Mean square difference of position, velocity, and orientation estimation between the proposed GPS‐aided SINU system\'s output with Piccolo II\'s output.
\r\n\tGlobalization does not represent a pure and generous process for humanity or other species, but rather it implies social exclusion and also provokes situations of vulnerability in groups of people, forced exclusion, and apartheid: poor job opportunities, lack of access to education, worse socio-sanitary conditions. Specifically, it can be said that social segregation entails the apartheid of social groups of different ages, genders, and ethnicities; these groups live a reality manifested through the deepening of poverty, in terms of increased vulnerability of the poor and groups with little economic, social, cultural, labor and health stability.
\r\n\r\n\tThis book aims to talk about some topics that are neglected in the discourses of academic communities and political elites. The inequality process is deeply rooted among humans and is part of many people's lives in the form of modern apartheid, gender segregation, lack of health access, and cultural gap. All those structural inequality processes are the product of the biopower perpetuated and produced in the macrosystem, exosystem, mesosystem, and microsystem. For many people from the academy, the information-consuming public, and the society in general, it is a problem to talk about these processes, since they have either lost interest or have normalized the structural and social inequity. For this reason, we see it as transcendental to explain how this situation occurs from the most internal fibers to the most evident processes, intending to make it more visible and thus expose the situation for possible solutions.
",isbn:"978-1-83768-406-9",printIsbn:"978-1-83768-405-2",pdfIsbn:"978-1-83768-407-6",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"cefab077e403fd1695fb2946e7914942",bookSignature:"Ph.D. Yaroslava Robles-Bykbaev",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11473.jpg",keywords:"Wage Gap, Gender Segregation, Fundamental Human Rights, Health Access, Social Inequity Processes, Modern Apartheid, Resilience, Cultural Gaps, Globalization, Geopolitics of Social Inequality, Public Policies, Social Vulnerability",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"June 15th 2022",dateEndSecondStepPublish:"July 13th 2022",dateEndThirdStepPublish:"September 11th 2022",dateEndFourthStepPublish:"November 30th 2022",dateEndFifthStepPublish:"January 29th 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"13 days",secondStepPassed:!1,areRegistrationsClosed:!1,currentStepOfPublishingProcess:2,editedByType:null,kuFlag:!1,biosketch:"Dr. Bykbaev is a member of the UNESCO Chair of Politecnica Salesiana University. She has contributed as co-author and author to approximately thirty scientific publications in the field of statistics, inclusive education, and social and cultural anthropology. These publications focus on the visibility of problems in the field of public health and focus on the creation of proposals to improve community health. Dr. Bykbaev is an active member of the NODO Ecuadorian Network of Women Scientists (REMCI).",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"313341",title:"Ph.D.",name:"Yaroslava",middleName:null,surname:"Robles-Bykbaev",slug:"yaroslava-robles-bykbaev",fullName:"Yaroslava Robles-Bykbaev",profilePictureURL:"https://mts.intechopen.com/storage/users/313341/images/system/313341.jpg",biography:null,institutionString:"Politecnica Salesiana University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Politecnica Salesiana University",institutionURL:null,country:{name:"Ecuador"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"23",title:"Social Sciences",slug:"social-sciences"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"444316",firstName:"Blanka",lastName:"Gugic",middleName:null,title:"Mrs.",imageUrl:"https://mts.intechopen.com/storage/users/444316/images/20016_n.jpg",email:"blanka@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"6926",title:"Biological Anthropology",subtitle:"Applications and Case Studies",isOpenForSubmission:!1,hash:"5bbb192dffd37a257febf4acfde73bb8",slug:"biological-anthropology-applications-and-case-studies",bookSignature:"Alessio Vovlas",coverURL:"https://cdn.intechopen.com/books/images_new/6926.jpg",editedByType:"Edited by",editors:[{id:"313084",title:"Dr.",name:"Alessio",surname:"Vovlas",slug:"alessio-vovlas",fullName:"Alessio Vovlas"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6942",title:"Global Social Work",subtitle:"Cutting Edge Issues and Critical Reflections",isOpenForSubmission:!1,hash:"222c8a66edfc7a4a6537af7565bcb3de",slug:"global-social-work-cutting-edge-issues-and-critical-reflections",bookSignature:"Bala Raju Nikku",coverURL:"https://cdn.intechopen.com/books/images_new/6942.jpg",editedByType:"Edited by",editors:[{id:"263576",title:"Dr.",name:"Bala",surname:"Nikku",slug:"bala-nikku",fullName:"Bala Nikku"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"50419",title:"Kalman Filtering and Its Real‐Time Applications",doi:"10.5772/62352",slug:"kalman-filtering-and-its-real-time-applications",body:'\nKalman filter exists for the past 50 years. It was first introduced by Rudolf Emil Kalman in 1960 [1] and was implemented on the Apollo Project in 1961 to solve the space navigation problem [2]. Kalman filter is claimed to be an optimal estimator [1] due to its ability to optimally estimate the system\'s error covariance and use the prediction in a recursive manner to improve the system measurements from time to time. As such, Kalman filter was implemented as the estimator in various applications, such as in navigations [3, 4], image processing [5, 6], and finance [7].
\nOne of the uniqueness in Kalman filter is that it consists of two distinct processes, namely, the prediction process and the measurement process. Both processes are combined and operated in a recursive manner to achieve optimal Kalman filtering process [8]. Another uniqueness of Kalman filter is the incorporation of prediction errors and measurement errors into the overall Kalman filtering process. It is common that each prediction and measurement process consists of errors in random nature. These errors or “noise” are normally being described using the stochastic process. On the other hand, a real‐time application can be defined as an application or program that reacts or responses within a predefined time frame, where such predefined time frame is a quantified time using a physical clock [9]. From a real‐time application\'s point of view, the real world\'s continuous time is turned into discrete time frame Δ. Different real‐time applications have different Δ, which in turn defined the response time of the applications. The real‐time application must react within the predefined time frame to provide an up‐to‐date response. Such real‐time constraint forced the application to complete its routine within the time frame, else the output may not be accurately reflecting the current state of input [10].
\nNote that the realization of Kalman filter, in its recursive nature, can be described as a real‐time implementation. In this book chapter, the authors will demonstrate two real‐time Kalman filtering examples. The first example demonstrated the real‐time Kalman filter implementation on vehicle tracking application using vision camera\'s image processing. A Kalman filtering model is established to estimate the positions and velocities of the moving vehicles and to provide tracking on the vehicles at a normally visible condition [11]. The second example demonstrated the Kalman filter implementation on the real‐time Global Positioning System (GPS)‐aided Strapdown Inertial Navigation Unit (SINU) System or GPS‐aided INU system for Unmanned Aerial Vehicle (UAV) motion sensing. The results obtained from both experiments will be illustrated and discussed in this book chapter.
\nThe outline of this chapter is as follows. Section 2 illustrates the generalized Kalman filter model from real‐time system\'s point of view. Section 3 outlines the real‐time vehicle tracking system using vision camera. The contents include the elaboration of image processing algorithms, illustration of the Kalman filtering model on the tracking system, result in acquisition, and discussions. Section 4 depicts the real‐time GPS‐aided SINU system for UAV motion sensing using Kalman filter. The contents included the derivation of Kalman filter for the GPS‐aided SINU system, the offline and real‐time implementation of the Kalman filter on the GPS‐aided SINU system, results and discussions, and conclusion. Lastly, Section 5 concludes the chapter.
\nKalman filtering is a popular technique used to solve observer problems [12] in control engineering [13]. Numerous derivations of the Kalman filter model can be obtained from various researchers’ works [3, 8, 12, 14, 15], where detailed elaborations and explanations of the Kalman filter, which included the derivation of the prerequisites such as the state space model and random variables, are outlined. Hence, in this chapter, the authors derived and explained the discrete real‐time Kalman filter model from the implementation point of view to ensure readers can understand the idea of Kalman filter from the real‐time implementation angle.
\nA typical Kalman filtering process is separated into two distinct processes, namely, the prediction process and the measurement process [14]. In general, the Kalman filter prediction model and the measurement model of a real‐time system, expressed in discrete form, are as follows:
where
The Kalman filtering algorithm starts from the prediction process by estimating the prediction state based on the derived state space equation. The state space equation, or state transition equation, may differ in different systems. From the implementation point of view, the expression of the prediction state, similar to Equation (1), is outlined as follows:
where
From Equation (4), the
From Equation (6), substituting
Because the state estimation error and the process noise error are uncorrelated,
Therefore, Equation (7) can be simplified into:
Equation (9) yielded an important step in the prediction process of the Kalman filtering algorithm in obtaining the
The next stage of the Kalman filtering algorithm is the measurement process. Equation (2) depicts the observation equation, or the actual measurement equation, of the system. The measurement output
where
Given the
Substituting Equation (11) into Equation (12) yielded:
Because the state estimation error and measurement noise error are uncorrelated,
Therefore, Equation (13) can be simplified into:
Equation (15) depicts the error covariance update equation in the measurement process of the Kalman filtering algorithm. From Equation (15), one could obtain the optimal Kalman gain
The mean squared error reflected by the
where
where
Lastly, substituting Equation (19) into Equation (16) yielded:
where Equation (20) is the simplified version of error covariance update equation expressed in terms of optimal Kalman gain obtained from Equation (19) and the
In summary, the Kalman filtering algorithm can be summarized and is shown in Figure 1. The prediction process, as shown in Figure 1, covers the prediction of
Block diagram of the Kalman filtering algorithm.
Figure 1 depicts a typical Kalman filtering process algorithm in its recursive form. Notice from the block diagram that the algorithm processed each stage one by one and rewind back to the initial block for the next cycle of processing. From the real‐time perspective, there are certain time critical events that need to be handled within a specific time frame. In this subsection, the time critical events are analyzed and discussed as part of the consideration of real‐time Kalman filtering algorithm.
\nThe pseudo code of the Kalman filtering algorithm is outlined in Figure 2. It is divided into three sections. The first section denotes the system initialization, and it is covered from steps 100 and 101. The second section is the prediction process section, covered from steps 200 to 202. The third and final section is the measurement process section, covered from steps 300 to 310. Note that the second and third sections run recursively.
\nA typical Kalman filtering algorithm process pseudo code.
Figure 3 depicts the timing diagram of the real‐time Kalman filtering algorithm based on the pseudo code illustrated in Figure 2. The following observations are obtained by examining Figure 3:\n
Δ
Δ
Δ
The total duration for a single iteration is Δ
A typical timing diagram of real‐time Kalman filtering algorithm process.
A vision‐based real‐time vehicle tracking system used vision camera to achieve target tracking [17]. The number of tracked vehicle can be single or multiple. The detection and tracking of vehicles are done through the image processing of consecutive frames of video. Before tracking the vehicles across frames, target detection algorithm such as background subtraction is responsible for isolating the position of the moving vehicles in every frame. The tracking algorithm used the measurements from the detection stage to relate the moving vehicles from frame to frame. However, due to the limitation of performance in the target detection algorithm, it is not reliable to solely depending on the measurements computed from the detection stage. As such, Kalman filtering algorithm can be adopted to compensate the fluctuation and missing measurements whenever the detection stage fails. The missing measurements are predicted based on the center position and velocity of the detected vehicle. An experimental study was conducted on the real‐time vehicle tracking at a road junction. The results showed that the Kalman filtering algorithm is capable of tracking the vehicles even with loss measurements appeared on the scene.
