\r\n\tThis book intends to provide the reader with a comprehensive overview of the current state-of-the-art novel imaging techniques by focusing on the most important evidence-based developments in this area.
",isbn:null,printIsbn:null,pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"d9159ce31733bf78cc2a79b18c225994",bookSignature:"Dr. Gabriel Cismaru",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11867.jpg",keywords:"Hypertrophic Cardiomyopathy, Dilated Cardiomyopathy, Restrictive Cardiomyopathy, Transesophageal Echocardiography, Intracardiac Echocardiography, 3-Dimensional Echocardiography, Adult Congenital Heart Disease, Tetralogy of Fallot, Transposition of the Great Vessels, Coronary Artery Disease, Risk Stratification, Revascularization",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 21st 2022",dateEndSecondStepPublish:"May 19th 2022",dateEndThirdStepPublish:"July 18th 2022",dateEndFourthStepPublish:"October 6th 2022",dateEndFifthStepPublish:"December 5th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Cismaru Gabriel is an Assistant Professor at the University of Medicine and Pharmacy Cluj-Napoca, certified in Cardiology. After completing his certification in cardiology, Dr. Cismaru began his electrophysiology fellowship at the Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu. He has authored or co-authored peer-reviewed articles and book chapters in the field of cardiac pacing, defibrillation, electrophysiological study, and catheter ablation.",coeditorOneBiosketch:"Raluca Tomoaia is an MD, Ph.D. in novel techniques in Echocardiography at the University of Medicine and Pharmacy in Cluj-Napoca, Romania., assistant professor, and a researcher in echocardiography and cardiovascular imaging.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"191888",title:"Dr.",name:"Gabriel",middleName:null,surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru",profilePictureURL:"https://mts.intechopen.com/storage/users/191888/images/system/191888.png",biography:"Dr. Cismaru Gabriel is an assistant professor at the Cluj-Napoca University of Medicine and Pharmacy, Romania, where he has been qualified in cardiology since 2011. He obtained his Ph.D. in medicine with a research thesis on electrophysiology and pro-arrhythmic drugs in 2016. Dr. Cismaru began his electrophysiology fellowship at the Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu, France, after finishing his cardiology certification with stages in Clermont-Ferrand and Dinan, France. He began working at the Rehabilitation Hospital\\'s Electrophysiology Laboratory in Cluj-Napoca in 2011. He is an experienced operator who can implant pacemakers, CRTs, and ICDs, as well as perform catheter ablation of supraventricular and ventricular arrhythmias such as ventricular tachycardia and ventricular fibrillation. He has been qualified in pediatric cardiology since 2022, and he regularly performs device implantation and catheter ablation in children. Dr. Cismaru has authored or co-authored peer-reviewed publications and book chapters on cardiac pacing, defibrillation, electrophysiological studies, and catheter ablation.",institutionString:"Iuliu Hațieganu University of Medicine and Pharmacy",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"7",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:null},relatedBooks:[{type:"book",id:"5970",title:"Bedside Procedures",subtitle:null,isOpenForSubmission:!1,hash:"ba56d3036ac823a7155f40e4a02c030d",slug:"bedside-procedures",bookSignature:"Gabriel Cismaru",coverURL:"https://cdn.intechopen.com/books/images_new/5970.jpg",editedByType:"Edited by",editors:[{id:"191888",title:"Dr.",name:"Gabriel",surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9064",title:"Epidemiology and Treatment of Atrial Fibrillation",subtitle:null,isOpenForSubmission:!1,hash:"1cd6bf2b3181eb82446347fbe478a2bc",slug:"epidemiology-and-treatment-of-atrial-fibrillation",bookSignature:"Gabriel Cismaru and Keith Andrew Chan",coverURL:"https://cdn.intechopen.com/books/images_new/9064.jpg",editedByType:"Edited by",editors:[{id:"191888",title:"Dr.",name:"Gabriel",surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6550",title:"Cohort Studies in Health Sciences",subtitle:null,isOpenForSubmission:!1,hash:"01df5aba4fff1a84b37a2fdafa809660",slug:"cohort-studies-in-health-sciences",bookSignature:"R. 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Posterior femoral and tibal osteophytes tent upon the capsule resulting in further flexion at the knee and sometimes mechanical block to extension. Other factors like hamstring shortening and ligament contracture also contribute to flexion at the knee. There is increase in energy expenditure while walking or standing along with decreased endurance and inability to stand for long period of time [1, 2]. Fixed flexion at single knee increases abnormal forces on other knee resulting in abnormal gait. There is limb length discrepancy and short stride length. There is associated increase in extension and adduction. In severe flexion deformities, there is alteration of kinematics of spine. There are increased chances of lumbar spondylosis and accelerated degeneration of contralateral knee in cases of long standing flexion deformity at knee. Isolated flexion deformity is very rare and generally associated with either varus or valgus deformity at knee [3]. Some authors have reported incidence of flexion deformity up to 60° in cases of osteoarthritis knee [4]. To achieve complete range of movement at knee, full surgical correction should be achieved during surgical correction.
\nRitter et al. [5] had described that residual flexion contracture by more than 10 degree can result in poor functional outcome in patients who undergo knee replacement. The risk factors for persistence of deformity were male gender, higher age and preoperative flexion contracture of more than five or more degrees [6]. Among these the single most important factor predictive of residual flexion contracture was preoperative flexion deformity at knee. Body mass index has no role in persistence of flexion deformity after surgical correction [7]. Surgical technique factor like overstuffing of extension gap and flexion of femoral component also determines the post-operative flexion deformity. The femoral component placed in flexion can result in limitation of arc of motion due to constraints in articulation.
\nLong standing cases of arthritis have intercondylar osteophytes, which acts as mechanical block to extension [4]. The posterior osteophytes in addition impinge upon posterior capsule further increasing flexion contracture. Subsequently, it leads to contraction of soft tissues over the posterior aspect of knee adding to the deformity.
\nThere is erosion of the posterior aspect of the tibia and reduction in the strength of quadriceps resulting in extension lag even after correction of deformity. Lombardi et al. [8] had classified flexion deformity into three grades depending upon the severity of deformity. Grade I is mild contracture with deformity limited to less than 15°. Grade II is moderate contracture with deformity between 15° and 30°. Grade III is severe contracture with deformity greater than 30°.
\nA patient with knee flexion contracture undergoing knee replacement should be evaluated for coronal plane deformities, grade of flexion deformity, extensor lag and preoperative range of motion is recorded. The assessment of these variables helps a surgeon to decide regarding the clinical expectations, surgical technique, associated risks and complications. The next important step is to grade the flexion contracture. The standard radiographs should be evaluated to determine the disturbances in the bony anatomy especially posterior condylar deficiencies, coronal deformities and prominent osteophytes. The posterior condylar deficiency affects the rotation of femoral component when posterior referencing system or measured resection technique is used. Sometimes large bony defects would require augments in the form of allografts or modular inserts.
