Blade geometry.
\r\n\tThe proposed subtitles are
\r\n\t• Municipal Solid waste landfills
\r\n\t• Industrial waste landfills
\r\n\t• Hazardous waste landfills
\r\n\t• Global approaches and technologies
\r\n\t• Legal and economic aspects
Gynaecological emergencies are disease conditions of the female reproductive system that threaten the life of the woman, her sexual function and the perpetuation of her fertility. Common gynaecological emergencies present as acute abdomen, abnormal vaginal bleeding, or a combination of both, and are often related to early pregnancy complications, pelvic inflammatory disease (PID) and contraceptive issues.
Some hospitals, mostly in the developed world, have specialist Emergency Gynaecology Units that provide fast intervention for acute gynaecological problems, such as pelvic pain, severe menorrhagia, vulvar problems, acute PID, hyperemesis gravidarum and post gynaecology surgical problems. These units are often manned by specialist nurses, sonologists and an on-call gynaecology medical team headed by a consultant gynaecologist. The aim of such a unit is to deliver adequate healthcare quickly, thus reducing the possible complications, and in so doing reducing the morbidity and mortality associated with such cases.
Advances in sonography, biochemical pregnancy testing, minimal access surgery and new antibiotics have led to early diagnosis of these conditions and adoption of more conservative approaches to treatment.
The basic objective of this chapter is to have an overview of these emergency gynaecological conditions on an individual basis, and their management. The management of these cases often requires history taking, clinical examination, investigations, both general and specific, and instituting the required treatment plan. Time is of the essence in these cases and so often there is an overlap in the management steps, with some requiring immediate resuscitation.
Ectopic pregnancy is one in which the conceptus implants outside the normal endometrial lining of the uterus, with the vast majority, over 95%, occurring in the fallopian tube [1]. It is a life-threatening gynaecological emergency and a leading cause of maternal morbidity and mortality in the early half of pregnancy [2], [3].
The incidence of ectopic pregnancy is increasing worldwide [4], and reported incidence varies from 1:60 to 1:250 pregnancies, and is dependent on the incidence of genital tract pathology and contraceptive practices of the population studied [5].
Delay in the diagnosis of ectopic pregnancy can be catastrophic because of the associated haemorrhage. Ectopic pregnancy should always be ruled out when a woman in the reproductive age bracket presents with a missed period and abdominal pain.
There should be a high index of suspicion for early intervention and reduction of morbidity and mortality [6]. The presentation could be acute or chronic. Patients usually present with lower abdominal pain and minimal vaginal bleeding after 5-8 weeks period of amenorrhoea. There could also be shoulder tip pain and fainting spells if intraperitoneal bleeding is massive.
It is mandatory that patients with ectopic pregnancy be managed in a hospital. Sensitive pregnancy test and ultrasonography, preferably a transvaginal scan, aid in initial diagnosis. Laparoscopy may also be used to diagnose ectopic pregnancy, but fails to detect early ectopic pregnancies or those obscured by adhesion. Diagnostic mini-laparotomy comes into play here.
Expectant or medical management of ectopic pregnancy should be considered in selected cases, but they are not widely practiced [7]. Some ectopic pregnancies resolve spontaneously, and this is the basis for expectant management. Methotrexate is employed for medical management in patients with unruptured ectopic pregnancy who are haemodynamically stable [8].
Surgery remains the mainstay of treatment of ectopic pregnancy. Surgical management is carried out by laparoscopy (Fig. 1) or laparotomy. For tubal pregnancy surgery may be radical (salpingectomy) or conservative (usually salpingostomy). For patients with ruptured ectopic pregnancy, especially those who present late, resuscitation and emergency laparotomy and salpingectomy are often required [9].
Patients managed for ectopic pregnancy require counselling because of the risk of recurrence, which is up to 20.5%, and such cases often give rise to diagnostic dilemma, especially when it occurs in an ipsilateral location [10]. Misdiagnosis of ectopic pregnancy may lead to dire consequences and an increase in case fatality [11, 12].
Laparoscopy equipment.
The World Health Organization (WHO) defined abortion (preferably termed as miscarriage) as the termination of pregnancy prior to 20 weeks of gestation, or the birth of a fetus weighing less than 500g in case the period of gestation is not known. It is noteworthy to state here that a very early miscarriage can sometimes be assumed to be a delayed menstrual period.
There are several types of miscarriages – threatened, inevitable, incomplete, complete, missed, septic, spontaneous, habitual and induced. Miscarriages are a common problem. Approximately 75% of all miscarriages occur before 16 weeks of gestation and of these nearly three-quarters occur within the first 8 weeks of pregnancy [13].
Abortions, mostly the unsafe, are a leading cause of maternal mortality worldwide, accounting for a global average of 13% of fatalities related to pregnancy [14]. Estimates by the WHO give a global annual total of 42 million induced abortions, with 20 million being unsafe [15, 16]. About 98% of unsafe abortions occur in developing regions [16, 17]. Unsafe abortion generally refers to termination of unwanted pregnancy either by persons lacking the necessary skills or it being performed in an environment lacking the minimal medical standards, or both.
Vaginal bleeding with associated abdominal pain is a common complication in the first half of pregnancy, and most miscarriages present in this manner. There is a psychological impact of early pregnancy loss on women, their partners and families. For some there is need for psychological support.
For the management of miscarriages there is need for proper patient assessment with respect to the history and clinical evaluation, with the need to rule out ectopic gestation. If the vaginal bleeding is moderate to severe and the patient is in some distress or shock, an intravenous line should be set up with a wide bore cannula and crystalloids quickly infused, and blood samples collected for complete blood count and cross-matching of blood for possible transfusion.