\nTraditionally, the road traffic monitoring is analyzed based on the data collected from the electronic sensor (i.e., loop detector) and manual observation by the human operator. The integration of multiple targets tracking algorithms in the vision‐based vehicle tracking system offers an attractive alternative with additional potential to collect a variety of traffic parameters [18]. As illustrated in Figure 4, that the vehicle tracking process is the second processing stage in the existing vision‐based traffic monitoring system. The performance of this stage greatly depends on the output from the first stage (i.e., the vehicle detection stage). The frames from the video input are recognized as image sequences and fed into the first stage of traffic monitoring system. Moving vehicles are segmented from the stationary background. Because a moving vehicle is formed by a sequence of images from the consecutive frames, the foreground images are matched and combined into its respective tracked objects.
\nProcessing stages of the vehicle monitoring system.
Background subtraction technique is the most widely used image processing algorithm for moving vehicle segmentation [19]. The basic idea of background subtraction algorithm is to subtract (in pixel‐wise) all consecutive frames from an occupied background frame. As a result, this algorithm can be easily affected by sudden changes in background and illumination. Since then, numerous researches on updating the background image have been carried out to create a more adaptive background model. However, the contribution effort is still not able to perform vehicle segmentation perfectly, which indirectly affects the performance of vehicle tracking. This is where the Kalman filtering algorithm comes into the picture to improve the tracking performance.
\nFrom the vehicle tracking system\'s point of view, the Kalman filter is to be designed to have the ability to predict the movement of vehicles in the future video frames. The prediction provides a suitable area for searching vehicles in the future frames. Consequently, it shortens the processing time by excluding the foreground images that is not located in the search area [14]. Besides, it also assists the tracking process in the situations where vehicles are temporarily lost due to failed detection.
\nIn the common road traffic flow, vehicle movements can be sufficiently recorded with an optical sensor (i.e., camera) of 25 frames per second. This is because the changes in displacement of moving vehicles in
with
where
where
On the contrary, the measurement model of the vision‐based vehicle tracking system, expressed in terms of real‐time algorithm, is outlined as follows:
where
With Equations (24) to (26), the optimal Kalman gain can thus be derived using Equation (19) followed by the updates of the estimation state variables
An experimental study was carried out using the Kalman filtering model derived in Section 3.2 for real‐time vehicle tracking. The experiment used the video stream captured from a static camera installed on a pedestrian bridge above the road, somewhere near the Multimedia University, Melaka, Malaysia. The Kalman filtering model is implemented with C++ programming language. The Open source Computer Vision (OpenCV) library [21] is used for the vehicle detection stage using the background subtraction method based on adaptive Gaussian mixture model in OpenCV. The tracking stage is demonstrated with the Kalman filtering algorithm for associating the foreground images with tracked vehicles from the previous frame.
\nFigure 5 depicts one of the image frames of the experiment. During the experiment, the tracking of vehicle number 8 (Figure 5, left) suffered lost detections due to the imperfection of background subtraction technique. Figure 6 illustrates the tracking results comparison in terms of
Illustration of one of the image frames of Experiment 2.
Comparison of vehicle number 8\'s tracking results for (a)
This section demonstrated the experimental study of the Kalman filter model for multiple vehicle tracking. The model has incorporated the measurements of center positions of moving vehicles together with the computed velocity and acceleration from the displacement changes in the prediction phase. The tracking results show that the derived Kalman filter model is suitable for tracking multiple vehicles, although measurements are lost in a short period of time.
\nInertial navigation system, which relied on inertial sensors [22] to operate, existed for the past few decades for navigation applications. The SINU is a low‐cost inertial sensor developed to substitute the high‐cost, high‐performance inertial sensors. High‐performance inertial sensors are commonly being controlled by government regulations, resulting in unattainable of the sensors in civilian applications. On the contrary, the low‐cost, low‐performance SINU sensors can be easily acquired, but its measurement data suffered from various errors [23] that jeopardized its accuracy. Due to this issue, the GPS data are adopted as an external reference source to minimize the SINU\'s errors through the implementation of the Kalman filter.
\nA typical SINU consists of three orthogonally aligned accelerometers and three orthogonally aligned gyroscopes that provide direct measurement on 3 degrees‐of‐freedom (DOF) accelerations and 3‐DOF angular velocities. Some SINU consists of extra three orthogonally aligned magnetometers for true north measurement. These measurements, as discussed previously, are not accurate. To increase the SINU\'s accuracy, the GPS\'s position data obtained from dead reckoning technique is fused with the SINU data through the Kalman filtering algorithm. The system that used such fusion technique is commonly known as the GPS‐aided SINU system, in which this fusion is known to retain the advantages of both SINU and GPS while discarding the disadvantages [4].
\nThe GPS‐aided SINU system is supposed to provide outputs in terms of position, velocity, and orientation. However, the direct outputs provided by the SINU are in terms of accelerations and angular velocities. Hence, the inertial navigation equations, or navigation equations, are formulated to describe the relationship between the GPS‐aided SINU system\'s outputs in terms of the accelerations and angular velocities.
\nThe general form of navigation equations can be derived as follows:
where
The navigation equations outlined in Equation (27) served as the ideal equations to calculate the position, velocity, and orientation based on the data measured from the SINU. However, as discussed earlier, the measurement data from the low‐cost SINU contained various dynamic errors that were not reflected in Equation (27). Hence, perturbation process is applied on the navigation equations to acquire the dynamic error equations.
\nThe dynamic error equations, expressed in continuous time, can be elaborated as:
where
Equation (28) can be expressed in the state space model as follows:
with
where
The Kalman filter prediction stage of GPS‐aided SINU system used the state space model of the dynamic error equations of the SINU to predict the errors. For real‐time implementation, the dynamic error equations stated in Equation (29) are to be transformed into its discrete form as follows:
where
and
where
The observation equations of the dynamic errors, on the contrary, can be modeled as follows:
with
where
with\n
where Equations (36) and (37) represent the orientation measurement vectors. Note that the vector
Notice from Equation (35) that there are two different discrete instants described by subscripts
Real‐time operational diagram of the GPS‐aided SINU system.
Figure 8 delineates the operational block diagram of the design of GPS‐aided SINU system. As shown in Figure 8, that the SINU consists of three‐dimensional accelerometers, gyroscopes, and magnetometers that output three‐dimensional accelerations, angular velocities, and magnetic field strengths, respectively. The sampling rate of the SINU is 40 Hz. By combining these data with the GPS data (5 Hz) through the Kalman filtering model, the system is able to compute the estimated position, velocity, and orientation errors, which could be used to improve the overall estimations.
\nGPS‐aided SINU system operational block diagram.
Offline field experiment using a moving car was carried out to verify the performance of the GPS‐aided SINU system before real‐time implementation. The Kalman filtering process is carried out in offline mode to verify the performance of the developed system. Note that, in the experiment, the SINU and GPS data rate are 40 and 5 Hz, respectively. The data obtained from the offline experiment was fed into the Kalman filtering model to obtain the offline measurements. To test the performance of the proposed GPS‐aided SINU system, the same set of offline data was also fed into a conventional GPS‐aided SINU system with no magnetometers. The result obtained from the conventional GPS‐aided SINU system without magnetometers is compared to the result obtained from the proposed GPS‐aided SINU system with magnetometers to verify the performance of the proposed system. From the results of the offline experiment, there is an average difference computed to be 2.84 m between the navigation paths of GPS‐aided SINU system with and without magnetometers. The mean difference between the navigation paths of GPS measurements and the GPS‐aided SINU system with magnetometers is computed to be ′0.173 m. On the contrary, the mean difference between the navigation paths of GPS measurements and the GPS‐aided SINU system without magnetometers is calculated to be ′2.67 m, much higher than the mean difference from the previous calculation. Such results indicate that the proposed system work well in offline mode.
\nWith the success offline implementation on the moving car, the system is now ready for real‐time implementation. Both the GPS module and the SINU are connected to an embedded high‐performance computer (HPC) through RS‐232 for data acquisition and real‐time processing. The embedded HPC used in the system come with an Intel Core™ 2 Duo Processor E7500, 4 GB DDR2 RAM, 40 GB hard drive integrated into Zotac Nforce 9300‐ITX motherboard. Similar to the previous setting, the SINU\'s data rate is 40 Hz, which is relatively faster than the GPS data rate of 5 Hz. During the data acquisition stage, the embedded HPC acquired one set of SINU data every 25 ms (equivalent to 40 Hz). On the contrary, the embedded computer acquired one full GPS data every 0.2 s (equivalent to 5 Hz). Hence, it is obvious that there is a mismatch of GPS data to SINU data. As shown in Figure 7, when both GPS and SINU data are updated with the newest measurements, the real‐time processing system will proceed with the Kalman filtering process to provide a new update on the error prediction. At the instances where newest GPS data were not available, the real‐time system will compute the error prediction solely depending on the previous error prediction obtained from the Kalman filtering process and the newest SINU measurements.
\nA graphical user interface (GUI) is developed using Visual Basic software (from Microsoft Corporation) for the real‐time implementation. A total of 31 variables will be saved into the solid‐state hard disk continuously in binary file format. The first nine variables represent the raw data from the SINU, which serves the inputs of the GPS‐aided SINU system. The subsequent 15 variables represent the computed three‐dimensional position, velocity, orientation, acceleration errors, and orientation errors, which serve as the outputs of the GPS‐aided SINU system. The last seven variables are the GPS data. Figure 9 shows the GUI layout and the real‐time experimental results of the developed real‐time GPS SINU system. Figure 9 (top left) indicates the serial ports setting for the SINU and the GPS. An”Operation Start“button is located beneath the serial ports frame. An
GUI of the real‐time GPS‐aided SINU system and its field experiment result.
Navigation path of the real‐time GPS‐aided SINU system experiment on a UAV in Google Earth.
Figures 11 and 12 illustrate the results obtained from the real‐time experiment, with Figure 11 depicting the real‐time velocity plot and Figure 12 depicting the real‐time orientation plot. The motion sensing results are compared to the UAV\'s onboard Piccolo II Autopilot Navigation System [26] outputs. Note that the Piccolo II Autopilot Navigation System is a high‐performance, commercial‐grade navigation system for UAV autopilot. The mean square differences of position, velocity, and orientation were computed between the developed system and the Piccolo II system and the comparison results are outlined in Table 1. Such results indicate that the low‐cost GPS‐aided SINU system achieved a comparable, adequate performance when compared to a high‐performance, high‐cost system.
\n\n | Mean square difference | \n
---|---|
Position (m) | \n0.3081 | \n
Velocity (m/s) | \n0.0077 | \n
Orientation (°) | \n2.5930 | \n
Mean square difference of position, velocity, and orientation estimation between the proposed GPS‐aided SINU system\'s output with Piccolo II\'s output.
Real‐time GPS‐aided SINU system velocity plot.
Real‐time GPS‐aided SINU system orientation plot.
This chapter illustrated the real‐time implementation of Kalman filter in two applications, namely, the vision‐based vehicle tracking system and the GPS‐aided SINU system. The Kalman filtering algorithm was derived with the consideration of real‐time element. Detail illustrations on deriving the Kalman filtering models for the vision‐based vehicle tracking system and the GPS‐aided SINU system were outlined and discussed. Both implementations were put on real‐time experiments, and the results from both implementations were recorded and analyzed. The results show that the real‐time Kalman filtering algorithms work well in the applications.
\nUlcerative colitis (UC) is a chronic, idiopathic inflammatory disease that affects mainly young adults with no sex predominance. Its incidence is rising worldwide and is higher in developed countries [1, 2, 3].
