Number of larval stages in different orders of insects.
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A larva is a distinct immature developmental form of many animals particularly in insects. The term larva applies to the young hatchling which varies from the grown up adult in lacking some important organs like sex glands and associated parts. The animals such as insects, amphibians and cnidarians with indirect development typically have larval phase in their life cycle. The diet of the larva is considerably distinct from the adult.
The larval forms are often adapted to different environments than of adults. For example, larvae of mosquitoes live almost exclusively in aquatic environment during their developmental stages and live outside water after metamorphosing into adult forms. Such adaptations in distinct environments are for their protection from predators and to avoid competition for resources. During developmental stages, larvae consume more food to fuel up their transition into adult form. In some insect species immature forms are totally dependent on adult forms for feeding such as in social insects of orders Hymenoptera (e.g., bees, wasps, ants) and Isoptera (e.g., termites) and the female workers feed them.
There are several advantages of an embryo developing into larval form instead of growing into an adult directly because it would help the animal to overcome various difficulties. The hatchling may need to obtain food but due to its smaller size is unable to feed itself the same way as an adult does. Further, it would be unable to make an effective use of defense mechanism as done by adult. Thus, the new organization of freshly emerged organism is best suitable to its environment. Further it furnishes a mode of life which is better suited to newly emerged small hatchling. The additional advantage of this corresponding organization is that it enables the larva to exploit an entirely different environment from that of its grown-ups. Thus, a terrestrial adult may have aquatic larval form such as in order Odonata (Dragonflies and Damselflies), a flying adult may have burrowing larvae as in order Diptera (Flies) and an adult may have free-living larvae in order Trichoptera (Caddisflies).
The arthropods cast off their cuticle at regular intervals to undergo a brief period of development before reaching mature size. Post-embryonic development is divided into a series of stages in which each stage is distinct from the next one by a molt. The larval forms usually change in shape during their development and progressive stages are not similar in insects. This change in form is known as metamorphosis. These changes are controlled by a juvenile hormone which is secreted by glands-corpora allata present in the posterior region of insect’s head. It is released during each molt and its amount decreases each time. As the concentration of juvenile hormone declines, more adult characters appear and the adult stage is produced. In arthropods, the larval forms move between stages by molting of their exoskeleton. The new exoskeleton develops beneath the old skin. During the formation of new exoskeleton, insect’s body gets swelled up due to intake of either air or water until the old exoskeleton breaks down. The newly formed exoskeleton hardens and different tanning agents get deposited onto the surface. After the succession of molts, an insect reaches the final adult form and no further molt takes place. Each developmental stage of an arthropod between molts is termed as Instar. For example, after hatching from egg, the hatchling is said to be first instar. When the insect molts again, it is then a second instar and so on.
There are four patterns of growth and development in insects namely Ametabolous, Paurometabolous, Hemimetabolous and Holometabolous.
It is the type of insect development in which there is no metamorphosis. The emerged immature stage appears very similar to adult except that it lacks sexual structures. It grows only in size by replacing its old skin through molting. The larva grows bigger and the genitalia develops progressively with each molt. The young one which emerges from egg resembles adult in miniature form, is called nymph. The reproductive organs are undeveloped in nymph and after molting the nymph becomes an adult. Both forms i.e., the nymphs and adults live in the same habitat.
This is the characteristic feature of Apterygotes (e.g., Silverfish-
Ametabolous development in
Paurometabolous development is found in less primitive forms like cockroaches, grasshoppers, praying mantis and white ants. In this type of development, the newly emerged young one closely resembles the adult in general body form, habits and habitat but many adult characters like wings and reproductive organs are not developed and their relative proportions of the body also differs. The young forms are termed as nymphs. The wings develop as wing pads on second and third thoracic segments at an early stage and gradually increase in size during each successive molt. The external genitalia also develops gradually after each molt. These nymphs lead an independent life and attain adult features through several molts. There are three stages in the life cycle of these insects i.e., egg, nymph, imago (adult) and no pupal stage is there. For instance in grasshoppers, before becoming adults the nymphs undergo 5–6 molts to change their body form (Figure 2). The nymph stage is species specific and lasts for a period of 5–10 days depending upon the weather conditions like temperature and humidity.
Paurometabolous development in grass-hopper.
In this type of development, adult form is attained by gradual morphological changes with successive molts. The hatched larva lacks wings and genitalia but have some other characteristic features which are absent in adult. These features are lost at the final molt. The orders Plecoptera, Ephemeroptera and Odonata (Figure 3) have aquatic larval stages. The young forms are known as naiads which are aquatic and respire by external gills but the adults are terrestrial in behavior. Their life cycle also involves three stages: eggs, naiads and adults. When the naiads are ready to transform into adults, they come out of water and adult winged forms are released. The wings and genitalia develop externally but are not fully formed till adulthood. After the formation of wings no further molting takes place, only exception in mayflies where winged forms of aquatic nymphs come out and rest on trees to undergo final molting to become adults.
Hemimetabolous development in dragonfly.
Complete metamorphosis is a kind of morphological change during post-embryonic transformation in which larva has no similarity with adult and there is always a pupal stage. Complete metamorphosis takes place in orders Coleoptera, Diptera, Hymenoptera and Lepidoptera. Pupal stage is the characteristic of holometabolous development i.e., this stage is present between the last larval stage and the adult.
In Order Lepidoptera (moths and butterflies), the larva is known as Caterpillar (Figure 4). It possesses a distinct head with powerful mandibles and three pairs of jointed thoracic legs. The abdomen has four or five pairs of un-jointed, short abdominal legs which are termed as pseudo-legs or prolegs. These caterpillars eat voraciously and grow rapidly with several moltings. After completing four or five molts, the caterpillar is transformed into pupal stage.
Holometabolous development in butterfly.
In Order Diptera (Houseflies and other flies), the larva is worm-like and devoid of appendages and is known as maggot (Figure 5). The mature larva is about 12 mm long. The head is indistinct, with a pair of oral lobes and hooks.
Holometabolous development in housefly.
In Order Coleoptera (ground beetles, ladybirds and rove beetles), like adults the larvae referable to many beetle families are predatory in nature. The larval morphology is highly varied among species, with well-developed and sclerotized heads, distinguishable thoracic and abdominal segments and are known as grubs.
In Order Hymenoptera (bees and wasps), the larvae are grub-like with well developed head and mouthparts are of chewing type. Larvae are generally apodous, rarely eruciform with locomotory appendages.
The larvae in different orders of insects are known by different names i.e., larvae of butterflies and moths are termed as caterpillars and those of Diptera and Coleoptera are termed as maggots and grubs respectively. The larvae are grouped into four types on the basis of development of appendages (Figure 6).
On the basis of number and location of prologs, the lepidopteran larvae are further classified into three types: caterpillar, semilooper and looper.
Caterpillar: Caterpillar is the larval stage in Order Lepidoptera. It has soft body that can grow rapidly between molts. It bears five pairs of prolegs which are present on 3rd, 4th, 5th, 6th and 10th abdominal segments and three pairs of thoracic legs. e.g., larvae of gram pod borer and Lemon butterfly.
Semilooper: The semilooper larva bears three pairs of thoracic legs and three pairs of prolegs which are present on 5th, 6th, and 10th abdominal segments e.g., Cotton Semilooper and Castor Semilooper.
Looper: The looper larva have three pairs of thoracic legs and two pairs of prolegs present on 6th and 10th abdominal segments e.g., Cabbage looper.
Campodeiform type: The campodeiform larva has dorso-ventrally flattened and well sclerotized body which bears long thoracic legs and a pair of terminal cerci. This type of larvae is found in orders Neuroptera, Trichoptera, Strepsiptera and in some Coleoptera (e.g., Lacewing and Ladybird beetle).
Scarabaeiform type: The larva in this type is fleshy and ‘C’-shaped with poorly sclerotized abdomen and thorax. It bears short legs and terminal abdominal processes (cerci) are absent. These larvae are less active and sluggish in nature. Scarabaeiform larvae are mainly in Scarabaeoidea and also in some other Coleopterans (e.g., White grub, Rhinoceros beetle).
Eucephalous Larva: In this type, larva has well sclerotized head capsule with relatively reduced cephalic appendages and is found in Nematocera (Diptera), Cerambycidae (Coleoptera) and Aculeata (Hymenoptera). E.g., Mango stem borer, Mosquito.
Hemicephalous Larva: In this type, larva has reduced head capsule that can be withdrawn within the thorax. It is found in families Tipulidae and Tabanidae of order Diptera. E.g., Crane fly, Horse fly.
Acephalous Larva: This type of larva has no head capsule and cephalic appendages. E.g., Larva of House fly).
Like larvae, the pupae are also of various types (Figure 7). These can be grouped according to the presence or absence of functional mandibles which might be used by the adult to emerge from the cocoon or pupal cell. The functional mandibles are present in decticous type of pupa, whereas in the adecticous type, the mandibles are not functional. The latter type can be subdivided into two: exarate and obtect. The exarate pupa has free appendages and the obtect have appendages glued to the rest of the pupal body. An exarate pupa enclosed in a puparium is termed as coarctate whereas the silken protective case of obtect pupa is known as cocoon.
Different types of insect larvae: (a) Caterpillar, (b) Semilooper, (c) Looper, (d) Campodeiform, (e) Scarabaeiform, (f) Eucephalous larva, (g) Hemicephalous larva, (h) Acephalous larva.
Different types of insect pupae: (a) Decticous pupa (b) Adecticious pupa, (c) Exarate Adecticous pupa, (d) Obtect Adecticous pupa.
Heteromorphosis is the type of development characterized by radical change in forms between successive larval instars. The larval instars are pretty much similar in many endopterygotes. However, a larva experiences typical change in morphology and in habits during development in some families of orders Coleoptera (Meloidae, Ripiphoridae), Diptera, Hymenoptera, Neuroptera and in all Strepsiptera. It is common in parasitic and predaceous insects where change in habit occurs during course of development. This is further of two types:
In first type, eggs are laid in open and the first stage larva searches for its host. In this type, the newly emerged first stage larva is an active campodeiform larva. For example, in Strepsiptera, larva attaches itself to a host often a bee or a sucking bug. When the bee visits a flower in which the larva is lurking, subsequently, it becomes an internal parasite and loses all traces of appendages and a series of dorsal projections starts developing which increases its absorptive area. The cephalothorax develops during sixth and seventh larval stages. Another example is of blister beetles (Meloidae), the larva hatches as free-living campodeiform which can actively search for food. After locating the food source, the larva soon molts to second stage i.e., eruciform (caterpillar like). Further, it has to pass through either two or more additional larval instars, where it may remain as eruciform or become scarabaeiform. A basically similar life history with an active first stage larva followed by inactive parasitic stages occur in Acroceridae (Diptera), Bombyliidae, Epipyropidae (Lepidoptera), Mantispidae (Neuroptera), Nemestrinidae (Diptera), Perilampidae, Eucharidae (Hymenoptera), Meloidae and some Staphylinidae (Coleoptera).