Uterine evacuation is the management option for miscarriages, except for threatened miscarriage which requires a conservative approach. Retained products of conception may lead to infection and haemorrhage.
Surgical uterine evacuation is done either by vacuum aspiration or by sharp curettage. The use of the metal curette is not without complications, which invariably includes anaesthetic risk, risk of infection, bleeding, cervical trauma, uterine perforation, long term complications of decreased fertility and abnormal menstruation, including Asherman’s syndrome. The suction curettage is safer and easier than the metal/sharp curettage.
Non-surgical management options for miscarriages include expectant management and medical treatment. Expectant management requires an understanding of the course of an abortive process, which includes resorption of early pregnancies to complete abortion. Here, there is a need for close monitoring and early intervention if the need arises. Medical treatment on the other hand involves the use of drugs to achieve uterine evacuation. The medications used here are the prostaglandins and their derivatives like misoprostol, and the antiprogestogens like mifepristone.
With expectant and medical treatment, the risks and side effects include unpredictability of the timing until the abortion is completed (with the possibility of significant pain and bleeding requiring an emergent curettage) and retained products of conception requiring surgical intervention. Expectant and medical treatments of abortion assume that prompt medical evaluation and possible intervention are immediately on ground if required, otherwise they should not be considered.
Septic abortion results from any type of miscarriage complicated by infection, especially unsafe abortion, resulting in foul smelling vaginal discharge and/or bleeding, with fever and lower abdominal pain/tenderness. Here, it is advised to cover with appropriate intravenous antibiotics for at least 6 hours prior to evacuation of retained products of conception. The antibiotics should be continued for a total of 14 days.
For missed abortion, there is a need to ripen the cervix before evacuation of retained products of conception after having confirmed the diagnosis by ultrasonography, which is often repeated in cases of very early gestations to ascertain non-viability, and making provisions for management of disseminated intravascular coagulopathy (DIC) if such should arise.
Habitual abortions, which entail at least three consecutive miscarriages, would require screening of patients before they embark on future pregnancy, but most turn out negative. Only a few, those positive for antiphospholipid antibodies (APA), can be treated with anticlotting agents, like aspirin, enoxaparin (clexane) and heparin, to improve outcome. For those with cervical incompetence resulting in second trimester miscarriages or early preterm births, cervical cerclage procedures may need to be performed between 14-16 weeks of gestation. Most of those with habitual abortion still have a successful pregnancy.
The complications of abortions, mostly haemorrhage and infection, and iatrogenic injuries like perforated uterus (Fig. 2) and gut injuries [18, 19, 20] cut across the different types of abortions, especially if the secondary care given for cases of spontaneous incomplete abortion is less than optimal. Laparoscopy, and/or laparotomy, is indicated to determine the extent of injury and to properly manage.
Perforation on the anterior uterine wall following instrumentation demonstrated at laparotomy.
Most healthcare systems expend far more resources treating complications of unsafe abortion than they would to provide safe abortion services [21, 22]. These costs are mostly on beds, antibiotics, blood transfusions services, surgeries and management of subsequent long term complications like ectopic pregnancy and infertility.
There is the need to send the specimen obtained from uterine evacuation for pathological analysis and for cervical/vaginal cultures to be obtained in cases of infection. Histopathological study may also exclude gestational trophoblastic diseases which can present in a similar manner to the miscarriages, may require suction evacuation of the uterus, but also do require a specific follow up plan, which may indicate the need for further treatment.
Based on the history pelvic pain could either be cyclical or non-cyclical. Cyclical pain is commonly as a result of pre-menstrual syndrome, pelvic endometriosis, primary dysmenorrhoea and ovulation pain (Mittelschmerz). For non-cyclical pain the common causes include pelvic inflammatory disease (PID), severe endometriosis, pelvic tumours, pelvic congestion syndrome and surgical causes like appendicitis and diverticulitis. A good history is required to make a possible diagnosis. The nature of the pain, whether cyclical or non-cyclical, acute or chronic (if present for 6 months or more), severity and exacerbating and relieving factors should be noted. Other associations to be noted include the parity, vaginal discharge, abnormal vaginal bleeding, dyspareunia, urinary symptoms, gastrointestinal symptoms, loss of appetite, weight loss and cervical smear.
Examination of the patient would involve general and systemic examinations, most especially the abdomen, pelvis and vagina. Pallor, wasting, abdominal distension, masses in the abdomen and pelvis, and abnormal growth in the lower genital tract should be sought for.
For the investigations, ultrasonography of the abdomen and the pelvis plays a key role. A growth in the lower genital tract may require a biopsy, and tumour marker screen for cancer antigen 125 (CA-125), carcino-embryonic antigen (CEA) and alpha feto-protein (AFP) may be required for pelvic tumours. A complete blood count, C-reactive protein and urine culture are often required. Diagnostic laparoscopy, when available, is a positive addition in the management of chronic pelvic pain when there is diagnostic difficulty, but not forgetting idiopathic pain.
Tumours of the ovary are common in women, with about 80% being benign and occurring in the reproductive age group [23]. Ovarian tumours are multifaceted and their classification is based on the historical cell of origin [24, 25]. About 70-80% of primary ovarian tumours are epithelial in origin, 10% stromal and 5% germ cell, while the rest fall into other groups [26]. Dermoid cyst is one of the commonest ovarian tumours in child-bearing age [27], and 10% of cases are diagnosed during pregnancy [28].