\nIn patients suffering from inflammatory arthritis, there is minimal or no osteophyte formation associated with fixed flexion deformity hence preoperative manipulation is sometimes helpful in selected cases. In cases with bilateral hip and knee deformity, the preoperative manipulation is carried out after hip replacement with the aid of serial casting over the knee in maximal stretch [9]. The cast should be adequately padded to avoid pressure sores over the anterior aspect of knee. Epidural anesthesia can be very helpful in these cases as serial casting becomes relatively pain free and fruitful.
\nAfter all preoperative preparations, tourniquet is applied over the limb to operated and activated just before incision. The operative leg is examined again under anesthesia to ascertain the degree of deformities. Limb is draped and prepared with betadine or chlorhexidine solution as per the hospital infection control protocols. A midline skin incision is given extending approximately 5 cm proximal to suprapatellar pouch to a point just medial to tibial tubercle. Medial parapatellar osteotomy is performed with eversion of patella exposing both lateral and medial femoral condyle. Next step is to correction of coronal deformities with removal of osteophytes and soft tissue contractures. All efforts should be concentrated to correct the flexion deformity intraoperatively while maintaining soft tissue and adequate stability. The classical approach described by Insall [10] is to resect the posterior femoral condyle and releasing the soft tissues in order to achieve a rectangular flexion gap. Another technique of balancing is to measure the resected pieces of bones from femoral and tibial condyle and replacing the same with components of same size.
\nThe primary focus in case of fixed flexion deformity is over the posterior femoral recess. The posterior capsule should be released as far as possible. The posterior capsule release makes the extension gap equivalent to flexion gap. It also avoids excessive resection of distal femur which can lead to elevation of joint line and mid flexion instability there by altering the patellofemoral kinematics.
\nTibial and femoral cuts are carried out in usual manner as in primary uncomplicated arthroplasty. The flexion contracture is due to posterior recess and posterior osteophytes indenting upon the capsule. After the bony cuts, the osteophytes can easily be visualized and removed with the help of ¾ inch osteotome (\nFigure 1\n). A intramedullary rod may be used to elevate the distal femur or lamina spreaders can be used for better visualization of posterior capsule. There is clear dividing line between the osteophytes and femoral condyle. The loose osteophytes can be removed with the help of curette. The posterior obliterated posterior recess can be then be created with osteotome. The osteophytes from posterior aspect of tibia are visible clearly at this stage and can be removed with the help of curette and osteotome. The osteophytes attached to the posterior capsule is pulled forward and removed with the help of electrocautery. In case extension gap is less than flexion gap further release of posterior recess is carried out. However, if extension gap is more than flexion gap, the posterior slope of tibia is evaluated. The slope can be increased up to 8° in order to balance the knee. Tight flexion gap can result in poor roll back of femoral component and lift off of tibia tray.
\nPosterior osteophytes are removed with the help of osteotome.
In majority of the cases, the flexion contracture is corrected with these simple maneuvers. The type of knee prosthesis i.e. cruciate retaining or cruciate sacrificing depends upon the choice of surgeon in mild flexion contracture. Laskin [11] described a test to assess the correction of flexion deformity intraoperatively. The operated limb is lifted from the table and foot is dorsiflexed at ankle subsequently axial pressure is applied along the long axis of the limb. The sudden flexion at knee suggests residual flexion deformity. If there is no bending at knee due to axial pressure then it suggests achievement of adequate correction at the knee joint.
\nIn addition to release of posterior recess and removal of osteophytes as described in management of grade I flexion, the posterior cruciate ligament is released from the femoral end first and subsequently from the tibial end as per the requirement. Medial and lateral perforations of posterior cruciate ligament can also result in fractional lengthening. With this technique, the cruciate retaining components can be used. In other cases where posterior cruciate ligament is significantly weakened, one should opt for posterior stabilized components.
\nAt the end of all the above releases, if extension gap is smaller than flexion gap, the distal femur is resected by 2 mm. However, if surgeon decides to go ahead with cruciate retaining knee components then distal femur should be resected by more than 4 mm as it can lead to posterior cruciate ligament dysfunction due to elevation of joint line.
\nIn case of flexion contracture is more than 30°, sequential release is carried out as described in management of grade I and II flexion contracture. The posterior cruciate ligament should be released from its proximal and distal attachment to balance flexion and extension gap at this stage. The choice of implant should preferably be posterior stabilized rather than cruciate retaining. It is important to release posterior capsule and gastrocnemius heads from the posterior aspect of distal femur. In majority of the cases the balanced flexion and extension gap is achieved, however, if there is valgus-varus instability due to laxity of medial or lateral collateral ligament then constrained prosthesis should preferably be used. The lax extensor mechanism can be countered by distal and lateral advancement of vastus medialis and medial capsular structures.
\nSequential correction of fixed flexion deformity in total knee replacement (\nFigure 2\n).
Correct coronal deformity with mediolateral balancing and removal of all visible osteophytes. Perform all bony tibial and femoral cuts in the usual manner. In majority of mild flexion contractures, the deformity shall be corrected.
The posterior recess should be established with help of osteotome and periosteal elevator. If required the medial and lateral head of gastrocnemius should also be raised from the posterior and distal end of femur. Sometimes transverse capsulotomy is carried out starting medially and moving laterally. The collaterals are carefully separated from the capsule by longitudinal incisions.
In cases of severe flexion deformity, distal femoral resection of up to 4 mm in increments of 2 mm is carried out and gap mismatch is checked. It is advisable to resect minimal bone from the distal femur in order to prevent problem of patellofemoral kinematics, patella baja and elevation of joint line. Sometimes it results in mediolateral instability necessitating the need for constrained prosthesis.
Medial and lateral hamstrings are tenotomised in order to achieve full correction in rare cases. Biceps femoris should be clearly identified and separated under vision in order to avoid injury to common peroneal nerve. In cases with flexion deformity of more than 60 degrees, it is advisable to undergo serial casting prior to total knee arthroplasty.
Treating algorithms for grade I, II and III deformity (EG, extension gap; FC, flexion contracture; FG, flexion gap; PCL, posterior cruciate ligament; PCR, posterior cruciate retaining; PS, posterior stabilized; PSC, posterior stabilized constrained). Reproduced from [
The patients are encouraged to do quadriceps exercises at regular intervals. In cases of mild residual flexion deformity, patients are advised to wear night splints. Stretching exercises play a vital role in the rehabilitation of these cases. It is advised to avoid pillow below the knee and sitting on recliner chairs for a long time as there is tendency towards flexion. The patients should be closely followed in the post-operative period to look for recurrence of deformity. Sometimes patient require manipulation under anesthesia to achieve range of motion similar to that attained in immediate post-operative period. Excessive force should be avoided during manipulation as it might lead to fracture of distal femur.
\n1. Recurrence of flexion contracture and loss of movement
\nAs stated earlier, the aim should be full correction of flexion deformity intraoperatively. However, at the end of 1 year few cases experience recurrence of deformity.
\n2. Flexion extension imbalance
\nFlexion extension instability in case of flexion extension mismatch might require restraint with rotating hinge prostheses.