In second type of heteromorphosis, the eggs are laid in or on the host. It occurs in some endoparasitic Diptera and Hymenoptera. Among the parasitic Hymenoptera, the newly emerged larva is of protopod type larva. It has many different forms in different insect species. For instance, the first stage larva of
During immature development, larvae of insects and other arthropods molt regularly by shedding their exoskeletons. Thus, instar is a developmental stage between two successive molts in the life cycle of an arthropod and the development period of larvae in insects is divided into a few discrete stages. The dissimilarity between instars is often observed in altered body proportions, patterns, colors, number of body segments, head width and appendages. Arthropods shed their exoskeleton in order to grow and to assume a new form. After shedding their exoskeleton, the juvenile insects continue their life cycle till they either pupate or molt again. The first larval instar stage begins at hatching and it ends at the first larval molt. In holometabolous insects, the last instar is a phase from final molt to either prepupal or pupal stage or the eclosion of an imago in hemimetabolous insects. The period of growth is species specific and is fixed for every instar. The larval instars number varies across various insect species.
An insect instar number also depends on the surrounding environmental and other conditions. The most common factors affecting the number of instars are temperature, humidity, photoperiod, physical condition, inheritance, sex, food quality and quantity. Lower temperature and less humidity often slow down the rate of development. In some insects, e.g., in salvinia stem borer moth, the number of instars relies on early larval nutrition. In addition, the presence of injuries has been observed to influence the number of instars in some species. During suitable conditions, the instar number is higher in exceptional species of orders Orthoptera and Coleoptera. Intraspecific variability in the number of larval instars is a widespread phenomenon occurring in most major insect orders, in both hemimetabolous and holometabolous insects. For instance, the hymenopteran egg parasitoid
Apart from other environmental factors, the inheritance and sex are the two factors which most commonly influence the instar number. The number of instars is usually sexually dimorphic and the females in general have a higher number of instars than males. The inherited factors affecting number of instars may be either hereditary or achieved by means of maternal impacts and further may rely upon environmental conditions encountered by a parent. Instar number might be genetically unique in larvae from various populations [7], between genetically determined phenotypes or between the offsprings of different individuals from the same population. Moreover, instar number may also differ genetically between subspecies [8], or between short and long winged individuals [9]. The instar number of progeny is influenced by the prevailing ecological conditions during the oviposition or larval period of parents. When reared in isolation, the nymphs of locusts namely
The larvae enter in a stage of inactivity i.e., remain motionless after final instar and stop feeding. This stage is known as pupal stage (chrysalis in case of butterflies). The larvae begin to resemble adults at the end of this stage due to the anatomical modifications that take place in them and also due to the appearance of new organs and tissues (Table 1).
Orders | Number of larval stages |
---|---|
Siphonaptera | 3 |
Phthiraptera | 3–4 |
Coleoptera | 3–5 |
Hemiptera | 3–5 |
Neuroptera | 3–5 |
Diptera | 3–6 |
Hymenoptera | 3–6 |
Mecoptera | 4 |
Zoraptera | 4–5 |
Dermaptera | 4–6 |
Embioptera | 4–7 |
Lepidoptera | 5–6 |
Thysanoptera | 5–6 |
Trichoptera | 5–7 |
Mantodea | 5–9 |
Isoptera | 5–11 |
Orthoptera | 5–11 |
Psocoptera | 6 |
Blattodea | 6–10 |
Grylloblattodea | 8 |
Phasmida | 8–12 |
Thysanura | 9–14 |
Ephemeroptera | 20–40 |
Plecoptera | 22–23 |
Number of larval stages in different orders of insects.
In larval forms, when the exoskeleton is outgrown, the insects undergo molting regularly. In insects, the unique process of molting is under hormonal control and thus involves various hormones, proteins and enzymes. During developmental phase when an immature insect needs a larger exoskeleton, the neurosecretary cells present in the brain are activated. It helps the larva to ward off its old exoskeleton. Thus molting is the phenomenon by which insects develops. Under controlled and protected conditions, it permits the body of the developing insect to expand. In order to increase in size the insect must sheds its skin in favor of new underneath skin. Insect can molt 5–60 times in the total life span depending upon its species. Stadium is the time interval between the two subsequent molts and instar is the form assumed by the insect in any stadium. Each instar ends with molting.
When there is no more space for the insect to expand inside its old exoskeleton, hormone triggers molting which separates the exoskeleton from the underlying epidermis and the molting fluid fills the newly created gap. Proteins are secreted by the epidermal cells to form a new cuticle. Later on, when the new cuticle is in place, the inner layer of the exoskeleton is digested by the enzymes present in the molting fluid. Epidermal cells recycle the chitin and proteins which are then secreted under the new cuticle.
With the formation of new exoskeleton the insects can further start shedding its old exoskeleton. The insect expands its body with the intake of large amount of air and the outer shell is forced to get split, usually down the dorsal side as a result of muscular contractions. The outgrown exoskeleton squeezes out the bud. It is a compulsion for the insect to expand and swell its newly formed cuticle which conclusively makes this new cuticle large enough so it can allow room for any further growth. The newly formed overcoat is much paler in appearance and is soft than that of the older one, however, it starts to become darker and hardens itself within few hours. The appearance of the insect seems like a slightly larger copy of its previous form.
The whole procedure of development of an insect is influenced mainly by three hormones: Prothoracicotropic hormone (PTTH), Ecdysone and Juvenile hormone which are secreted by neuro-secretory cells (NSC) present in the brain, Prothoracic gland (JH) and corpora allata respectively. The signals are sent by the developing body of the insect to the brain and direct it to activate the clusters of neurosecretory cells which then produce PTTH which passes down into neurohemal organ, Corpora Cardiaca (CC) to release stored PTTH into the circulatory system (Figure 8). The prothoracic glands get stimulated by this to secrete Ecdysone. The active form of ecdysone triggers a series of physiological events leading to the formation of a new exoskeleton by the process known as apolysis.
Hormonal control of insect development.
Along with serving the purpose of acting as a hormone release site, the Neurohemal organ also synthesizes hormones. It is the responsibility of JH to maintain the insect in its young state and it modifies expression of the molt, acts in conjunction with ecdysone. JH hormone favors the synthesis of larval structures and adult differentiation and thus considered as a modifying agent.
During larval development some insects are able to regenerate their appendages following their accidental loss. If the loss occurs early in a developmental stage, before the production of molting hormone, the appendage reforms at the next molt. The regeneration occurs in larval forms of Blattodea, Phasmatodea, in some Hemiptera, Orthoptera and holometabolous insects. The regeneration of cuticular structures can only happen at a molt as this is the only time at which new cuticle is produced. Consequently, regeneration of appendages does not occur in adults and is restricted to larval stages only. Regeneration of muscles and parts of the nervous system also occurs during development stages.
In an organism, body size is one of the most important life history characters. Its effects on fitness are well documented and have been extensively studied both theoretically and empirically. Gaining weight and eating is the foremost function of the larva which leads to several developmental changes during this phase. The eyes, palpi, proboscis, antennae, reproductive organs and wings starts developing and the larval legs will develop into the adult legs. Prior to pupation, growth of these organs accelerates during the last one or 2 days, hence when pupa is formed the major important changes to the adult form have already been taken place. There is a progressive increase in weight throughout the developmental stages. Body size is flexible i.e., it can change in response to different environmental conditions. For example, insects developing at higher temperatures are generally smaller than those developing at lower temperatures and well fed organisms are typically larger than those fed at poor quality diet.
Normally the weight increases consistently throughout the phase of development and then falls slightly at the time of molting due to the loss of cuticle and some loss of water that is not replaced because the insect is not feeding. After molting, the weight quickly increases above its previous level. Expressed in terms of increase in absolute weight, the growth rate is usually greater in the later stages, but the relative growth rate normally decreases as the organism increases in size. In some aquatic insects before a molt there is no decrease in weight, but, at the same time, there is a sharp increase at the time of ecdysis due to the retention of water, either through the cuticle or by means of alimentary canal. This is utilized to build the volume of the insect, thus splitting the old cuticle.
D’Amico
In final (fifth) instar larvae of
Holometabolous insects acquire their adult biomass during larval growth. In this manner, food consumption is intense and the fat body enlarges amid larval development. However, they do not feed during metamorphosis and simply exploit the nutrients stored during their larval development. During metamorphosis, the fat body is reconstructed through cellular turnover to the degree that when the adult insect emerges, the fat body has been remolded or is completely replaced [17].
The crowding affects the rate of development and also influences the adult size. Insects from crowded conditions are generally smaller than the others developed in isolation. For example in
Larval growth is characterized by periodic molts and to some extent the internal changes are correlated with the molting cycle. Larval growth is regulated by ecdysteroid molting hormone which helps in producing larval characters. While hormones exert an overall controlling influence, local factors are also responsible for controlling the form of particular areas in the larval body. For example, epidermal cells often show distinct polarity secreting cuticle in a form giving an obvious anterior–posterior pattern. In the first stage larva of
In addition to having a specific orientation, cuticular structures are dispersed in regular patterns. For example, in assassin bugs (
There is relatively little information on control of growth of the integral organs, but some show cyclical activity which coincides with the molt. In
Integument is the external layer of tissue that covers the outer surface of insects and the surfaces of the foregut and hindgut. It is composed of epidermis which is a continuous single layered epithelium, an underlying thin basal lamina and the extracellular cuticle that lies on top of the epidermis. An extracellular layer i.e., the cuticle covers the outer surface of the insect’s body. It serves dual function. Firstly, it acts as a skeleton for muscle attachment and secondly, as a protective barrier between the insect and its respective environment.
Depending upon insect species, its developmental stage along with the body region, the cuticular layer may vary in thickness which can range from few micrometers to millimeters. It can be as thin as 1 μm in the hindgut and over gills (Ephemeropteran larvae) and as thick as 200 + μm (elytra of large beetles). The cuticle is highly diverse in their mechanical properties and can be divided into two groups: stiff, hard cuticles and soft, pliant (easily bent) cuticles. It also differs in color and in surface sculpturing, but electron microscopy shows that all types of cuticles are built according to a common plan. It is the essential part of the integument which further has the cuticle producing epidermal cells, sense organs and various glands. Epicuticle, procuticle and subcuticle are three distinct layers of the cuticle (Figure 9). The epicuticle being the outermost covers the complete cuticular surface. Procuticle comprises the principle part of the cuticle. Subcuticle is present in between the procuticle and the epidermal cells. It is a thin histo-chemically well-defined layer. This layer serves as the accumulation zone where the newly formed cuticular material is assembled and added to the cuticle that already exists and also binds the cuticle and epidermis. In the early stages of the development of the cuticle, before the insect sheds the cuticle of its previous stage, the amount of protein per unit chitin is much less than in the mature developed cuticle [20].
Structure of insect integument.