Generally, ovarian cysts that are painful may be as a result of torsion (Fig. 3), haemorrhage, rupture, be endometriotic or cancerous. Torsion of ovarian cyst commonly presents as severe acute lower abdominal pain that is often associated with nausea and vomiting. The abdomen is usually tender, with a palpable pelvic mass on bimanual pelvic examination and ultrasonography would reveal a large ovarian cyst. Such patients should be managed in a hospital and they require emergency surgery, usually a laparotomy. Conservative surgery (cystectomy) is usually carried out, but sometimes ovarectomy is done.
Torsion of left ovarian cyst (see torted stalk). This patient also had subserous uterine fibroids.
Ruptured ovarian cyst presents in a similar way to torsion of ovarian cyst. The patient may be known to have an ovarian cyst but this is no longer seen on ultrasonography. There may be evidence of peritonitis, including chemical peritonitis if the cyst was originally a dermoid cyst [29], and haemoperitonium. The patient would probably require a laparotomy if the condition worsens and so should be admitted to hospital urgently.
Uterine leiomyomas or fibroids are benign tumours that arise from the myometrial smooth muscle fibres. They are the commonest tumours found in the human body. It is estimated that one-fifth of all women have one or more in the uterus at death [30]. Fibroids are present in 20-25% of women of reproductive age, commonly associated with nulliparity, and for some uncertain reasons are 3-9 times more common in blacks [30, 31]. Most uterine fibroids are symptomless but 35-50% of patients have symptoms [31], and these are dependent on their location, size, state of preservation and/ or degeneration, and whether or not the patient is pregnant.
Fibroids are usually not painful. Acute pain may arise under certain circumstances, such as torsion of pedunculated fibroids, degeneration (especially red degeneration), associated endometriosis/adenomyosis, and/or expulsion of pedunculated submucous fibroids through the cervix [32]. Fibroid also rarely causes acute pain when it outgrows its blood supply, thereby causing necrosis. Spasmodic dysmenorrhoea may result when expulsion of a pedunculated submucous fibroid stimulates uterine contraction [32]. Sarcomatous change, which occurs in 0.1-0.5% of cases [31], can result in pain as well. There is the need to look out for other co-morbid conditions in cases of fibroids associated with pains.
With respect to the treatment of fibroids the factor considered in this section is the pain, therefore the patient has to be thoroughly evaluated; history, examination, and investigations. Pain is generally managed with the use of analgesics, ranging from acetaminophen (paracetamol) to non-steroidal anti-inflammatory drugs and opioids. Definitive treatment would require surgery if analgesics alone, sometimes with antibiotics in cases associated with infection, fail to alleviate the symptoms. There is usually no room for use of medical treatment options for fibroids presenting with acute abdomen or severe pains.
Definitive surgical modalities for management of uterine fibroids include myomectomy, which leaves behind a functional uterus and thus preserving fertility, and hysterectomy, which is desirable for patients over 40 years of age and those not desirous of future fertility. Both procedures can be carried out via the abdominal route, vaginal route, or even laparoscopically. Hysteroscopic myomectomy is indicated for submucous fibroids complicated by abnormal bleeding with pain. Robotic surgery is employed in high technology medical facilities, especially in countries with advanced healthcare systems.
Pelvic inflammatory disease (PID) is a spectrum of inflammatory disorders of the upper female genital tract, including any combination of endometritis, salpingitis, oophoritis or tubo-ovarian abscess and pelvic peritonitis/cellulitis. Sexually transmitted organisms, particularly Neisseria gonorrhoeae and Chlamydia trachomatis, are implicated in many cases. Organisms of the vaginal flora however also cause PID, which is often polymicrobial.
There is a worldwide increase in the incidence of PID, and it is the most common infectious disease that affects young women and accounts for a significant percentage of the morbidity that is associated with sexually transmitted diseases (STDs). Although it does not usually constitute an emergency in the sense that immediate treatment is life-saving, urgent treatment is required to minimize the effect of the disease on subsequent fertility and reduces the risk of sequelae such as ectopic pregnancy and chronic pelvic pain. This applies to both mild and severe disease.
The diagnosis of PID is usually based on clinical features although clinical diagnosis is usually imprecise, and many cases of PID go unrecognized or are subclinical. These patients are usually young, sexually active, and complain of abdominal pain, with or without fever and vaginal discharge. Bimanual pelvic examination usually elicits extreme tenderness on movement of the cervix, uterus and parametria. On laboratory investigations, saline microscopy of vaginal discharge may show abundant leucocytic infiltration, complete blood count may reveal leucocytosis, and C-reactive protein and erythrocyte sedimentation rate may be raised.
Endocervical swab may be positive for infection with N. gonorrhoeae and C. trachomatis. The true significance of this is questionable and the results lack consistency. However all women who have acute PID should be tested for these organisms, and screened for other STDs [33].
Endometrial biopsy, though not often done in practice, is more specific and usually shows histopathologic evidence of endometritis. Imaging, most especially transvaginal ultrasonography, showing thickened fluid-filled tubes with or without free fluid in the pouch of Douglas or tubo-ovarian mass are quite specific for PID. In less complicated cases imaging may be normal.
Laparoscopy is the gold standard for diagnosis of PID. However limited access and attendant surgical risks preclude its universal use for this purpose. The criteria for diagnosis of PID using laparoscopy include visualizing an overt hyperaemia of the tubal surface, oedema of the tubal wall, and sticky exudates on the tubal surface and/or fimbrial ends. All 3 are required for diagnosis.
The treatment of PID is essentially empirical, with use of antibiotics (parenteral and oral) for 10-14 days. Based on the severity and response to treatment this can either be done on outpatient or inpatient basis. Goals of treatment are to alleviate the acute symptoms of inflammation, and prevent the long term sequelae associated with PID. There may be need for contact tracing and treatment of sexual partners. Follow up and education are necessary to prevent re-infection and complications.
