Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\n
This achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\n
We are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\n
Thank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
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\r\n\tGlobally, dietary interventions with special reference to polyphenols have emerged as the preferred choice for scientists to curtail different life-threatening ailments. In this milieu, Resveratrol has gained immense fame owing to its strong antioxidant potential and therapeutic capacity. Structurally, it is a trans-stilbene-based polyphenol present in more than 70 plants. However, grapes and wine are considered their rich source. Numerous previous scientific studies delineated its strong antioxidant and pharmacological potential. Resveratrol exhibited strong therapeutic application against cancer, obesity, CVD, and diabetes. Moreover, it protects the body against oxidative stress-related damage. The therapeutic worth is attributed due to its ability to modulate various biomarkers involved in the parthenogenesis of these maladies. However, its utilization in the pharmaceutical industry required intensive research regarding its solubility, bio-availability, and adverse effects. This current book will encompass all the topics on resveratrol, chemistry, bio-availability, application, and therapeutic perspective with the intent to disclose the mechanistic route associated with its therapeutic potential.
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1. Introduction
The building sector in Europe is responsible for 40% of energy consumption and 36% of CO2 emissions. Due to the high estimated energy saving potential of the building sector, the European Union (EU) set up a policy framework focused on reducing the energy of buildings which consists of policy actions, i.e., Energy Performance of Buildings Directive (EPBD) [1], Energy Efficiency Directive (EED) [2], EcoDesign Directive [3], Energy Labelling Regulation [4], and the Renewable Energy Directive (RED) [5]. The EED was prepared with the goal to achieve a 20% energy consumption reduction target across the EU. It establishes a number of important provisions to be implemented by the EU Member States, including the requirement to establish obligatory national energy efficiency targets, national building energy efficiency strategies, a requirement to renovate 3% of public sector buildings annually, the need to establish energy efficiency obligation schemes, and provisions for auditing and metering.
The evaluation of energy consumption, reduction, or efficiency on the building level is somehow problematic since different technical systems use various forms of energy to operate. Therefore, energy consumption and efficiency should be evaluated on a common basis. A single metric for combining different sources or types of energy is primary energy (PE). As the name indicates, PE evaluates different forms of energy based on the conversion of primary energy to useful energy. However, the concept does not differentiate between different energy forms. Therefore, exergy could be incorporated into the concept as it reflects the energy “quality” in terms of its capacity to do work. Although there are currently no requests, for such an approach, from energy practitioners, exergy analysis could gain significantly on importance in light of future resource scarcity to, for example, penalize the use of exergy-rich energy vectors for low-temperature applications.
The task of measuring energy efficiency may seem straightforward, contingent only on the choice of indicators for the input and output. In reality, however, both can be measured in numerous ways, and choosing one approach over another always leads to trade-offs [6, 7, 8, 9, 10, 11]. Based on the input and output characteristics, three main indicator groups can be distinguished:
Thermodynamic indicators—inputs and outputs represented in terms of thermodynamic quantities (e.g., the thermal efficiency of a heating system)
Physical-thermodynamic indicators—energy inputs represented by thermodynamic quantities, outputs represented with physical units (e.g., building energy use intensity)
Economic-thermodynamic indicators—products or services represented by market prices, energy represented by means of thermodynamic quantities (e.g., GDP energy intensity)
Each of these approaches has its advantages and disadvantages and should, thus, be defined with regard to the area of application, while considering environmental, social, economic, or other aspects of energy efficiency.
PE has become an important policy metric in the EU. Namely, the EPBD prescribes that the energy performance of a building shall also include a numeric indicator of PE, based on primary energy factors (PEF) per energy carrier, which may be based on national or regional annual weighted averages or a specific value for onsite production. A PEF connects primary and final energy. It indicates how much primary energy is used to generate a unit of electricity or a unit of useable thermal energy. The PEF describes the efficiency of converting energy from primary sources (e.g., coal, crude oil) to a secondary energy carrier (e.g., electricity, natural gas) that provides energy services delivered to end users. In the EU, the Member States can freely define its value. Consequently, this has become a political decision, with a direct impact on the actual energy consumption of a building.
Similar concept of analysis of the impact of building and appliance energy consumption is used in the USA. Compared to the more legislative-constrained EU approach the US approach is more market oriented. Full-fuel-cycle (FFC) metrics are used in building codes and appliance standards to evaluate the energy and environmental impact of consumer fuels and appliances [12].
To translate PE into final energy use, the PEF is applied in several EU legislative documents. In the EED and EPBD, the PEF is used to convert final energy consumption into PE consumption to monitor progress against targets. The EPB Directive aims at reducing the PE demand for buildings. Since technologies applied in the building and improvements in the building envelope lead to savings in final energy, the PEF is applied to convert these savings into primary energy.
The latest version of the EPB Directive [13] claims that “the energy performance of a building shall be expressed by a numeric indicator of PE use for the purpose of both energy performance certification and compliance with minimum energy performance requirements.” In addition, Member States may define additional numeric indicators of total nonrenewable and renewable primary energy use and of greenhouse gas emission. Member States have some flexibility in defining these metrics.
EED requires energy targets expressed in both primary and final energy form. PEFs are applied for conversion of final energy savings into primary energy savings. EPBD and EED both allow the Member States the option of choosing their own PEF values. Within the EcoDesign Directive and Energy Labelling Directive, the PEF value of 2.5 for electricity is prescribed to allow a comparison.
From the foregoing, it is evident that the PEF is defined on two different boundary conditions within the EU legislation. For instance, the boundary condition for energy-consuming appliances is defined at the appliance level. The next level of boundary is the building (or part of it), defined as a sum of all energy used by different appliances considering different energy sources. This boundary condition is important when on-site-produced renewable energy is used by building appliances.
The method for calculating the PE for fossil fuels is quite straightforward and consistent, while the calculation of PEFs for electricity or heat generated from renewable energies or grid-supplied electricity is more complex. First of all, the PEF for fossil fuels (also for combustible renewable fuels) does not change significantly over time. For electricity, especially grid supplied, the calculation of PEF involves different energy sources as well as different electricity generation technologies. The combination of various PE sources forms a so-called power generation mix, which is the share of different energy sources used to generate electricity. The share of energy sources changes over time depending on the availability of energy sources and the level of demand. However, evaluating this is a challenge especially in renewable energy sources and nuclear energy.
2. Methodology
PE sources are usually defined as inputs into energy systems (or conversion processes) which convert them into secondary energy carriers such as electricity, oil products, heat, or mechanical work. The EPBD [13] defines primary energy as the energy that has not been subjected to any (human induced) conversion or transformation process.
As mentioned before, PEF connects primary and final energy. It indicates how much primary energy is used to generate a unit of electricity or a unit of useable thermal energy, according to Eq. (1):
PEF=primaryenergyfinalenergyE1
PE is divided into renewable and nonrenewable energy [14]. The sum of renewable and nonrenewable energy is total energy. Energy extracted from sources that are naturally replenished on a human timescale is called renewable energy. The definition of renewable energy also includes some forms of energy carrier such as biomass and energy recovered from waste. For nonrenewable energy sources, the extraction rate is higher than refill rate. Energy obtained from nonrenewable energy sources is called nonrenewable energy. This approach enables the determination of three primary energy factors for each energy carrier [14, 15]:
Energy sources can be further divided into combustible and noncombustible. Where primary energy is used to characterize fossil fuels, the embodied energy of the fuel is available as thermal energy, and typically around 70% is lost in conversion to electrical or mechanical energy.
In accordance with the laws of thermodynamics, the renewable PEF can be derived from the relevant energy conversion efficiency. For example, the electricity from a PV system with an overall efficiency of 20% can be considered to have a renewable PEF of 5. There is a similar 60–80% conversion loss when wind energy is converted to electricity. This also applies to nuclear energy, where only around 10% of the fuel’s energy content is converted to electricity.
Although primary energy factors are thermodynamically universal, many different calculation methods exist. Moreover, there are also national variations. In order to calculate the PEFs, two approaches are mainly used, namely the partial substitution method and the physical energy method. They differ in the way how to calculate the PEFs from nuclear power plants and renewable energy sources such as hydroelectric power plants, solar energy, geothermal energy, etc.
