained effort to contain AMR. The drivers of AMR are beyond the hospital and hospital AMR stewardship. Therefore, the need for one health concept to manage it.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Istifanus Anekoson Joshua, Mathew Bobai and Clement Sokfa Woje"},{id:"81918",title:"Machine Learning for Antimicrobial Resistance Research and Drug Development",slug:"machine-learning-for-antimicrobial-resistance-research-and-drug-development",totalDownloads:53,totalDimensionsCites:0,doi:"10.5772/intechopen.104841",abstract:"Machine learning is a subfield of artificial intelligence which combines sophisticated algorithms and data to develop predictive models with minimal human interference. This chapter focuses on research that trains machine learning models to study antimicrobial resistance and to discover antimicrobial drugs. An emphasis is placed on applying machine learning models to detect drug resistance among bacterial and fungal pathogens. The role of machine learning in antibacterial and antifungal drug discovery and design is explored. Finally, the challenges and prospects of applying machine learning to advance basic research on and treatment of antimicrobial resistance are discussed. Overall, machine learning promises to advance antimicrobial resistance research and to facilitate the development of antibacterial and antifungal drugs.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Shamanth A. Shankarnarayan, Joshua D. Guthrie and Daniel A. Charlebois"},{id:"81891",title:"Alternatives to Antibiotics in Semen Extenders Used in Artificial Insemination",slug:"alternatives-to-antibiotics-in-semen-extenders-used-in-artificial-insemination",totalDownloads:29,totalDimensionsCites:0,doi:"10.5772/intechopen.104226",abstract:"Antimicrobial resistance is a serious global threat requiring a widespread response. Both veterinarians and medical doctors should restrict antibiotic usage to therapeutic use only, after determining the sensitivity of the causal organism. However, the addition of antibiotics to semen extenders for animal artificial insemination represents a hidden, non-therapeutic use of antimicrobial substances. Artificial insemination for livestock breeding is a huge global enterprise with hundreds of million sperm doses prepared annually. However, reporting of antimicrobial resistance in semen is increasing. This review discusses the consequences of bacteria in semen samples, as well as the effect of antimicrobial substances in semen extenders on bacteria in the environment and even on personnel. Alternatives to antibiotics have been reported in the scientific literature and are reviewed here. The most promising of these, removal of the majority of bacteria by colloid centrifugation, is considered in detail, especially results from an artificial insemination study in pigs. In conclusion, colloid centrifugation is a practical method of physically removing bacteria from semen, which does not induce antibiotic resistance. Sperm quality in stored semen samples may be improved at the same time.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Jane M. Morrell, Pongpreecha Malaluang, Aleksandar Cojkic and Ingrid Hansson"},{id:"81699",title:"Efflux Pumps among Urinary E. coli and K. pneumoniae Local Isolates in Hilla City, Iraq",slug:"efflux-pumps-among-urinary-e-coli-and-k-pneumoniae-local-isolates-in-hilla-city-iraq",totalDownloads:13,totalDimensionsCites:0,doi:"10.5772/intechopen.104408",abstract:"Urinary tract infections (UTI) are the most common bacterial infections affecting humans. Escherichia coli and Klebsiella pneumoniae were common enterobacteria engaged with community-acquired UTIs. Efflux pumps were vital resistance mechanisms for antibiotics, especially among enterobacteria. Overexpression of an efflux system, which results in a decrease in antibiotic accumulation, is an effective mechanism for drug resistance. The ATP-binding cassette (ABC) transporters, small multidrug resistance (SMR), and multidrug and toxic compound extrusion (MATE) families, the major facilitator superfamily (MFS), and the resistance-nodulation- cell division (RND) family are the five superfamilies of efflux systems linked to drug resistance. This chapter highlights the results of studying the prevalence of efflux pump genes among local isolates of E. coli and K. pneumoniae in Hilla City, Iraq. class RND AcrAB-TolC, AcrAD-TolC, and AcrFE-TolC genes detected by conventional PCR of E. coli and K. pneumoniae respectively. The result revealed approximately all studied efflux transporter were found in both E. coli and K. pneumoniae in different percentages. Biofilm formation were observed in 50(100%) of K. pneumoniae and 49(98%) of E. coli isolates were biofilm former and follow: 30(60%), 20(40%) were weak, 12(24%), 22(44%) were moderate and 7(14%) and 8(16%) were Strong biofilm former for E. coli and K. pneumoniae, respectively.",book:{id:"11373",title:"The Global Antimicrobial Resistance Epidemic - Innovative Approaches and Cutting-Edge Solutions",coverURL:"https://cdn.intechopen.com/books/images_new/11373.jpg"},signatures:"Hussein