The single celled layer of epidermis constructs the cuticle. The epidermis effectively stores the lamellate endocuticle in those regions where the cuticle is extensible during the intermolt period. At the apical surface of epidermal cells, the plaques of chitin and protein are discharged at the tips of microvilli. Above the plaques in the extracellular space, the cuticle arises by self-assemblage of chitin microfibrils and secreted proteins. As the larva develops, the epidermal cells beneath the flexible cuticle also grow. The epicuticle in the case of soft-bodied insects e.g., in tobacco hornworm,
Ecdysis is derived from the Greek word
Close to the end, where molting fluid is reabsorbed the insect undergoes ecdysis i.e., shedding of the old cuticle which takes place in a stereotyped arrangement of behavior. This behavior is characterized by a series of coordinated movements which helps to loosen the muscle attachments with the old cuticle. After this phase, there is a series of peristaltic waves which travel from posterior to anterior and helps to make the insect to rupture the old cuticle anteriorly and to free itself. The cuticle opens at ecdysial sutures. These are the areas of old cuticle which lack exocuticle. In order Lepidoptera, the head capsule has slipped down over the forming mandibles early in the molt to allow the formation of a larger head capsule. The old head capsule isolates from the rest of the old cuticle during ecdysis and falls off as the new larva leaves its old cuticle.
Dermal glands i.e., Verson’s glands secretes a waterproofing cement layer on the top of epicuticle. When the larva sheds its old cuticle this layer sprawls over the surface as a result of larval movements under the old cuticle. There are certain cases in which there is a secretion of waxy layer on the top of this layer for the first few days after ecdysis which helps in preventing desiccation. The pore canals transversing through the cuticle from the epidermal cells help in secreting this waxy layer.
The larva fills its tracheae with air after the process of ecdysis and furthermore swallows air so as to expand the new larger cuticle. After achieving its final size, the new cuticle solidifies. It gets dark or tanned to changing degrees relying upon whether the cuticle is to be rigid or flexible.
Sclerotization is the phenomenon of hardening the exocuticle by cross-linking the proteins together with the chitin to form a balanced structure appropriate for an exoskeleton which helps to anchor the muscles to permit the movement. N-β-alanyldopamine and N-acetyldopamine are the two essential cross-linking agents. The N-β-alanyldopamine is found in tan cuticles of many pupae belonging to order Lepidoptera. The key enzymes for the formation of these compounds are phenoloxidase for conversion of tyrosine to dopa and dopa decarboxylase for conversion of dopa to dopamine.
The form of the cuticle is determined by the epidermis which may grow either by an increase in cell number or by an expansion in cell size. During developmental period the cell number increases just before molting in larval stages of insects. For instance, the size of the larval forms of
The growth of central nervous system in hemimetabolous insects does not involve the production of new neurons except in the brain. In the terminal abdominal ganglion of
During larval development, the marked changes occur in the sensory system of hemimetabolous insects. At each molt additional mechanoreceptors and chemoreceptors are added to the already present receptors. The ommatidia forming the compound eyes also increase by number. In contrast, the number of sensilla remains constant throughout the larval life in holometabolous insects and compound eyes are only present in the adults.
The musculature in larval forms closely resembles to that of adults in most hemimetabolous insects. In addition, there may be some muscles that are operative only during molting and later disappear after the final molt. During larval development, muscles increase in size and there is no basic change in their arrangement. The muscles grow by an increase in fiber size between molts and by the addition of new fibers at molts.
In case of epidermis, increase in the size of an internal organ results from an increase in cell size or in cell number or sometimes both. The increase in volume of internal structures especially the fat body is limited by the cuticle. In holometabolous insects, larvae with soft, folded cuticle, considerable growth is possible. The extension of the abdomen by unfolding inter-segmental membranes occurs in species with more rigid cuticles. In grasshoppers, and probably in some other insects, some growth of internal organs occurs at the expense of air sacs which become increasingly compressed during each developmental stage. The fat body of larval
The development of Malpighian tubules varies. In Orthopteroid orders, Malpighian tubules increase in number throughout the larval life. The primary tubules arise as diverticula from the proctodeum in the embryo. There are four primary tubules in
Many animals possess a distinct immature developmental form (e.g.) in case of insects larval forms are distinct during developmental period. The immature forms are much more adapted to environmental conditions than adults and consume more food to undergo the process of transition from immature to adult form. Larval stages undergo metamorphosis in which they usually change in shape, size and organization to form an adult. These changes are triggered and monitored by hormones such as juvenile hormone. Class Insecta is characterized by four different patterns of growth and development i.e., Ametabolous, Paurometabolous, Hemimetabolous and Holometabolous. Each pattern is characterized by specific morphological and hormonal changes. Insect larvae are broadly classified into four groups: Protopod larva, polypod larva, oligopod larva and apodous larva.
During the process of molting, the insect larvae molt with number of times. The number of instars varies across insect species. The environmental conditions like temperature, humidity, photoperiod along with other factors such as sex, inheritance, food quality and quantity affect the number of instars. Some insects can regenerate their lost appendages before the production of molting hormone. Regeneration can be seen in larval forms of Blattodea, Phasmatodea, some hemipterans and orthopterans. Larval development is also marked by significant changes in the sensory system in hemimetabolous insects. Mechanoreceptors, chemoreceptors are added along with the increase in size of muscles.
Larval development is a significant phase in the development history of an insect which molts and physiologically change the insect to adjust in different environmental conditions and habitats.
All surgical procedures, including dental surgery, present risk of complications, which may include pain, nerve injury, swelling, infections, and hemorrhage. Dental surgery is defined as any dental intervention including an incision in the oral mucosa or gingiva, including anything from a simple dental extraction to alveoloplasties [1]. Bleeding control is an important step during dental surgery procedures [2] because excessive bleeding complicates surgery and increases the risk of morbidity. To avoid such complications when long-lasting bleeding occurs, despite the proper use of traditional techniques for hemorrhage control, a broad range of hemostatic agents are available, as adjunctive measures to enhance hemostasis in the course of dental surgeries [3]. Despite the expressive rise in the amount and types of topical hemostats in the past decade, high-level evidence regarding the management of these agents during bleeding in dental surgery is still lacking.
\nThe periprocedual management of patients receiving therapeutic anticoagulation represents a challenge for dental practitioners, as the risk of bleeding must be counterbalanced against the risk of systemic or local thromboembolic phenomena. Recommendations for dental interventions in individuals receiving anticoagulation therapy remain quite unclear, in spite of practice guidelines from both dental [4] and medical [5] fields.
\nThis chapter aims to discuss the effective ways of managing bleeding complications in dental surgery, mainly in high-risk patients. The role of biosurgical materials to prevent or solve these complications, during and after dental surgery procedures, will also be addressed, as well as their modes of action, practical applications, adverse effects, and effectiveness.
\nThe physiological mechanism that prevents and hinders bleeding at the area of an injury while preserving regular blood flow everywhere else in the circulation is called hemostasis [6]. The hemostasis process has two major components. Primary hemostasis initiates promptly after vascular injury, and it can be divided into four consecutive and superposed stages: (A) vasoconstriction, (B) platelet adhesion, (C) platelet activation, and (D) platelet aggregation [7, 8, 9, 10]. Primary hemostasis results in the formation of a platelet plug [10]. Secondary hemostasis comprises a sequence of serine protease zymogens and their cofactors, which interact successively on phospholipid surfaces (damaged endothelial cells or platelets), leading to the development of covalently cross-linked fibrin [10, 11, 12]. This cross-linked fibrin mesh is then incorporated into and around the platelet plug. It strengthens and stabilizes the blood clot. These two processes are intertwined and occur at the same time [6]. These systems are regulated by multiple anticoagulant mechanisms, which are responsible for maintaining blood fluidity in the absence of injury, generating a clot that is consistent with the trauma. Hemostasis and the avoidance of bleeding or thrombosis are directly related to the adequate balance between procoagulant and anticoagulant systems [6].
\nHemorrhage in dental surgery can be categorized as:
Primary hemorrhage: bleeding occurs during surgery
Reactionary hemorrhage: bleeding occurs 2–3 hours after surgery
Secondary hemorrhage: bleeding occurs until 14 days after surgery, probably due to an infection
Hemorrhage can also be categorized according to the area injured: vascular, bone, and soft tissue [13, 14]. Bleeding diathesis is an unusual susceptibility to bleeding and may be genetic, autoimmune, or acquired (Table 1) [15, 17]. Selected bleeding disorders will be covered in this chapter.
\n\nThe most prevalent hereditary bleeding disorders are von Willebrand disease and hemophilia, affecting 1% of the population and 20,000 people in the USA, respectively [18, 19, 20, 21, 22]. Dental patients presenting inherited bleeding present a significantly higher risk of perioperative bleeding. The frequency and severity of bleeding are related to disease-related factors, such as the severity of the hemophilia. Factors related to the patient include the level of periodontal disease, vasculopathy or platelet dysfunction, and procedure-related factors (teeth extracted—type and the number—or the size of the wound area) [23].
\nOne example of autoimmune bleeding diathesis is the immune thrombocytopenic purpura (ITP), an idiopathic thrombocytopenic purpura condition, characterized by isolated thrombocytopenia without a clinically apparent cause [24].
\nThe most common acquired bleeding diathesis is the one related to hemostasis-altering medications. Anticoagulant agents are among the most prescribed medications in the USA [25]. For decades, anticoagulants have been prescribed to prevent arterial and venous thromboembolism [1]. Prolonged bleeding and bruising are some of the adverse events related with these medications [4]. The most frequently used drugs are therapeutic platelet inhibitors, vitamin K antagonists, or direct oral anticoagulants. Patients susceptible to hemorrhage may present severe bleeding resulting from dental surgery procedures. The use of biosurgical hemostatic agents to decrease or control bleeding may be beneficial for patients at risk for bleeding diathesis.
\nBleeding complications can occur either in healthy or systemically compromised patients. Some patients tend to bleed excessively during or after dental surgery, due to different factors, such as anticoagulant therapy, inherited bleeding disorders, uncontrolled hypertension, extreme trauma to soft tissues, and non-compliance to postoperative recommendations. In these cases, the use of an effective hemostatic agent enhances hemostasis, providing a wide spectrum of benefits, such as superior management of the anticoagulated patient, shorter operation time, as well as smaller wound exposure and shorter recovery time.
\nThe ideal topical hemostatic agent should be biocompatible, affordable, and effective [14, 26, 27]. In recent years, the number of different topical hemostatic agents has increased significantly (Table 2). Knowledge and familiarity with the wide range of topical hemostatic agents available are essential for dental practitioners, including their effectiveness, mode of action, and adverse effects. A well-informed professional will be able to opt for the most effective and practical agent for each situation. In relation to the use of local hemostatic in dental procedures, available scientific data is not homogenous. Most publications use one or more local hemostatic agents to compensate for the anticoagulant effect and prevent postoperative bleeding [29]. The most common local biosurgical hemostatic agents used in dentistry and approved by the Food and Drug Administration (FDA) are listed in Table 2.
\nTypes and trade name of some biosurgical agents–adapted from Pereira et al. [28].
Local biosurgical hemostatic agents can be classified into (A) passive or mechanical, (B) active, and (C) flowables [30].