The disease is characterized by relapsing and remitting mucosal inflammation, starting in the rectum and extending to proximal segments of the colon. Clinically, UC usually presents with chronic bloody diarrhea. Extraintestinal manifestations, including peripheral arthritis, primary sclerosing cholangitis, and pyoderma gangrenosum occur in about a third of patients [4, 5].
The diagnosis of UC is based on a combination of clinical presentation, endoscopic findings, histology, and the exclusion of alternative diagnoses. The histopathological examination of biopsy specimens is fundamental, not only for making a specific diagnosis but also in determining the state of disease activity and evaluating the prospect of healing and risk of relapse [6]. Even further, histology is essential in assessing the response to treatment and diagnosing complications of treatment and longstanding UC, such as dysplasia and cytomegalovirus (CMV) infection.
For a reliable diagnosis of IBD, at least two endoscopic biopsies each should be taken from at least five sites along the ileum, colon, and rectum [7, 8, 9, 10, 11]. The histological features of UC include non-active inflammation, active inflammation, structural changes, and epithelial abnormalities [5, 8]. The inflammation is concentrated in the mucosa, only occasionally the inflammation may spread into the superficial part of the submucosa.
Non-active inflammation includes the presence of lymphocytes and plasma cells in the lamina propria that could be associated with edema and hyperemia. Apart from areas of ulceration, the inflammatory infiltrate in untreated UC is limited to the mucosa, diffuse or continuous without any variations in intensity or skip lesions, and its severity increases characteristically toward the rectum [5, 12, 13]. When three or more plasma cells accumulate in the mucosal lamina propria around the crypt base or between the crypt base and the muscularis mucosae, a condition is termed basal plasmacytosis [11, 14]. This phenomenon is observed already in biopsies obtained at early onset, sometimes it is the first lesion to appear. Although limited and focal in the initial phase of UC, it later spreads to more colonic segments [15, 16]. The occurrence of eosinophils in the lamina propria, between the crypts, and within the muscularis mucosae, has been associated with aggressive disease and a high risk of relapse [17].
Active inflammation is defined by the presence of neutrophils in the lamina propria, crypts, or surface epithelium. The term cryptitis is used when neutrophils are found penetrating the crypt epithelium, and crypt abscess is a term describing neutrophils occupying the crypt lumens [11]. Neutrophils infiltrating the surface epithelium lead to mucosal erosions or ulcerations, on the other hand, cryptitis and crypt abscesses are associated with crypt destruction, all features of structural changes of the mucosa [8, 18].
Structural changes of the mucosa include crypt distortion and changes in surface topography (surface irregularity). Chronic inflammation leads to irregular size and shape of crypts (e.g., branching and shortening), irregular distribution of the crypts in the lamina propria, and crypts with loss of parallelism. Crypt atrophy is defined as shortened crypts, accompanied by an increased layer of lamina propria stroma between the crypt basis and the muscularis mucosae [5, 11, 19, 20]. Irregular mucosal surface or pseudovillous transformation means wide crypt mouths giving the mucosal surface a finger-like appearance [15].
Epithelial abnormalities include surface epithelial damage, metaplastic changes, and mucin depletion. Surface epithelial damage, such as flattening, focal cell loss, erosions, and ulcers reflect the activity of the disease. Ulcers in UC colitis are always associated with mucosal inflammation in contrast with Crohn’s disease, in which the surrounding mucosa can appear uninflamed [5]. In addition, UC ulcerations tend to be more superficial, broad based and continuous [21]. In severe disease, these ulcers may undermine the adjacent mucosa, finally resulting in denudation of the mucosal surface or deep penetration through the muscularis mucosae [8]. Extensive ulceration with sparing of remaining mucosal islands may give rise to inflammatory pseudopolyps, which are common in the sigmoid and descending colon, but rare in the rectum [9, 20]. Hypertrophy of the muscularis mucosae and submucosal fibrosis is rarely identified in UC [22]. Paneth cell metaplasia, a term used when pyramidal crypt epithelial cells with supranuclear eosinophilic granular cytoplasm are present in the transverse and left colon [11], is an epithelial abnormality that can help in the diagnosis of long-standing UC [16, 19, 23]. Mucin depletion, defined as a reduction in number of goblet cells or depleted mucin within cells is additional epithelial abnormality frequently encountered in UC [11]. Characteristic histological features are shown in Figures 1 and 2.
Diffuse continuous inflammation with basal plasmacytosis, active inflammation with cryptitis, and structural changes including crypt distortion and atrophy. An erosion is present on the far right.
Cryptitis and crypt abscess are shown on the left, while on the right Paneth cell metaplasia and cryptolytic granuloma are present.
UC generally begins in the rectum, extending proximally in a continuous, circumferential pattern. The inflammatory infiltrate is diffuse or continuous without any variations in intensity and its severity increases characteristically toward the rectum. There are no skip-areas characteristics for Crohn’s disease. The demarcation between inflamed and normal mucosa is sharp, although histological inflammation can be found in normal-appearing mucosa [22, 24]. Based on the spread of disease, three subtypes of UC are distinguished in Montréal classification—ulcerative proctitis where the proximal extent of inflammation is distal to the rectosigmoid colon, left-sided colitis, and extensive colitis when involvement extends proximal to the splenic flexure. The later also includes pancolitis [7, 25].
However, unusual inflammation patterns can occur, such as rectal sparing, cecal patch, and backwash ileitis. Rectal sparing should not be interpreted as evidence of Crohn’s disease, as it can be the result of topical or systemic medications. The rectum may be spared in some adults with fulminant colitis [26, 27]. In up to 75% of patients with left-sided UC an isolated area of inflammation around the appendiceal orifice can be appreciated; this association is referred to as cecal patch [28]. In some patients with pancolitis, the ileum too is affected by acute or chronic inflammation. This condition has been termed “backwash ileitis” [29]. The ileal lesions in “backwash ileitis” are characterized by active inflammation in the villi and lamina propria, together with shortening and blunting of the villi. Focal erosions, mucous gland metaplasia, or patchy edema with mild active inflammation are features suggestive of Crohn’s disease [29, 30].
UC is a chronic disease with the relapsing-remitting course and histological alterations are changing during the course of the disease. They are further influenced by medical treatment. In early-stage disease, the diagnosis of UC can be challenging due to the fact, that crypt architecture may still be preserved [17]. In longstanding disease, with widespread architectural crypt distortion and increased cellularity of the lamina propria the diagnosis of UC is more obvious. However, in this situation, rectal sparing, cecal patch, and backwash ileitis can be found that should not lead to misdiagnosis. Under treatment, the extent of involvement of the colon tends to decrease and the distribution pattern may change from diffuse (continuous) to patchy (discontinuous). Complete restoration of the rectal mucosa can be found in 34–44% of patients [5, 18]. In quiescent (clinically inactive) disease neutrophils are not observed, the mucosa may look nearly normal, however, some features, related to chronic mucosal injuries, such as architectural abnormalities, reduced crypt density, and basal plasmacytosis remain [13] (Figure 3). Histological mucosal healing is characterized by the resolution of crypt architectural distortion and inflammatory infiltrate. Nevertheless, the mucosa can still show some features of sustained damage, such as decreased crypt density with branching and shortening of crypts.
Crypt architectural distortion and hypocellular stroma in quiescent disease.
Assessment of disease activity is essential for developing and determining appropriate therapy in patients with UC. Disease activity and treatment response can be assessed using symptoms, biomarkers, endoscopy, and histology. Currently, clinical decision-making is predominantly based on clinical and endoscopic measures. Recently, histology has been recognized as an important prognostic factor and potential treatment target in patients with UC [31]. Both, epithelial damage in association with neutrophils and basal plasmacytosis have been proposed as markers of disease activity and the prediction of relapse. A recent meta-analysis revealed that histological remission was associated with lower rates of clinical relapse compared with those with histological activity and was a superior predictor of clinical relapse compared with endoscopic and clinical remission [32]. Furthermore, the presence of mucosal inflammation during follow-up in patients with UC was associated with a greater risk of subsequent colorectal neoplasia than in those with mucosal healing [33].
Histologically, the level of activity and the stage of the disease (e.g., flaring vs. quiescent UC) can be assessed by different scoring systems. Although more than 30 histological scoring systems in UC have been described, three have undergone extensive validation—the GS, Nancy Index, and Robarts Histopathologic Index [31, 34]. Recently a new consensus-based scoring index has been proposed, intended for both clinical practice and clinical trials that still needs to be validated [10]. Although these are not applied routinely, the pathology report should include some information on the level of activity in the biopsies to assess the effect of therapy and the risk of relapse. Pai [31] recommends that pathologists classify UC biopsies into 1 of 5 categories: normal colonic mucosa, quiescent chronic colitis without basal plasmacytosis, quiescent chronic colitis with basal plasmacytosis, chronic active colitis without basal plasmacytosis, or chronic active colitis with basal plasmacytosis. If present, active inflammation should be graded. Assessing the degree of activity should be carried out on the worst affected biopsy sample [10].
Fulminant colitis is a term used for clinically acute severe colitis, usually involving the entire large bowel, often associated with systemic illness and sometimes accompanied by colonic dilatation (toxic megacolon). It is a well-recognized mode of presentation of UC that typically requires surgical resection [35]. In fulminant UC resections show mainly acute features (Figure 4), while chronic changes are rarely present. With the absence of the part of classical histological changes characteristic of UC both, identification and subclassification of inflammatory bowel disease can be very difficult.
Surgical resection of the colon from a patient with fulminant UC. Sharp demarcation from macroscopically normal terminal ileum is apparent (arrow).
In fulminant colitis, the macroscopic appearance of the mucosa is not sufficiently distinct to differentiate UC from Crohn’s disease and serositis may be observed [27, 36]. In parallel, fulminant colitis caused by UC may show Crohn’s-like histological features, such as deep ulcers, transmural inflammation, and rectal sparing. There may be deep ulcerations, typically eroding down to muscularis propria in a broad-based fashion. The transmural inflammation in this setting is typically more active and diffuse, lacking discrete lymphoid aggregates. This finding does not preclude a diagnosis of UC. In a study by Swan, the two most specific predictors of a final diagnosis of Crohn’s disease were granulomas and transmural lymphoid aggregates, macroscopic features were unhelpful [27]. Apparent rectal sparing is also recognized in fulminant UC, where inflammation of the transverse colon is so severe as to make the rectum look comparatively spared [37].
The main histological feature of UC is chronic active inflammation. In addition to Crohn’s disease, many conditions can mimic UC on mucosal biopsies. Besides being familiar with histological features of a wide range of diseases and conditions that can be included in the differential diagnosis, a knowledge of the clinical, endoscopic, and in some cases even imaging features is required for the pathologist to come to the right conclusion. It is, therefore, recommended that the pathologist has access to the endoscopy report and possibly also radiological and microbiological investigations [21, 22]. Some more common mimickers are addressed in the following section.