For those complicated by tubo-ovarian abscess unresponsive to extended antibiotic therapy, surgical management involving exploratory laparotomy by an experienced gynaecologic surgeon may be required. The extent of the surgery depends on the extent of the disease, the patient’s age and desire for future fertility. There is risk of injury to contiguous structures as a result of the inflammatory process, which may cause adhesions and a frozen pelvis.
Endometriosis is the presence of endometrial stroma and glands outside of the uterine cavity. The pelvis is the commonest site, with the reproductive organs the most frequently affected [34]. The most common symptoms related to it are dysmenorrhoea, dyspareunia and low back pain which worsen during menstruation, and subfertility. It is a leading cause of disability in women of reproductive age, and the pain may be mild, or it may be severe enough to negatively affect health-related quality of life.
Endometriosis remains a difficult clinical problem and quite a number of patients are often referred to other specialists before seeing the gynaecologist [35]. Painful symptoms, especially when cyclical, may be caused by endometriosis, and it is the underlying cause of pelvic pain in 15% of cases [36]. The exact prevalence is unknown because surgery and/or histology is required for its diagnosis, but estimates of 3-10% of women in the reproductive age group, and 25-35% of infertile women have been made [37].
The symptoms of endometriosis and the laparoscopic findings do not always correlate [38]. The focus during management should be on the illness rather than the disease. There is no place for medical treatment of endometriosis with drugs in infertile women desirous of having babies [39]. Surgery can be done via laparotomy or laparoscopy [40, 41]. Analgesics are often required for symptomatic relief of pain. Unlike infection, endometriosis does not damage the luminal epithelium of the fallopian tube, and thus conservative surgery is more likely to be successful in restoring normal anatomic relations. However, endometriosis is also a well known cause of frozen pelvis.
Severe vaginal bleeding may or may not be related to menstruation. Common causes are dysfunctional uterine bleeding (DUB), uterine fibroids, adenomyosis and genital tract malignancy.
Normal menstrual cycles range from 21-35 days, with the estimated blood loss less than 80 ml, with flow not more than 7 days. Most women who complain of heavy periods have normal loss. Extremely heavy menstrual loss is uncommon and other causes such as a miscarriage or a genital tract malignancy like carcinoma of the cervix or endometrial carcinoma should be ruled out. If the patient is symptomatic after a heavy menstrual loss, like having dizziness or fainting spells, appears pale or has tachycardia, she should be admitted to hospital for treatment.
Patients with massive vaginal bleeding require resuscitation which includes securing of intravenous access with a wide bore cannula, obtaining blood samples for a complete blood count and infusing of crystalloids. Possible causes of the vaginal bleeding should be ruled out. There is the need to correct anaemia with haematinics and even blood transfusion.
Control of bleeding may be achieved by use of haemostatic drugs like tranexamic acid (an antifibrinolytic agent) and ethamsylate, or by hormonals like medroxyprogesterone, prior to definitive treatment of the cause. Mirena, a levonorgestrel-impregnated intrauterine system, and endometrial ablation techniques like the NovaSure system may also be employed [42] for control of bleeding.
The definitive treatment is dependent on the cause and emergency dilatation and curettage (D&C), myomectomy, and even a hysterectomy (Fig. 4) are possibilities. For those emanating from gynaecological cancers referral to oncology units with expertise in their management is required.
Hysterectomy specimen of a 50-year old woman who had total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine fibroids associated with menorrhagia.
Bartholin’s cysts are the commonest cysts of the vulva, and they are of two types, a cyst of the duct and a cyst of the gland, with differentiation made on histology using the surface epithelium. The position of the swelling at the junction of the anterior two-third and the posterior one-third of the labia majora is diagnostic. Bartholin’s abscesses are secondarily infected cysts. Organisms involved in the infection of the gland are similar to those responsible for PID [43, 44].
Drainage should be established whenever an abscess develops. Apart from the pains, which may be severe, there is the theoretical risk of ascending infection, with a more extreme inflammatory process, with systemic symptoms and signs of infection, and these may affect the quality of life. Cases of necrotizing fasciitis have been reported in immuno-compromised women, including those with diabetes mellitus. Septic shock and toxic shock-like syndrome can also complicate Bartholin’s abscess [45], [46].
The treatment of Bartholin’s abscess encompasses bed rest, use of antibiotics and analgesics, coupled with surgical drainage and warm sitz bath. The procedure of choice for surgical drainage is marsupialization, and this has the advantage of preserving the gland, which continues its secretory function and prevents recurrence by the creation of a new gland ostium or fistula to replace the function of the presumed damaged or obstructed duct. Simple incision and drainage (I&D) of the abscess is associated with a high recurrence rate.
Abscesses that rupture spontaneously are treated by warm sitz bath. Gland excision is not recommended for Bartholin’s abscess because of the risk of spread of infection which may result following surgery in an inflamed hyperaemic tissue environment [47].
Another less common vulvar abscess is that involving the Skene’s gland. Treatment basically follows the same principles as that for Barthoin’s abscess.
Toxic shock syndrome is a rare entity primarily occurring in menstruating women and caused by exotoxins produced by penicillinase-producing non invasive Staphylococcus aureus of phage type 1. It is associated with use of super absorbent tampons, especially if left in place for long. Tampon use may also excoriate the cervical and vaginal mucous membranes, thereby encouraging absorption of the exotoxin.
Non-menstrual toxic shock syndrome has been reported with prolonged use of contraceptive diaphragm or sponge [48], after delivery, laser therapy for condylomata acuminatum [49] and non-gynaecological surgery.