The partial substitution method solves the aforementioned problem by concentrating on the theoretical energy content in traditional fossil fuels (coal, oil, and gas). The PEF for a mixture of electricity is calculated from these sources by dividing the energy content of the fuel as the input energy with the generated electricity. In the case of renewable energy and nuclear energy, this means calculating how much primary energy would be needed for such an amount of electricity if it were produced from fossil fuels.
The physical energy method differs from the partial substitution method in that it uses a different approach for the evaluation of primary energy in the production of electricity from hydro, wind, and nuclear power plants. The calculation of the PEF for the production of electricity from nuclear and geothermal energy is based on the thermal energy of the steam boiler that drives the turbine of the power plant. The efficiency of nuclear power plants is estimated at 33 and 10% for geothermal. For other renewable energy sources, such as hydro, wind, and solar energy, this is equal to gross electricity production.
The calculation of the PEF can also be made using the method described in the standard SIST EN 15603:2008 [15]. The standard describes two alternative approaches for calculating the factor, namely, the total and nonrenewable PEF. The difference between these factors is that the latter does not include the use of renewable energy. In addition, the national PEF for the electricity mix is based either on the average electricity mix or on the marginal electricity production. The standard defines the default PEFs for different energy sources, including electricity. The values of the factors are given in Table 1.
We made a calculation of the PEF for the electricity mix in Slovenia, based on the three previously described methods, and conducted a temporal comparison. Statistical data on the generation of electricity from individual sources were obtained from the Statistical Office of Slovenia [16]. Table 2 shows the produced electricity by years from various sources of energy.
The electricity mix in Slovenia is mainly composed of five sources of primary energy, namely nuclear, fossil, hydro, wind, and solar energy. Since Slovenia is a member of the EU, the directives stipulate that, by 2020, as much as 20% of the energy used is to be recovered from renewable energy sources as far as electricity is concerned. Therefore, in addition to calculating the factor for previous years, we have also tried to predict the generation of energy from individual sources, using linear regression, and then determine the resulting PEF for the electricity mix and the share of renewable sources. Figure 1 presents the sources of energy, the share of energy sources in the production of electricity, and the share of energy from renewable sources.
Figure 1.
Electricity mix in Slovenia.
Figure 1 shows that electricity generation from fossil fuels is somewhat lower, while production from solar energy and hydro resources is increasing. Generally speaking, the share of renewable resources is increasing. Wind energy represents a very small share; therefore, increasing the share is not noticeable from the figure, but if we look at Table 1, we see that production is slowly increasing from 2013 onward.
2.1 Calculation of primary energy factor by partial substitution method
In this method, the PE equivalent of the sources of electricity generation represents the amount of energy that would be necessary to generate an identical amount of electricity with conventional thermal power plants [17]. The PE equivalent is calculated using an average generating efficiency of these plants. This method has several shortcomings including the difficulty of choosing an appropriate energy conversion efficiency to determine the energy value of renewable energy and nuclear energy. For example, it may not be possible to quantify the energy content in the wind or the sun that serves as a fuel for wind and solar power plants. In conventional nuclear power plants, only 10% of the theoretical energy content in the fuel is converted to electricity. The partial substitution solves this challenge by focusing on the theoretical energy content of traditional fossil fuels (coal, gas, and oil). PEF for electricity produced from these sources is calculated by dividing the energy content of the fuel with the electricity production. For renewable and nuclear power, the partial substitution method calculates how much PE would be required if the electricity was generated from fossil fuels. Therefore, a conversion efficiency of 40% is assumed for these types of energy [18]. Also the efficiency of fossil fuel production is 40%. By means of these set values, we obtained for 2017 the results shown in Table 3.
PEF
Nonrenewable
Total
Fuel oil
1.35
1.35
Gas
1.36
1.36
Biomass
0.07
1.07
Hydro power plant (electricity)
0.5
1.5
Nuclear power plant (electricity)
2.8
2.8
Coal power plant (electricity)
4.05
4.05
Table 1.
Primary energy factors according to the Standard EN 15603:2008.
Year
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Nuclear
5528
5207
5459
5884
5548
5695
6273
5739
5657
6215
5528
5300
6370
5648
5715
6285
Fossil
5759
5657
5718
5772
5975
6082
6107
5945
6067
6073
5958
5661
4440
5081
5718
5610
Hydro
3313
2957
4095
3461
3591
3266
4018
4715
4703
3706
4087
4923
6366
4091
4782
4141
Wind
0
0
0
0
0
0
0
0
0
0
0
4
4
6
6
6
Solar
0
0
0
0
0
0
1
4
13
66
163
215
257
274
267
283
Table 2.
Yearly historical data on the electricity production in Slovenia (values in GWh) [16].
Production [GWh]
Efficiency
Primary energy [GWh]
Nuclear
6285
40%
14,288
Fossil
5610
40%
14,295
Hydro
4141
40%
11,955
Wind
6
40%
15
Solar
283
40%
668
Total
16,325
40,813
Table 3.
Calculation of PE by partial substitution method for the production of electricity in Slovenia in 2017.
As mentioned above, PE was obtained by dividing the energy produced by the production efficiency. This gave us the amount of PE needed to produce a certain amount of electricity. PE does not take into account the network losses; therefore, we calculated how much the losses are and what is our consumption. From this data we could then directly calculate the PEF for the electricity mix. We assumed that the amount of losses was 10% of the energy produced [18]. If by this method the factors are calculated for all the years, we can see that the factors do not change, which is because we have assumed that the efficiency is always the same, so the ratio between the energy used and the electricity produced is constant.
2.2 Calculation of primary energy factor by physical energy content method
The energy content method distinguishes itself in the approach for evaluating renewable sources and nuclear power plants production [19, 20]. PE in this method is considered as the first practically utilizable energy flow. In the case of directly combustible energy carriers (e.g., coal, natural gas, oil, biogas, bio liquids, solid biomass, combustible municipal/industrial waste), PE is defined as the heat generated in the combustion process. For non-directly combustible energy sources, PE can be expressed with the produced heat (e.g., nuclear, geothermal and solar thermal) or produced electricity (e.g., solar photovoltaic, wind, hydro, tide, wave, and ocean).
A PEF value of 1 is assumed for fuels. For noncombustible renewables a conversion efficiency of 100% is assumed. In contrast, a conversion efficiency of 33% is assumed for nuclear power stations. For combustible renewables such as biomass, the conversion efficiency is calculated from [15]. The resulting PEF for electricity from the various sources are 1 for hydro, wind, and solar PV; 3–4 for biomass; and 3 for solar thermal and nuclear. The results for 2017 are shown in Table 4.
Production [GWh]
Efficiency
Primary energy [GWh]
Nuclear
6285
33%
19,045
Fossil
5610
40%
14,025
Hydro
4141
100%
4141
Wind
6
100%
6
Solar (PV)
283
100%
283
Total
16,325
37,500
Table 4.
Calculation of PE by physical energy content method for the electricity production in Slovenia in 2017.
Just like at the partial substitution method, we took into account 10% losses in the network to obtain the PE shown in Table 5.
Production [GWh]
Network loss [GWh]
Useful energy [GWh]
Primary energy [GWh]
PEF
Total
16,325
1632.5
14,692
37,500
2.55
Table 5.
Calculation of PEF by physical energy content method for the electricity production in Slovenia in 2017.
The calculated PEF for the electricity mix using the physical energy method for 2017 is 2.55. For this year, this value is similar to the value assumed for Slovenia, i.e., 2.5. In order to observe the temporal variation of PEF, the same calculations were also carried out for previous years, based on statistical data for Slovenia. The results are illustrated in Figure 2.
Figure 2.
PEFs for the electricity mix in Slovenia using the physical energy method for the years 2000–2018.
Figure 2 shows that the factor is constantly changing, but we can notice that from 2011 onward the factor has fallen slightly. The likely reason for this is that the share of renewable resources began to increase markedly in the meantime. Since this method assumes 100% conversion efficiency for electricity produced from renewable sources, the primary energy for production is the same as production itself.
2.3 Calculation of the primary energy factor according to the Standard EN 15603:2008
The last calculation was carried out by using the default PEFs prescribed by the standard SIST EN 15603 [15]. This methodology evaluates separately the nonrenewable part and the total part of PE. Solar energy (PV) was evaluated in the same way as water and wind energy. Therefore, the default factors are the same in this case. In this method, we used the fractions of individual energies which comprise the mixture of electricity from Table 1. The full calculation for 2017 is shown in Table 6.