Although Crohn’s and UC are frequently discussed together under the term chronic inflammatory bowel disease, distinguishing UC from Crohn’s is nevertheless important. One of the reasons is that only patients with UC are considered for ileal pouch formation, because of the high risk of complications after this procedure in patients with Crohn’s disease. The most common macroscopic and microscopic features distinguishing UC from colonic Crohn’s disease are listed in Table 1. Although non-caseating epithelioid granulomas are considered a classical feature of Crohn’s disease, the presence of granulomas associated with cryptolysis are now well recognized in UC and their presence should not exclude the possibility of UC [21, 38] (Figure 2). Rectal sparing, cecal patch, and ileal disease, all features of UC that might suggest the diagnosis of Crohn’s disease were discussed in one of the previous sections. Treatment of UC can also result in patchy disease, that is, a change from continuous to discontinuous inflammation and should not lead to reclassification to Crohn’s disease [26]. Transmural inflammation, another classical feature of Crohn’s disease may be encountered in fulminant UC [27]. Compared to surgical resection samples, the confident distinction of UC from Crohn’s disease is even more challenging in endoscopic biopsy samples where only mucosal and limited submucosal tissue is sampled. When convincing features of chronic inflammatory bowel disease are evident, but further classification is not possible, the diagnostic term inflammatory bowel disease, unclassified (IBDU) is used [5, 22].
Typical features | Ulcerative colitis | Crohn’s disease |
---|---|---|
Localization of inflammation | Limited to the mucosa, sometimes submucosa | Transmural |
Non-active inflammation | Diffuse (continuous) | Focal (discontinuous), with skip lesions |
Lymphoid aggregates | Frequent in mucosa, submusosa | Common, transmural |
Granulomas | Absent, except cryptolytic | Common, transmural |
Active inflammation (cryptitis, crypt abscesses) | Diffuse (continuous | Focal (discontinuous) |
Ulcers | Superficial | Deep, fissure-like, aphtous |
Fistulae | Absent except in fulminant UC | Common |
Inflammatory pseudopolyps | Common | Rare |
Crypt architectural irregularity | Diffuse (continuous), marked | Focal (discontinuous) |
Atrophy | Present, pronounced | Uncommon, mild |
Paneth cell metaplasia | Present | Uncommon |
Pyloric gland metaplasia | Rare | Present |
Neuronal/muscular hypertrophy | Rare/absent | Common/present |
Serositis | Absent except in fulminant UC | Present |
Wall thickness | Normal | Increased |
Strictures | Uncommon | Common |
Fat wrapping | Absent | Common |
Classical microscopic and macroscopic characteristics of ulcerative colitis and Crohn’s disease.
Infective colitis is one of the most important differential diagnoses of chronic inflammatory bowel disease including UC since the steroid therapy used for treating inflammatory bowel disease can have adverse results in patients with infective colitis.
One of the most common inflammatory patterns in enteric infections is the so-called nonspecific acute self-limited colitis that characteristically features intact crypt architecture with neutrophilic infiltrates of the surface epithelium. Basal plasmacytosis should not be seen as this is a marker of chronicity [39]. However, crypt abscesses and cryptitis may be present in the acute phase. As patients often do not come to endoscopy until several weeks after onset of symptoms, pathologists frequently do not see the classic histological features of acute infectious-type colitis. The protracted course of colitis, which may be seen for example in Campylobacter infections or shigellosis is more challenging to diagnose histologically as the development of “chronic” features such as crypt destruction and architectural disturbance may resemble inflammatory bowel disease including UC [40]. Extensive involvement of the surface mucosa by neutrophils is not often seen in inflammatory bowel disease and should alert the pathologist to the possibility of infection or toxin-induced injury [40]. In contrast, basal plasmacytosis, one of the earliest features of UC, crypt distortion, and irregular mucosal surface favor inflammatory bowel disease over infection [16, 19, 41]. However, in patients with early-onset UC (within 10 days of symptoms) structural changes may not yet be present [5, 42].
Lymphogranuloma venereum (LGV) and syphilis are sexually transmitted diseases caused by Chlamydia trachomatis and Treponema pallidum, respectively. LGV and syphilitic proctitis are usually reported in men who have sex with men and can clinically mimic UC [43]. Histologically, both infections are characterized by an intense lymphohistiocytic infiltrate associated with prominent plasma cells within the mucosa and submucosa but minimal basal plasmacytosis. Characteristically, the associated acute inflammation with cryptitis and crypt abscesses is only mild to moderate. Crypt distortion and granulomas are minimal as well and Paneth cell metaplasia is rare [19, 43, 44]. Specific antibodies for T. pallidum are available that work well on paraffin-embedded tissue, however, real-time polymerase chain reaction on rectal swab specimens is the most reliable diagnostic test [43].
In addition to infections mimicking UC, in treated patients with clinical deterioration, superimposed infection, particularly CMV and Clostridium difficile should be considered [45, 46].
In some cases, diagnosis of infectious colitis is not possible on histological grounds alone. It is, therefore, vital to exclude infection by stool culture. In addition, a detailed clinical history addressing intestinal and extraintestinal symptoms, travel history, sexual history, and conditions influencing immune status should be collected [41].
Drug-induced colitis can show several histological patterns, one of them being a UC-like pattern with diffuse inflammation and ulceration. Histological features that favor drug-induced etiology include significant eosinophilic infiltrate, epithelial apoptosis, melanosis, cytoplasmic vacuolation, and increased intraepithelial lymphocytes [39].
Recently several monoclonal antibodies targeting immune checkpoint molecules became available for the treatment of advanced neoplasms. These immune checkpoint inhibitors (ICIs) induce immune activation and robust antitumor T-cell activity and can greatly improve survival. Following the administration of ICIs, immune-mediated adverse events including enterocolitis that can be severe are common [41, 47]. Microscopic features of ICI colitis include mixed inflammation of the lamina propria, cryptitis, crypt abscesses, crypt destruction, and granulomas [48] (Figure 5). In cases of distal distribution or pancolitis they may suggest UC. In ICI colitis crypt distortion, if present, is usually mild. Atrophic crypts often show marked attenuation of crypt epithelium and contain luminal apoptotic debris admixed with inflammatory cells [49]. If ICI colitis recurs, there may be chronic features such as basal lymphoplasmacytosis, crypt architectural irregularity, and Paneth cell metaplasia. Apoptosis and lymphocyte-mediated epithelial damage at the base of crypts favor ICI colitis, whereas severe inflammation, severe crypt distortion, and basal plasmacytosis favor UC [41, 50].
Colitis associated with ICIs showing diffuse chronic inflammation with cryptitis and crypt abscesses without crypt distortion and basal plasmacytosis.
Segmental colitis associated with diverticulosis (SCAD) is chronic colitis that is confined to the colonic segment containing diverticula [51]. By definition, the rectum and proximal colon are spared from inflammation [51]. SCAD is histologically characterized by a transmucosal chronic inflammation associated with crypt distortion, cryptitis, crypt abscesses, goblet cell depletion, basal plasmacytosis, or granulomas (UC-like or Crohn’s disease-like pattern)[52]. However, these features are exclusively distributed in the sigmoid tract with sparing of the rectal and distal colonic mucosa [52, 53, 54]. Thus, for a correct diagnosis, it is fundamental to know the exact biopsy site and to compare the morphology of the sigma and rectum in the differential diagnosis with IBD. In addition, patients with SCAD tend to be older compared to inflammatory bowel disease patients.
Primary sclerosing cholangitis (PSC) is a chronic, cholestatic liver disease, characterized by the inflammation and fibrosis of both intrahepatic and extrahepatic bile ducts, leading to the formation of multifocal bile duct strictures [55]. It is frequently associated with other diseases and a classic extraintestinal manifestation of IBD. The diagnosis of PSC may precede diagnosing the patient with IBD but can present even after colectomy in IBD patients [56]. The course of UC differs significantly when PSC is present; the most notable differences are the presence of more extensive but colitis showing lower activity. It is also more often associated with rectal sparing and so-called backwash ileitis compared with patients with UC without primary sclerosing cholangitis [56]. Another important issue is the higher incidence of carcinomas in the PSC-UC patients [56, 57].
Absolute indications for surgery in UC patients include uncontrolled hemorrhage, perforation, and colorectal carcinoma or dysplastic lesions not amenable to endoscopic removal. Surgery is also indicated in refractory acute severe UC or medically refractory disease [1]. The most commonly performed surgery for UC is restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) [58].
Adaptive changes of the pouch mucosa (“colonic metaplasia”) are present several months after surgery in up to 87% of biopsies and consist of villous atrophy, crypt hyperplasia, and infiltration of the lamina propria by mononuclear cells, eosinophils, and histiocytes. In addition, mild ischemic changes can be observed in a few patients, while others may show features of mucosal prolapse. These changes should not be regarded as evidence of pouchitis. True pouchitis is associated with increased villous atrophy, acute and/or chronic inflammatory infiltrates, cryptitis, crypt abscesses, and ulceration [20, 59]. Based on the etiology pouchitis can be subdivided into idiopathic and secondary. Secondary pouchitis can occur in up to 30% of cases and can be classified as infectious (CMV, candida), ischemic, nonsteroidal antiinflammatory drugs-induced, collagenous, autoimmune-associated, or Crohn’s disease [59]. Histology has a limited role in the evaluation of pouchitis; the main purpose for histology evaluation of the pouch is the exclusion of secondary pouchitis and dysplasia [60]. The diagnosis and differential diagnosis of pouchitis should be based on a combination of clinical, endoscopic, and histological findings [61].
When pouch biopsies show severe inflammation with neutrophils within the lamina propria and epithelium associated with erosions and ulcerations this should not lead to the reclassification into Crohn’s disease. Even deep submucosal lymphoid aggregates and fistulous tracts were found in pouches excised from UC patients. A diagnosis of Crohn’s disese after IPAA surgery should only be made when reexamination of the previous histological specimens shows typical pathologic features of Crohn’s disese [62].
Pouchitis should be distinguished from cuffitis, which is inflammation in the columnar cuff mucosa distal to the pouch. After the IPAA procedure patients might often have residual rectal tissue, referred to as a rectal cuff, at the anastomosis between the ileum and anal canal. This area can become inflamed due to an exacerbation of UC leading to cuffitis [8, 60].
In patients with UC, the risk for reactivation of latent cytomegalovirus (CMV) infection is a common complication, particularly in those with steroid-resistant disease [45]. On routine H&E stained slides, CMV typically presents as large cells, two- to four-fold larger than normal, with large amphophilic intranuclear inclusions, surrounded by a clear halo, and smaller cytoplasmic inclusions. However, CMV colitis in IBD patients tends to present with atypical, small viral inclusions, often lacking the characteristic owl-eye appearance, and it mostly affects endothelial cells in granulation tissue in ulcers [45, 63]. Therefore, CMV reactivation should be actively sought in all patients with severe colitis refractory to immunosuppressive therapy and on biopsies with prominent granulation tissue associated with large ulcers. Because the infected cells are usually scarce on limited biopsy material and morphologically less characteristic they may be missed on routine H&E stains. Immunohistochemistry, using monoclonal antibodies directed against CMV immediate early antigen, increases the diagnostic yield in comparison with H&E staining. Semiquantitative immunohistochemistry, reporting the number of infected cells and/or the number of CMV positive biopsy fragments, may have a predictive value [64].
Colitis cystica profunda (CCP) is a rare benign condition characterized by cystic dilatation and misplacement of mature crypts through the muscularis mucosae into the submucosa and/or deeper layers of the bowel wall. It is a complication of various conditions including inflammatory bowel diseases, more commonly UC [65]. The condition usually affects the rectum and sigmoid colon, though it may diffusely involve the entire large bowel. It is believed to be the result of misplacement and entrapment of regenerating glands during healing. With gland formation extending deep into the bowel wall, it can be easily misdiagnosed as adenocarcinoma, particularly in endoscopic biopsies. Features favoring the diagnosis of CCP over cancer include multiple lesions, intact mucosa on the surface and no atypia on histology. Special care must be taken not to over-diagnose regenerative atypia as a well-differentiated adenocarcinoma [66].