\n3. Peroneal nerve injury
\nPeroneal nerve injury sometimes occurs in cases of fixed flexion with valgus deformity at knee. There could be associated lengthening of the lower limb.
\nThe complexity of surgical procedure increases with increasing flexion deformity of knee. The less complex deformities correct with usual bony resections and removal of osteophytes. Special attention should be paid to creation of posterior capsule. The bony resection especially distal femur should be reserved in cases where soft tissue release achieves inadequate flexion-extension gap match. Postoperatively, the patients should be followed up closely to prevent recurrence of deformity. The patients need monitoring of neurovascular status to miss on an untoward complication.
\nThe first account of giant cell arteritis (GCA) can be traced back to tenth-century Baghdad by Arab ophthalmologist of medieval Islam Ali ibn Isa al-Kahhal. It was then more precisely described by Sir Jonathan Hutchinson in 1890, who noted the peculiar thrombotic appearance of the temporal artery (TA), a defining feature of the course of GCA. With the progression of the discovery of this disease and various case studies exploring its nature, ophthalmologists have additionally attempted to view how GCA could affect certain populations. During the second half of the twentieth century and the course of the twenty-first century, facilities across continents have published their findings on the tendencies of GCA to affect certain individuals more than others. In this chapter, we describe the epidemiology of GCA across continents and countries from individual reports and studies presenting the incidence rate of this vasculitis in their respective locations or populations.
Europe remains the continent with the most abundant publications pertaining to the epidemiology of GCA. One of the longest studies on the epidemiology of GCA was conducted in Western Norway, a retrospective study encompassing cases from 1972 to 2012 [1]. This study was one among many that noted how changing the criteria for the identification of GCA could greatly alter its incidence, especially due to the rarity of this vasculitis. For instance, the incidence rate of patients potentially affected by GCA satisfying the ACR 1990 criteria was 16.7 per 100,000 persons over 50 years of age. The incidence of patients clinically diagnosed as having GCA was 18.4 per 100,000 persons aged 50 years or more. Meanwhile, the incidence of biopsy-proven GCA was 11.2 per 100,000 persons over 50 years of age. The extended period of this study additionally contributed to the lowering of the mean annual incidence. When solely evaluating cases during a certain 5-year period (from 1992 to 1996), the incidence rate was found to be 26.7 per 100,000 persons over 50 years of age. Regardless of this, the prevalence remained among the highest recorded globally. This study also describes the increasing GCA incidence with age, where an older individual has a greater susceptibility to acquiring this vasculitis, as well as a greater ratio of women having this disease. Similarly, in the southern region of Norway, comparisons with past records from the same set of population were provided [24]. In a study spanning a period of 14 years (2000–2013), the Hospital of Southern Norway presented a GCA occurrence rate of 16.8 per 100,000 persons over the age of 50 years, one of the highest recorded globally and in line with other epidemiological findings from the Scandinavian region. As previously noted, one must consider that a small study sample and a short study period both have the potential of overestimating the incidence of a disease, as demonstrated by this study. In the same vicinity, the rate of giant cell arteritis in Western Nyland, Finland was examined [2]. From 1984 and 1988, 54 patients were diagnosed with GCA, among which 16 patients had a positive biopsy. The retrospective annual incidence of GCA was 69.8 for every 100,000 individuals older than 50 years. From 1984 to 1990, 133 patients in Iceland fulfilling the ACR criteria for GCA were identified, rendering an incidence rate of 27 in 100,000 people older than 50 years [3]. This study also suggests that the clinicians’ greater tendency to suspect GCA and perform TA biopsies (TABs) may have contributed to a higher statistical incidence. The results of these studies and their reported high mean annual incidence rates go on to highlight the possibility of a greater susceptibility to GCA among Scandinavian population. These are among the highest globally, supporting the claim that the Scandinavian population is most considerably afflicted by this inflammatory disease.
When gauging the incidence of GCA cases in other parts of Europe, we witness a lowering in the number of cases. For instance, in Italy, 285 cases of biopsy-proven GCA were observed in the Reggio Emilia area from 1986 to 2012 [4]. The adjusted incidence rate was 5.8 per 100,000 people older than 50 years of age and was significantly greater in women. In Lugo, Spain, a retrospective study was conducted from 1986 to 1995 to identify the occurrence rate of biopsy-proven GCA [5]. The mean annual incidence was computed for each 5-year period, rendering a rate of 8.26 and 10.49 per 100,000 people older than 50 years, respectively. Nearby countries and regions in the southern part of Europe presented similar incidence rates, demonstrating the moderate tendency of individuals from this area of the continent of being acquiring GCA. Namely, the incidence rate in France was concluded to be between 7 and 10 individuals out of 100,000 older than 50 years [6]. Likewise, in Slovenia, the estimated annual incidence rates of GCA were overall 8.7 per 100,000 aged greater than 50 years. This lowered rate suggests a different ethnical make up in the region that is perhaps less susceptible to acquiring this vasculitis, suggesting a genetic factor, while the geographical location in a lower latitude than the Scandinavian region may imply an environmental etiology. The exact etiology remains unknown.
Epidemiological studies from 2002 to 2008 in Southern Europe and Northwestern Turkey aimed to assess the epidemiology of GCA by following patients at Trakya University Medical Faculty [7]. During this period, the incidence of GCA was found to be 1.13 patients per 100,000 persons 50 years of age or older. The incidence of GCA for females was slightly greater than that for males. The fact that this study relied on a single center presents the possibility of missing individuals who sought care in a different location or simply neglected their condition. Regardless of this, the contribution of this report is crucial due to the paucity of epidemiological outlook on GCA in this space.
A retrospective study of patients with giant cell arteritis in China was performed from August 1992 to May 2014 at the Peking Union Medical College Hospital [8]. A total of 70 patients were diagnosed with GCA. The demographic data of these patients differed from that in the previously discussed epidemiological studies in Europe. First, the average age of Chinese GCA patients was 65.2 years. This age at onset is lower than the mean reported age in other populations, which hovered between 70 and 80 years. In addition, male patients with GCA predominated the study, which differed from most reports globally. Chinese male may be more susceptible to GCA than female or they may present greater health-seeking behavior. It is important to note that patients in this study were identified from a single healthcare center, which may substantially underestimate the occurrence of this vasculitis despite its current rare occurrence. On a similar note, statistical records, pathology records, and case records from university hospitals were gathered to estimate an annual incidence of one out of 100,000 people aged older than 50 years in Hong Kong [9]. These findings suggest the particularly lower frequency of GCA among the Chinese population. In 1998, a nationwide survey was performed in Japan, revealing 690 patients treated for GCA in the previous year [10]. An incidence rate of the population was calculated to be 1.47 per 100,000 people older than 50 years of age. In conclusion, the epidemiological reports of GCA from East Asian countries reveal extremely low prevalence of GCA among this population.
From 2008 to 2014, a total of 17 patients fulfilling the classification criteria for GCA in India were identified [11]. Comparably to a previously discussed study in China, the mean age of GCA patients in the Indian population was 67 years, lower than the mean age from European reports. In addition, individuals with GCA in India were predominately male. The reasoning behind a lower mean age and a male predominant patient status is unknown and was hypothesized to be due to the greater likelihood of individuals with these characteristics to seek healthcare.