2017
PEF [/]
Nonrenewable
Total
Slovenia (average)
Energy share [%]
Nonrenewable
Total
Nuclear
2.8
2.8
38.5
1.05
1.08
Fossil
4.05
4.05
34.36
1.39
1.39
Hydro
0.5
1.5
25.37
0.13
0.38
Wind
0.5
1.5
0.04
0.00
0.00
Solar
0.5
1.5
1.73
0.01
0.03
Sum
2.61
2.88
Table 6.
Calculation of the PEF of electricity mix for Slovenia for 2017, using the reference values from the standard SIST EN 15603.
In Table 6, two PEFs for the electric mixture are calculated through the fractions of individual energies composing the electricity mix in Slovenia for 2017. We can see that the average PEF for nonrenewable is less than the total factor. The reason for this is that the default primary factors that take into account only the nonrenewable part of primary energy are lower than the total or total factor. The difference between the two average factors is almost 0.3, which is not negligible. As with previous methods, here again, the calculation was also performed for previous years, with the same default factors. The results are shown in Figure 3.
Figure 3.
Average PEFs for nonrenewable and total PE calculated in accordance with SIST EN 15603.
3. Results and discussion
By comparing the methods, we can find that the calculation after partial substitution yields the same results for each year. This is due to the default efficiency, which is based on certain default values. Since we get the same PEF for the electricity mixture in all years, we cannot see changes in individual years. It is also impossible to predict what will happen to the factor in the coming years. We can see that the factor is 2.78, which represents a higher value than the predicted factor for Slovenia, which is 2.5 [21].
In the case of the physical energy method, we can better categorize individual years, and from the calculations, we see the PEF fluctuation. Physical energy method assumes energy conversion efficiency of 100% for renewable sources (produced electricity equals primary energy). The highest value of the factor occurred in 2003, while the lowest value amounted to 2.23 in 2016. The reason for such a change in the last year is in the increased production of electricity from renewable sources.
In the last method proposed by the standard SIST EN 15603, which computes two factors, we can see that in the case of the total factor, the value is higher than the average PEF, which takes into account only the nonrenewable part of energy. This is the case for renewable energy sources where PEF values are lower by threefold in comparison to nonrenewable energy sources. What is logical is that we do not consume any energy for the generation of hydro, wind, and solar energy. Likewise, we can also notice here that both factors are the highest in 2003, while they are the lowest in 2014. The reason for this is that the share of produced electricity from fossil fuels is the lowest, and the share of water energy is the highest, which means that due to the low share of energy from fossil fuels and high energy from renewable energy, the factor of PE has decreased.
3.1 Forecast of electricity generation and impact on PEF
By analyzing statistical data and calculating the PEF, we can predict the change of PEF for the electricity mix of Slovenia. The total production of electricity for the coming years and the annual growth of production were calculated by adding the individual quantities of electricity that were calculated by linear regression for each source separately. This means that we added the predicted production of electricity from nuclear power, fossil fuels, hydroelectric power, wind energy, and solar energy. With this simple linear regression, we predicted the amount of energy produced from different sources and how it affects the PEF. The predictions were made for 2020, 2030, and 2040 (Table 7). The share of individual sources and the total share of renewables are shown in Table 8.
Year
2017
2020
2030
2040
Nuclear
6285
6147
6574
7001
Fossil
5610
5592
5524
5455
Hydro
4141
5350
6384
7418
Wind
6
9
14
25
Solar
283
475
894
1312
Total
16,325
17,574
19,392
21,211
Table 7.
Forecast of total electricity production [GWh].
Year
2017
2020
2030
2040
Nuclear
38.5
35.0
33.9
33.0
Fossil
34.36
31.8
28.5
25.7
Hydro
25.37
30.4
32.9
35.0
Wind
0.04
0.1
0.1
0.1
Solar
1.73
2.7
4.6
6.2
Total share of renewables
27.1
33.2
37.6
41.3
Table 8.
Prediction of energy shares in the production of electricity.
In Table 8, we see that the nuclear energy share will decrease over time as well as for fossil fuels, whose share will decrease by more than 5% by 2040. In the case of hydro energy, the share will increase by just over 7%. Wind energy already represents a very small share in electricity, so in the future it is not expected to grow significantly. The share of solar energy will also increase; by 2040, we can expect an almost 5% increase. As we can see, Slovenia already generates a large share of electricity from renewable sources; by 2040, we can expect that this share will grow by almost 15%.
3.2 Forecast of the primary energy factor for Slovenia
For the partial substitution method, we used the same production efficiency as given in Table 3. The only difference is that in this case we carry out the calculation for 2020, 2030, and 2040. In Table 9 we see an example of the calculation for 2020, where we used the previously predicted quantity of produced electricity.
Production [GWh]
Network loss [GWh]
Useful energy [GWh]
Primary energy [GWh]
PEF
Total
17,574
1757.4
15,816
43,934
2.78
Table 9.
Calculation of predicted PEF by partial substitution method for the production of electricity in Slovenia in 2020.
The PEF calculated according to the method of partial substitution method does not change over the years. The reason why the factor remains the same is that the method assumes the same production efficiency for all energy sources.
For the physical energy method, we used the same production efficiency as in Chapter 2.2. The predictions for 2020, 2030, and 2040 have been recalculated, taking into account the energy production predicted by linear regression. In this method we also considered 10% network losses in the network. The forecasts of the PEF are listed in Table 10.
Year
Production [GWh]
Primary energy [GWh]
PEF
2020
17,574
38,442
2.43
2030
19,392
41,024
2.35
2040
21,211
43,607
2.23
Table 10.
Forecast of the PEF for the electricity mix in Slovenia using the physical energy method.
We can see that the PEF will decrease over time. This result is logical, since the share of renewable energy sources will increase substantially over time. Hence, the PEF is expected to decrease. For better transparency, the PEF calculated by the physical energy method is depicted along its forecast in Figure 4.
Figure 4.
PEF of electricity calculated according to the physical energy method.
Calculation of PEF according to the standard SIST EN 15603 was carried out as described in Chapter 2.3. In this method we use the proportions of individual sources determined by linear regression. Two PEFs are proposed, namely, the average PEF-nonrenewable and average PEF-total. The PEFs for 2020 are given in Table 11. The average PEF for the electricity mix with predicted values is illustrated in Figure 5. It can be noticed that by 2040, the average PEF for nonrenewable energy will decrease to a value of 2.17, while the average PEF-total will be 2.58.
2020
PEF
Nonrenewable
Total
Slovenia (average)
Energy Share [%]
Nonrenewable
Total
Nuclear
2.8
2.8
34.98
0.98
0.98
Fossil
4.05
4.05
31.82
1.29
1.29
Hydro
0.5
1.5
30.45
0.15
0.46
Wind
0.5
1.5
0.05
0.00
0.00
Solar
0.5
1.5
2.70
0.01
0.04
Sum
2.43
2.77
Table 11.
Forecast of the PEF for the electricity mix in Slovenia for 2020, using the reference values from the standard SIST EN 15603.
Figure 5.
Average PEF for electricity mix according to the SIST EN 15603 method with predicted values.
According to the conversion factors of PE, discrepancy between nonrenewable and total PEFs for the electricity mix can be significant. From Figure 6, we can see the annual progress of all the PEFs, calculated with all three evaluated methods, for electricity in Slovenia.
Figure 6.
Comparison of the methods of calculating the PEF for the electricity mix in Slovenia.
With the partial substitution method, we can see that the PEF for electricity does not change over the years, i.e., it remains 2.78. The reason for this lies in the assumption about the efficiency of production from renewable energy sources and nuclear energy, where 40% efficiency is taken into account. Furthermore, the same efficiency is also used for fossil fuels. Therefore, the efficiency of production from all primary sources is 40%. This is why we get the same PEF for all years. This means that according to this method, we do not get the correct representation of the PEF for the electricity mix, or the assumptions are not applicable for the case of Slovenia. In the event that Slovenia produced part of the electricity from biomass, whose production efficiency is estimated with 30% in this method, the PEF would be more volatile. However, Slovenia does not use biomass for the production of electricity; therefore, this method does not give us the useful values of the factor. We also notice that the factor 2.78 is quite high in terms of other methods.