It has long been known that the risk of colorectal carcinoma in patients with colonic IBD is greater than in the general population [67, 68]. Recent population-based cohort studies indicate that current treatment approaches and surveillance measures have markedly reduced the risk making it more comparable to that of the general population [69]. Colorectal cancer risk, however, remains elevated in certain populations, such as those with young age at onset, long duration of disease, extensive and uncontrolled inflammation, and those with primary sclerosing cholangitis or family history of colorectal cancer [70].
Mucosal dysplasia is the best and most reliable marker of an increased risk of malignancy in patients with UC [70, 71]. Dysplasia should be distinguished into low and high degrees, using the architectural and cytological criteria of the World Health Organization [72]. In low-grade dysplasia, crypt architecture shows minimal distortion. Cytologically, the nuclei have slight hyperchromasia and the nuclear membrane has irregular edges. High-grade dysplasia is characterized by greater architectural complexity and marked nuclear pleomorphism, irregular nuclear membranes, and macronucleoli. There is more nuclear crowding and overlapping, and consequently greater nuclear stratification. Cytoarchitectural alterations not meeting the above-mentioned criteria that can also not be attributed to regeneration secondary to inflammation or medical procedure are considered “indefinite for dysplasia.”
Dysplasia related to UC develops in areas with chronic inflammation and is often multifocal. Dysplasia and neoplastic lesions in UC can often be non-polypoid, flat, or ill-defined. Flat dysplasia is not endoscopically visible and can be detected microscopically in random biopsies from unremarkable mucosa. For that reason, many biopsies are performed in patients at risk to increase detection of neoplasia. The interobserver variability for dysplasia is high among pathologists, particularly for low-grade and indefinite dysplasia, making this field one of the most challenging in gastrointestinal pathology [73]. Therefore, confirmation of dysplasia by a pathologist with expertise in gastrointestinal pathology has been recommended [22]. Although discussed in past recommendations [22], recent recommendations do not encourage the use of p53 immunohistochemistry for detecting and discriminating dysplasia (Figure 6) [6, 8, 11].
Low-grade dysplasia in a patient with longstanding active UC (left) showing p53 positivity (right).
UC is a complex disease that requires a multidisciplinary approach. Histological evaluation of biopsies and resection specimens from the gastrointestinal tract plays a vital part in the management of UC patients. Despite the evolution of advanced endoscopic procedures that help in a detailed assessment of mucosa recent studies have confirmed the value of histology in predicting clinical outcomes.
The author declares no conflict of interest.
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Some of these heavy metals such as copper, cobalt, iron, nickel, magnesium, molybdenum, chromium, selenium, manganese and zinc have functional roles which are essential for various diverse physiological and biochemical activities in the body. However, some of these heavy metals in high doses can be harmful to the body while others such as cadmium, mercury, lead, chromium, silver, and arsenic in minute quantities have delirious effects in the body causing acute and chronic toxicities in humans. The focus of this chapter is to describe the various mechanism of intoxication of some selected heavy metals in humans along with their health effects. Therefore it aims to highlight on biochemical mechanisms of heavy metal intoxication which involves binding to proteins and enzymes, altering their activity and causing damage. 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In vitro, chemicals such as drugs and pesticides have different cytotoxicity mechanisms such as destruction of cell membranes, prevention of protein synthesis, irreversible binding to receptors etc. In order to determine the cell death caused by these damages, there is a need for cheap, reliable and reproducible short-term cytotoxicity and cell viability assays. Cytotoxicity and cell viability assays are based on various cell functions. A broad spectrum of cytotoxicity assays is currently used in the fields of toxicology and pharmacology. There are different classifications for these assays: (i) dye exclusion assays; (ii) colorimetric assays; (iii) fluorometric assays; and (iv) luminometric assays. Choosing the appropriate method among these assays is important for obtaining accurate and reliable results. When selecting the cytotoxicity and cell viability assays to be used in the study, different parameters have to be considered such as the availability in the laboratory where the study is to be performed, test compounds, detection mechanism, specificity, and sensitivity. In this chapter, information will be given about in vitro cytotoxicity and viability assays, these assays will be classified and their advantages and disadvantages will be emphasized. The aim of this chapter is to guide the researcher interested in this subject to select the appropriate assay for their study.",book:{id:"6310",slug:"genotoxicity-a-predictable-risk-to-our-actual-world",title:"Genotoxicity",fullTitle:"Genotoxicity - A Predictable Risk to Our Actual World"},signatures:"Özlem Sultan Aslantürk",authors:[{id:"211212",title:"Dr.",name:"Özlem Sultan",middleName:null,surname:"Aslantürk",slug:"ozlem-sultan-aslanturk",fullName:"Özlem Sultan Aslantürk"}]},{id:"66259",doi:"10.5772/intechopen.85270",title:"Antioxidant Compounds and Their Antioxidant Mechanism",slug:"antioxidant-compounds-and-their-antioxidant-mechanism",totalDownloads:7489,totalCrossrefCites:53,totalDimensionsCites:135,abstract:"An antioxidant is a substance that at low concentrations delays or prevents oxidation of a substrate. Antioxidant compounds act through several chemical mechanisms: hydrogen atom transfer (HAT), single electron transfer (SET), and the ability to chelate transition metals. The importance of antioxidant mechanisms is to understand the biological meaning of antioxidants, their possible uses, their production by organic synthesis or biotechnological methods, or for the standardization of the determination of antioxidant activity. In general, antioxidant molecules can react either by multiple mechanisms or by a predominant mechanism. The chemical structure of the antioxidant substance allows understanding of the antioxidant reaction mechanism. This chapter reviews the in vitro antioxidant reaction mechanisms of organic compounds polyphenols, carotenoids, and vitamins C against free radicals (FR) and prooxidant compounds under diverse conditions, as well as the most commonly used methods to evaluate the antioxidant activity of these compounds according to the mechanism involved in the reaction with free radicals and the methods of in vitro antioxidant evaluation that are used frequently depending on the reaction mechanism of the antioxidant.",book:{id:"8008",slug:"antioxidants",title:"Antioxidants",fullTitle:"Antioxidants"},signatures:"Norma Francenia Santos-Sánchez, Raúl Salas-Coronado, Claudia Villanueva-Cañongo and Beatriz Hernández-Carlos",authors:[{id:"143354",title:"Dr.",name:"Raúl",middleName:null,surname:"Salas-Coronado",slug:"raul-salas-coronado",fullName:"Raúl Salas-Coronado"},{id:"148546",title:"Dr.",name:"Norma Francenia",middleName:null,surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez"},{id:"193718",title:"Dr.",name:"Beatriz",middleName:null,surname:"Hernández-Carlos",slug:"beatriz-hernandez-carlos",fullName:"Beatriz Hernández-Carlos"},{id:"278133",title:"Dr.",name:"Claudia",middleName:null,surname:"Villanueva-Cañongo",slug:"claudia-villanueva-canongo",fullName:"Claudia Villanueva-Cañongo"}]},{id:"40253",doi:"10.5772/50486",title:"Lipid Nanoparticulate Drug Delivery Systems: A Revolution in Dosage Form Design and Development",slug:"lipid-nanoparticulate-drug-delivery-systems-a-revolution-in-dosage-form-design-and-development",totalDownloads:11245,totalCrossrefCites:21,totalDimensionsCites:103,abstract:null,book:{id:"2509",slug:"recent-advances-in-novel-drug-carrier-systems",title:"Recent Advances in Novel Drug Carrier Systems",fullTitle:"Recent Advances in Novel Drug Carrier Systems"},signatures:"Anthony A. Attama, Mumuni A. Momoh and Philip F. Builders",authors:[{id:"142947",title:"Prof.",name:"Anthony",middleName:null,surname:"Attama",slug:"anthony-attama",fullName:"Anthony Attama"}]},{id:"42016",doi:"10.5772/55187",title:"Why are Early Life Stages of Aquatic Organisms more Sensitive to Toxicants than Adults?",slug:"why-are-early-life-stages-of-aquatic-organisms-more-sensitive-to-toxicants-than-adults-",totalDownloads:3477,totalCrossrefCites:35,totalDimensionsCites:99,abstract:null,book:{id:"3408",slug:"new-insights-into-toxicity-and-drug-testing",title:"New Insights into Toxicity and Drug Testing",fullTitle:"New Insights into Toxicity and Drug Testing"},signatures:"Azad Mohammed",authors:[{id:"147061",title:"Dr.",name:"Azad",middleName:null,surname:"Mohammed",slug:"azad-mohammed",fullName:"Azad Mohammed"}]}],mostDownloadedChaptersLast30Days:[{id:"64762",title:"Mechanism and Health Effects of Heavy Metal Toxicity in Humans",slug:"mechanism-and-health-effects-of-heavy-metal-toxicity-in-humans",totalDownloads:10236,totalCrossrefCites:100,totalDimensionsCites:229,abstract:"Several heavy metals are found naturally in the earth crust and are exploited for various industrial and economic purposes. Among these heavy metals, a few have direct or indirect impact on the human body. Some of these heavy metals such as copper, cobalt, iron, nickel, magnesium, molybdenum, chromium, selenium, manganese and zinc have functional roles which are essential for various diverse physiological and biochemical activities in the body. However, some of these heavy metals in high doses can be harmful to the body while others such as cadmium, mercury, lead, chromium, silver, and arsenic in minute quantities have delirious effects in the body causing acute and chronic toxicities in humans. The focus of this chapter is to describe the various mechanism of intoxication of some selected heavy metals in humans along with their health effects. Therefore it aims to highlight on biochemical mechanisms of heavy metal intoxication which involves binding to proteins and enzymes, altering their activity and causing damage. More so, the mechanism by which heavy metals cause neurotoxicity, generate free radical which promotes oxidative stress damaging lipids, proteins and DNA molecules and how these free radicals propagate carcinogenesis are discussed. Alongside these mechanisms, the noxious health effects of these heavy metals are discussed.",book:{id:"7111",slug:"poisoning-in-the-modern-world-new-tricks-for-an-old-dog-",title:"Poisoning in the Modern World",fullTitle:"Poisoning in the Modern World - New Tricks for an Old Dog?"},signatures:"Godwill Azeh Engwa, Paschaline Udoka Ferdinand, Friday Nweke Nwalo and Marian N. 