\nConsidered as the most effective agents for small amounts of bleeding, passive or mechanical agents provide platelet activation and aggregation. This results in a matrix formation in the bleeding area that works as a barrier to stop bleeding, by activating the extrinsic clotting pathway and providing a surface that will allow coagulation to occur faster [30]. As these agents are biologically inactive, they rely on the individual’s own fibrin production to attain hemostasis. Passive hemostats are only indicated for individuals with an unscathed coagulation cascade [27]. They are generally applied as frontline agents, since they are readily available, do not require special storage or handling, and are relatively affordable [14, 27, 31].
\nGelatin is a hydrocolloid derived from acid partial hydrolysis of purified animal collagen. It is presented as a gelatin sponge, powder (mixed to form a paste), or film. Gelatin can be placed dry or after moistening it with saline [14, 28, 32, 33]. Gelatin-based products adapt effortlessly to wounds making it appropriate for application into irregular surfaces [27]. Although their mode of action is not completely understood, gelatin-based products likely act more physically than chemically in the coagulation cascade [28, 34]. Affordability, ease of use and good hemostatic activity make topical hemostats with gelatin matrix a popular tool for reducing the morbidity caused by hemorrhage [27, 28] after dental extractions and periodontal surgeries.
\nThe most popular absorbable gelatin sponge in dentistry is Gelfoam®. It is a hemostatic compressed sponge obtained from purified porcine skin gelatin. Gelfoam® is capable of absorbing many times its weight of whole blood [35]. Generally, when applied in soft tissues, its complete absorption occurs within 4–6 weeks.
\nCollagen absorbable products are nontoxic and non-pyrogenic. They are sourced from either bovine dermal collagen or bovine tendon. Collagen hemostats provide a matrix for clot formation and consolidation. These products also improve clotting factor release and platelet aggregation and degranulation, thereby breaking up clot formation. Their presentation in sheets and flours allows for easy adaptation and adhesion to irregular surfaces. Although they are commercialized at a higher price than gelatin-based hemostats, hemostasis can usually be accomplished relatively quicker (1–5 min). Collagen absorbable products are easily removed, reducing the risks of rebleeding and the need for various applications. They are absorbed in 8–10 weeks if remained in place. Adverse effects linked to bovine collagen products might include swelling and allergic reaction [30].
\nHelistat® is a collagen-based product originated from purified and freeze-dried bovine flexor tendon and is available as a spongelike structure [14, 27]. Helistat® can hold many times its own weight of fluid, as it is highly absorbent. Collagen induces platelet agglomeration when in contact with blood. In order to achieve hemostasis, Helistat® must be kept at the site (approximately 2–5 minutes). Subsequently, it can be removed, replaced, or left in place. It is easily manipulated, and it must be handled dry, and any excess must be removed. Complete reabsorption occurs within 14–56 days [14, 27, 36]. Helistat® may foster bacterial growth, acting as a nidus for abscess formation [14, 27, 37]; therefore, it should not be placed in wounds with any kind of contamination or infection. Possible adverse reactions of Helistat® or similar products are allergic reaction, foreign body reaction, and adhesion formation [27, 38].
\nSimple oxidized cellulose was first introduced in the early 1940s in the USA. In the 1960s, a new topical hemostatic-oxidized regenerated cellulose (ORC) was launched as a meshwork made from treated and sterilized cellulose—Surgicel®. ORC products are originated from vegetal-based alpha cellulose, available in absorbable knitted fabrics (low or high density), and prepared as sterile fabric meshworks. They are ready-to-use products that may be kept at room temperature and absorb 7–10 times its own weight [27, 30]. ORC cause contact activation and platelet activation, and, when absorbed, a gelatinous mass is created, assisting in the establishment of the clot formation [30]. Thrombin is ineffective with these agents due to low-pH factors. ORC are utilized in the management of capillary, venous, and small arterial bleeding, and they require dry application, without addition of saline or thrombin [27, 39] and are absorbed within 4–8 weeks, depending on the volume applied, the tissue bed, and the magnitude of blood saturation [27, 40, 41, 42]. To prevent delayed healing, excessive volumes should be removed [27]. ORC should not be used in osseous defects as it may intervene with bone regeneration [14, 27, 31]. Adverse effects also include reactions related to the acidic nature of ORC. This characteristic may induce necrosis and inflammation of the surrounding tissue and makes thrombin inefficient with these agents. When left in the wound, they may lead to fluid encapsulation and foreign body reaction [14, 27].
\nThe most common commercial products in this category are Surgicel®, Oxycel®, and Surgicel Nu-Knit®. Surgicel® and Surgicel Nu-Knit® come in knit, solid fiber form, whereas Oxycel® comes in knit, hollow fiber form; however, they function basically in a similar manner [30].
\nOxidized cellulose (OC) agents are produced from sterilized and treated cellulose, presented as a meshwork. In the presence of blood, they present a three- to fourfold increase in volume and are converted into gel. OC dissolve completely in 1–2 weeks into biodegradable end products glucose and water, and they do not interfere with wound healing [14, 27].
\nActCel® binds to calcium ions, resulting in more calcium available for the coagulation cascade [14, 27, 37]. Biochemically, it intensifies the coagulation process by increasing platelet aggregation and physically by 3D clot stabilization. ActCel® is especially indicated in third molar extractions, to avoid the occurrence of dry sockets, and in orthognathic and periodontal surgeries [27]. ActCel® is hypoallergenic, as it does not contain collagen, thrombin, or chemical additives. It also has important bacteriostatic properties [27, 43], which are particularity relevant in infected wounds [27].
\nGelita-Cel® is a relatively quick acting, oxidized resorbable cellulose hemostatic gauze of natural origin. It presents a decreased risk for encapsulation, as it resorbs as fast as 96 hours [14, 27, 37].
\nPolysaccharide hemospheres are a fairly new class of topical biosurgical hemostatic agents, produced from vegetable starch, and they contain no animal or human elements. They are commercially presented in powder form. Polysaccharide hemospheres increase barrier formation by creating a hydrophilic effect, dehydrating the blood, and concentrating its solid components [14, 27]. Due to their 3D scaffold, they are devised to enhance clot formation and organization, even in the absence of intrinsic coagulation activity [14, 44, 45]. Polysaccharide hemospheres should be used with caution in diabetic patients, as they consist of sugars [27].
\nArista™AH is the only FDA-approved product in the polysaccharide hemosphere category. It is used in dental surgery as an adjunctive hemostatic agent, when conventional mechanical procedures, such as pressure and ligature, are not effective or practical.
\nHemostatic adhesives are often used as adjuncts to standard hemostatic procedures to control bleeding from surgical areas [30]. One of the most well-known products in this category is BioGlue®. It consists of a solution of 10% glutaraldehyde and 45% bovine albumin solution purified by precipitation, heat, and chromatography radiation [28, 46]. BioGlue® has been extensively used for its sealants and hemostatic characteristics. The risk of leaking through the suture tracks is the main disadvantage of BiolGue® [27]. In the search for newly created adhesives with the chemical features and the safe reabsorptive profile required to benefit dental surgery patients, several clinical trials are currently in process.
\nActive hemostatic agents are biologically active, as they play a direct role in the coagulation cascade, inducing the formation of a fibrin clot [26, 27].
\nThrombin is key to hemostasis, as well as to the inflammatory and cell signaling processes. It is the base of the fibrin clot, fostering the transformation of fibrinogen to fibrin [28]. Topical thrombin hemostats are originated from either bovine or human plasma, and they can also be produced through recombinant DNA techniques [14, 27]. In the past, the only thrombin hemostat available was composed of bovine plasma (Thrombin-JMI). Although it has proven to be efficient in terminating bleeding, bovine thrombin induces an important immune response [28, 47]. Individuals on hemodialysis, with increased levels of antibodies against topical bovine thrombin, had higher incidence of vascular access thrombosis, severe coagulopathy, and bleeding after exposure to bovine thrombin [28, 48]. As an attempt to avoid these hazardous effects, thrombin derived from human plasma (Evithrom®) and recombinant human thrombin (Recothrom®) were developed. In 2010, Browman et al. [49] demonstrated, in a comparative study between recombinant human thrombin and bovine thrombin, that human recombinant thrombin showed the same efficacy in surgical hemostasis, a comparable safety profile, and a remarkably lower immune response than bovine thrombin. Thrombin may be applied topically, as a solution combined with gelatin sponges mixed with a gelatin matrix, as a dry powder, or as a spray [14, 27]. It is commonly used in conjunction with Gelfoam® to stop moderate to severe bleeding.
\nFibrin sealant or fibrin glue originates from bovine and/or human blood components and simulates the last phases of the coagulation cascade, generating a fibrin clot [30]. These agents control local, as well as diffuse, bleeding from the surgical area. Nevertheless, they are ineffective in controlling intense bleeding. Its use in dentistry includes tooth extraction sites, bone grafting, and periodontal surgery [14].
\nTisseel® was the first fibrin sealant approved by the FDA. It has in its composition human thrombin and fibrinogen, intermixed with aprotinin and CaCl2. Because aprotinin is a bovine protein, it is a potential allergen. Multiple exposures may cause allergic reactions, as well as anaphylactic reaction approaching lethality [30, 50]. As for its ideal application, a dry operating field is required; Tisseel® is particularly effective when applied prior to bleeding. In this situation, fibrinogen may polymerize before blood pressure increases local microcirculation flow. When used after the onset of bleeding, one should apply local pressure over the wound to allow polymerization [28, 51]. Tisseel® is available in a pre-filled syringe, allowing for effective application using the EasySpray and DuploSpray MIS systems.
\nAnother option for fibrin sealants, Evicel®, originates from pooled human plasma. It is available as two separate vials of fibrinogen and human thrombin. Prior to use, the two deep frozen solutions must be thawed and mixed after defrosting and heating up (20–30°C) [30].
\nCrosseal™ is a virally inactivated, second-generation surgical sealant. It is produced from concentrated human clottable proteins, namely, biological active component (BAC), which contains the active component fibrinogen, and human α-thrombin (1000 IU/ml) [52]. This fibrin sealant is applied using an application device which drips/sprays Crosseal™ onto the bleeding site.
\nThere are two main categories of flowable biosurgicals: products containing porcine gelatin, which can be combined with thrombins (bovine, human-pooled plasma thrombin, or rhThrombin), and bovine collagen-based agents, packed with human-pooled plasma thrombin. The flowable agents are deemed the most effective of all the local hemostatic agents [30, 53].
\nSurgiflo® is an absorbable, sterile, hemostatic porcine gelatin matrix, combined with Thrombin-JMI, a topical bovine-derived thrombin. It should be placed directly to the bleeding areas to activate the hemostatic process [30]. A compression period is required for polymerization of the sealant components [28].
\nFloseal® consists of a bovine gelatin matrix, plasma-extracted human thrombin, and CaCl2. Its gelatin granules expand (10–20%), as it comes in contact with blood, producing a seal when the product is applied to a bleeding area [27, 30]. The thrombin fraction of the product triggers the regular pathway of the coagulation cascade, converting fibrinogen to a fibrin polymer and creating a clot around the firm matrix [27], which is reabsorbed within the expected period of standard wound healing (6–8 weeks) [14, 27, 33, 42, 54]. A distinctive feature of Floseal® is the need for the presence of blood for activation [30, 55]. Neither compression, nor a dry surgical field is required for its application [28].