The other method used to determine the PEF for electricity is the physical energy method. With this method we evaluate the efficiency of production from renewable energy sources as 100%, while the default efficiency of nuclear power generation and fossil fuel is 33 and 40%, respectively. The PEF calculated according to this method is very low, as shown in Figure 4. The reason is in the assumption that the efficiency of production from renewable sources is 100% and Slovenia has a large share of renewable sources in its electricity production, mainly from hydropower sources. In the previous analyses of individual years and forecasts, we also noticed that the share of renewable resources is increasing over time. For this reason, from Figure 4 decreasing trend for the future is clear. This means that a PEF determined by this method will slowly decrease with respect to the increase in renewable energy sources in electricity generation.
With calculation according to the standard SIST EN 15603, we calculated two different primary energy factors: the average PEF for nonrenewables, which takes into account only the nonrenewable part of the energy of individual primary sources, and the PEF, which takes into account the total share of primary energies. We used the default values of the individual factors determined by the method for each primary source separately. We can see that the average PEF for nonrenewable energy is much lower than the total. The reason for this is that the default values of the factors that we use to calculate the nonrenewable and total factor are different. The greatest differences occur in renewable energy sources. This is because renewable energy sources have a very small share of nonrenewable energy. Therefore, the factors for calculating the individual PE sources are low in the case of hydropower, wind, and solar energy. When calculating the total factor, the factor value for these types of energy is 1.5. Moreover, a different calculation approach is used in this method, i.e., the PEF is calculated through the shares of individual energy sources in the total electricity.
4. Conclusions
PEFs are used to describe the conversion efficiency from primary energy sources to secondary energy sources, which are supplied to end consumers. PEFs are, therefore, used for comparing necessary quantities of primary energy to the final energy demands. At EU level as well as national levels, PEFs are used for converting final energy to primary energy consumption, for comparing efficiency of devices with different energy sources as well as to benchmark building energy performance. As it stands, the EU Member States can autonomously determine national PEFs, which in turn can skew the evaluation process of primary energy use in buildings.
We analyzed the three most commonly used methods used to determine the PEF for the electricity mix. We examined what are the assumptions of the individual methods and the individual default values that the method assumes. Then, using these methods, the value of the PEF for electricity in Slovenia was determined. We also recalculated with all the methods how the PEF changed over time at an annual level. All calculations were made using statistical data about produced electricity from various primary energy sources and individual assumptions determined by the methods. In addition, a statistical analysis using linear regression was carried out in order to predict the future PEF values for all three considered methods.
We have found that the methods differ in the evaluation of individual primary sources, which has a significant impact on the PEF value. In addition, we observed that the factor is also changing in terms of the electricity production from different sources, which means that the factor depends on the amount of energy that is produced either from nonrenewable sources of energy or from renewable energy sources. If the annual production of electricity from renewable energy sources is higher, we can expect a lower PEF and vice versa. We also noted that the share of renewable resources increases over time, which is also noticeable in the predicted values of production from renewable energy sources.
We also found that with the partial substitution method, we do not get representative results about the PEF, since it remains constant over the years. This means that this method does not provide a proper representation of the PEFs and, hence, is not applicable for the case in Slovenia. The method of physical energy gives the efficiency of production from renewable energy sources as 100%. Here, too, the question arises as to whether the evaluation is completely correct and if we can truly assume that the use of PE is equal to the actual production of electricity. In the third method, defined in the standard SIST EN 15603, which provides two PEFs, a certain measure of criticality of the assumed factors for the different sources of energy is used.
\n',keywords:"primary energy, primary energy factor, electricity mix, renewable energy sources",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/66151.pdf",chapterXML:"https://mts.intechopen.com/source/xml/66151.xml",downloadPdfUrl:"/chapter/pdf-download/66151",previewPdfUrl:"/chapter/pdf-preview/66151",totalDownloads:849,totalViews:0,totalCrossrefCites:3,totalDimensionsCites:3,totalAltmetricsMentions:1,introChapter:null,impactScore:1,impactScorePercentile:54,impactScoreQuartile:3,hasAltmetrics:1,dateSubmitted:"September 13th 2018",dateReviewed:"January 20th 2019",datePrePublished:"March 14th 2019",datePublished:"July 22nd 2020",dateFinished:"March 14th 2019",readingETA:"0",abstract:"According to the European energy policy, the energy use of technical systems in buildings is given at the level of primary energy. This calculation requires knowledge of the primary energy conversion factors according to their source; however, there is currently no single European-wide recognized method for their determination. The aim of this study is to present and compare three methods for determining primary energy factors, namely the method of partial substitution, the physical energy method, and calculation according to EN 15603 standard. For the case study, the electricity factor for Slovenia was calculated according to the aforementioned methods. The results of this study showed that the methods differ in the evaluation of individual primary sources, which has a significant impact on the PEF value. We found that with the partial substitution method, we do not get representative results about the PEF. The method of physical energy defines the efficiency of production from renewable energy sources as 100%. The question arises if we can truly assume that the use of PE is equal to the actual production of electricity. In the third method, defined in the EN 15603 standard, which provides two PEFs, a certain measure of criticality of the assumed factors for the different sources of energy is used.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/66151",risUrl:"/chapter/ris/66151",book:{id:"7633",slug:"energy-policy"},signatures:"Matjaž Prek",authors:[{id:"144302",title:"Dr.",name:"Matjaz",middleName:null,surname:"Prek",fullName:"Matjaz Prek",slug:"matjaz-prek",email:"matjaz.prek@fs.uni-lj.si",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"University of Ljubljana",institutionURL:null,country:{name:"Slovenia"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Methodology",level:"1"},{id:"sec_2_2",title:"2.1 Calculation of primary energy factor by partial substitution method",level:"2"},{id:"sec_3_2",title:"2.2 Calculation of primary energy factor by physical energy content method",level:"2"},{id:"sec_4_2",title:"2.3 Calculation of the primary energy factor according to the Standard EN 15603:2008",level:"2"},{id:"sec_6",title:"3. Results and discussion",level:"1"},{id:"sec_6_2",title:"3.1 Forecast of electricity generation and impact on PEF",level:"2"},{id:"sec_7_2",title:"3.2 Forecast of the primary energy factor for Slovenia",level:"2"},{id:"sec_9",title:"4. Conclusions",level:"1"}],chapterReferences:[{id:"B1",body:'Directive 2010/31/EU of European Parliament and of the Council of 19 May 2010 on the Energy Performance of Buildings (Recast). 2010. http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2010:153:0013:0035:en:PDF'},{id:"B2",body:'Directive 2012/27/EU of the European Parliament and of the Council of 25 October 2012 On Energy Efficiency, Amending Directives 2009/125/EC and 2010/30/EU and Repealing Directives 2004/8/EC and 2006/32/EC. 2012. https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2012:315:0001:0056:en:PDF'},{id:"B3",body:'Directive 2009/125/EC of the European Parliament and of the Council of 21 October 2009 Establishing a Framework for the Setting of Eco-Design Requirements for Energy-Related Products. https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2009:285:0010:0035:en:PDF'},{id:"B4",body:'Regulation EU 2017/1369 of the European Parliament and of the Council of 4 July 2017 Setting a Framework for Energy Labelling and Repealing Directive 2010/30/EU. https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32017R1369&rid=7'},{id:"B5",body:'Directive 2009/28/EC of the European Parliament and of the Council of 23 April 2009 on the Promotion of the Use of Energy from Renewable Sources and Amending and Subsequently Repealing Directives 2001/77/EC and 2003/30/EC. https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32009L0028&rid=8'},{id:"B6",body:'Taner T, Sivrioglu M. Data on energy, exergy analysis and optimisation for a sugar factory. Data in Brief. 