The rarity of GCA among the Indian population was demonstrated at Moorfields Eye Hospital, a center in London, UK [12]. From 2006 to 2014, patients of Indian descendance were significantly less likely to have a biopsy-positive GCA. Perhaps, some ethnicities are less likely to present a positive result to the TA biopsy or clinicians may simply be more likely to diagnose these individuals with GCA. A study of this nature, in which ethnicities are compared in a population, could provide important findings on the vulnerability of certain individuals to present with this vasculitis Figures 1 and 2.
A temporal artery biopsy involves acquiring a small section of the artery, which can potentially appear thrombotic. The length of the segment can vary across studies and may influence the results of the biopsy [
Graphical representation of incidence rates of GCA among some of the populations described in the literature. The highest incidence rates appear to be among the Scandinavian countries, regardless of the criteria utilized to diagnosis the incidence of GCA.
The true incidence of GCA in the Arab population is difficult to assess due to the absence of a more nationwide perspective as well as a lack of population-based study in Arab countries. In a 22-year study, the epidemiology of GCA in Saudi Arabia was investigated [13]. From 1983 to 2004, 102 patients at King Khaled Eye Specialist Hospital underwent TAB, as seen in Figure 1, and seven patients were identified with biopsy-proven GCA. They noted that the incidence of GCA increases with age. Regardless of this, many aspects of the healthcare system in Saudi Arabia closely resemble that of the United States, with a similar life expectancy and a ratio of ophthalmologists relative to the size of the population.
In 1980, the incidence of giant cell arteritis in Jerusalem over a 25-year period was evaluated in a study involving four general hospitals in Jerusalem [14]. Among them, 170 patients with GCA had a positive TA biopsy. Furthermore, 36 biopsy-negative cases were also considered as they fulfilled the 1990 ACR criteria for GCA classification and responded adequately to steroid therapy. The age-adjusted incidence rate was computed to be 11.3 per 100,000 people ≥50 years of age for all incorporated GCA cases, but lower at 9.5 for the biopsy-proven cases. Moreover, this study observed seasonal patterns with a statistically insignificant rise in GCA diagnosis during the summer. The incidence rate of GCA in this study is comparable with those in other Mediterranean countries, with a less prominent frequency of female patients.
The results of a cohort of 114 patients who met the 2016 rACR criteria for the diagnosis of GCA and underwent TAB over a 10-year period in a tertiary center, Rassoul Akram Hospital, in Tehran, Iran were described [15]. This finding reflects the increase in GCA incidence with age. Although this study did not sufficiently provided a macroscopic account of the incidence and manifestation of GCA in a population, it was the first study performed in Iran assessing the intricacies of characterizing GCA and the discrepancies that may arise as a result of heterogeneous studies, especially due to the absence of definite criteria for the diagnosis of GCA.
Africa stands out for its scarcity of information on GCA and its epidemiology. Perhaps, this could be due to an underdeveloped healthcare system, which hinders the proper equipment and tools for an adequate diagnosis, which could ultimately serve as data to be studied on a larger scale. It may also be that the African population has a lower susceptibility to GCA. In addition, the life expectancy in Africa is lower, which could influence statistics related to a disease with an increased likelihood of manifesting at a later stage in life. Therefore, it can be hypothesized that this region presents with lower rates of this vasculitis. The two studies discussing the epidemiology of GCA in the African population both pertain to French-colonized islands. From 1991 to 2016, data from two pathology units in Martinique, West Indies were reviewed to discuss the features of cases of biopsy-proven giant cell arteritis [16]. The findings fortified the assumption that GCA is less prevalent in an African descent population. Nevertheless, the retrospective nature of the study and the exclusion of a biopsy-negative GCA may have led to an underestimation of cases of GCA.
In a retrospective study from La Reunion near the Southwest region of the Indian Ocean from 2005 to 2017, an incidence rate roughly 4–12 times lower than in most European countries was calculated [17]. An exact count was difficult to provide due to the presence of a diverse group of ethnicities in La Reunion, especially from regions of the world with a lower prevalence of GCA. A shorter life expectancy may contribute to a lower frequency of cases observed as GCA increases with age. Other characteristics were found to be analogous observations made in previous epidemiological studies.
Studies conducted in the United States have the potential of presenting important findings due to the possibility of comparing and contrasting features of a disease between ethnicities. A retrospective study spanning 11 years was conducted in the Texas Gulf Coast. Twenty-seven out of 101,239 patients aged 40 years or older had GCA. Intriguingly, 13 of these patients were black females, rendering it a noteworthy aspect of this study in which a significantly greater proportion of patients with GCA were black individuals [18].
A report from a study spanning from 1971 to 1980 in Shelby County, Tennessee identified 26 cases of GCA [19]. The average annual incidence was computed to be 1.58 per 100,000 individuals older than 50 years of age. The predominant patient from this study was white and female. This study presents one of the lowest frequencies of GCA cases across the globe. This could partially be due to the racial makeup of this population, which has a high percentage of black residents. African descent population is assumed to present a lower incidence rate of GCA. Among other contributions to a low incidence rate such as a retrospective design as well as inconsistencies in the diagnosis criteria, this study urged the need to consider environmental factors as potential causes for the onset of the vasculitis, such as the climate, exposure to the sun, frequency of rainfall, elevation, etc.
In another region of the United States, Olmsted County, Minnesota holds a population with northern European ancestry, which appears to be the group of people most severely afflicted by GCA. Therefore, the observation of a greater incidence rate may indicate a genetic factor in the onset of GCA. Between 1950 and 1991, 125 Olmsted County inhabitants were diagnosed with giant cell arteritis. The incidence per 100,000 persons 50 years of age or older was 17.8, which was significantly higher in women than in men. The incidence of GCA had increased to 19.8 from 2000 to 2009. The annual incidence rates substantially increased over the study period and with congregated cases of GCA, suggesting a regular cyclic pattern over time, which suggested the possibility of an infectious root for giant cell arteritis.
Previous studies suggested a low incidence of GCA in black patients, although conclusions were drawn from relatively small sample sizes. Nevertheless, the impression that GCA rarely impacts black individuals is generally assumed. Some reports have sought to compare GCA more directly between two races. A multicenter study involving 10 healthcare institutions was conducted to evaluate the presentation of GCA in African Americans [20]. An African American group of patients was compared with a cohort of Caucasian patients with a positive biopsy for ophthalmic GCA. Both the groups appeared to have a similar sex distribution, as around 70% of patients in both the cohorts were females. At Johns Hopkins Wilmer Eye Institute, findings notably challenging the commonly held belief that GCA is uncommon in African Americans were presented [21]. However, annual rates may not be directly calculated due to racial distributions in patients not reflecting that of the census population of the city of Baltimore, a detail that needs to be approached diligently prior to establishing conclusions. Furthermore, the screening and diagnosis process may differ among races and ethnicities due to physicians and clinicians holding preconceived perception of a greater prevalence in certain populations.