\nBecause of this biosurgical flowability, they can easily adapt to irregular wounds. Flowables have been utilized as frontline topical hemostats in major dental surgeries, in patients where conventional procedures are ineffective. They can be utilized as an adjunct to hemostasis in practically all dental surgical interventions. Flowables are effective on both hard and soft tissues [27, 30]. They have a risk of transmitting infectious agents and are contraindicated in patients who are allergic to materials of bovine origin [27].
\nAlthough traditional methods, such as ligature and manual pressure, can promote hemostasis, they are not an effective approach of bleeding control in less accessible sites and complex injuries. Furthermore, bleeding control is especially challenging in patients presenting acquired or congenital coagulation disorders.
\nTopical biosurgical hemostatic agents comprise a wide range of products aiming at minimizing the risk of bleeding. In recent years, several clinical trials have analyzed the effectiveness, advantages, and limitations of biosurgicals, as well as performed comparisons among the different types of biosurgicals and other non-biologic agents. Despite the beneficial effect of these local hemostatic agents in preventing bleeding in dental surgery, available data comparing their effectiveness and efficiency is still scarce and inconclusive. Methodological heterogeneities, such as the lack of a standard therapy and comparable treatment regimens, are noticeable among studies, as well as the reduced number of randomized controlled trials [2, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70].
\nIn summary, local hemostatic agents are very distinct products with diverse indications. Presently, there is no definite evidence-based approach to guide the dental practitioner when selecting a local hemostatic agent. They must be aware of the characteristics of each single hemostatic agent, to elect the most suitable product for every particular clinical situation. In addition, current available data shows that no topical agent can be regarded as superior or more effective than the others [2]. Further experimental research and controlled clinical trials are warranted to define the most cost-effective biosurgical hemostatic agents in dentistry.
\nThe dental practitioner should assess the bleeding risk of the patient, as well as the bleeding risk of the surgical intervention, preoperatively. After assessing both bleeding risks, the professional can then conceive an intraoperative and postoperative plan. The international normalized ratio (INR) must be evaluated in patients reporting an elevated risk of bleeding. While a standard parameter of coagulation has an INR of 1 [71], the therapeutic range runs from 2.0 to 3.5. In this case, it is recommended to use local hemostatic measures independently or in combination with conventional methods. These agents can be used before, during, and after dental surgeries.
\n\n
Comprehensive medical history, including all medications in the patient’s regimen, to identify potential bleeding issues prior to the surgery [26].
In order to decrease surgical bleeding, patients receiving anticoagulant therapy may need to break up exodontia into multiple appointments [26, 72].
Laboratory values such as platelet count, INR, and prothrombin time are of critical value in medically compromised patients [26].
Demographic risk factors (female sex and older age) [73].
Supplemental patient-related risk determinants: diabetes mellitus, hypertension, obesity, hemostatic disorders, renal impairment, and other major organ system failures [73, 74, 75].
Timing of the appointment: early morning visits allowing patients to return to the dental office in case of postsurgical hemorrhage [26].
Patients at a higher bleeding risk are those reporting family history of bleeding and previous bleeding problems after dental surgery or trauma and individuals using medications, such as aspirin, anticoagulants, and/or long-term antibiotics. Any illnesses associated with bleeding problems, such as leukemia, congenital heart disease, liver disease, or hemophilia, present a higher risk of bleeding. The dental professional needs to be aware and prepared for any intercurrence, during or after a surgical procedure. Individuals presenting advanced periodontal disease are also considered as having a higher risk of perioperative bleeding. In such cases, the surgical plan should include a preoperative phase, consisting of scaling and root planning and a proper chlorhexidine gluconate mouth rinse regimen, 2 weeks before an elective procedure [26].
\nThe risk of bleeding of a dental intervention may be ranked as high, moderate, and low [25, 76, 77, 78]. In most patients, antithrombotic therapy is not interrupted before dental interventions with low bleeding risk, due to the disastrous complications of thrombosis (Table 3) [25, 76, 77, 78]. Moderate and high bleeding potential interventions might need the temporary discontinuation of the antithrombotic therapy [25, 76, 77, 78].
\nDental interventions that do not require anticoagulation therapy interruption*–adapted from Kaplovitch and Dounaevskaia [25].
Dental surgical interventions are considered by most recommendations, as minor procedures presenting self-limited blood loss and low bleeding risk. Bleeding, in most cases, can be managed with local hemostatic agents [79, 80].
\nThe dental care of individuals receiving therapeutic anticoagulation becomes critical when invasive procedures are needed. At this time, the clinician must decide either to maintain the anticoagulation therapy and risk bleeding complications or withdraw the anticoagulation medication and risk developing systemic thrombosis [1]. After decades of controversial data, there is currently a nearly unanimous consensus that anticoagulation therapy, for most dental surgeries, should not be discontinued. The higher risk of bleeding complications is compensated by the elevated risk of developing thromboembolic complications [1, 81, 82, 83, 84].
\nNational dental and medical group statements and multiple evidence-based clinical guidelines have considered the issue independently and support the maintenance, for most dental patients, of anticoagulation therapy (American Dental Association; American Academy of Dental Sleep Medicine; American Heart Association; American College of Cardiology; American Academy of Neurology; American Society of Anesthesiologists; Society for Neuroscience in Anesthesiology and Critical Care; American College of Chest Physicians (ACCP)) [1]. In a 2012 statement [76], the ACCP recommended continuing anticoagulation therapy with warfarin, with the additional utilization of a local hemostatic. The ACCP advised a 2–3-day anticoagulation therapy suspension, in order to lower the INR levels to a range of 1.6 and 1.9 [76, 85].
\nLately, the dental care of patients receiving anticoagulant treatment has been the focus of expressive scientific interest, in both dental and medical fields. A recent literature review showed that only 31 (0.6%) of more than 5400 patients receiving over 11,300 dental surgical interventions while continuing to take vitamin K antagonist anticoagulants (warfarin in most cases) demanded more than local maneuvers for hemostasis. No cases of fatal hemorrhage were reported. In over 2600 individuals whose anticoagulation was discontinued for dental interventions, 22 thromboembolic complications (0.8% of medication withheld), including 6 fatal events (0.2% of medication withheld), were observed [83]. Similar results have been shown in a literature review of dental surgery and antiplatelet medications. Of more than 1200 patients receiving over 2300 dental surgical procedures while continuing their antiplatelet medications (aspirin in most cases), only 2 (0.2%) needed more than local measures for hemostasis. Conversely, in over 320 individuals undergoing 370 antiplatelet interruptions for dental procedures, 17 (5.3%) suffered thromboembolic complications [86].
\nAvailable data shows that the majority of dental interventions can be safely conducted in patients receiving anticoagulation treatment, when considering older medications [4]. However, there are fewer studies reporting the provision of dental care in individuals using newer direct oral anticoagulants. The clinical implications of these newer anticoagulant and antiplatelet therapies have only been recently investigated [80, 87]. The protocol followed by the dental practitioner when managing these patients varies significantly and shows inconsistencies reflecting the lack of large-scale studies and evidence-based clinical guidelines [80, 88, 89]. The risk of postoperative bleeding after invasive periodontal treatment in individuals using different anticoagulation therapies was assessed, retrospectively, in 456 individuals receiving an antiplatelet and/or anticoagulant therapy [90]. Data was collected after 484 invasive periodontal interventions, with 99.6% of patients continuing their medications during the procedures. Postoperative bleeding was reported only following three interventions (0.35%), and it was controlled with local hemostatic maneuvers. Although the authors did not specify which type of local hemostatic procedure was used, this retrospective study showed a very low risk of bleeding in patients receiving an invasive periodontal intervention while using an anticoagulant or antiplatelet medication [90]. These results support the recommendation that such medications do not need to be discontinued in anticipation to invasive periodontal interventions.
\nExtended inter- or postoperative bleeding following dental surgery is infrequent, seldom demanding anything more than the use of local hemostatic biosurgicals. The judgment of whether or not to interrupt anticoagulation treatment can be both intricate and dynamic, and it should be based on the indication for pharmacological therapy, as well as previous thromboembolic history. The discontinuation of anticoagulant therapy may be required in dental interventions with moderate and high bleeding risk [25, 76, 77, 78]. Currently, most clinicians dealing with anticoagulant management tend to personalize the periprocedural management of the bleeding potential, according to the individual risk of each procedure—low, moderate, or high—following the current clinical practice recommendations based on best evidence and maintaining the anticoagulant therapy. Thereby, the patient anticoagulant regimen should be continued in specific low-risk dental procedures, without consultation or fear of disproportionate bleeding demanding additional intervention (Table 3) [25].
\nUndoubtedly, anticoagulant agents are effective in preventing thromboembolism. Nevertheless, their potential for critical adverse effects cannot be ignored. The use of antithrombotic medications is the most frequent cause of an adverse drug event requiring individuals to seek out emergency care [25, 91]. The majority of drug interactions with anticoagulants lead to elevated risk of bleeding. The nature of the interactions cannot be predicted, as they are expressed through both pharmacodynamic mechanisms and pharmacokinetic properties [25].
\nRegarding patient safety, potential risk for interaction, as well as knowledge of appropriate prescribing and monitoring, is crucial. Equally decisive is selecting the appropriate anticoagulant agent and monitoring the potential for drug–drug interaction [10, 11, 12, 13, 14, 15, 17, 25]. Common anticoagulants and their interaction with the most common medications prescribed for dental patients are described in Table 4 [25, 92, 93, 94, 95, 96, 97, 98].
\nCommon anticoagulants and potential interactions with dental medications–adapted from Kaplovitch and Dounaevskaia [25].
Most studies evaluating the occurrence of peri- and postoperative bleeding show anticoagulation therapy can be maintained when adequate local hemostatic maneuvers are used.
\nAs an example, a controlled clinical trial compared the occurrence of bleeding following dental extractions in individuals receiving oral anticoagulants (experimental group) versus patients that had never received oral anticoagulant therapy (control group). Tooth extractions were performed, and a piece of oxidized cellulose was placed only into the sockets in the experimental group. The wound borders were sutured, and a gauze saturated with tranexamic for 30–60 minutes was applied with pressure in the wound. Both groups presented similar bleeding complications [99]. In a similar clinical trial [100], 161 tooth extractions were performed in patients undertaking warfarin. After tooth extraction, an oxidized cellulose gauze was placed in the socket, and the wound was sutured. Patients were assigned to four groups, according to their INR range (INR was 1.5–1.99 in group 1; 2.0–2.49 in group 2; 2.5–2.99 in group 3; and 3.0–3.7 in group 4). No significant differences were found in the postoperative bleeding among groups.