2015;5:408-410. DOI: 10.1016/j.dib.2015.09.028'},{id:"B7",body:'Taner T, Sivrioglu M. Energy-exergy analysis and optimisation of a model sugar factory in Turkey. Energy. 2015;93:641-654. DOI: 10.1016/j.energy.2015.09.007'},{id:"B8",body:'Taner T. Energy and exergy analyze of PEM fuel cell: A case study of modeling and simulations. Energy. 2018;143:284-294. DOI: 10.1016/j.energy.2017.10.102'},{id:"B9",body:'Taner T. Exergy analysis of a circulating fluidized bed power plant co-firing with olive pits: A case study of power plant in Turkey. Energy. 2017;140:40-46. DOI: 10.1016/j.energy.2017.08.042'},{id:"B10",body:'Taner T. Optimisation processes of energy efficiency for a drying plant: A case of study for Turkey. Applied Thermal Engineering. 2015;80:247-260. DOI: 10.1016/j.applthermaleng.2015.01.076'},{id:"B11",body:'Taner T, Sivrioglu M. A techno-economic & cost analysis of a turbine power plant: A case study for sugar plant. Renewable and Sustainable Energy Reviews. 2017;78:722-730. DOI: 10.1016/j.rser.2017.04.104'},{id:"B12",body:'ANSI/ASHRAE Standard 105-2014. Standard Method of Determining, Expressing and Comparing Building Energy Performance and Greenhouse Gas Emission. Atlanta, USA: ASHRAE; 2014'},{id:"B13",body:'Directive (EU) 2018/844 of the European Parliament and of the Council of 30 May 2018 Amending Directive 2010/31/EU on the Energy Performance of Buildings and Directive 2012/27/EU on Energy Efficiency. https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32018L0844&from=IT'},{id:"B14",body:'ISO 52000-1:2017. Energy performance of buildings—Overarching EPB assessment—Part 1: General framework and procedures. Geneva: International Organization for Standardization; 2017'},{id:"B15",body:'SIST EN 15603:2008. Energy performance of buildings—Overall energy use and definitions of energy ratings. Brussels: European Committee for Standardization; 2008'},{id:"B16",body:'Statistični Urad Republike Slovenije: Električna Energija (GWh). Slovenija. Available from: https://pxweb.stat.si/pxweb/Dialog/varval.asp?ma=1817602S&ti=&path=../Database/Okolje/18_energetika/03_18176_elektricna_energija/&lang=2'},{id:"B17",body:'Segers R. Three options to calculate the percentage renewable energy: An example for a EU policy debate. Energy Policy. 2008;36:3243-3248. DOI: 10.1016/j.enpol.2008.05.014'},{id:"B18",body:'Conversion Factors for Electricity in Energy Policy. A Review of Regulatory Application of Conversion Factors for Electricity and an Assessment of their Impact on EU Energy and Climate Goals. Norway: ADAPT Consulting a.s.; 2013'},{id:"B19",body:'IEA (International Energy Agency). Energy Statistics Manual. France: IED Publications; 2005'},{id:"B20",body:'Eurostat: Definition of the Primary Energy Content of Fuels. Available from: https://ec.europa.eu/eurostat/statistics-explained/index.php/Calculation_methodologies_for_the_share_of_renewables_in_energy_consumption#Definition_of_the_primary_energy_content_of_fuels'},{id:"B21",body:'Tehnična Smernica TSG-1-004:2010. Učinkovita Raba Energije. Slovenia: Ministrstvo za Okolje in Prostor; 2010. Available from: http://www.mop.gov.si/fileadmin/mop.gov.si/pageuploads/zakonodaja/graditev_objektov/TSG_01_004_2010_ure.pdf'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Matjaž Prek",address:"matjaz.prek@fs.uni-lj.si",affiliation:'
Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana, Slovenia
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Averina",slug:"elena-averina"}]},{id:"58665",title:"Degradation in PEM Fuel Cells and Mitigation Strategies Using System Design and Control",slug:"degradation-in-pem-fuel-cells-and-mitigation-strategies-using-system-design-and-control",signatures:"Jekan Thangavelautham",authors:[{id:"210571",title:"Prof.",name:"Jekan",middleName:null,surname:"Thangavelautham",fullName:"Jekan Thangavelautham",slug:"jekan-thangavelautham"}]},{id:"58423",title:"Chalcogenides and Carbon Nanostructures: Great Applications for PEM Fuel Cells",slug:"chalcogenides-and-carbon-nanostructures-great-applications-for-pem-fuel-cells",signatures:"Yadira Gochi-Ponce, Gabriel Alonso-Núñez, Nicolás Alonso-Vante\nand Mercedes Teresita Oropeza-Guzmán",authors:[{id:"104665",title:"Dr.",name:"Gabriel",middleName:null,surname:"Alonso-Nuñez",fullName:"Gabriel Alonso-Nuñez",slug:"gabriel-alonso-nunez"},{id:"211953",title:"Dr.",name:"Yadira",middleName:null,surname:"Gochi Ponce",fullName:"Yadira Gochi Ponce",slug:"yadira-gochi-ponce"},{id:"213630",title:"Dr.",name:"N.",middleName:null,surname:"Alonso-Vante",fullName:"N. Alonso-Vante",slug:"n.-alonso-vante"}]},{id:"57938",title:"Fundamentals of Electrochemistry with Application to Direct Alcohol Fuel Cell Modeling",slug:"fundamentals-of-electrochemistry-with-application-to-direct-alcohol-fuel-cell-modeling",signatures:"Juan Sánchez-Monreal, Marcos Vera and Pablo A. García-Salaberri",authors:[{id:"176049",title:"Dr.",name:"Marcos",middleName:null,surname:"Vera",fullName:"Marcos Vera",slug:"marcos-vera"},{id:"213212",title:"Dr.",name:"Juan",middleName:null,surname:"Sánchez-Monreal",fullName:"Juan Sánchez-Monreal",slug:"juan-sanchez-monreal"},{id:"213213",title:"Dr.",name:"Pablo A.",middleName:null,surname:"García-Salaberri",fullName:"Pablo A. García-Salaberri",slug:"pablo-a.-garcia-salaberri"}]},{id:"58686",title:"PEM-Less Microbial Fuel Cells",slug:"pem-less-microbial-fuel-cells",signatures:"Reuben Y. 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1. Introduction
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Physical appearance has been of immense importance for centuries B.C. including the wives of Persian rulers (Figures 1–3) and as seen in portraits dating back to the Italian Renaissance (Figures 4 and 5). Although there were no procedures available to address unwanted excess truncal fat and loose skin, artists in the above cited figures portrayed the ideal male contour and the unattractive body contour in a young child. The child demonstrates early obesity with neck, truncal, and extremity lipodystrophy. Unaesthetic fat deposits or loose skin, especially the ones without response to diet or physical exercise, are a major concern to patients. Witness the frequency of body contouring procedures throughout the world where liposuction is the most common esthetic surgical procedure. There are, however, differences in the distribution of the body fat between male and female patients. Men have less body fat around the waist, especially in the abdominal area; women generally have a higher percentage of body fat than men, especially around their thighs and buttocks, which is called gynoid fat. In overweight women, normally, the deposition is mainly found below the waist.
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Figure 1.
Symbols of beauty from the Persian Culture.
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Figure 2.
Symbols of beauty from the Persian Culture.
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Figure 3.
Symbols of beauty from the Persian Culture.
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Figure 4.
Symbols of beauty from the Renaissance.
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Figure 5.
Symbols of beauty from the Renaissance.
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2. Early treatment of abdominal lipodystrophy and skin excess
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The earliest procedures that addressed excess skin and subcutaneous fat in the abdominal area were performed for functional indications, not for esthetic improvements. Certainly, removing skin and fat (dermo-lipectomy) had the secondary benefit of having the patient look better. In 1880, in France, Demars and Marx reported a large resection of skin and fat from the abdominal wall. In 1899, Dr. Kelly (a Johns Hopkins Gynecologist) performed a panniculectomy with an elliptical transversal incision around the umbilicus [1]. In 1901, Peters described a similar surgery extracting 7450 g from a patient, including the umbilicus, without the undermining [2]. Gaudet and Morestin extracted fat and skin with correction of an umbilical hernia while preserving the umbilicus. Eventually, Babcock in 1916 described dermo-lipectomies using a vertical incision [3].
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3. Evolving procedures in body contouring
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Thorek performed the first umbilicus-preserving abdominoplasty in 1924 [4]. This was the first abdominal contouring procedure with esthetic benefits. Passot’s contribution was to use undermining as a modification of Kelly’s technique [5]. Vernon in the 1950s developed a novel concept by combining extensive undermining with the umbilical transposition and relocation, which is a procedure still in use today. Callia described aponeurotic suturing as an important component of his procedure in 1967, which involved an infra-inguinal incision. Pitanguy in the same year published a series of 300 abdominal lipectomies with an infra-inguinal incision [6]. Previously, the published literature consisted mostly of case reports of a few patients. In the 1970s, Regnault modified the Pitanguy’s incision into the “W” incision [7]. In 1973, Grazer championed the “bikini line” incision used frequently today [8]. Grazer and Goldwyn in 1977 observed that abdominoplasty decreased anterior projection of the abdomen but did little to change waist diameter This led to Psillakis’ assertion in 1978 that muscular aponeurotic suturing was an underutilized tool to decrease waistline dimensions [9]. Somalo and Gonzalez-Ulloa extended the transverse abdominal incision circumferentially and introduced the belt lipectomy [10]. This concept would provide the background for many subsequent more aggressive procedures.