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Antioxidant compounds act through several chemical mechanisms: hydrogen atom transfer (HAT), single electron transfer (SET), and the ability to chelate transition metals. The importance of antioxidant mechanisms is to understand the biological meaning of antioxidants, their possible uses, their production by organic synthesis or biotechnological methods, or for the standardization of the determination of antioxidant activity. In general, antioxidant molecules can react either by multiple mechanisms or by a predominant mechanism. The chemical structure of the antioxidant substance allows understanding of the antioxidant reaction mechanism. This chapter reviews the in vitro antioxidant reaction mechanisms of organic compounds polyphenols, carotenoids, and vitamins C against free radicals (FR) and prooxidant compounds under diverse conditions, as well as the most commonly used methods to evaluate the antioxidant activity of these compounds according to the mechanism involved in the reaction with free radicals and the methods of in vitro antioxidant evaluation that are used frequently depending on the reaction mechanism of the antioxidant.",book:{id:"8008",slug:"antioxidants",title:"Antioxidants",fullTitle:"Antioxidants"},signatures:"Norma Francenia Santos-Sánchez, Raúl Salas-Coronado, Claudia Villanueva-Cañongo and Beatriz Hernández-Carlos",authors:[{id:"143354",title:"Dr.",name:"Raúl",middleName:null,surname:"Salas-Coronado",slug:"raul-salas-coronado",fullName:"Raúl Salas-Coronado"},{id:"148546",title:"Dr.",name:"Norma Francenia",middleName:null,surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez"},{id:"193718",title:"Dr.",name:"Beatriz",middleName:null,surname:"Hernández-Carlos",slug:"beatriz-hernandez-carlos",fullName:"Beatriz Hernández-Carlos"},{id:"278133",title:"Dr.",name:"Claudia",middleName:null,surname:"Villanueva-Cañongo",slug:"claudia-villanueva-canongo",fullName:"Claudia Villanueva-Cañongo"}]},{id:"66742",title:"Introductory Chapter: Alkaloids - Their Importance in Nature and for Human Life",slug:"introductory-chapter-alkaloids-their-importance-in-nature-and-for-human-life",totalDownloads:4035,totalCrossrefCites:14,totalDimensionsCites:29,abstract:null,book:{id:"6828",slug:"alkaloids-their-importance-in-nature-and-human-life",title:"Alkaloids",fullTitle:"Alkaloids - Their Importance in Nature and Human Life"},signatures:"Joanna Kurek",authors:[{id:"214632",title:"Dr.",name:"Joanna",middleName:null,surname:"Kurek",slug:"joanna-kurek",fullName:"Joanna Kurek"}]}],onlineFirstChaptersFilter:{topicId:"19",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82439",title:"Cellular Cytotoxicity and Multiple Sclerosis",slug:"cellular-cytotoxicity-and-multiple-sclerosis",totalDownloads:0,totalDimensionsCites:0,doi:"10.5772/intechopen.105681",abstract:"Multiple sclerosis (MS) is an autoimmune disease in which discrete central nervous system lesions result from perivascular immune cell infiltration associated with damage to myelin (demyelination), oligodendrocytes and neurons. This culminates in debilitating neurological symptoms, primarily affecting women in their child-bearing years. Both the innate and adaptive branches of the immune system have been implicated in disease initiation and progression, and although the underlying cause remains elusive, there is compelling evidence for a complex interaction between genetic and environmental factors, leading to inflammation and neurodegeneration. Both direct cellular toxicity and antibody-dependent cellular cytotoxicity (ADCC) involving several cell types have been identified in playing major roles. These cells and their interactions in the pathogenesis of MS will be discussed.",book:{id:"11678",title:"Cytotoxicity",coverURL:"https://cdn.intechopen.com/books/images_new/11678.jpg"},signatures:"Annie M.L. Willson and Margaret A. Jordan"},{id:"82226",title:"Early Signal Detection: Data Mining of Mental Disorders with Statins",slug:"early-signal-detection-data-mining-of-mental-disorders-with-statins",totalDownloads:0,totalDimensionsCites:0,doi:"10.5772/intechopen.105504",abstract:"Statins are widely prescribed to treat dyslipidemias. It is well-known adverse reaction of these active ingredients related to rhabdomyolysis and myalgia, but there are other signals to be aware of, such as mental disorders. Pharmacovigilance tools help to trace known risks and detect early other unknown effects that appear over time. Data of all the reported suspected adverse drug reactions for statins from the international World Health Organization (WHO) repository Vigibase were analyzed with an adaptation of data mining Bayesian methodology to search for positive signals, threshold of false discovery rate (FDR) < 0.05, and listed candidates for priority clinical investigation. Among positive mental signals observed, some were currently stated as adverse reactions in technical factsheets as insomnia, depression, dementia, and nightmares, but others have not reached this condition as bipolar, psychotic, and emotional disorders or symptoms and suicide. Other diverse central positive signals that can be confounded with mental conditions obtained and not stated were senses impairment, such as blindness, deafness, balance disorder, and events related to suicide. Worrying positive signals proposed as candidates to further investigation are insomnia for pitavastatin, pravastatin, and simvastatin; dementia for atorvastatin and rosuvastatin; and suicide and psychotic disorders for atorvastatin, lovastatin, pravastatin, rosuvastatin, and simvastatin.",book:{id:"11679",title:"Pharmacovigilance and Regulations",coverURL:"https://cdn.intechopen.com/books/images_new/11679.jpg"},signatures:"Maria-Isabel Jimenez-Serrania"},{id:"82398",title:"Computer-Aided Drug Design and Development: An Integrated Approach",slug:"computer-aided-drug-design-and-development-an-integrated-approach",totalDownloads:3,totalDimensionsCites:0,doi:"10.5772/intechopen.105003",abstract:"Drug discovery and development is a very time- and resource-consuming process. Comprehensive knowledge of chemistry has been integrated with information technology to streamline drug discovery, design, development, and optimization. Computer-aided drug design is being utilized to expedite and facilitate hit identification, hit-to-lead selection, and optimize the absorption, distribution, metabolism, excretion, and toxicity profile. Regulatory organizations and the pharmaceutical industry are continuously involved in the development of computational techniques that will improve the effectiveness and efficiency of the drug discovery process while decreasing the use of animals, cost, and time and increasing predictability. The present chapter will provide an overview of computational tools, such as structure-based and receptor-based drug designing, and how the coupling of these tools with a rational drug design process has led to the discovery of small molecules as therapeutic agents for numerous human disease conditions duly approved by the Food and Drug Administration. It is expected that the power of CADD will grow as the technology continues to evolve.",book:{id:"11091",title:"Drug Development Life Cycle",coverURL:"https://cdn.intechopen.com/books/images_new/11091.jpg"},signatures:"Neelima Dhingra"},{id:"81186",title:"Germicidal and Antineoplastic Activities of Curcumin and Curcumin-Derived Nanoparticles",slug:"germicidal-and-antineoplastic-activities-of-curcumin-and-curcumin-derived-nanoparticles",totalDownloads:4,totalDimensionsCites:0,doi:"10.5772/intechopen.103076",abstract:"Curcumin is a major constituent of turmeric and has been shown to have a plethora of health benefits, which include, among many, antimicrobial, anticancer, and reduction of cholesterol. However, it has also been reported that curcumin has less bioaccumulation and is quickly metabolized and cleared from the body. Nanoparticle formulations are known to increase curcumin biocompatibility and targeting. Additionally, the antimicrobial activity of curcumin has been extensively studied and the mechanism of action provides clues for the development of new drugs for drug-resistant microbes. Thus, this chapter will review the biomedical application of curcumin and its nanoformulations against different microbes and other diseases, including cancer.",book:{id:"11323",title:"Antimicrobial and Pharmacological Aspects of Curcumin",coverURL:"https://cdn.intechopen.com/books/images_new/11323.jpg"},signatures:"Lilian Makgoo and Zukile Mbita"},{id:"82304",title:"Nonbiodegradable Hospital Waste Burden and Implications",slug:"nonbiodegradable-hospital-waste-burden-and-implications",totalDownloads:5,totalDimensionsCites:0,doi:"10.5772/intechopen.105009",abstract:"Hospitals and other healthcare facilities are very essential for the cure and care of persons suffering from health issues and also to promote health in society. As the health care services are improving and increasing their reach even in underdeveloped countries, so is the problem of health care waste (HCW) as hospitals generate a relatively huge amount of HCW, which consists of general as well as hazardous waste. The persons handling HCW are at immediate risk, followed by persons residing near HCW dumping/processing areas and the general public. Infectious HCW is a major threat to the health of humans and animals as it has the potential to spread various infectious diseases to the human and animal population. Due to the uncontrolled use of disposable nonbiodegradable materials by healthcare systems and their processing or lack of it, the HCW has emerged as one of the major sources of environmental pollution including the emission of the significant amount of greenhouse gases, which stands from 3 to 10% of total emissions of nations. HCW also leads to leaching chemicals, heavy metals like Pb, Cd, Cr, radioactive substances, and even generating carcinogens like dioxin in the environment contaminating air, soil, and water in general and especially in areas surrounding HCW dumping or processing affecting health and quality of life of not only of humans but cohabiting flora and fauna in those areas. Thus, the HCW is becoming one of the major sources of environmental pollution and collectively contributing to the problem of global warming. The HCW needs to be given the desired attention and priority in actions and policy. The chapter focuses on sources, types, and various environmental and health hazards related to HCW, its global environmental impact and management strategies for minimum effects with an eco-friendly and sustainable approach.",book:{id:"11329",title:"The Toxicity of Environmental Pollutants",coverURL:"https://cdn.intechopen.com/books/images_new/11329.jpg"},signatures:"Deepak S. Khobragade"},{id:"82246",title:"Heavy Metal Contamination of Water and Their Toxic Effect on Living Organisms",slug:"heavy-metal-contamination-of-water-and-their-toxic-effect-on-living-organisms",totalDownloads:16,totalDimensionsCites:0,doi:"10.5772/intechopen.105075",abstract:"Water has become a major threat in today’s world. Collection of heavy metals, a few of them, is potentially toxic and these get distributed to different areas through different pathways. With an increase in the earth’s population, development and industrialization are taking place rapidly and these get the major source of water contamination. With heavy metals in lakes, rivers, groundwater, and various water sources, water gets polluted by the increased concentration of heavy metals and metalloids through release from the suddenly mine tailings, disposal of high metal wastes, growing industrial areas, leaded gasoline and paints, usage of fertilizers inland, animal manures, E-waste, sewage sludge, pesticides, wastewater irrigation, coal, etc. Exposure to heavy metals has been linked to chronic and acute toxicity, which develops retardation; neurotoxicity can damage the kidneys, lead to the development of different cancers, damage the liver and lungs; bones can become fragile; and there are even chances of death in case of huge amount of exposure. This chapter mainly focuses on heavy metal pollution in water and its toxic effect on living organisms.",book:{id:"11329",title:"The Toxicity of Environmental Pollutants",coverURL:"https://cdn.intechopen.com/books/images_new/11329.jpg"},signatures:"Anubhav Singh, Anuj Sharma, Rohit K. Verma, Rushikesh L. Chopade, Pritam P. Pandit, Varad Nagar, Vinay Aseri, Sumit K. Choudhary, Garima Awasthi, Kumud K. Awasthi and Mahipal S. 