Toxic shock syndrome can also be caused by some streptococcus species, including Streptococcus viridans which causes a more fulminant disease with high mortality.
The clinical manifestations of toxic shock syndrome are diverse and these often develop rapidly in otherwise healthy persons. These include sudden onset of high fever, hypotension, and associated symptoms like vomiting, diarrhoea, myalgia, abdominal pain, and headache. A characteristic “sunburn-like” rash, a diffuse maculopapular erythroderma, appears over the face, trunk and proximal extremities over a period of 5-14 days, which later desquamates, especially over the palms and soles during convalescence. Multi-systemic involvement is typical and these include coagulopathy, renal, hepatic, muscular, cardiovascular, neurological and respiratory systems.
On taking a history, ask the patient if she is menstruating or using tampons. A vaginal examination should be performed and any foreign body in the vagina such as tampon or contraceptive device should be removed.
The diagnosis of toxic shock syndrome is usually clinical. A full septic and biochemical screen should be done to exclude multiorgan failure. Isolation of the exotoxin for Staphylococcus aureus is pathognomonic.
Treatment entails aggressive supportive therapy, preferably in an intensive care unit. Fluid resuscitation is necessary, and vasopressors, packed red cells and coagulation factors, mechanical ventilation and haemodialysis may be required. Antibiotics, given intravenously, are used for 10-14 days to eradicate the organism. Protein synthesis inhibitors such as clindamycin which suppress toxin production are more effective than cell wall active agents like beta-lactams. Cephalosporins or beta-lactamase-resistant penicillins like nafcillin or oxacillin, and vancomycin (for penicillin-allergic patients) may also be used. Since toxic shock syndrome is toxin related, antibiotic treatment is not directly effective, but it reduces the bacterial load and ultimately prevents further toxin production.
Rape definitions vary from country to country, but generally regarded as the physically forced entry or the otherwise coerced penetration of the mouth, vulva, vagina or anus with a penis, other body part or object. It is an act of sexual violence. It can result in serious short and long-term physical, mental, sexual and reproductive health problems for victims and their families and can lead to social and economic costs.
Health consequences may include headache, back pain, abdominal pain, gastrointestinal disorders, limited mobility and poor overall health. Non fatal and fatal injuries can also result.
Rape can result in unwanted pregnancies, gynaecological problems, induced abortions, sexually transmitted infections, including human immunodeficiency virus (HIV) and hepatitis B infections. Mental disorders like post-traumatic stress disorder, sleep difficulties, depression, suicidal tendencies and drug and alcohol abuse can arise.
Some gynaecologists hardly receive proper orientation or training in managing intimate partner violence as part of their medical training and therefore tend to underestimate the extent of the problem and feel insufficiently skilled to deal with it [50]. Treatment here typically involves dealing with coital lacerations, STDs, including HIV and hepatitis-B post-exposure prophylaxis, tetanus prophylaxis, and emergency contraception to prevent unwanted pregnancy. Due to the extent of coital injuries, especially when foreign objects are used, emergency laparotomy may be required.
It is crucial that advice is sought from the police or sexual assault referral centre before undertaking any examination for forensic reasons, unless it is life-saving. Pictures of the victim, multiple swabs and aspirations from body cavities and parts, and a whole lot more may need to be taken. A checklist may be required to follow due process on the management of such cases, as well as employing the services of a clinical psychologist or psychiatrist for long-term management.
Wind is an abundant resource available in the earth’s atmosphere, and the need for renewable energy is demanding due to climate change and the energy crisis. Wind energy is low carbon footage leads to importance in research increasing the efficiency and use of the wind resource even in low wind speed. In the case of renewable and carbon-free emission energy production; firstly, solar power gains less attraction due to the less efficient and cannot produce energy on a night or cloudy days. Secondly, hydropower depends on rainfall; has a high impact on river ecosystems and forest environments. Additionally, tidal power and geothermal energy are far away from mass energy production. At last, carbon-free energy production can be achieved in nuclear energy but gain a vast life risk during a disaster and handling nuclear waste is a big challenge. Therefore, wind energy gains significance in the technological and political community in fighting climate change without compromising the modern depend and national economy.
In Denmark, 28% of wind energy is generated at total consumption in 2018 [1], and wind energy capacity almost doubled in 2020, where China had a major part of 72 GW [2]. The wind farm located in China (Gansu Wind Farm) with a capacity of 7965 MW is the world’s largest and the second-largest is located in India (Muppandal Wind Farm) with a capacity of 1500 MW [3]. Wind energy production is increasing globally by installing wind turbines in large offshore farms located in agricultural lands, valleys and hills. In addition, onshore wind turbines on the sea bed and new initiatives for installing wind turbines in urban areas (University Campus or highway street lights) [4].
The power extraction from the wind is by converting the wind energy into useful mechanical energy by rotating the turbine or through vibration. The latest research trends in wind energy are in the construction of horizontal wind turbines (liftbased rotation), vertical wind turbines (drag-based rotation) and bladeless wind turbines (aero-elastic-based vibration). The other significant research focused on the pattern of sitting wind to gain more aerodynamic efficiency to get more power output in farm and urban areas, the aerofoil and flow control mechanism in the blade increase the power output efficiency and decrease the cutoff wind velocity. The major challenges in wind energy are turbine transportation and installation, especially in the hilly area, bird’s attack in turbines, the need for extensive land acquisition and recycling of retired wind turbines.