When comparing the rate of GCA between Caucasians and Asians, a significant lower occurrence rate of GCA in Asians was identified, which they computed to be 0.26–3.8 per 100,000 individuals older than 50 years of age, in parallel with studies from Asia [22]. The data for this study were collected from the University of California San Francisco computer database for patients from July 1989 to July 2006.
Similarly, giant cell arteritis has been reported to be very rare in Hispanics. From 1996 to 2002, patients with GCA at the Bascom Palmer Eye Institute were assessed [23]. Rates of a positive temporal artery biopsy were similar among Hispanic and non-Hispanic patients. Thirty-two patients with biopsy-proven GCA revealed similar mean age, symptoms, and final visual acuity between Hispanic and non-Hispanic cohorts. Hispanic and non-Hispanic cases are similarly impacted by the onset of giant cell arteritis.
A retrospective review was performed of all the biopsy-positive cases of giant cell arteritis presenting to a neuro-ophthalmology practice in Saskatoon, Saskatchewan [24]. Records of 141 consecutive patients who underwent temporal artery biopsy at the Saskatoon Eye Centre from July 1998 to June 2003 were reviewed. The average age of the biopsy-positive patients was 76.5 years, and the patients were 2.4 times more likely to be women. A total of 35 patients had a European ancestry, while two patients were of Aboriginal descent. The estimated incidence of GCA for Saskatoon was 9.4 per 100,000 for people over the age of 50 years. This study reveals the prospect of GCA to affect the people of Aboriginal descent despite a probable low incidence rate.
Very few studies pertaining to the epidemiology of GCA have come from South American countries. One that most closely attempted to depict the status of GCA nationwide collected findings from three university hospitals in Brazil for patients with GCA between 2009 and 2010 [25]. This was, in fact, the first study addressing the features of GCA in Brazilian patients having the disease. Most GCA patients were Caucasians, while a few were of a combined European and Indigenous lineage. The Caucasian cohort was mostly of Portuguese, Italian, or Spanish ancestry. These suggested the possibility of asymptomatic manifestations, which may skew the epidemiological perspective of this disease.
The last geographic region to be discussed is Oceania, which can be hypothesized to most closely resemble findings from Europe. From 1992 to July 2011, 314 cases of biopsy-proven GCA in South Australia were studied, in which the incidence for people over the age of 50 was 3.2 per 100,000 individuals [26]. Most characteristics of the disease were in line with observations described in studies from Europe, including a similar mean age and female predominance. Seasonal variations were additionally perceived, with a greater amount of diagnosis occurring during the summer season.
Cyclical variations were similarly noted in a study conducted in Otago, New Zealand. Records of 363 consecutive patients who underwent temporal artery biopsy at Dunedin Hospital between 1996 and 2005 were reviewed, with biopsy-proven GCA diagnosed in 70 patients. The mean annual incidence of GCA in Otago for people older than 50 years was 12.73 per 100,000 persons ≥50 years of age [26].
Nordic countries present the highest annual incidence rates of GCA. This vasculitis moderately affects southern European countries (Italy, Spain, France, etc.). The lowest incidence rates have been reported in East Asia. The diverse ethnical populations in countries such as United States lead to variations across regions, such as a higher incidence rate in the Northern states due to Scandinavian ancestry. Different ethnicities may present varying susceptibility because clinicians may exhibit different degree of suspicion with certain races, leading to influence on the number of biopsies performed and diagnosis made. In some regions, race and ethnicity is self-identified, which may reveal limited information on genetic background. Figure 2 reveals the varied incidence rate observed in different populations across the globe.
The incidence rate increases substantially with age and a greater ratio of patients are women in most regions, except for Asian countries. Whether female susceptibility is genuinely lower in that region or whether this discrepancy is due to different health-seeking behavior is unknown. Although seasonal and cyclic patterns were observed in a few studied and environmental factors were suggested, such influence remains inconclusive.
The definition of giant cell arteritis is inconsistent across literature, resulting in the inclusion of heterogeneous data during extensive review. Hence, there may be an over- or underestimation of statistical values. The criteria for the diagnosis of this disease substantially varied, with incidence rates presented based on biopsy-proven cases, ACR-criteria-fulfilling cases, or unspecified clinical diagnosis. Therefore, data may vary depending on which inclusion criteria were used.
Moreover, the technicality for biopsy-proven cases (length of the segment or threshold for diagnosis) may also alter the rate of incidence. In many reviews, the length of the arterial specimen remains unmentioned.
In 2016, an alteration to the list of criteria for a more comprehensive diagnosis of GCA was submitted. Furthermore, additional diagnostic tools have recently emerged, including the color Doppler ultrasound (CDUS), despite requiring extensive experience for utilization and a proper diagnosis. Other high-resolution magnetic resonance imaging technologies include magnetic resonance angiography (MRA), positron emission tomography (PET), computed tomography (CT), CT with angiography, and conventional MRA, which alternatively permit the visualization of the temporal artery. Although most reports attempted to thoroughly describe the equipment and tools for diagnosis, the heterogeneous approach across studies hinders appropriate comparisons, which may limit a precise epidemiological outlook of the disease in question.
Although this study repeatedly describes the rarity of GCA, it remains the most common vasculitis with severe consequences if remained untreated, ultimately resulting in permanent visual loss. Therefore, clinicians should remain diligent when coming across individuals presenting symptoms of the disease because an immediate course of action may greatly influence a person’s course of life and impact their well-being physiologically and psychologically.