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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:"6",title:"Infectious Diseases",doi:"10.5772/intechopen.71852",issn:"2631-6188",scope:"This series will provide a comprehensive overview of recent research trends in various Infectious Diseases (as per the most recent Baltimore classification). Topics will include general overviews of infections, immunopathology, diagnosis, treatment, epidemiology, etiology, and current clinical recommendations for managing infectious diseases. Ongoing issues, recent advances, and future diagnostic approaches and therapeutic strategies will also be discussed. This book series will focus on various aspects and properties of infectious diseases whose deep understanding is essential for safeguarding the human race from losing resources and economies due to pathogens.",coverUrl:"https://cdn.intechopen.com/series/covers/6.jpg",latestPublicationDate:"June 25th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:13,editor:{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"3",title:"Bacterial Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",isOpenForSubmission:!1,editor:null,editorTwo:null,editorThree:null},{id:"4",title:"Fungal Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",isOpenForSubmission:!0,editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",slug:"yuping-ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",biography:"Dr. Yuping Ran, Professor, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China. Completed the Course Medical Mycology, the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Netherlands (2006). International Union of Microbiological Societies (IUMS) Fellow, and International Emerging Infectious Diseases (IEID) Fellow, Centers for Diseases Control and Prevention (CDC), Atlanta, USA. Diploma of Dermatological Scientist, Japanese Society for Investigative Dermatology. Ph.D. of Juntendo University, Japan. Bachelor’s and Master’s degree, Medicine, West China University of Medical Sciences. Chair of Sichuan Medical Association Dermatology Committee. General Secretary of The 19th Annual Meeting of Chinese Society of Dermatology and the Asia Pacific Society for Medical Mycology (2013). In charge of the Annual Medical Mycology Course over 20-years authorized by National Continue Medical Education Committee of China. Member of the board of directors of the Asia-Pacific Society for Medical Mycology (APSMM). Associate editor of Mycopathologia. Vice-chief of the editorial board of Chinses Journal of Mycology, China. Board Member and Chair of Mycology Group of Chinese Society of Dermatology.",institutionString:null,institution:{name:"Sichuan University",institutionURL:null,country:{name:"China"}}},editorTwo:null,editorThree:null},{id:"5",title:"Parasitic Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",isOpenForSubmission:!0,editor:{id:"67907",title:"Dr.",name:"Amidou",middleName:null,surname:"Samie",slug:"amidou-samie",fullName:"Amidou Samie",profilePictureURL:"https://mts.intechopen.com/storage/users/67907/images/system/67907.jpg",biography:"Dr. Amidou Samie is an Associate Professor of Microbiology at the University of Venda, in South Africa, where he graduated for his PhD in May 2008. He joined the Department of Microbiology the same year and has been giving lectures on topics covering parasitology, immunology, molecular biology and industrial microbiology. 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She is now a lecturer at the University of Witwatersrand, South Africa, and a principal researcher at the Health Economics and Epidemiology Research Office (HE2RO), South Africa. Dr. Moolla holds a Ph.D. in Psychology with her research being focused on mental health and resilience. In her professional work capacity, her research has further expanded into the fields of early childhood development, mental health, the HIV and TB care cascades, as well as COVID. She is also a UNESCO-trained International Bioethics Facilitator.",institutionString:"University of the Witwatersrand",institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"419588",title:"Ph.D.",name:"Sergio",middleName:"Alexandre",surname:"Gehrke",slug:"sergio-gehrke",fullName:"Sergio Gehrke",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038WgMKQA0/Profile_Picture_2022-06-02T11:44:20.jpg",biography:"Dr. Sergio Alexandre Gehrke is a doctorate holder in two fields. The first is a Ph.D. in Cellular and Molecular Biology from the Pontificia Catholic University, Porto Alegre, Brazil, in 2010 and the other is an International Ph.D. in Bioengineering from the Universidad Miguel Hernandez, Elche/Alicante, Spain, obtained in 2020. In 2018, he completed a postdoctoral fellowship in Materials Engineering in the NUCLEMAT of the Pontificia Catholic University, Porto Alegre, Brazil. He is currently the Director of the Postgraduate Program in Implantology of the Bioface/UCAM/PgO (Montevideo, Uruguay), Director of the Cathedra of Biotechnology of the Catholic University of Murcia (Murcia, Spain), an Extraordinary Full Professor of the Catholic University of Murcia (Murcia, Spain) as well as the Director of the private center of research Biotecnos – Technology and Science (Montevideo, Uruguay). Applied biomaterials, cellular and molecular biology, and dental implants are among his research interests. He has published several original papers in renowned journals. In addition, he is also a Collaborating Professor in several Postgraduate programs at different universities all over the world.",institutionString:null,institution:{name:"Universidad Católica San Antonio de Murcia",country:{name:"Spain"}}},{id:"342152",title:"Dr.",name:"Santo",middleName:null,surname:"Grace Umesh",slug:"santo-grace-umesh",fullName:"Santo Grace Umesh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/342152/images/16311_n.jpg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"333647",title:"Dr.",name:"Shreya",middleName:null,surname:"Kishore",slug:"shreya-kishore",fullName:"Shreya Kishore",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333647/images/14701_n.jpg",biography:"Dr. Shreya Kishore completed her Bachelor in Dental Surgery in Chettinad Dental College and Research Institute, Chennai, and her Master of Dental Surgery (Orthodontics) in Saveetha Dental College, Chennai. She is also Invisalign certified. She’s working as a Senior Lecturer in the Department of Orthodontics, SRM Dental College since November 2019. She is actively involved in teaching orthodontics to the undergraduates and the postgraduates. Her clinical research topics include new orthodontic brackets, fixed appliances and TADs. She’s published 4 articles in well renowned indexed journals and has a published patency of her own. Her private practice is currently limited to orthodontics and works as a consultant in various clinics.",institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"323731",title:"Prof.",name:"Deepak M.",middleName:"Macchindra",surname:"Vikhe",slug:"deepak-m.-vikhe",fullName:"Deepak M. Vikhe",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/323731/images/13613_n.jpg",biography:"Dr Deepak M.Vikhe .\n\n\t\n\tDr Deepak M.Vikhe , completed his Masters & PhD in Prosthodontics from Rural Dental College, Loni securing third rank in the Pravara Institute of Medical Sciences Deemed University. He was awarded Dr.G.C.DAS Memorial Award for Research on Implants at 39th IPS conference Dubai (U A E).He has two patents under his name. He has received Dr.Saraswati medal award for best research for implant study in 2017.He has received Fully funded scholarship to Spain ,university of Santiago de Compostela. He has completed fellowship in Implantlogy from Noble Biocare. \nHe has attended various conferences and CDE programmes and has national publications to his credit. His field of interest is in Implant supported prosthesis. Presently he is working as a associate professor in the Dept of Prosthodontics, Rural Dental College, Loni and maintains a successful private practice specialising in Implantology at Rahata.\n\nEmail: drdeepak_mvikhe@yahoo.com..................",institutionString:null,institution:{name:"Pravara Institute of Medical Sciences",country:{name:"India"}}},{id:"204110",title:"Dr.",name:"Ahmed A.",middleName:null,surname:"Madfa",slug:"ahmed-a.-madfa",fullName:"Ahmed A. Madfa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204110/images/system/204110.jpg",biography:"Dr. Madfa is currently Associate Professor of Endodontics at Thamar University and a visiting lecturer at Sana'a University and University of Sciences and Technology. He has more than 6 years of experience in teaching. His research interests include root canal morphology, functionally graded concept, dental biomaterials, epidemiology and dental education, biomimetic restoration, finite element analysis and endodontic regeneration. Dr. Madfa has numerous international publications, full articles, two patents, a book and a book chapter. Furthermore, he won 14 international scientific awards. Furthermore, he is involved in many academic activities ranging from editorial board member, reviewer for many international journals and postgraduate students' supervisor. Besides, I deliver many courses and training workshops at various scientific events. Dr. Madfa also regularly attends international conferences and holds administrative positions (Deputy Dean of the Faculty for Students’ & Academic Affairs and Deputy Head of Research Unit).",institutionString:"Thamar University",institution:null},{id:"210472",title:"Dr.",name:"Nermin",middleName:"Mohammed Ahmed",surname:"Yussif",slug:"nermin-yussif",fullName:"Nermin Yussif",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210472/images/system/210472.jpg",biography:"Dr. Nermin Mohammed Ahmed Yussif is working at the Faculty of dentistry, University for October university for modern sciences and arts (MSA). Her areas of expertise include: periodontology, dental laserology, oral implantology, periodontal plastic surgeries, oral mesotherapy, nutrition, dental pharmacology. She is an editor and reviewer in numerous international journals.",institutionString:"MSA University",institution:null},{id:"204606",title:"Dr.",name:"Serdar",middleName:null,surname:"Gözler",slug:"serdar-gozler",fullName:"Serdar Gözler",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204606/images/system/204606.jpeg",biography:"Dr. Serdar Gözler has completed his undergraduate studies at the Marmara University Faculty of Dentistry in 1978, followed by an assistantship in the Prosthesis Department of Dicle University Faculty of Dentistry. Starting his PhD work on non-resilient overdentures with Assoc. Prof. Hüsnü Yavuzyılmaz, he continued his studies with Prof. Dr. Gürbüz Öztürk of Istanbul University Faculty of Dentistry Department of Prosthodontics, this time on Gnatology. He attended training programs on occlusion, neurology, neurophysiology, EMG, radiology and biostatistics. In 1982, he presented his PhD thesis \\Gerber and Lauritzen Occlusion Analysis Techniques: Diagnosis Values,\\ at Istanbul University School of Dentistry, Department of Prosthodontics. As he was also working with Prof. Senih Çalıkkocaoğlu on The Physiology of Chewing at the same time, Gözler has written a chapter in Çalıkkocaoğlu\\'s book \\Complete Prostheses\\ entitled \\The Place of Neuromuscular Mechanism in Prosthetic Dentistry.\\ The book was published five times since by the Istanbul University Publications. Having presented in various conferences about occlusion analysis until 1998, Dr. Gözler has also decided to use the T-Scan II occlusion analysis method. Having been personally trained by Dr. Robert Kerstein on this method, Dr. Gözler has been lecturing on the T-Scan Occlusion Analysis Method in conferences both in Turkey and abroad. Dr. Gözler has various articles and presentations on Digital Occlusion Analysis methods. He is now Head of the TMD Clinic at Prosthodontic Department of Faculty of Dentistry , Istanbul Aydın University , Turkey.",institutionString:"Istanbul Aydin University",institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"240870",title:"Ph.D.",name:"Alaa Eddin Omar",middleName:null,surname:"Al Ostwani",slug:"alaa-eddin-omar-al-ostwani",fullName:"Alaa Eddin Omar Al Ostwani",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/240870/images/system/240870.jpeg",biography:"Dr. Al Ostwani Alaa Eddin Omar received his Master in dentistry from Damascus University in 2010, and his Ph.D. in Pediatric Dentistry from Damascus University in 2014. Dr. Al Ostwani is an assistant professor and faculty member at IUST University since 2014. \nDuring his academic experience, he has received several awards including the scientific research award from the Union of Arab Universities, the Syrian gold medal and the international gold medal for invention and creativity. Dr. Al Ostwani is a Member of the International Association of Dental Traumatology and the Syrian Society for Research and Preventive Dentistry since 2017. He is also a Member of the Reviewer Board of International Journal of Dental Medicine (IJDM), and the Indian Journal of Conservative and Endodontics since 2016.",institutionString:"International University for Science and Technology.",institution:{name:"Islamic University of Science and Technology",country:{name:"India"}}},{id:"42847",title:"Dr.",name:"Belma",middleName:null,surname:"Işik Aslan",slug:"belma-isik-aslan",fullName:"Belma Işik Aslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/42847/images/system/42847.jpg",biography:"Dr. Belma IşIk Aslan was born in 1976 in Ankara-TURKEY. After graduating from TED Ankara College in 1994, she attended to Gazi University, Faculty of Dentistry in Ankara. She completed her PhD in orthodontic education at Gazi University between 1999-2005. Dr. Işık Aslan stayed at the Providence Hospital Craniofacial Institude and Reconstructive Surgery in Michigan, USA for three months as an observer. She worked as a specialist doctor at Gazi University, Dentistry Faculty, Department of Orthodontics between 2005-2014. She was appointed as associate professor in January, 2014 and as professor in 2021. Dr. Işık Aslan still works as an instructor at the same faculty. She has published a total