The wind played an important role in ancient civilization in developing sailing boats, kites, agriculture, and metrology. In the ancient period, there are a lot of myths about wind being raised and a hole in the sky which blew it from the sky to earth. In Greek mythology, the God of the Sea, Aeolus, is a guardian of the wind. Feng Po (Wind God) had a sack with an opening that controlled the wind in China. In 3500 BC, Egyptians used wind power to sail the boat in the Nile river, and in Persia, 500 BC millstone, the water pump is driven using wind power. In 1300–1850 AD windmill was designed for water pumping and large-scale milling, which is similar to modern wind turbine design [5]. In 1887, a wind turbine was firstly used to generate electricity built by Prof. James Blyth in Scotland. In 1900, 30 MW of power was generated with around 2500 windmills in Denmark. A Smith Putnam 75—feet wind turbine blade generated 1.25 MW of power for local energy needs gained colossal importance and possibilities in the wind energy sector. In 1975, a wind turbine was developed by NASA—with a composite material blade with pitch control, steel tube tower installed with aerodynamics and structural design ignited more possibilities in the max power output and led to building large wind turbines for energy production [6]. Today, the Sea Titan three-bladed wind turbine can generate 10 MW of power with a rotor diameter of 190 m.
Aerodynamics is a branch of fluid dynamics, the study of the motion of air with forces and moments that act on the body. Aerodynamics plays a vital role in the flight of the aeroplane and helicopter, rocket technology, designing high speed and fuel-efficient cars, reducing the drag on the athlete in sports events and a lot more engineering applications. For example, the aerodynamics of the wind turbine is an important area to increase power output and design a large turbine blade.
The forces and moments on the body are due to pressure and shear stress distribution (Figure 1). The pressure acts perpendicular to the surface, which acts as a load on the wind turbine and shear stress is the frictional force tangential to the surface. The pressure difference between the bottom of the blade and the top of the blade generates the lift force (Eq. (1)) (perpendicular to freestream velocity) the wind turbine blade generates the power by rotating the generator.
Aerodynamic forces in the aerofoil.
Where,
The lift force on the wind turbine blade is proportional to the square of the wind velocity gains essential parameters in the wind energy generation. The blade span area depends on the length and width of the blade throughout the cross-section and
Reynolds number (Re) is a non-dimensional number used to predict the behavior of the fluid at varying environments and used to model the scale-down model [8]. The Reynolds number is named after Irish-born Osborne Reynolds, who predicted the different flow patterns by inducing die in the pipe flow. Reynolds number (Re) is the ratio of inertial force to viscous force (Eq. (2)).
Where,
Re = Reynolds number
η´ = dynamic viscosity of air (Pa.s/Kg m−1 s−1)
The flow pattern is differentiated into laminar flow and turbulent flow. Both possess different characteristics in nature. Laminar flow is a smooth and regular streamline pattern, whereas turbulent flow is a random and irregular flow pattern. The critical Reynolds number is 5 × 105 transition between the laminar to turbulent flow over a flat plate.
In 1904, Ludwig Prandtl developed the theory boundary layer [9], the flow field around the body had two areas where flow is frictional and non-frictional. The boundary layer is the area where the friction of the flow is considered due to viscous characteristics. The thickness of the boundary layer is a distance between the surface to freestream velocity of flow, the velocity at the surface is zero (
Velocity profile in boundary layer.
Pressure is a dimensional quantity (Eq. (3)) (SI unit N/m2) and important variable to express the force that acts on the body. The pressure must be expressed in the dimensionless quantity pressure coefficient (
To measure the pressure coefficient, the pressure tapping is distributed around the model’s surface in the wind tunnel. To measure the pressure coefficient, on the surface of the model in the wind tunnel the pressure tapping will be distributed around the surface. The tubes will be connected to multi-tube manometer or pressure sensors to measure the pressure difference at the tappings (
Aerodynamics lift is a complex topic for understanding, the lift generated by wings made the heavier than air flight possible. There is much debate on how the wing or turbine creates lift with aerofoil cross-sections. When the fluid flow over an object, the force exited due to the fluid motion where the lift is perpendicular to the freestream and drag is parallel to the freestream. Concentrating on the lift produces a high lift with minimum drag on the streamlined body like an aerofoil.
The aerofoil shape is used in aeroplane wings, wind turbines and propellers to generate the lift and based on the application and need the different aerofoil profiles are used. Consider a wind turbine aerofoil where the wind flow over it causes a pressure distribution with high pressure in the bottom and low pressure on the top cause a lift generation on the turbine to rotate the generator to produce electricity. The shape of the aerofoil creates an uneven pressure when fluid moves over it to generate the lift, but how is the uneven pressure distribution formed on the aerofoil? It is a tricky question to answer. We discuss two widely accepted explanations of lift generation in the aerofoil. The following explanation is based on Newton’s third law of motion, where the fluid nature is considered in lift generation. When fluid flows over an aerofoil, the fluid will suddenly experience the aerofoil where the flow moves upward, called upwash and downward called downwash. Due to the large fluid volume displacement, every action has an equal and opposite reaction, the aerofoil creates lift as a reaction force by turning down the incoming air. In conclusion, the lift is created due to uneven pressure distribution, but the pressure distribution is complex and has a different explanation based on the approach.
We will now discuss how the aerofoil shape and orientation affect lift generation. At freestream velocity
(a)
The flow control technique (flaps and slats) alters the lift slope and increases the
(a)
A wind turbine is a mechanical device that converts the kinetic energy of the incoming airflow striking the blade surface, producing considerable lift on the airfoils; thereby, rotation of blades is effected and successfully converted to electrical power through gearbox assembly. According to the mode of operation, wind turbines can be classified as follows.
Each type of wind turbine mentioned in (Figure 5) above can be summarized as:
Horizontal axis wind turbine: It is a type of wind turbine in which the rotor’s axis of rotation is parallel to wind flow.