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The understanding was included to the literature as personnel management at the beginning of the twentieth century and it turned into an approach as human resources management in the 1980s. It could be observed that many organizations, which deem the human as the most critical stakeholder, adopt a traditional way of personnel management in operating human resources. The employees play a key role in the success of an organization. For this reason, subjects such as recruitment, training, development, career management, performance appraisal, occupational health, and safety are the fundamental functions of human resources management. The study examines to what extent these roles are evaluated through a case study. The subject matter of the study is the most powerful culture and art foundation in Turkey. Compared to many other nonprofit organizations, the foundation actively performs a variety of services within a year worldwide. The fact that the total number of employees might rise up to 800, including the field personnel, indicates the need of a good functioning human resources management. The human resources practices of the foundation are examined and evaluated within that scope.",book:{id:"5826",slug:"issues-of-human-resource-management",title:"Issues of Human Resource Management",fullTitle:"Issues of Human Resource Management"},signatures:"Beste Gökçe Parsehyan",authors:[{id:"189113",title:"Dr.",name:"Beste",middleName:null,surname:"Gokce Parsehyan",slug:"beste-gokce-parsehyan",fullName:"Beste Gokce Parsehyan"}]},{id:"70045",title:"Islamic Leadership: Comparisons and Qualities",slug:"islamic-leadership-comparisons-and-qualities",totalDownloads:3015,totalCrossrefCites:5,totalDimensionsCites:6,abstract:"This chapter explores the concept and principles Islamic leadership which generate qualities. These qualities differentiate the Islamic leadership with other leadership concepts. The fundamental sources of Islamic leadership and guidance for the Muslim leaders are Al-Qur’an and Hadith. The sub-topics related to the Islamic leadership elaborate all attributes (traits, skills, power, authority) needed by the leaders. This content analysis method is based on a review of literature and other secondary data. The information in this chapter expectedly will give understanding on the importance of the Islamic leadership concept and can be useful or as a reference for further studies.",book:{id:"7799",slug:"digital-leadership-a-new-leadership-style-for-the-21st-century",title:"Digital Leadership",fullTitle:"Digital Leadership - A New Leadership Style for the 21st Century"},signatures:"Ahmad Rafiki",authors:[{id:"307090",title:"Ph.D.",name:"Ahmad",middleName:null,surname:"Rafiki",slug:"ahmad-rafiki",fullName:"Ahmad Rafiki"}]},{id:"63695",title:"The Role of National Cultures in Shaping the Corporate Management Cultures: A Three-Country Theoretical Analysis",slug:"the-role-of-national-cultures-in-shaping-the-corporate-management-cultures-a-three-country-theoretic",totalDownloads:5067,totalCrossrefCites:8,totalDimensionsCites:9,abstract:"This chapter explores answers to the question that how national cultures influence the management cultures of organizations. In this case, therefore, differences and similarities among the national cultures of Pakistan, Mexico, and the USA are under investigation in order to analyze the impacts of such differences and similarities on the management cultures of organizations located in these countries. The outcomes of the analysis based on the existing literature suggest that differences in national cultures greatly influence the way organizations are managed in these countries. These findings present cross-cultural management challenges for organizations working in these countries, especially when they want to build trilateral or bilateral business partnerships. This is in addition to the fact that the USA and Mexico are geographically far from Pakistan.",book:{id:"7251",slug:"organizational-culture",title:"Organizational Culture",fullTitle:"Organizational Culture"},signatures:"Mohammad Ayub Khan and Laurie Smith Law",authors:[{id:"247709",title:"Prof.",name:"Mohammad",middleName:null,surname:"Khan",slug:"mohammad-khan",fullName:"Mohammad Khan"},{id:"247712",title:"Prof.",name:"Laurie Smith",middleName:null,surname:"Law",slug:"laurie-smith-law",fullName:"Laurie Smith Law"}]},{id:"60433",title:"The Role of Leadership in the Professional Development of Subordinates",slug:"the-role-of-leadership-in-the-professional-development-of-subordinates",totalDownloads:2661,totalCrossrefCites:4,totalDimensionsCites:7,abstract:"Professional development is relevant for the workers themselves, for the organizations, and, in a more macro view, also for the countries. In this sense, this chapter aims to discuss the influence of leadership in the professional development of subordinates, pointing out the importance of leadership performance. To achieve this goal, research results are presented on the relationship between leadership and professional development of subordinates. Research in the field shows that professional development is directly related to the day-to-day activities of workers and should be part of a broader process of continuous learning, which results both from formal and informal learning actions. The debate proposed for this chapter considers that professional development is more directly related to the combination of cognitive, affective, and behavioral processes that involve learning than the specific results of certain formal or informal learning actions. Thus, we discuss how the relations established with the leadership in the work environment can influence the professional development of the subordinates besides the type of learning provided to the workers. This discussion can shift the focus of research—currently centered on learning modes—to a focus on leadership practices for skills development and the consequent career progression of subordinates.",book:{id:"6781",slug:"leadership",title:"Leadership",fullTitle:"Leadership"},signatures:"Luciana Mourão",authors:[{id:"239876",title:"Ph.D.",name:"Luciana",middleName:null,surname:"Mourão",slug:"luciana-mourao",fullName:"Luciana Mourão"}]},{id:"55244",title:"Corporate Governance and Fraud: Evolution and Considerations",slug:"corporate-governance-and-fraud-evolution-and-considerations",totalDownloads:3098,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"There are many definitions of Corporate Governance, as a structure, as process, as policies, as mechanisms, but despite their differences of focus, they mainly addressed the sustainable economic growth and protection of shareholders and other stakeholder’s rights. The purpose here is to present the evolution of the main principles and frameworks as corporate and financial environment changes and set new challenges. Some important scandals that revealed the weaknesses of corporate governance frameworks are described to complement the comprehension of the object of it. It is detached the aspects simulated or ignored and the subsequent enforcement and monitoring response. Discussion about the new challenges, what corporate governance is supposed to provide and what it can promote, closes this chapter.",book:{id:"5968",slug:"corporate-governance-and-strategic-decision-making",title:"Corporate Governance and Strategic Decision Making",fullTitle:"Corporate Governance and Strategic Decision Making"},signatures:"Ana Paula Paulino da Costa",authors:[{id:"201677",title:"Dr.",name:"Ana Paula P.",middleName:null,surname:"Costa",slug:"ana-paula-p.-costa",fullName:"Ana Paula P. 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Using the Apostolic Faith Mission in Zimbabwe church as a point of reference, this article argues that in Christian circles there is need to deliberately develop a perspective of conflict that reflects conflict as a positive force that generates both co-existence and growth in the church to counter the conventional view in the majority of churches that consider conflict as a destructive force. In the Apostolic Faith Mission church, intra-church disputes have a negative effect on the wellbeing of individuals and groups (the church) as conflict creates rivalry, hostility, divisions, hate, breakaways, among others. This is because a strongly adversarial attitude to conflict of all sorts is reflected in the approach of the church to conflict and in particular, some pastors have responded with legal action against the disciplinary activities of the church. Consequently, this article suggests that faith-based organizations should appreciate the importance of conflict for positive growth and development as a good number of Christians today are still pessimistic about conflict.",book:{id:"8452",title:"Organizational Conflict - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/8452.jpg"},signatures:"Norman Chivasa"},{id:"75982",title:"How Task Conflict Can Support Creative Problem Solving in Teams by Stimulating Knowledge Sharing, Critical and Creative Thinking and Meta-Cognition",slug:"how-task-conflict-can-support-creative-problem-solving-in-teams-by-stimulating-knowledge-sharing-cri",totalDownloads:281,totalDimensionsCites:0,doi:"10.5772/intechopen.96600",abstract:"This