\nBased on the latest evidence and clinical practice recommendations on the perioperative management of dental patients receiving direct oral anticoagulants, on single or dual antiplatelet therapy or vitamin K antagonists, as well as on the current scientific knowledge on biosurgical hemostatic agents, the following conclusions can be made:
The majority of dental procedures can be securely executed without the withholding of anticoagulants, using only local hemostatic therapy. In fact, current recommendations and consensus support the continuation of antiplatelet or anticoagulant therapy. Discontinuing these drugs can increase the risk of thromboembolism, at the cost of minor bleeding, which can be restrained without difficulty. The appropriate use of local hemostatic measures, such as topical biosurgical hemostatic agents, should always be considered whenever indicated.
In order to safely treat a patient receiving anticoagulant therapy, familiarity with anticoagulants and with the potential for drug–drug interactions is required, in addition to knowledge about the topical hemostatic options available.
Topical biosurgical hemostatic agents are diverse agents with distinct indications. The dental practitioner must be aware of the properties of each single agent, in order to properly select the product needed in each different clinical condition.
Based on current available data, no topical hemostatic agent can be regarded as superior or more effective than the others. Further experimental research and controlled clinical trials are warranted to define the most cost-effective biosurgical hemostatic agents in dentistry.
A definite protocol for excessive bleeding is still required for dental surgery in patients with hemorrhagic diathesis. The most effective local hemostatic agent with lesser complications should be determined in future research, considering their availability and cost-effectiveness.
The authors are grateful to Kisa Iqbal BSc Hons, DDS Candidate c/o 2020, New York University College of Dentistry, for editing this article.
\nThe authors declare no conflict of interest.
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Saleh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8436",title:"Sandy Materials in Civil Engineering",subtitle:"Usage and Management",isOpenForSubmission:!1,hash:"b448d888478a3a8836bb6dca78facaf8",slug:"sandy-materials-in-civil-engineering-usage-and-management",bookSignature:"Saeed Nemati and Farzaneh Tahmoorian",coverURL:"https://cdn.intechopen.com/books/images_new/8436.jpg",editedByType:"Edited by",editors:[{id:"296316",title:"Dr.",name:"Saeed",middleName:null,surname:"Nemati",slug:"saeed-nemati",fullName:"Saeed Nemati"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7690",title:"Tunnel Engineering",subtitle:"Selected Topics",isOpenForSubmission:!1,hash:"c0c03565105a25fb6cfe85f83885afe3",slug:"tunnel-engineering-selected-topics",bookSignature:"Michael Sakellariou",coverURL:"https://cdn.intechopen.com/books/images_new/7690.jpg",editedByType:"Edited by",editors:[{id:"16550",title:"Dr.",name:"Michael",middleName:null,surname:"Sakellariou",slug:"michael-sakellariou",fullName:"Michael Sakellariou"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8757",title:"Compressive Strength of Concrete",subtitle:null,isOpenForSubmission:!1,hash:"2170e51b425059296e5464e0fe13f237",slug:"compressive-strength-of-concrete",bookSignature:"Pavlo Kryvenko",coverURL:"https://cdn.intechopen.com/books/images_new/8757.jpg",editedByType:"Edited by",editors:[{id:"180922",title:"Prof.",name:"Pavel",middleName:null,surname:"Krivenko",slug:"pavel-krivenko",fullName:"Pavel Krivenko"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9989",title:"ISBS 2019",subtitle:"4th International Sustainable Buildings Symposium",isOpenForSubmission:!1,hash:"a34ca3367e8af39c3718aca2f3557efe",slug:"isbs-2019-4th-international-sustainable-buildings-symposium",bookSignature:"Arzuhan Burcu Gültekin",coverURL:"https://cdn.intechopen.com/books/images_new/9989.jpg",editedByType:"Edited by",editors:[{id:"143644",title:"Dr.",name:"Arzuhan",middleName:"Burcu",surname:"Gültekin",slug:"arzuhan-gultekin",fullName:"Arzuhan Gültekin"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"2",chapterContentType:"conference paper",authoredCaption:"Edited by"}},{type:"book",id:"8412",title:"Sustainable Construction and Building Materials",subtitle:null,isOpenForSubmission:!1,hash:"dec13857a884f2b52b887e8751e4c37f",slug:"sustainable-construction-and-building-materials",bookSignature:"Sayed Hemeda",coverURL:"https://cdn.intechopen.com/books/images_new/8412.jpg",editedByType:"Edited by",editors:[{id:"258282",title:"Prof.",name:"Sayed",middleName:null,surname:"Hemeda",slug:"sayed-hemeda",fullName:"Sayed Hemeda"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7225",title:"Dam Engineering",subtitle:null,isOpenForSubmission:!1,hash:"a845c7ddd9193f56a6bc91bc22bc503d",slug:"dam-engineering",bookSignature:"Hasan Tosun",coverURL:"https://cdn.intechopen.com/books/images_new/7225.jpg",editedByType:"Edited by",editors:[{id:"79083",title:"Dr.",name:"Hasan",middleName:null,surname:"Tosun",slug:"hasan-tosun",fullName:"Hasan Tosun"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5214",title:"High Performance Concrete Technology and Applications",subtitle:null,isOpenForSubmission:!1,hash:"4f7096ba0b4812663b72c918c4a4eff7",slug:"high-performance-concrete-technology-and-applications",bookSignature:"Salih Yilmaz and Hayri Baytan Ozmen",coverURL:"https://cdn.intechopen.com/books/images_new/5214.jpg",editedByType:"Edited by",editors:[{id:"75636",title:"Associate Prof.",name:"Salih",middleName:null,surname:"Yilmaz",slug:"salih-yilmaz",fullName:"Salih Yilmaz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:10,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"66446",doi:"10.5772/intechopen.85675",title:"Compressive Behavior of Concrete under Environmental Effects",slug:"compressive-behavior-of-concrete-under-environmental-effects",totalDownloads:1150,totalCrossrefCites:10,totalDimensionsCites:33,abstract:"Concrete strength is fairly sensitive to environmental effects. Extreme weather conditions and changes in humidity rates significantly affect the concrete compressive strength development. Concrete as one of the substantial material used in residential buildings and infrastructures is subjected to a massive strength change under extreme weather conditions. For understanding, the different concrete’s behavioral aspects, various commercial cement types under different temperatures, and humidity rates are investigated in this chapter. The experiments are aimed to investigate the concrete strength development over time when the material is cast at lower to mild temperatures and different humidity index rates. Results show that reducing the curing temperature more than 15° could result in 20% reduction in total compressive strength, while decreasing humidity rates by 50% leads to less than 10% drop in ultimate strength. To understand the strength developing process, maturity tests are conducted. It is shown that concrete is not able to reach to the expected ultimate strength if the temperature is significantly low regardless of curing time. The effect of temperature change during the curing process is more tangible on strength development compared to cement type and humidity rate values.",book:{id:"8757",slug:"compressive-strength-of-concrete",title:"Compressive Strength of Concrete",fullTitle:"Compressive Strength of Concrete"},signatures:"Alireza Farzampour",authors:null},{id:"51720",doi:"10.5772/64574",title:"Microstructure of Concrete",slug:"microstructure-of-concrete",totalDownloads:4908,totalCrossrefCites:16,totalDimensionsCites:21,abstract:"Concrete is a composite material that consists of a binding medium and aggregate particles and can be formed in several types. It may be considered to consist of three phases: a cement paste, the aggregate, and the interfacial transition zone (ITZ) between them. In addition to ordinary Portland cement, the essential components of the base of concrete are aggregates and water. For practical requirements, additives and admixtures can be added to these raw materials to improve some desirable characteristics. The following requirements should be considered in producing high performance concrete (HPC): (i) low water/cement (w/c) ratio; (ii) fine aggregate; (iii) large quantity of mineral additives, silica fume, and fly ash; (iv) high dosage of superplasticizer; and (v) high-pressure steam curing. The microstructure of high performance concrete (HPC) is more homogenous than that of normal concrete (NC) due to the physical and chemical contribution of the additives (silica fume and fly ash) as well as it is less porous due to reduced w/c ratio with the addition of a superplasticizer. Inclusion of additives (individually or in combination) helped in improving the strength and durability of concrete mixes due to the additional reduction in porosity of cement paste and an improved interface between it and the aggregate.",book:{id:"5214",slug:"high-performance-concrete-technology-and-applications",title:"High Performance Concrete Technology and Applications",fullTitle:"High Performance Concrete Technology and Applications"},signatures:"Ameer A. Hilal",authors:[{id:"180518",title:"Dr.",name:"Ameer",middleName:null,surname:"Hilal",slug:"ameer-hilal",fullName:"Ameer Hilal"}]},{id:"51861",doi:"10.5772/64779",title:"Concretes with Photocatalytic Activity",slug:"concretes-with-photocatalytic-activity",totalDownloads:2860,totalCrossrefCites:8,totalDimensionsCites:15,abstract:"This chapter is a short review about the modified concretes with photocatalytic activity. In the beginning, the photocatalysis process is explained; the authors are focused on the mechanism of organic contamination and nitrogen oxide decomposition. Next the three main methods for concretes modification are presented: the first group is when the concrete is covered by thin layer of TiO2 materials, e.g., paints or TiO2 suspensions. The second group is the concretes with thick layer of photoactive concrete on the top. The third group constitutes concretes modified in mass with TiO2. The two main methods for photocatalytic activity of the modified concrete determination were shown: an air purification by a nitrogen oxide decomposition and the self-cleaning properties by dyes decomposition. Also in this chapter the mechanical properties of the modified concrete are presented. In the end, the examples of the buildings made of photocatalytic concretes are shown.",book:{id:"5214",slug:"high-performance-concrete-technology-and-applications",title:"High Performance Concrete Technology and Applications",fullTitle:"High Performance Concrete Technology and Applications"},signatures:"Magdalena Janus and Kamila Zając",authors:[{id:"180824",title:"Associate Prof.",name:"Magdalena",middleName:null,surname:"Janus",slug:"magdalena-janus",fullName:"Magdalena Janus"}]},{id:"64801",doi:"10.5772/intechopen.82489",title:"Bitumen and Its Modifier for Use in Pavement Engineering",slug:"bitumen-and-its-modifier-for-use-in-pavement-engineering",totalDownloads:1572,totalCrossrefCites:5,totalDimensionsCites:12,abstract:"This chapter focuses on bitumen specifically. This chapter consists of several parts that can be mentioned, including the history of the appearance of bitumen and the types of constituent elements, as well as its mechanical properties and chemical structure and its thermal sensitivity. In all parts, the effects of bitumen on asphalt are discussed. In the following sections, the bitumen modification mechanism, polymer modifiers, and their behavior on the bitumen resistance to asphalt failures are also discussed. This chapter is very suitable for students and researchers interested in improving polymerization asphalt and bitumen and will help them to carry out research and concepts.",book:{id:"8412",slug:"sustainable-construction-and-building-materials",title:"Sustainable Construction and Building Materials",fullTitle:"Sustainable Construction and Building Materials"},signatures:"Mehrdad Honarmand, Javad Tanzadeh and Mohamad Beiranvand",authors:[{id:"268734",title:"M.Sc.",name:"Mehrdad",middleName:null,surname:"Honarmand",slug:"mehrdad-honarmand",fullName:"Mehrdad Honarmand"},{id:"271251",title:"Prof.",name:"Javad",middleName:null,surname:"Tanzadeh",slug:"javad-tanzadeh",fullName:"Javad Tanzadeh"}]},{id:"64787",doi:"10.5772/intechopen.82525",title:"A Decade of Research on Self-Healing Concrete",slug:"a-decade-of-research-on-self-healing-concrete",totalDownloads:1484,totalCrossrefCites:7,totalDimensionsCites:9,abstract:"The main findings of a decade of research on the design and development of the first self-healing concrete are summarized in