Dutch type grain grinding windmill: It operates at the thrust exerted by wind, and the number of blades in a turbine is four. Wooden slats have been used for making the blades of the turbine.
Multiblade water pumping windmill: Blades of this type of turbine are made of metal or wood and the selection of a site depends on the water availability of the area. It operates at low velocities and is also called a fan mill.
High-speed propeller-type wind machines: The working of this turbine is only dependent on the aerodynamic force generated when wind flows on the airfoil surface of the blade section. They find their applications in the electricity generation of our modern era. The selection of the airfoil section forms the core of the blade design of modern wind turbines.
Vertical axis wind turbine: It is a type of wind turbine in which the rotation axis is placed vertical or perpendicular to the ground.
The Savonius rotor: This wind turbine consists of a drum cut into two halves and attached opposite to the vertical shaft. The rotor torque is generated due to wind flow on concave and convex surfaces.
The Darrieus turbine: This type of wind turbine has two or more blades made flexible and attached in the shape of a bow to the vertical shaft. The rolling action of blades generates the torque.
Classification of wind turbines.
Rotor: Rotor blades of wind turbines work under the principle of an aircraft wing. The airflow on their surface creates pressure difference; blades rotate to produce electrical power.
Nacelle: It forms the housing, which contains gearbox, generator, drive train, brakes, etc.
Blades: Blade is a critical part of any wind turbine design as they are responsible for lift and power by rotation. The blade section close to the rotor is the hub, whereas the section away from the rotor is the tip of the blade. Hub is designed thicker, and the blade’s tip is thinner to facilitate the airflow.
Tower: It is designed to hold the rotor blades and whole assembly off the ground. Usually, a tower is constructed 50–100 m above the ground surface or water (in the case of offshore wind turbines).
Brake: The braking system is specifically designed to stop the whole machine when there is a flaw or damage in a component of the turbine. The braking system demands higher cycle rates and reliability. The brake pad of the modern turbine is coated with Kevlar to ensure longevity and robustness.
Gearbox: The gearbox is used to is to increase the rotational velocity of the low-speed rotor to an electrical generator by gearing arrangement. The gearbox ratio varies from 15:1 to 30:1, depending on the power output of turbines.
Anemometer: Instrument used to measure the velocity of incoming wind flow, and it transmits the wind speed to the controller.
Controller: A wind turbine controller is a series of systems connected to monitor the operation of the wind turbine and adjacent turbines (wind farm). It is responsible for the initiation and shutdown of the system in adverse conditions.
Yaw system: The orientation of the wind turbine towards the incoming wind is done by the yaw system. It has two systems; active and passive yaw systems and comprises mainly of yaw drive, yaw brake, and yaw bearing.
Horizontal axis wind turbine (Figure 6) blades demand a pre-requisite of specific terminologies and mathematical formulas, which converge to a critical section called blade element momentum theory [10]. The preliminary step in blade element momentum theory is dividing the blade into equal sections and let each sectional element has a radius “
Horizontal axis wind turbine mechanism.
The output power (
Where,
Betz law states that “The power extracted from the wind is independent of wind turbine design in the open flow. Therefore, it is impossible to capture more than 59.3% of Kinetic energy from the wind.” From the Betz law, power is validated from the above equation.
The angle of attack (
Tip speed ratio: Tip speed ratio of the wind turbine is defined as the ratio of blade tip velocity to the wind velocity as mentioned in (Eq. (5)).
The tip speed ratio of wind turbines should be greater than 4 for electrical power generation applications. The optimum value for TSR is 6 for a horizontal axis wind turbine blade.
The number of blades (B) is an essential criterion in the power performance of blades. In horizontal axis wind turbines, the number of blades is chosen to be three as it is 40% more efficient when blades are reduced (wobbling) or increased (high drag). In the case of vertical axis wind turbines, blade number varies from 2, 3, or 4 depending on the operating conditions.
Once the number of blades is fixed, the immediate next step in blade design is evaluating the relative wind angle (
In Eq. (6),
Schematic representation of blade elements.
The design lift coefficient is measured from the properties of airfoil used in a wind turbine blade. For example, if the analyst uses NACA 4418 airfoil [10] for the wind turbine analysis, the aerodynamic properties of an airfoil can be extracted from the lift curve and lift-drag curve.
Maximum lift coefficient, (
Critical angle of attack, (
Zero lift angle,
Design lift coefficient,
The next step in the design process is the evaluating the chord length of airfoil sections in the blade by using (Eq. (7)) below:
Pitch angle (
Mathematically pitch angle is calculated using (Eq. (8)) by the difference between blade angle and angle of attack.
The twist angle at each section of the blade is calculated using (Eq. (9)) by subtracting the blade pitch with the pitch at the tip:
In this expression,
The twist angle reduces from the hub to zero at the tip. From the above data, we can create a table for the geometric design of the horizontal axis wind turbine blade, as shown in Table 1. The geometrical modeling of the blade can be done using commercial software ANSYS (or) SOLIDWORKS.
S. No. | Radius of element ( | Chord length ( | Twist angle ( |
---|---|---|---|
1 | |||
2 | |||
… | … | … | … |
10 |
Blade geometry.
Computational analysis (3D) of the blade is a tedious process as modeling of the blade is a complex process to the core. The computational domain involves a stationary element and a rotational element to perform the moving reference frame approach, as shown in (Figure 8). Moving reference frame involves varied translation and rotational velocities of individual cell zones of the mesh. Stationary equations are generated and solved for stationary element. The rotating element is solved by moving reference frame equations such as centripetal acceleration and Coriolis acceleration in the momentum equation. The flow variables in one zone are extracted to calculate the adjacent zone by transforming the local reference frame in the interface between the cell zones.