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4. Evolution of liposuction
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Describing the evolution of body contouring procedures would be entirely inadequate without presenting the chronologic events in the development of closed liposuction techniques. For certain, the most significant advancement in body contouring WITH OR WITHOUT concomitant excision of skIn and subcutaneous fat was the development of closed liposuction.
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Removing excess fat from localized body sites is not a new idea [11]. In 1921, in France, Charles Dujarrier tried to remove subcutaneous fat using a uterine curette on a dancer’s calves and knees [12]. Unfortunately, he damaged the femoral artery, and the patient has lost her leg. One of the original and creative initiatives came from Schrudde in 1964, when he extracted fat from lower areas of the limb, through a visibly small incision, utilizing a curette. The unfortunate results from this surgical initiative were unpleasant hematomas and seromas [13]. Pitanguy, on the other hand, was in favor of a removal of both fat and skin in a block, in order to remove excess thigh adiposities in one act [14]. Of course, this was an excisional procedure, not closed liposuction. Significant visible incisions made this method quite unpopular and made closed, non-excisional, procedures preferred, but, at that time, not discovered. The field of modern liposuction began with the technique and new instruments developed by Arpad and Fischer [15, 16]. During their work in Rome, Italy, they managed to develop a blunt hollow cannula, with additional function of suction. Some of the previous cannula designs contained a cutting blade also. They made their results public in 1976 [17] Fischer also started the crisscross tunnel formation method, from several incision sites. The new instruments brought very promising results avoiding the above complications.
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Kesselring and Meyer [18] published their surgery results of sharp curettage aided by a suction device in 1978, but their method did not receive a wide acceptance. Fournier, in Paris, showed an early interest in the Fischer’s liposculpture technique [19]. He was an initial enthusiast of the “dry technique” in which no fluids were infiltrated into the patient prior to liposuction. Fournier would become a world leader in liposuction and fat transplantation, eventually insisting on the benefits of tumescent anesthesia and making a great contribution in opening new horizons and ideas to surgeons from different parts of the world. Illouz, a French gynecologist, was quite attracted by the Fishers’ work. His preferred method was the”wet technique”, which consisted of a solution of hypotonic saline together with hyaluronidase inserted into the adipose tissue before the aspiration. Lllouz thought that the solution itself was a “dissecting hydrotomy” which would catalyze the removal of fat and thus reduce trauma, as there was smaller amount of bleeding. Lllouz received worldwide publicity and promoted this method. The first US surgeon to visit France to learn the new area of liposuction was Lawrence Field in 1977, a Californian dermatologic surgeon. Other surgeons from the States, coming to conferences and educating themselves about new methods in the literature, also showed an interest in the area. One of them was Norman Martin, an otolaryngologist. He visited Illouz in 1980 and quickly started with liposuction surgeries in Los Angeles in 1981 [20, 21]. It was 1982 when a group of physicians from various specialty disciplines received lectures from Illouz and Fournier. At the annual meeting of the American Society of Plastic Surgeons (known at that time as The American Society of Plastic and Reconstructive Surgeons) in 1982, Dr. Illouz, for the first time in front of an audience of Board Certified Plastic Surgeons presented his technique of closed liposuction utilizing hollow cannulas of 1 cm in diameter connected to a suction pump with one atmosphere of negative pressure to extract fat that was pretreated with his wetting solution. The photographs (presented in carousel slide format) showed pre and pos-op photos of women who underwent liposuction of their “saddle bags” with only one cm. scars. This was remarkable in light of the existing treatment option which required large incisions (as published by Pitanguy) for the performance of dermo-lipectomies of this area. After this meeting, a task group formed by the American Society of Plastic and Reconstructive Surgeons visited Europe to learn and form opinions about this new procedure. Several pioneers in the closed technique of liposuction visited Dr. Fred Grazer after the national presentation in 1982 and I had the privilege of attending this small group course. Dr. Frank Ashley, former Chairman of the Division of Plastic Surgery at the University of California attended as well to learn this revolutionary technique. Dr. Grazer named this new procedure Suction Assisted Lipectomy. Important pioneers in the closed liposuction technique had developed cannulas which were quite aggressive when compared to the 5 mm and smaller cannulas in widespread use today. Schrudde, Kesselring, and Ilouz left their cannulas in Dr. Grazer’s office and they are of historical importance as one studies the refinement in the performance of liposuction (Figures 6–9). Julius Newman, otolaryngologist and cosmetic surgeon, together with his associate Richard Dolsky, who was a plastic surgeon, together taught the first American course on liposuction, held in Philadelphia in 1982. The five live surgery workshops were held in Hollywood, California, in June 1983, under the authority of the American Society of Cosmetic Surgeons and the American Society of Liposuction Surgery. There were altogether 10 dermatologists in attendance. The American Society of Plastic Surgeons and The American Society for Esthetic Plastic Surgery subsequently developed teaching courses and symposia to teach closed liposuction to fully trained, Board Eligible and Board Certified Plastic Surgeons. Subsequently, the core curriculum in accredited Plastic Surgery Resident Training Programs included didactic and hands-on training in liposuction. The development of the Tumescent (from Latin meaning swollen or being swollen) Technique for performing Liposuction, described in publications by Dr. Jeffrey Klein [22, 23, 24, 25, 26], a Dermatologist, had an enormous impact in the safe and more easily performed liposuction procedure. The formula currently includes Lidocaine 2%, Sodium Bicarbonate, and Epinephrine (1–1,000,000), added to 1 liter of Sodium Chloride (if Ringers Lactate is substituted for Normal Saline, sodium bicarbonate is not added to the solution). The tumescent technique was modified such that only a 1:1 or 1.5:1 ratio of tumescent fluid to expected aspiration volume is injected rather than a 2 or 3:1 ratio which was the initial ratio in the Klein tumescent solution. The introduction of the tumescent liposuction technique allowed for the office- based removal of fatty deposits under no sedation, minimal Class 1 sedation, intravenous sedation, or general anesthesia. (Safe guidelines and other safety considerations are described below).
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Figure 6.
Examples of first generation suction cannulas.
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Figure 7.
Examples of first generation suction cannulas.
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Figure 8.
Examples of first generation suction cannulas.
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Figure 9.
Examples of first generation suction cannulas.
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As the number of cases increased dramatically over the years, important additions to the options in body contouring occurred. Lockwood’s observance and, perhaps the discovery, of the SFS (superficial fascial system) [27, 28, 29] resulted in his landmark publications wherein he utilized this fascial system for important support of elevated soft tissue flaps including abdominal and lower extremity flaps that were elevated and repositioned to correct soft tissue ptosis. Liposuction was a component of his body contouring procedures. Certainly, liposuction allowed remodeling of the abdomen and lower extremities combined with, based upon the clinical anatomical findings, surgical excision of excess skin and subcutaneous tissues. Prior to Lockwood’s description of the SFS, lower extremity medial thigh lifts were accompanied by migrating, unattractive scars. He also utilized the SFS in his High Lateral Tension Abdominoplasty to obtain improved contours and favorable scars as a trade-off for important excision of redundant soft tissues.
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Prior to liposuction, upper extremity unwanted fatty deposits with or without accompanying excess skin required large excisions of skin and subcutaneous tissue with resultant unfavorable scars. Liposuction has allowed fatty deposits to be removed through small access incisions and the incisions needed for skin and subcutaneous tissue removal have decreased in length.
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Combined with available energy-based devices, soft tissue retraction can be an important component to body contouring of the head and neck, extremities and anterior and posterior trunk.