Al-Dahmoshi, Sahar A. Ali and Noor Al-Khafaji"}],onlineFirstChaptersTotal:13},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:141,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:124,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:22,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"10",title:"Physiology",doi:"10.5772/intechopen.72796",issn:"2631-8261",scope:"Modern physiology requires a comprehensive understanding of the integration of tissues and organs throughout the mammalian body, including the cooperation between structure and function at the cellular and molecular levels governed by gene and protein expression. While a daunting task, learning is facilitated by identifying common and effective signaling pathways mediated by a variety of factors employed by nature to preserve and sustain homeostatic life. \r\nAs a leading example, the cellular interaction between intracellular concentration of Ca+2 increases, and changes in plasma membrane potential is integral for coordinating blood flow, governing the exocytosis of neurotransmitters, and modulating gene expression and cell effector secretory functions. Furthermore, in this manner, understanding the systemic interaction between the cardiovascular and nervous systems has become more important than ever as human populations' life prolongation, aging and mechanisms of cellular oxidative signaling are utilised for sustaining life. \r\nAltogether, physiological research enables our identification of distinct and precise points of transition from health to the development of multimorbidity throughout the inevitable aging disorders (e.g., diabetes, hypertension, chronic kidney disease, heart failure, peptic ulcer, inflammatory bowel disease, age-related macular degeneration, cancer). With consideration of all organ systems (e.g., brain, heart, lung, gut, skeletal and smooth muscle, liver, pancreas, kidney, eye) and the interactions thereof, this Physiology Series will address the goals of resolving (1) Aging physiology and chronic disease progression (2) Examination of key cellular pathways as they relate to calcium, oxidative stress, and electrical signaling, and (3) how changes in plasma membrane produced by lipid peroxidation products can affect aging physiology, covering new research in the area of cell, human, plant and animal physiology.",coverUrl:"https://cdn.intechopen.com/series/covers/10.jpg",latestPublicationDate:"July 20th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:14,editor:{id:"35854",title:"Prof.",name:"Tomasz",middleName:null,surname:"Brzozowski",slug:"tomasz-brzozowski",fullName:"Tomasz Brzozowski",profilePictureURL:"https://mts.intechopen.com/storage/users/35854/images/system/35854.jpg",biography:"Prof. Dr. Thomas Brzozowski works as a professor of Human Physiology and is currently Chairman at the Department of Physiology and is V-Dean of the Medical Faculty at Jagiellonian University Medical College, Cracow, Poland. His primary area of interest is physiology and pathophysiology of the gastrointestinal (GI) tract, with the major focus on the mechanism of GI mucosal defense, protection, and ulcer healing. He was a postdoctoral NIH fellow at the University of California and the Gastroenterology VA Medical Center, Irvine, Long Beach, CA, USA, and at the Gastroenterology Clinics Erlangen-Nuremberg and Munster in Germany. He has published 290 original articles in some of the most prestigious scientific journals and seven book chapters on the pathophysiology of the GI tract, gastroprotection, ulcer healing, drug therapy of peptic ulcers, hormonal regulation of the gut, and inflammatory bowel disease.",institutionString:null,institution:{name:"Jagiellonian University",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:6,paginationItems:[{id:"10",title:"Animal Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/10.jpg",editor:{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",biography:"Catrin Rutland is an Associate Professor of Anatomy and Developmental Genetics at the University of Nottingham, UK. 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He studied \r\nchemistry at the Universidad Nacional de La Plata, Argentina, where received aPh.D. degree in chemistry (Biological Branch) in 1965. From\r\n1964 to 1974, he worked as Assistant in Biochemistry at the School of MedicineUniversidad Nacional de La Plata, Argentina. From 1974 to 1976, he was a Fellowof the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor oBiochemistry at the Universidad Nacional de La Plata, Argentina. He is Member ofthe National Research Council (CONICET), Argentina, and Argentine Society foBiochemistry and Molecular Biology (SAIB). His laboratory has been interested for manyears in the lipid peroxidation of biological membranes from various tissues and different species. Professor Catalá has directed twelve doctoral theses, publishedover 100 papers in peer reviewed journals, several chapters in books andtwelve edited books. 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