Computational domain of wind turbine blade.
Usually, the computational domain for horizontal axis wind turbine blade is designed as follows.
Diameter of inner cylinder = 1.5 D
Length of inner cylinder = 0.5 D
Diameter of outer cylinder = 5 D
Length of outer cylinder = 20 D
Distance between the cylinder and upstream domain =
The meshing of domain involves creating unstructured mesh [11] around the domain with tetrahedral elements as they give good results during the simulation. The exploded view of mesh and meshing elements around the blade (Figure 9).
Mesh elements of wind turbine blade.
Simulation of the turbine blade is done using commercial software such as ANSYS-FLUENT/CFX. The turbulence model suitable for external flows [12] such as wind turbine flows is the
Experimental analysis of wind turbine blades involves modeling and fabrication of blade setup as its preliminary step. Fabrication of blade is done using 3D printing of reinforced composite material.
The velocity profile of the rotor is extracted by fixing a pitot tube with equal holes in the X and Y-axis along the surface. Then, the pressure difference readings can calculate the velocity using (Eq. (10)) derived from (Eq. (3)).
Flow control [12] is one of the essential phenomena to be addressed in aerodynamics. As the name says, the flow control mechanism aims to control the flow of wind, thereby delaying the flow separation leading to the generation of lift and power output. Flow control is primarily classified into two types: active flow control and passive flow control mechanism.
Active flow control mechanism involves an instantaneous change in the design of the installation the installed device to increase the
Vortex generator was introduced by Taylor [18] during 1947 as thin plates arranged in a spanwise manner projecting on the airfoil surface. Intensive research in Vortex generators had its roots in the 1970s when Kuethe [19] performed analysis on wave-type vortex generators with (
Effect of leading-edge VG on the power curve.
Triangular Vortex generator.
The performance comparison is shown in (Figure 12) depicts the increment in output power due to the addition of vortex generators. The vortex generators placed in the airfoil surface’s whole span predominantly produce a 6% increase in power output with a mean wind speed of 7.15 m with a counter-rotating arrangement. The optimum dimensions suggested are pair width of vortex generators should be 0.1 c and pair spacing between generators is 0.15 c where “c” is chord length of airfoil. It also deduces vortex generators used to suppress the sensitivity of the blade to dirt accumulation on the leading edge. The following research step is optimizing the design and performance prediction of turbines [22] installing vortex generators [23]. Integrating vortex generators in wind turbines is the next giant leap in aerodynamic research.
Influence of span-wise location of vortex generator on power output.
Design risks and modifications in the vortex generators are studied [24] thoroughly for different radius as tabulated in Table 2.
Radius | Radius | Modification |
---|---|---|
0–30 m | Laminar flow is observed at 25% radius. Forward placement of VG leads to early transition and increased drag penalty. | VGs are placed aft outboard of the blade. |
0–45 m | Vortex generators are positioned to stall at a velocity range of 14.3–15.6 m/s where a portion of the blade is installed sharply, leading to adverse effects. | The slope of the chordwise VG locations is increased, leading to the smooth progression of the stall. |
5–60 m | A stall angle closer to maximum peak rotor power may lead to an unwanted increase in the rotor power. As a result, outboard sections are less significant and sometimes lead to additional drag. | Removal of unwanted outboard vortex generators will compromise the drag penalty. |
Design risk and modification for varied dimension.
The design of the vortex generator depends on parameters such as:
Height of vortex generator: In most analyses, the boundary layer thickness (
Spacing between generators: The spacing between a pair of vortex generators depends on the chord length of the airfoil element of the surface and flow characteristics.
Position of vortex generator: The position of the vortex generator is fixed by the prediction of flow separation point in the blade surface extracted from the CFD analysis of the blade.
A triangular vortex generator [25] is designed for a wind turbine blade as a sample analysis as it is simple and effective under varied operating conditions.
In a preliminary analysis, one of the airfoil elements in BEM analysis is taken, and the vortex generator is placed at different locations in the chordwise direction. The meshing of an airfoil with VG involves special near-wall mesh. The flow can be captured on the surface without any jumps in this mesh type.
From the wall shear analysis, we can predict the flow separation point, forming the underlying basics for consequent 3-dimensional analysis.
The flow separation point is decided by fixing the vortex generator in different positions on the elemental surface and it is evident from CL vs. angle of attack (Figure 13) and recirculation zone (Figure 14) that the highest lift is obtained when the vortex generator is placed on the flow separation point [26]. The experimental analysis is validated from the CFD analysis to get qualitative results [27].
Lift coefficient vs. angle of attack.
Recirculation zone behind the vortex generator.
Wind turbine aerodynamics is one of the intriguing sections in the field of aerodynamics with much varied scope in the future years. Wind turbine blade analysis is practically a tedious and challenging area as the design parameters are vast, and each of them has a specified impact on the turbine performance either directly or indirectly. Effects of climatic change, terrain location, the wind rose of a particular area, environmental effects of the wind turbine, impact of blade materials in performance, height of tower and impact of the surrounding environment on the turbine’s performance. Research on offshore turbines and bladeless turbines has started and improvement of performance with considerable cost will be the key objective. The effect of ocean currents, ecosystem, and airflow in the ocean are exciting areas to ponder as energy conservation will be the prime focus for the future. Wind energy, the cheapest energy source, will be looked upon in the immediate future. The chapter gives a preface to the concept of aerodynamics and explains wind turbine terminologies to briefly explain the design and analysis of turbines to form a formidable and appealing pre-requisite for researchers to begin their work on wind turbine analysis.
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Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:null},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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