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Fat grafting, although introduced by Gustav Neuber (1850–1932) late in the 19th century [30], was authenticated and refined with the landmark work of Sydney Coleman [31]. He introduced structural fat grafting which required small amounts (macrografts) of fat carefully placed in parallel tunnels, separated by adjacent blood vessels which nourish the grafted fat. Without a doubt, his contribution brought fat grafting to the armamentarium of cosmetic physicians and surgeons with a method that proved that grafted fat, when obtained, processed, and carefully injected in tiny amounts (0.1 cc or less) survived. He also showed how the stem cell component of fat grafts rejuvenate the skin, improve dermatologic skin conditions, with improved texture, etc. Fat grafting has evolved to include soft tissue augmentation of the face and breast, revision of breast reconstruction, treatment of post-augmentation mammoplasty contour deformities (including capsular contracture), contour deformities from prior liposuction and/or skin and subcutaneous fat excisions, and treatment of depressed scars. It is included in High Definition Liposuction further defining the underlying abdominal wall musculature. Fat grafting has evolved to the production of smaller particles including nanofat introduced by Tonnard [32].
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Recently, cosmetic surgeons have injected Tranexemic Acid (TXA) and have observed an impressive decrease in blood loss. It has been used intravenously and topically as well, but the addition of tranexemic acid to the liposuction infusion has seen its’ application in closed liposuction. TXA is safe and its’ application has been studied in other cosmetic procedures with a notable decrease in blood loss [33].
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When one looks at the statistics regarding obesity and morbid obesity with 40% of Americans considered obese and 18% considered severely obese as of 2019 with severe obesity defined as a BMI greater than 35 (Research performed at the Harvard T.H. Chan School of Public Health) it is clear as to why liposuction which is consistently listed in position 1 or 2 of the 5 most frequently performed cosmetic surgical procedures in the U.S. and dermolipectomies (270,670 liposuction and 140,381 abdominoplasties performed by Board Certified Plastic Surgeons) are so popular, increasing in numbers yearly (American Society of Plastic Surgeons Annual Statistics, 2019). Moreover, bariatric procedures to treat morbid obesity have evolved in tandem with body contouring procedures to address excess skin throughout the body after significant weight loss.
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In summary, Liposuction has evolved from the removal of fatty deposits in the neck, upper and lower extremities, and anterior and posterior trunk to artistic remodeling of the shape of the face, neck, extremities, and trunk, performed alone or in combined treatment with various energy based devices.
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5. Safety considerations in performing liposuction
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5.1 Combining suction lipectomy with other procedures
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Safety in liposuction combines proper education, patient selection, and proper application of science while achieving the goal of esthetics. Providing safe surgery in a hospital or accredited surgery center (or Ambulatory Surgery Center (ASC) has become increasingly a topic of discussion as the roles of fat grafting (breast surgery, Brazilian Butt Lift, facial surgery, etc.) have increased. Office based procedures can be done safely and should still follow proper guidelines. As noted above, the role of wetting solutions allowed safe and reproducible results over the past several decades.
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There are various oversight organizations and governmental regulations that have been well established. These are designed to help ensure patient safety. As this is not a comprehensive review of each organization, some general parameters are presented below. For those that will be using freestanding ASCs through Medicare and or Medicaid, rules include An ASC must be certified and approved to enter into a written agreement with CMS, The regulatory definition of an ASC does not allow the ASC and another entity, such as an adjacent physician’s office, to mix functions and operations in a common space during concurrent or overlapping hours of operations., and ASCs are not permitted to share space, even when temporally separated, with a hospital or Critical Access Hospital outpatient surgery department, or with a Medicare-participating Independent Diagnostic Testing Facility (IDTF), as noted on CMS.gov. (REF- CMS.gov). ASCs must comply with a multitude of state as well as federal regulations and statutes. This includes proper licensing, Health Insurance Portability and Accountability Act (HIPAA) and more (REF ASCassociation.org). Furthermore, the ASC is also responsible to ensure that the providers comply with all the standards that govern ensuring professional training, equipment, medications, physical layout of the facility and operational safety. Outpatient surgery is suited best for healthy people undergoing minor or intermediate procedures (plastic surgery, ob-gyn, limited urologic, ophthalmologic, or ear, nose and throat procedures and procedures involving the extremities). However, health care reform and the Affordable Care Act of 2010 have expanded the types and complexity of surgical procedures, with much of the growth driven by advancements in anesthesia and technology. (REF AAAASF.org).
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5.2 Wetting solutions and volume extractions
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Wetting solutions were covered earlier in this chapter. The surgeon should become familiar with the various solutions. Furthermore, the amount of blood loss with the different must be accounted for by the surgeon to maintain safety. (ADD TABLE FOR APPROXIMATE BLOOD LOSS?) That percentage of blood loss can range from 1% with solutions such as tumescent and superwet to nearly 40% in the infranatant with the dry technique. (REF?) Preoperatively the patient should be healthy and optimized and laboratory studies should be checked to help guide proper patient selection. These solutions can also vary in terms of lidocaine load to the patient. The surgeon should be familiar with the correct calculations to not over-deliver lidocaine to the patient as well as understanding that absorption can be variable between patients. As lidocaine absorption from the subcutaneous fat, the plasma lidocaine levels may not peak until 10–12 hours after delivery. Furthermore, chronic disease, stress, tobacco use, hormones, and more will influence the protein binding and when the peak will effect the patient. Care must be taken and individualized for each patient.
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Volume extraction concerns have evolved to help protect patients, but discussions continue how to apply and ensure proper application. In general, the most commonly accepted guideline is based on “Large volume lipoplasty” as greater than 5000 cm3 of supranatant fat during a single surgery. Volumes greater than this can be done, and patient safety parameters should be utilized and regulations followed. These large volume liposuction procedures can be completed in a hospital setting or often mandate overnight monitoring. Patient age, general health and even the percentage of body surface are examples of considerations. While we have discussed lidocaine issues previously, general fluid shifts should be considered for patient safety as well. High quality teamwork and communication with all team members are critical. Volume overload, shock, pulmonary edema, hypovolemia, myocardial infarction are all risk factors, as is fat embolism. Proper teamwork, communication, monitoring, etc., are so important to add to proper patient selection.
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Cannula selection is another component of patient safety, from tissue injury to contour irregularities. Proper cannula selection is a combination of education, experience, esthetic goals and more. While there is a role for some of the cannulae that can cut (release of fibrous bands) or “post-tunneling” (such as basket cannulae), the accepted safe cannula systems are generally blunt tipped. These most commonly range from 2 to 5 mm, but larger are available for harvesting and smaller are often used for fat grafting. Furthermore, the number of holes, location and patterns of the holes will all play a role in both efficiency of fat extraction and patient safety. While the cannulas play a role in patient safety, so do the aspiration devices and assistance devices (syringes, pumps, oscillating tips, energy based, etc.) must be considered for patient safety. Proper education on the devices, mechanisms of action, technique, etc. must be employed to avoid complications such as thermal injury, contour irregularities, incorrect cannula positioning and more.
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Beyond the previously mentioned complications of liposuction, the surgeon must also be concerned about several other issues and these include Fat Embolism Syndrome, bleeding, and Deep Vein Thrombosis among others. Bleeding and clotting issue concerns should be addressed pre-, intra-, and postoperatively. A complete history should discuss any family history of blood clots, early myocardial infarction, multiple miscarriages, bleeding history, previous deep vein thrombosis, etc. Several measures can be done on the day of surgery such as proper patient and operating room temperature, placement and application of sequential compression devices before induction and not being removed until after the patient is fully awake (home compression therapies are also available), and even consideration for pre and post operative anti-thrombotic (chemoprophylaxis) medications. Early ambulation has been a largely accepted proper therapy to help minimize deep venous thrombosis and pulmonary embolism risk. Fat Embolism Syndrome (FES) is less understood, but classically demonstrates respiratory distress, petechial rash along with cerebral dysfunction. Other concerns include tachycardia, fever, hypocalcemia and even thrombocytopenia. FES is the syndrome that is a secondary consequence of Fat Embolism. Proper diagnosis is critical for the patient long term outcome and the surgeon should be familiar with the diagnosis and willing/able to work with other team members to get early and proper treatment for the patient.
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Proper patient selection, maximizing pre-, intra- and post operative management is the responsibility of the surgeon. The surgeon should coordinate the team and maintain maximum communication so that all team members can maximize their experience and opportunities to protect the patient.
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As suction lipectomy became universally accepted as a stand-alone procedure, it was quickly added to other body contouring procedures. Frequently, liposuction is performed along with reduction mammoplasty, abdominoplasty, high-definition liposuction, brachioplasty, thigh lifts, lower body lifts, gynecomastia, breast reconstruction, etc. Although liposuction can be safely added to other body contouring procedures, it has been shown to increase morbidity and mortality when combined with a full abdominoplasty especially worrisome in patients with a high BMI and/or a high Caprini score [34].