this chapter. The autonomous healing concept is introduced, and plethora of design campaigns is enlisted. Healing agent encapsulation and agent tubes vascular networks are reported as the most efficient healing configurations for laboratory-scale and real-size applications, respectively. Crack formation, closure after healing and further damage are phenomena tracked by using advanced experimental monitoring methods and their performance is critically revised. The effect of self-healing technology on concrete mechanical response, durability and long-term response to damage are critically discussed. The study contributes to the open discussion in the scientific research community regarding self-healing concrete upscaling feasibility and finally it aims to contribute as a base for the future studies dealing with concrete design optimization.",book:{id:"8412",slug:"sustainable-construction-and-building-materials",title:"Sustainable Construction and Building Materials",fullTitle:"Sustainable Construction and Building Materials"},signatures:"Eleni Tsangouri",authors:[{id:"263163",title:"Ph.D.",name:"Eleni",middleName:null,surname:"Tsangouri",slug:"eleni-tsangouri",fullName:"Eleni Tsangouri"}]}],mostDownloadedChaptersLast30Days:[{id:"70605",title:"Designing a Tunnel",slug:"designing-a-tunnel",totalDownloads:2801,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Designing a tunnel is always a challenge. For shallow tunnels under cities due to the presence of buildings, bridges, important avenues, antiquities, etc. at the surface and other infrastructures in the vicinity of underground tunnels, parameters like vibrations and ground settlements must be tightly controlled. Urban tunnels are often made in soils with very low values of overburden. Risks of collapse and large deformations at the surface are high; thus negative impact on old buildings are likely to occur if appropriate measures are not taken in advance, when designing and constructing the tunnel. For deep tunnels with high overburden and low rock mass properties, squeezing conditions and excessive loads around the excavation can jeopardize the stability of the tunnel, leading to extensive collapse. The aim of the chapter is to give details on advance computational modelling and analytical methodologies, which can be used in order to design shallow and deep tunnels and to present real case studies from around the world, from very shallow tunnels in India with only 4.5 m overburden to a deep tunnel in Venezuela with extreme squeezing conditions under 1300 m overburden.",book:{id:"7690",slug:"tunnel-engineering-selected-topics",title:"Tunnel Engineering",fullTitle:"Tunnel Engineering - Selected Topics"},signatures:"Spiros Massinas",authors:[{id:"295762",title:"Dr.",name:"Spiros",middleName:null,surname:"Massinas",slug:"spiros-massinas",fullName:"Spiros Massinas"}]},{id:"70990",title:"Engineering Geology and Tunnels",slug:"engineering-geology-and-tunnels",totalDownloads:2001,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Currently, knowledge and understanding of the role of geological material and its implication in tunnel design is reinforced with advances in site investigation methods, the development of geotechnical classification systems and the consequent quantification of rock masses. However, the contribution of engineering geological information in tunnelling cannot be simply presented solely by a rock mass classification value. What is presented in this chapter is that the first step is not to start performing numerous calculations but to define the potential failure mechanisms. After defining the failure mechanism that is most critical, selection of the suitable design parameters is undertaken. This is then followed by the analysis and performance of the temporary support system based on a more realistic model. The specific failure mechanism is controlled and contained by the support system. A tunnel engineer must early assess all the critical engineering geological characteristics of the rock mass and the relevant mode of failure, for the specific factors of influence, and then decide either he or she will rely on a rock mass classification value to characterise all the site-specific conditions. Experiences from the tunnel behaviour of rock masses in different geological environments in Alpine mountain ridges are presented in this chapter.",book:{id:"7690",slug:"tunnel-engineering-selected-topics",title:"Tunnel Engineering",fullTitle:"Tunnel Engineering - Selected Topics"},signatures:"Vassilis Marinos",authors:[{id:"298713",title:"Associate Prof.",name:"Vassilis",middleName:null,surname:"Marinos",slug:"vassilis-marinos",fullName:"Vassilis Marinos"}]},{id:"51720",title:"Microstructure of Concrete",slug:"microstructure-of-concrete",totalDownloads:4910,totalCrossrefCites:16,totalDimensionsCites:21,abstract:"Concrete is a composite material that consists of a binding medium and aggregate particles and can be formed in several types. It may be considered to consist of three phases: a cement paste, the aggregate, and the interfacial transition zone (ITZ) between them. In addition to ordinary Portland cement, the essential components of the base of concrete are aggregates and water. For practical requirements, additives and admixtures can be added to these raw materials to improve some desirable characteristics. The following requirements should be considered in producing high performance concrete (HPC): (i) low water/cement (w/c) ratio; (ii) fine aggregate; (iii) large quantity of mineral additives, silica fume, and fly ash; (iv) high dosage of superplasticizer; and (v) high-pressure steam curing. The microstructure of high performance concrete (HPC) is more homogenous than that of normal concrete (NC) due to the physical and chemical contribution of the additives (silica fume and fly ash) as well as it is less porous due to reduced w/c ratio with the addition of a superplasticizer. Inclusion of additives (individually or in combination) helped in improving the strength and durability of concrete mixes due to the additional reduction in porosity of cement paste and an improved interface between it and the aggregate.",book:{id:"5214",slug:"high-performance-concrete-technology-and-applications",title:"High Performance Concrete Technology and Applications",fullTitle:"High Performance Concrete Technology and Applications"},signatures:"Ameer A. Hilal",authors:[{id:"180518",title:"Dr.",name:"Ameer",middleName:null,surname:"Hilal",slug:"ameer-hilal",fullName:"Ameer Hilal"}]},{id:"77899",title:"Review of Existing Methods for Evaluating Adhesive Bonds in Timber Products",slug:"review-of-existing-methods-for-evaluating-adhesive-bonds-in-timber-products",totalDownloads:252,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Gluing is an integral part of the majority of production processes in the timber industry. The effectiveness of adhesive application, glue bond development and glue penetration into the wood structure is becoming more and more important as more structural glued timber products are used in construction and other applications. The continued increase in utilisation of mass timber products (MTPs) such as CLT, glulam and LVL in tall timber buildings requires an accurate and in-depth understanding of adhesive roles and their performance effectiveness during the life span of any of those products in relation to the type of loading applied, environmental effects (e.g. RH and temperature) and in-service condition of elements (e.g. exposure to major wet events and degradation from decay). This review aims to provide a comprehensive summary of existing imaging and other visualisation methods used to assess the glue line properties and examine the performance of glue lines in relation to factors such as species, product type and environmental conditions during manufacture and in-service life.",book:{id:"10584",slug:"engineered-wood-products-for-construction",title:"Engineered Wood Products for Construction",fullTitle:"Engineered Wood Products for Construction"},signatures:"Maryam Shirmohammadi and William Leggate",authors:[{id:"346973",title:"Dr.",name:"Maryam",middleName:null,surname:"Shirmohammadi",slug:"maryam-shirmohammadi",fullName:"Maryam Shirmohammadi"},{id:"426650",title:"Dr.",name:"William",middleName:null,surname:"Leggate",slug:"william-leggate",fullName:"William Leggate"}]},{id:"78315",title:"Engineered Wood Products as a Sustainable Construction Material: A Review",slug:"engineered-wood-products-as-a-sustainable-construction-material-a-review",totalDownloads:445,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Engineered wood products are considered as best building materials due to environmentally friendly. Huge change to the way in which wood has been utilized in primary application of construction in the course of the most recent 25 years are in light of decreased admittance to high strength timber from growth forests, and the turn of events and creation of various new design of manufactured wood products. Engineered wood products are available in different variety of sizes and measurements like laminated veneer lumber, glued laminated timber, finger jointed lumber, oriental strand board etc. It is utilized for rooftop and floor sheathing, solid structure, beams and the hull of boats. This review objectively explores not only the environmental aspects of the use of different engineered wood composites as a building material, but also their economic aspects, to understand their effect on sustainability.",book:{id:"10584",slug:"engineered-wood-products-for-construction",title:"Engineered Wood Products for Construction",fullTitle:"Engineered Wood Products for Construction"},signatures:"Ranjana Yadav and Jitendra Kumar",authors:[{id:"335083",title:"Dr.",name:"Jitendra",middleName:null,surname:"Kumar",slug:"jitendra-kumar",fullName:"Jitendra Kumar"},{id:"354856",title:"Dr.",name:"Dr Ranjana",middleName:null,surname:"Yadav",slug:"dr-ranjana-yadav",fullName:"Dr Ranjana Yadav"}]}],onlineFirstChaptersFilter:{topicId:"284",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"81503",title:"The Data Representations of a Building Project: BIM Model, and IFC or IFCXML Data Standard",slug:"the-data-representations-of-a-building-project-bim-model-and-ifc-or-ifcxml-data-standard",totalDownloads:28,totalDimensionsCites:0,doi:"10.5772/intechopen.104580",abstract:"Building regulations in the construction industry are legal documents written in human language. These are interpreted and implemented by people and generally controlled by local governments. Traditional building regulation control and supervision methods emerge as a time-consuming and error-prone process for architects, engineers, and public authorities. Therefore, BIM\\'s effective building regulation control is considered a promising field of study in the construction industry. Automated Code Compliance Checking (ACCC) method is a rule-based method that provides simultaneous control of the computer’s building regulations. ACCC takes into account the characteristics of the building elements and related building regulations. BIM is recognized as the most effective platform for information exchange of building projects in the construction industry. It supports the development of various software. It facilitates automated or semi-automated ACCC of the building projects for compliance with building regulations and standards for the participants involved in the building production process. The data of the building project are represented in two ways in the ACCC. These are BIM Model, and IFC or IFCXML Data Standard. In this study, the BIM, IFC, and IFCXML representations of the building project data were explained over the sample housing project in the ACCC process.",book:{id:"11186",title:"Sand in Construction",coverURL:"https://cdn.intechopen.com/books/images_new/11186.jpg"},signatures:"Murat Aydın"},{id:"81506",title:"Bentonite Clay Modified Concrete",slug:"bentonite-clay-modified-concrete",totalDownloads:28,totalDimensionsCites:0,doi:"10.5772/intechopen.103803",abstract:"Replacing cement with pozzolanic materials to some extent in construction is found to be one of the sustainable approaches in the construction industry. Pozzolanic materials of industrial origin like fly ash and Ground Granulated Blast furnace Slag will have to be replaced with natural pozzolanic materials once the world moves towards renewable energy sources. Bentonite is one such pozzolanic clay material that is rich in SiO2 content. A little research was made to assess the performance of bentonite modified concrete. Based on those, an improvement in the fresh, hardened, durability properties was reported. This chapter presents the current scenario on the development of bentonite modified concrete. It