study explores how task conflict can support creative problem solving in teams and the cognitive processes applied. As multidisciplinary teams can be diverse in nature, they may not always partake competently in the pooling of information, and as a result task conflict may arise due to differences in mental models. Under certain conditions task conflict is considered to be beneficial to creative problem solving because it stimulates knowledge exchange and integration and constructive criticism to reach co-created decisions and solutions. Four case studies were conducted to analyse the discourse of teams carrying out design and innovation projects. Task conflict was found to have a positive impact on creative problem solving in the application of four cognitive processes: knowledge processing, critical and creative thinking and metacognition (team self-reflection). Task conflict was positively related to creativity in the proposal of solution alternatives. The successful application of the cognitive processes was dependent on an awareness of when task conflict is appropriate and high level social skills. The findings have implications for managers of teams solving complex problems. They highlight how the cognitive processes can be constructively used to stimulate and manage conflict to effectively solve problems in teams.",book:{id:"8452",title:"Organizational Conflict - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/8452.jpg"},signatures:"Louise Kiernan, Ann Ledwith and Raymond Lynch"},{id:"75879",title:"Intergroup Conflict and Organizational Performance: A Case of Kiboga Hospital, Uganda",slug:"intergroup-conflict-and-organizational-performance-a-case-of-kiboga-hospital-uganda",totalDownloads:323,totalDimensionsCites:0,doi:"10.5772/intechopen.96150",abstract:"The study aimed at finding out whether there is a relationship between intergroup conflicts and organizational Performance, using the case of Kiboga hospital. The study contributes to the body of existing literature by laying down strategies for managing and reducing intergroup conflicts. The study employed a cross-sectional research design along with a quantitative approach. The study population was 95 of which a sample size of 76 respondents was selected using Krejcie and Morgan table. Data was collected by the use of a questionnaire which was self-administered. Data were analyzed by the use of Statistical Package for Social Science (SPSS) through descriptive statistics and correlation analysis. Results revealed that respondents consented that intergroup conflicts affect performance with an average mean of 4.154 and a standard deviation of 1.092. A correlation coefficient of 0.903 which is significant at 0.01, revealed that there is a significant relationship between intergroup conflicts and performance which lead to the rejection of a null hypothesis. The study concluded that moderate levels of conflicts improve performance since they stimulate thinking and creativity in decision making towards goal achievement. However, extreme levels of conflict reduce performance in terms of patient care for our case of investigation. The study recommended strategies management can employ to manage extreme levels of conflicts to improve patient care.",book:{id:"8452",title:"Organizational Conflict - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/8452.jpg"},signatures:"Antony Tebitendwa"},{id:"75316",title:"Conflicts in Environmental and Agricultural Organizations in the Far North Region of Cameroon",slug:"conflicts-in-environmental-and-agricultural-organizations-in-the-far-north-region-of-cameroon",totalDownloads:247,totalDimensionsCites:0,doi:"10.5772/intechopen.95860",abstract:"The population of the Far North Region of Cameroon suffers the most from poverty and huge environmental challenges. As a result, they have the highest concentration of environmental organizations in Cameroon. Data was collected by interviewing key informants who work in environmental and agricultural companies. It was discovered that conflicts in such organizations are caused by the differences people have in terms of opinions, interests and needs as they work together with each other. Their strictness with one another also causes conflict especially when doing dirty or difficult work tasks. Conflict also comes about when the religious values of each other is not respected especially that of the Muslims in Christians dominated companies. There is also generational conflict which is characterized by the confrontation between the older and less educated generation who have some experience and young graduates who would like to implement new practices. Other causes are discrimination where workers are not promoted basing on merit but on their ethnic relation to one another. There is equally an economic cause which is due to the non-distribution of part of the substantial profits that some companies make to their employees as well as too low salary and poor work tasks distribution.",book:{id:"8452",title:"Organizational Conflict - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/8452.jpg"},signatures:"Nanche Billa Robert"},{id:"74723",title:"Rhetoric Communication to Handle Interpersonal Conflicts at Workplaces",slug:"rhetoric-communication-to-handle-interpersonal-conflicts-at-workplaces",totalDownloads:294,totalDimensionsCites:0,doi:"10.5772/intechopen.95526",abstract:"Organisations are large platforms amalgamating people from diverse backgrounds, mindsets, experiences, opinions and beliefs. It is likely that at times there may be a clash in personalities leading to conflicts. While conflicts resolved create productive workplaces, on the contrary unresolved conflicts generate dissatisfaction and discontent among the people further leading to inefficiency among the employees directly hampering the organisation as a whole. Communication is understood as the most indispensable factors that moulds and reflects in our everyday relationships. Because of its dynamism and complexity, communication forms the essence of interpersonal relationships in organisational contexts. Understanding the vitality of communication, the concept this paper explores is how rhetoric communication, an Aristotelian principle may help resolving interpersonal conflicts, creating a win-win situation and further extending healthy interpersonal relationships at workplaces.",book:{id:"8452",title:"Organizational Conflict - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/8452.jpg"},signatures:"Mitashree Tripathy"},{id:"74603",title:"Power Asymmetry, Negotiations and Conflict Management in Organizations",slug:"power-asymmetry-negotiations-and-conflict-management-in-organizations",totalDownloads:517,totalDimensionsCites:0,doi:"10.5772/intechopen.95492",abstract:"Relationships are seldom equal. In fact, social interactions involve most of the times power asymmetric relationships. Especially in organizations people are daily faced with situations where they are either in a powerful or in a powerless position compared to others. Power stems from various sources and takes several forms. For instance, people are powerful when they can administer punishments or rewards, when they are in a hierarchically higher position than others, when they have knowledge and expertise, when they are admired and respected, and when they have alternative options which enable them to make choices. Importantly, power determines the way people interact with each other and subsequently, the way they engage in conflicts and conflict resolution. Power-holders are best able to asymmetrically enforce their will and therefore, they have the capability to determine the process and the outcome of a conflict. In this chapter, I present the major sources of power and the main differences between them. Consequently, I elaborate on the impact of power on conflict management based on the negotiation literature. I conclude by touching on the necessity to distinguish between two contradictory faces of power: power as opportunity and power as responsibility.",book:{id:"8452",title:"Organizational Conflict - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/8452.jpg"},signatures:"Kyriaki Fousiani"}],onlineFirstChaptersTotal:6},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"August 2nd, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:33,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"14",title:"Cell and Molecular Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",isOpenForSubmission:!0,editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",slug:"rosa-maria-martinez-espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",biography:"Dr. Rosa María Martínez-Espinosa has been a Spanish Full Professor since 2020 (Biochemistry and Molecular Biology) and is currently Vice-President of International Relations and Cooperation development and leader of the research group 'Applied Biochemistry” (University of Alicante, Spain). Other positions she has held at the university include Vice-Dean of Master Programs, Vice-Dean of the Degree in Biology and Vice-Dean for Mobility and Enterprise and Engagement at the Faculty of Science (University of Alicante). She received her Bachelor in Biology in 1998 (University of Alicante) and her PhD in 2003 (Biochemistry, University of Alicante). She undertook post-doctoral research at the University of East Anglia (Norwich, U.K. 2004-2005; 2007-2008).