of 35 articles, 10 book chapters, 39 conference proceedings both internationally and nationally. Also she was the academic editor of the international book 'Current Advances in Orthodontics'. She is a member of the Turkish Orthodontic Society and Turkish Cleft Lip and Palate Society. She is married and has 2 children. Her knowledge of English is at an advanced level.",institutionString:"Gazi University Dentistry Faculty Department of Orthodontics",institution:null},{id:"178412",title:"Associate Prof.",name:"Guhan",middleName:null,surname:"Dergin",slug:"guhan-dergin",fullName:"Guhan Dergin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178412/images/6954_n.jpg",biography:"Assoc. Prof. Dr. Gühan Dergin was born in 1973 in Izmit. He graduated from Marmara University Faculty of Dentistry in 1999. He completed his specialty of OMFS surgery in Marmara University Faculty of Dentistry and obtained his PhD degree in 2006. In 2005, he was invited as a visiting doctor in the Oral and Maxillofacial Surgery Department of the University of North Carolina, USA, where he went on a scholarship. Dr. Dergin still continues his academic career as an associate professor in Marmara University Faculty of Dentistry. He has many articles in international and national scientific journals and chapters in books.",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"178414",title:"Prof.",name:"Yusuf",middleName:null,surname:"Emes",slug:"yusuf-emes",fullName:"Yusuf Emes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178414/images/6953_n.jpg",biography:"Born in Istanbul in 1974, Dr. Emes graduated from Istanbul University Faculty of Dentistry in 1997 and completed his PhD degree in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery in 2005. He has papers published in international and national scientific journals, including research articles on implantology, oroantral fistulas, odontogenic cysts, and temporomandibular disorders. Dr. Emes is currently working as a full-time academic staff in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery.",institutionString:null,institution:{name:"Istanbul University",country:{name:"Turkey"}}},{id:"192229",title:"Ph.D.",name:"Ana Luiza",middleName:null,surname:"De Carvalho Felippini",slug:"ana-luiza-de-carvalho-felippini",fullName:"Ana Luiza De Carvalho Felippini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192229/images/system/192229.jpg",biography:null,institutionString:"University of São Paulo",institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"256851",title:"Prof.",name:"Ayşe",middleName:null,surname:"Gülşen",slug:"ayse-gulsen",fullName:"Ayşe Gülşen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256851/images/9696_n.jpg",biography:"Dr. Ayşe Gülşen graduated in 1990 from Faculty of Dentistry, University of Ankara and did a postgraduate program at University of Gazi. \nShe worked as an observer and research assistant in Craniofacial Surgery Departments in New York, Providence Hospital in Michigan and Chang Gung Memorial Hospital in Taiwan. \nShe works as Craniofacial Orthodontist in Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, University of Gazi, Ankara Turkey since 2004.",institutionString:"Univeristy of Gazi",institution:null},{id:"255366",title:"Prof.",name:"Tosun",middleName:null,surname:"Tosun",slug:"tosun-tosun",fullName:"Tosun Tosun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255366/images/7347_n.jpg",biography:"Graduated at the Faculty of Dentistry, University of Istanbul, Turkey in 1989;\nVisitor Assistant at the University of Padua, Italy and Branemark Osseointegration Center of Treviso, Italy between 1993-94;\nPhD thesis on oral implantology in University of Istanbul and was awarded the academic title “Dr.med.dent.”, 1997;\nHe was awarded the academic title “Doç.Dr.” (Associated Professor) in 2003;\nProficiency in Botulinum Toxin Applications, Reading-UK in 2009;\nMastership, RWTH Certificate in Laser Therapy in Dentistry, AALZ-Aachen University, Germany 2009-11;\nMaster of Science (MSc) in Laser Dentistry, University of Genoa, Italy 2013-14.\n\nDr.Tosun worked as Research Assistant in the Department of Oral Implantology, Faculty of Dentistry, University of Istanbul between 1990-2002. \nHe worked part-time as Consultant surgeon in Harvard Medical International Hospitals and John Hopkins Medicine, Istanbul between years 2007-09.\u2028He was contract Professor in the Department of Surgical and Diagnostic Sciences (DI.S.C.), Medical School, University of Genova, Italy between years 2011-16. \nSince 2015 he is visiting Professor at Medical School, University of Plovdiv, Bulgaria. \nCurrently he is Associated Prof.Dr. at the Dental School, Oral Surgery Dept., Istanbul Aydin University and since 2003 he works in his own private clinic in Istanbul, Turkey.\u2028\nDr.Tosun is reviewer in journal ‘Laser in Medical Sciences’, reviewer in journal ‘Folia Medica\\', a Fellow of the International Team for Implantology, Clinical Lecturer of DGZI German Association of Oral Implantology, Expert Lecturer of Laser&Health Academy, Country Representative of World Federation for Laser Dentistry, member of European Federation of Periodontology, member of Academy of Laser Dentistry. Dr.Tosun presents papers in international and national congresses and has scientific publications in international and national journals. He speaks english, spanish, italian and french.",institutionString:null,institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",biography:"Zühre Akarslan was born in 1977 in Cyprus. She graduated from Gazi University Faculty of Dentistry, Ankara, Turkey in 2000. \r\nLater she received her Ph.D. degree from the Oral Diagnosis and Radiology Department; which was recently renamed as Oral and Dentomaxillofacial Radiology, from the same university. \r\nShe is working as a full-time Associate Professor and is a lecturer and an academic researcher. \r\nHer expertise areas are dental caries, cancer, dental fear and anxiety, gag reflex in dentistry, oral medicine, and dentomaxillofacial radiology.",institutionString:"Gazi University",institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"256417",title:"Associate Prof.",name:"Sanaz",middleName:null,surname:"Sadry",slug:"sanaz-sadry",fullName:"Sanaz Sadry",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256417/images/8106_n.jpg",biography:null,institutionString:null,institution:null},{id:"272237",title:"Dr.",name:"Pinar",middleName:"Kiymet",surname:"Karataban",slug:"pinar-karataban",fullName:"Pinar Karataban",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272237/images/8911_n.png",biography:"Assist.Prof.Dr.Pınar Kıymet Karataban, DDS PhD \n\nDr.Pınar Kıymet Karataban was born in Istanbul in 1975. After her graduation from Marmara University Faculty of Dentistry in 1998 she started her PhD in Paediatric Dentistry focused on children with special needs; mainly children with Cerebral Palsy. She finished her pHD thesis entitled \\'Investigation of occlusion via cast analysis and evaluation of dental caries prevalance, periodontal status and muscle dysfunctions in children with cerebral palsy” in 2008. She got her Assist. Proffessor degree in Istanbul Aydın University Paediatric Dentistry Department in 2015-2018. ın 2019 she started her new career in Bahcesehir University, Istanbul as Head of Department of Pediatric Dentistry. In 2020 she was accepted to BAU International University, Batumi as Professor of Pediatric Dentistry. She’s a lecturer in the same university meanwhile working part-time in private practice in Ege Dental Studio (https://www.egedisklinigi.com/) a multidisciplinary dental clinic in Istanbul. Her main interests are paleodontology, ancient and contemporary dentistry, oral microbiology, cerebral palsy and special care dentistry. She has national and international publications, scientific reports and is a member of IAPO (International Association for Paleodontology), IADH (International Association of Disability and Oral Health) and EAPD (European Association of Pediatric Dentistry).",institutionString:null,institution:null},{id:"202198",title:"Dr.",name:"Buket",middleName:null,surname:"Aybar",slug:"buket-aybar",fullName:"Buket Aybar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202198/images/6955_n.jpg",biography:"Buket Aybar, DDS, PhD, was born in 1971. She graduated from Istanbul University, Faculty of Dentistry, in 1992 and completed her PhD degree on Oral and Maxillofacial Surgery in Istanbul University in 1997.\nDr. Aybar is currently a full-time professor in Istanbul University, Faculty of Dentistry Department of Oral and Maxillofacial Surgery. She has teaching responsibilities in graduate and postgraduate programs. Her clinical practice includes mainly dentoalveolar surgery.\nHer topics of interest are biomaterials science and cell culture studies. She has many articles in international and national scientific journals and chapters in books; she also has participated in several scientific projects supported by Istanbul University Research fund.",institutionString:null,institution:null},{id:"260116",title:"Dr.",name:"Mehmet",middleName:null,surname:"Yaltirik",slug:"mehmet-yaltirik",fullName:"Mehmet Yaltirik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/260116/images/7413_n.jpg",biography:"Birth Date 25.09.1965\r\nBirth Place Adana- Turkey\r\nSex Male\r\nMarrial Status Bachelor\r\nDriving License Acquired\r\nMother Tongue Turkish\r\n\r\nAddress:\r\nWork:University of Istanbul,Faculty of Dentistry, Department of Oral Surgery and Oral Medicine 34093 Capa,Istanbul- TURKIYE",institutionString:null,institution:null},{id:"172009",title:"Dr.",name:"Fatma Deniz",middleName:null,surname:"Uzuner",slug:"fatma-deniz-uzuner",fullName:"Fatma Deniz Uzuner",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/172009/images/7122_n.jpg",biography:"Dr. Deniz Uzuner was born in 1969 in Kocaeli-TURKEY. After graduating from TED Ankara College in 1986, she attended the Hacettepe University, Faculty of Dentistry in Ankara. \nIn 1993 she attended the Gazi University, Faculty of Dentistry, Department of Orthodontics for her PhD education. After finishing the PhD education, she worked as orthodontist in Ankara Dental Hospital under the Turkish Government, Ministry of Health and in a special Orthodontic Clinic till 2011. Between 2011 and 2016, Dr. Deniz Uzuner worked as a specialist in the Department of Orthodontics, Faculty of Dentistry, Gazi University in Ankara/Turkey. In 2016, she was appointed associate professor. Dr. Deniz Uzuner has authored 23 Journal Papers, 3 Book Chapters and has had 39 oral/poster presentations. She is a member of the Turkish Orthodontic Society. Her knowledge of English is at an advanced level.",institutionString:null,institution:null},{id:"332914",title:"Dr.",name:"Muhammad Saad",middleName:null,surname:"Shaikh",slug:"muhammad-saad-shaikh",fullName:"Muhammad Saad Shaikh",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Jinnah Sindh Medical University",country:{name:"Pakistan"}}},{id:"315775",title:"Dr.",name:"Feng",middleName:null,surname:"Luo",slug:"feng-luo",fullName:"Feng Luo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Sichuan University",country:{name:"China"}}},{id:"423519",title:"Dr.",name:"Sizakele",middleName:null,surname:"Ngwenya",slug:"sizakele-ngwenya",fullName:"Sizakele Ngwenya",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"419270",title:"Dr.",name:"Ann",middleName:null,surname:"Chianchitlert",slug:"ann-chianchitlert",fullName:"Ann Chianchitlert",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"419271",title:"Dr.",name:"Diane",middleName:null,surname:"Selvido",slug:"diane-selvido",fullName:"Diane Selvido",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"419272",title:"Dr.",name:"Irin",middleName:null,surname:"Sirisoontorn",slug:"irin-sirisoontorn",fullName:"Irin Sirisoontorn",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"355660",title:"Dr.",name:"Anitha",middleName:null,surname:"Mani",slug:"anitha-mani",fullName:"Anitha Mani",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"355612",title:"Dr.",name:"Janani",middleName:null,surname:"Karthikeyan",slug:"janani-karthikeyan",fullName:"Janani Karthikeyan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"334400",title:"Dr.",name:"Suvetha",middleName:null,surname:"Siva",slug:"suvetha-siva",fullName:"Suvetha Siva",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}}]}},subseries:{item:{id:"20",type:"subseries",title:"Animal Nutrition",keywords:"Sustainable Animal Diets, Carbon Footprint, Meta Analyses",scope:"An essential part of animal production is nutrition. 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