also reviews the literature about the physical & chemical properties of bentonite, bentonite blended cement mortar, bentonite modified cement concrete, and reinforced concrete. The history and development of Bentonite modified concrete were also briefly presented in this chapter.",book:{id:"11186",title:"Sand in Construction",coverURL:"https://cdn.intechopen.com/books/images_new/11186.jpg"},signatures:"Metta Achyutha Kumar Reddy and Veerendrakumar C. Khed"},{id:"81381",title:"Oil Contaminated Sand: Sources, Properties, Remediation, and Engineering Applications",slug:"oil-contaminated-sand-sources-properties-remediation-and-engineering-applications",totalDownloads:32,totalDimensionsCites:0,doi:"10.5772/intechopen.103802",abstract:"Oil leakage during the exploration, production, and transportation of crude oil is a significant issue worldwide because crude oil spills severely impact the physical and chemical properties of the surrounding soil. A range of remediation methods for oil-contaminated soil is recommended, consisting of sand washing, bioremediation, electro-kinetic sand remediation, and thermal desorption; however, none are cost-effective. To find a suitable alternative remediation method, oil-contaminated sand utilisation in construction was considered. Several researchers found that oil contamination generally has an adverse effect on the mechanical properties of sand, but certain levels of contamination have beneficial effects on some of the important properties of the sand and its produced concrete. This chapter reviews the main sources of oil contamination and the existing remediation methods for this waste material. It analyses the different factors that affect the properties of oil-contaminated sand and concrete, including the type of crude oil and permeability of sand, like its properties, absorption, chemical composition, and spillage quantity. Furthermore, the intensive evaluation results of light crude oil effects on the geotechnical properties of fine sand, cement mortar and concrete were presented. Potential applications for oil-contaminated sand were also identified for the re-use of this material in engineering and construction.",book:{id:"11186",title:"Sand in Construction",coverURL:"https://cdn.intechopen.com/books/images_new/11186.jpg"},signatures:"Rajab Abousnina and Rochstad Lim Allister"},{id:"81175",title:"Thermal Conductivity and Mechanical Properties of Organo-Clay-Wood Fiber in Cement-Based Mortar",slug:"thermal-conductivity-and-mechanical-properties-of-organo-clay-wood-fiber-in-cement-based-mortar",totalDownloads:25,totalDimensionsCites:0,doi:"10.5772/intechopen.102321",abstract:"This paper orientated to study the compressive resistance and thermal conductivity of compressed and stabilized clay blocks in the cement matrix. The effect of the content of wood fiber (WF) became studied as a reinforcement material in cement mortars. The porosity, compressive energy, thermal conductivity and composite of cement hydration had been investigated. The addition of NFC suggests a very good pore reduction, and the fine result becomes acquired with the emulsion of a combination incorporating 2%wt of WF inside the presence of an anionic surfactant (SDBS). The results revealed that used in this study were a mix of water with ordinary portland cement and organo-clay (OC) modified with Cetyltrimethylammonium bromide at water-to-solid ratios 1%. The effect depending on w/s ratio of OC used samples with cement substitution for organoclay showed from 2% higher compressive strength results than that of the plain cement paste and a decrease of the thermal conductivity by addition of 2%wt of WF from 2.26 to 0.8 W/m °C. It was also observed that with increasing w/s ratio higher amount of cement can be replaced by OC. These analyses have revealed that the presence of WF promoted the hydration, by producing more portlandite and calcium silicate gel.",book:{id:"11186",title:"Sand in Construction",coverURL:"https://cdn.intechopen.com/books/images_new/11186.jpg"},signatures:"Fadhel Aloulou and Habib Sammouda"},{id:"80651",title:"The Effects of Mill Conditions on Breakage Parameters of Quartz Sand in the District of Şile on the Black Sea Coast of İstanbul",slug:"the-effects-of-mill-conditions-on-breakage-parameters-of-quartz-sand-in-the-district-of-ile-on-the-b",totalDownloads:55,totalDimensionsCites:0,doi:"10.5772/intechopen.102554",abstract:"Casting, glass, ceramic, construction, plastic, dyeing, and abrasive industries are the main consumption areas of quartz sand, which are formed as a result of the weathering of igneous metamorphic rocks. In such industries, it is very important to select the correct ball size in order to grind the raw material to the desired particle size in optimum time. In this study, the changes in the specific rate of breakage of the quartz sand sample were investigated by using alloy steel balls of five different sizes. For this purpose, three different mono-size samples were prepared according to 4√2 series in the range of 0.090–0.053 mm. The quartz sand prepared in these three intervals was ground with 6.35, 7.94, 9.52, 12.70, and 19.05 mm alloy steel balls for different durations. The specific rate of breakage values was obtained from the particle size distributions acquired after various grinding periods. As a result of grinding tests, an increase in the rate of breakage is observed due to the increase in ball diameter.",book:{id:"11186",title:"Sand in Construction",coverURL:"https://cdn.intechopen.com/books/images_new/11186.jpg"},signatures:"Serhan Haner"},{id:"80288",title:"The Role of Sand in Mortar’s Properties",slug:"the-role-of-sand-in-mortar-s-properties",totalDownloads:61,totalDimensionsCites:0,doi:"10.5772/intechopen.102489",abstract:"Mortars are diachronic composite materials used in masonry construction to serve multiple roles. Their durability and esthetic harmonization in constructions of the different eras were the reasons why numerous research works have been realized over recent decades. Each time, the role of the mortars’ components revealed significant pieces of information on the technology used. Despite the indisputable role of the binders on the mortar’s quality, aggregates of different characteristics had a significant role in the behavior of mortars. The addition of aggregates to a binding system in mortars technology has proved to confer technical advantages as they contribute to volume stability, durability, and structural performance. Apart from the different types of aggregates, as their mineralogy and origin are concerned, the volume content in the mixture, the maximum size, and their gradation influences the structure of a binder—aggregate mixture and the performance of mortars overall. In the present article, the diachronic presence of mortars is presented. The role of aggregates is emphasized to understand their impact on the longevity and durability of the mortars.",book:{id:"11186",title:"Sand in Construction",coverURL:"https://cdn.intechopen.com/books/images_new/11186.jpg"},signatures:"Maria Stefanidou and Parthena Koltsou"}],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:11,numberOfPublishedChapters:91,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:333,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:11,numberOfPublishedChapters:144,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:126,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:113,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:23,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:13,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:"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"}}}},{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"}}}}]},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 17th, 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:"Rosa María Martínez-Espinosa is a Full Professor of Biochemistry and Molecular Biology at the University of Alicante, Spain, and has been the vice president of International Relations and Development Cooperation at this university since 2010. She created the research group in applied biochemistry in 2017 (https://web.ua.es/en/appbiochem/), and from 1999 to the present has made more than 200 contributions to Spanish and international conferences. Furthermore, she has around seventy-five scientific publications in indexed journals, eighty book chapters, and one patent to her credit. Her research work focuses on microbial metabolism (particularly on extremophile microorganisms), purification and characterization of enzymes with potential industrial and biotechnological applications, protocol optimization for genetically manipulating microorganisms, gene regulation characterization, carotenoid (pigment) production, and design and development of contaminated water and soil bioremediation processes by means of microorganisms. This research has received competitive public grants from the European Commission, the Spanish Ministry of Economy and Competitiveness, the Valencia Region Government, and the University of Alicante.",institutionString:"University of Alicante",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:45,paginationItems:[{id:"83122",title:"New Perspectives on the Application of Chito-Oligosaccharides Derived from Chitin and Chitosan: A Review",doi:"10.5772/intechopen.106501",signatures:"Paul Edgardo Regalado-Infante, Norma Gabriela Rojas-Avelizapa, Rosalía Núñez-Pastrana, Daniel Tapia-Maruri, Andrea Margarita Rivas-Castillo, Régulo Carlos Llarena-Hernández and Luz Irene Rojas-Avelizapa",slug:"new-perspectives-on-the-application-of-chito-oligosaccharides-derived-from-chitin-and-chitosan-a-rev",totalDownloads:0,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Chitin-Chitosan - Isolation, Properties, and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11670.jpg",subseries:{id:"15",title:"Chemical Biology"}}},{id:"83015",title:"Acute Changes in Lipoprotein-Associated Oxidative Stress",doi:"10.5772/intechopen.106489",signatures:"Ngoc-Anh Le",slug:"acute-changes-in-lipoprotein-associated-oxidative-stress",totalDownloads:2,totalCrossrefCites:0,totalDimensionsCites:0,authors:[{name:"Anh",surname:"Le"}],book:{title:"Importance of Oxidative Stress and Antioxidant System in Health and Disease",coverURL:"https://cdn.intechopen.com/books/images_new/11671.jpg",subseries:{id:"15",title:"Chemical Biology"}}},{id:"83041",title:"Responses of Endoplasmic Reticulum to Plant Stress",doi:"10.5772/intechopen.106590",signatures:"Vishwa Jyoti Baruah, Bhaswati Sarmah, Manny Saluja and Elizabeth H. Mahood",slug:"responses-of-endoplasmic-reticulum-to-plant-stress",totalDownloads:5,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}},{id:"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:16,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"}}}]},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. She is also the Global Harmonization Initiative (GHI)",institutionString:"Australian College of Business & Technology",institution:{name:"Kobe College",institutionURL:null,country:{name:"Japan"}}}]},{type:"book",id:"6820",title:"Keratin",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/6820.jpg",slug:"keratin",publishedDate:"December 19th 2018",editedByType:"Edited by",bookSignature:"Miroslav Blumenberg",hash:"6def75cd4b6b5324a02b6dc0359896d0",volumeInSeries:2,fullTitle:"Keratin",editors:[{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"}}}]},{type:"book",id:"7978",title:"Vitamin A",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7978.jpg",slug:"vitamin-a",publishedDate:"May 15th 2019",editedByType:"Edited by",bookSignature:"Leila Queiroz Zepka, Veridiana Vera de Rosso and Eduardo Jacob-Lopes",hash:"dad04a658ab9e3d851d23705980a688b",volumeInSeries:3,fullTitle:"Vitamin A",editors:[{id:"261969",title:"Dr.",name:"Leila",middleName:null,surname:"Queiroz Zepka",slug:"leila-queiroz-zepka",fullName:"Leila Queiroz Zepka",profilePictureURL:"https://mts.intechopen.com/storage/users/261969/images/system/261969.png",biography:"Prof. Dr. Leila Queiroz Zepka is currently an associate professor in the Department of Food Technology and Science, Federal University of Santa Maria, Brazil. She has more than fifteen years of teaching and research experience. She has published more than 550 scientific publications/communications, including 15 books, 50 book chapters, 100 original research papers, 380 research communications in national and international conferences, and 12 patents. She is a member of the editorial board of five journals and acts as a reviewer for several national and international journals. 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In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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