\nHer multidisciplinary research focuses on investigating archaea and their potential applications in biotechnology. She has an H-index of 21. She has authored one patent and has published more than 70 indexed papers and around 60 book chapters.\nShe has contributed to more than 150 national and international meetings during the last 15 years. Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. He performed post-doctoral studies at Max-Planck Institute, Germany, and University of Florence, Italy in addition to making several scientific visits abroad. He currently works as a Full Professor of Biochemistry in the Faculty of Pharmacy, Anadolu University, Turkey. Dr. Beydemir has published over a hundred scientific papers spanning protein biochemistry, enzymology and medicinal chemistry, reviews, book chapters and presented several conferences to scientists worldwide. He has received numerous publication awards from various international scientific councils. He serves in the Editorial Board of several international journals. Dr. Beydemir is also Rector of Bilecik Şeyh Edebali University, Turkey.",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",slug:"deniz-ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",biography:"Dr. Deniz Ekinci obtained a BSc in Chemistry in 2004, MSc in Biochemistry in 2006, and PhD in Biochemistry in 2009 from Atatürk University, Turkey. He studied at Stetson University, USA, in 2007-2008 and at the Max Planck Institute of Molecular Cell Biology and Genetics, Germany, in 2009-2010. Dr. Ekinci currently works as a Full Professor of Biochemistry in the Faculty of Agriculture and is the Head of the Enzyme and Microbial Biotechnology Division, Ondokuz Mayıs University, Turkey. He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. Dr. Ekinci serves as the Editor in Chief of four international books and is involved in the Editorial Board of several international journals.",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null},{id:"17",title:"Metabolism",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",isOpenForSubmission:!0,editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",slug:"yannis-karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",biography:"Yannis Karamanos, born in Greece in 1953, completed his pre-graduate studies at the Université Pierre et Marie Curie, Paris, then his Masters and Doctoral degree at the Université de Lille (1983). He was associate professor at the University of Limoges (1987) before becoming full professor of biochemistry at the Université d’Artois (1996). He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. His teaching areas are energy metabolism and regulation, integration and organ specialization and metabolic adaptation.",institutionString:null,institution:{name:"Artois University",institutionURL:null,country:{name:"France"}}},editorTwo:null,editorThree:null},{id:"18",title:"Proteomics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",isOpenForSubmission:!0,editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",slug:"paolo-iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",biography:"Paolo Iadarola graduated with a degree in Chemistry from the University of Pavia (Italy) in July 1972. He then worked as an Assistant Professor at the Faculty of Science of the same University until 1984. In 1985, Prof. Iadarola became Associate Professor at the Department of Biology and Biotechnologies of the University of Pavia and retired in October 2017. Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. In this context, he has developed and validated new methodologies (e.g., Capillary Electrophoresis coupled to Laser-Induced Fluorescence, CE-LIF) whose application enabled him to determine both the amounts of biochemical markers (Desmosines) in urine/serum of patients affected by Chronic Obstructive Pulmonary Disease (COPD) and the activity of proteolytic enzymes (Human Neutrophil Elastase, Cathepsin G, Pseudomonas aeruginosa elastase) in sputa of these patients. More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. He is a Consultant Reviewer for several journals, including the Journal of Chromatography A, Journal of Chromatography B, Plos ONE, Proteomes, International Journal of Molecular Science, Biotech, Electrophoresis, and others. He is also Associate Editor of Biotech.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",slug:"simona-viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",biography:"Simona Viglio is an Associate Professor of Biochemistry at the Department of Molecular Medicine at the University of Pavia. She has been working since 1995 on the determination of proteolytic enzymes involved in the degradation process of connective tissue matrix and on the identification of biological markers of lung diseases. She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. She is an author of about 90 publications (According to Scopus: H-Index: 23; According to WOS: H-Index: 20) on peer-reviewed journals, a member of the “Società Italiana di Biochimica e Biologia Molecolare,“ and a Consultant Reviewer for International Journal of Molecular Science, Journal of Chromatography A, COPD, Plos ONE and Nutritional Neuroscience.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null}]},overviewPageOFChapters:{paginationCount:42,paginationItems:[{id:"82914",title:"Glance on the Critical Role of IL-23 Receptor Gene Variations in Inflammation-Induced Carcinogenesis",doi:"10.5772/intechopen.105049",signatures:"Mohammed El-Gedamy",slug:"glance-on-the-critical-role-of-il-23-receptor-gene-variations-in-inflammation-induced-carcinogenesis",totalDownloads:8,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Chemokines Updates",coverURL:"https://cdn.intechopen.com/books/images_new/11672.jpg",subseries:{id:"18",title:"Proteomics"}}},{id:"82875",title:"Lipidomics as a Tool in the Diagnosis and Clinical Therapy",doi:"10.5772/intechopen.105857",signatures:"María Elizbeth Alvarez Sánchez, Erick Nolasco Ontiveros, Rodrigo Arreola, Adriana Montserrat Espinosa González, Ana María García Bores, Roberto Eduardo López Urrutia, Ignacio Peñalosa Castro, María del Socorro Sánchez Correa and Edgar Antonio Estrella Parra",slug:"lipidomics-as-a-tool-in-the-diagnosis-and-clinical-therapy",totalDownloads:7,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Fatty Acids - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11669.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82440",title:"Lipid Metabolism and Associated Molecular Signaling Events in Autoimmune Disease",doi:"10.5772/intechopen.105746",signatures:"Mohan Vanditha, Sonu Das and Mathew John",slug:"lipid-metabolism-and-associated-molecular-signaling-events-in-autoimmune-disease",totalDownloads:17,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Fatty Acids - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11669.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82483",title:"Oxidative Stress in Cardiovascular Diseases",doi:"10.5772/intechopen.105891",signatures:"Laura Mourino-Alvarez, Tamara Sastre-Oliva, Nerea Corbacho-Alonso and Maria G. Barderas",slug:"oxidative-stress-in-cardiovascular-diseases",totalDownloads:9,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Importance of Oxidative Stress and Antioxidant System in Health and Disease",coverURL:"https://cdn.intechopen.com/books/images_new/11671.jpg",subseries:{id:"15",title:"Chemical Biology"}}}]},overviewPagePublishedBooks:{paginationCount:33,paginationItems:[{type:"book",id:"7006",title:"Biochemistry and Health Benefits of Fatty Acids",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7006.jpg",slug:"biochemistry-and-health-benefits-of-fatty-acids",publishedDate:"December 19th 2018",editedByType:"Edited by",bookSignature:"Viduranga Waisundara",hash:"c93a00abd68b5eba67e5e719f67fd20b",volumeInSeries:1,fullTitle:"Biochemistry and Health Benefits of Fatty Acids",editors:[{id:"194281",title:"Dr.",name:"Viduranga Y.",middleName:null,surname:"Waisundara",slug:"viduranga-y.-waisundara",fullName:"Viduranga Y. Waisundara",profilePictureURL:"https://mts.intechopen.com/storage/users/194281/images/system/194281.jpg",biography:"Dr. Viduranga Waisundara obtained her Ph.D. in Food Science\nand Technology from the Department of Chemistry, National\nUniversity of Singapore, in 2010. She was a lecturer at Temasek Polytechnic, Singapore from July 2009 to March 2013.\nShe relocated to her motherland of Sri Lanka and spearheaded the Functional Food Product Development Project at the\nNational Institute of Fundamental Studies from April 2013 to\nOctober 2016. She was a senior lecturer on a temporary basis at the Department of\nFood Technology, Faculty of Technology, Rajarata University of Sri Lanka. She is\ncurrently Deputy Principal of the Australian College of Business and Technology –\nKandy Campus, Sri Lanka. 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Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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