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6. Evolution of energy based devices
\n
The early methods of performing closed liposuction included hand held aspiration (Toomey syringe liposuction) connected to a cannula, or connecting the suction cannula to a suction pump with one atmosphere of negative pressure, but still requiring manual movement of the cannula to break up and remove the fat. One of the most important advances in facilitating the removal of fat in a closed system was the introduction of Power-assisted Liposuction. Several devices were manufactured and quickly adopted to facilitate the removal of fat with less effort.
\n
Following the introduction of Power-assisted Liposuction, the development of Ultrasonic Energy based emulsification of the fat followed by suction lipectomy was introduced by Michele Zocchi, M.D. [35]. There was an evolution in the machinery required to perform the emulsification procedure, but the surviving technology was manufactured under the name of Vaser, engineered by Sound Surgical Technologies. This method of dissolving fat and causing energy to be delivered to the dermis has found its’ most important application in “High Definition Liposuction”, importantly advanced and refined by Alfredo Hoyos [36]. Other indications for ultrasonic emulsification of fat include the closed treatment of gynecomastia.
\n
The technique of applying freezing temperature to dissolve the fat through apoptosis (CoolSculpt) has received important acceptance in the Cosmetic Surgery community, has enormous social media presence, but complications are common with neo-fat formation and “shark-bite” contour complications being reported.
\n
Laser based energy has also been developed (Smart Lipo) where a small diameter probe is inserted into the fatty deposit and energy is applied to dissolve the fat. This requires a two step procedure, is quite tedious due to the small size of the fiber, with the risk of skin burns.
\n
Radiofrequency based energy has emerged as the most commonly energy based method of emulsifying fat and stimulating fibrous septae contraction as well as dermal tightening. Impressive pre and post-op measurements of circumference are seen when this energy based system is used alone or in combination with suction assisted liposuction. Real time monitoring of internal and external body temperatures ensure safe application of the energy (InMode,Ltd., Yokneam, Israel).
\n
Plasma based energy systems are available (Renuvion J-Plasma) which dissolve the fat, but lack sophisticated temperature monitoring.
\n
High intensity focused ultrasound devices are available, but has enjoyed limited market penetrance due to the minimal improvement shown when compared to other energy sources.
\n
\n
\n
7. Summary
\n
In summary, physical image has always been important. The history of body contouring began with procedures that were performed for functional benefits and evolved to cosmetic improvement in multiple areas of the body. The introduction of liposuction provided an incredible option in body contouring and became the number 1 or number 2 most performed cosmetic surgical procedure. Often combined with open surgical techniques, liposuction frequently allowed procedures to be performed with smaller incisions and was advanced to allow important sculpting of the face, neck, extremities, and trunk. Fat grafting provided improved volume and contour to soft tissues. The introduction of energy based devices allowed for the tightening of fascial networks and dermal remodeling often performed along with liposuction.
\n
\n\n',keywords:"liposuction, radiofrequency, energy",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/78973.pdf",chapterXML:"https://mts.intechopen.com/source/xml/78973.xml",downloadPdfUrl:"/chapter/pdf-download/78973",previewPdfUrl:"/chapter/pdf-preview/78973",totalDownloads:141,totalViews:0,totalCrossrefCites:0,dateSubmitted:"March 8th 2021",dateReviewed:"June 28th 2021",datePrePublished:"October 15th 2021",datePublished:"April 20th 2022",dateFinished:"October 15th 2021",readingETA:"0",abstract:"The evolution of body contouring follows decades of procedures and technologic advances in body shaping. Beginning many decades ago with extensive surgical resections of skin and subcutaneous fat, the evolution was dramatically changed with the introduction of suction assisted lipectomy (liposuction). Further refinement in the technique of liposuction allowed more precise sculpting of the body and, most recently, has evolved to high definition liposuction. Following the introduction of liposuction in the early 1980s, energy based devices were developed to allow non or minimally invasive procedures to sculpt the body. The energy sources include laser energy, radiofrequency energy, ultrasonic energy, and plasma based energy. This evolution has provide the cosmetic surgeon with a variety of options to obtain optimal body contouring in a variety of clinical presentations. The safety and the efficacy of these procedures are the most important considerations in adopting new technology and techniques.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/78973",risUrl:"/chapter/ris/78973",signatures:"Malcolm D. Paul and Garrett Wirth",book:{id:"10351",type:"book",title:"Enhanced Liposuction",subtitle:"New Perspectives and Techniques",fullTitle:"Enhanced Liposuction - New Perspectives and Techniques",slug:"enhanced-liposuction-new-perspectives-and-techniques",publishedDate:"April 20th 2022",bookSignature:"Diane Irvine Duncan",coverURL:"https://cdn.intechopen.com/books/images_new/10351.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-1-83968-105-9",printIsbn:"978-1-83962-823-8",pdfIsbn:"978-1-83968-106-6",isAvailableForWebshopOrdering:!0,editors:[{id:"279869",title:"Dr.",name:"Diane Irvine",middleName:null,surname:"Duncan",slug:"diane-irvine-duncan",fullName:"Diane Irvine Duncan"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"59069",title:"Mr.",name:"Malcom D.",middleName:null,surname:"Paul",fullName:"Malcom D. Paul",slug:"malcom-d.-paul",email:"mpaulmd@hotmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"418215",title:"Dr.",name:"Garrett",middleName:null,surname:"Wirth",fullName:"Garrett Wirth",slug:"garrett-wirth",email:"drwirth@wirthplasticsurgery.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Early treatment of abdominal lipodystrophy and skin excess",level:"1"},{id:"sec_3",title:"3. Evolving procedures in body contouring",level:"1"},{id:"sec_4",title:"4. Evolution of liposuction",level:"1"},{id:"sec_5",title:"5. Safety considerations in performing liposuction",level:"1"},{id:"sec_5_2",title:"5.1 Combining suction lipectomy with other procedures",level:"2"},{id:"sec_6_2",title:"5.2 Wetting solutions and volume extractions",level:"2"},{id:"sec_8",title:"6. Evolution of energy based devices",level:"1"},{id:"sec_9",title:"7. Summary",level:"1"}],chapterReferences:[{id:"B1",body:'\nKelly HA. Report of gynecological cases (excessive growth of fat). Johns Hopkins Med J. 1899;10:197-201.\n'},{id:"B2",body:'\nPeters L. Resection of Pendulous fat abdominal wall in cases of extreme obesity. Ann Surg. 1901;33:299-304\n'},{id:"B3",body:'\nBabcock W. The correction of the obese and relaxed abdominal wall with special reference to the use of the buried silver chain. Am J Obst. 1916;1:596-611\n'},{id:"B4",body:'\nThorek M. Plastic Reconstruction of the Female Breast and Abdomen Wall. Springfield, IL: Thomas; 1924.\n'},{id:"B5",body:'\nPassot R. Chirurgie Esthetique Pure. Paris: Doin; 1931. pp. 260-267\n'},{id:"B6",body:'\nPitanguy I. Abdominal lipectomy: An approach to it through an analysis of 300 consecutive cases. Plast Reconstr Surg. 1967;40:384-391\n'},{id:"B7",body:'\nRegnault P. Abdominoplasty by the W technique. Plast Reconstr Surg. 1975;55:265-266\n'},{id:"B8",body:'\nGrazer FM. Abdominoplasty. Plast Reconstr Surg. 1973;51:617-623\n'},{id:"B9",body:'\nPsillakis JM. Abdominoplasty: some ideas to improve results. Aesthetic Plast Surg. 1978;2:205-215\n'},{id:"B10",body:'\nSomalo M. Dermolipectomia circular del trunco. Cir Clin Exper. 1942;6:540-543\n'},{id:"B11",body:'\nColeman WP III. The history of liposculpture. J Dermatol Surg Oncol. 1990;16:1086\n'},{id:"B12",body:'\nDolsky RL, Newman J, Ferzek JR, Anderson RW. Liposuction: history techniques, and complications. Dermatol Clin. 1987;5:313-333\n'},{id:"B13",body:'\nSchrudde J. Lipexheresis (liposuction) for body contouring. Clin Plast Surg. 1982; Coleman WP III. The history of Dermatologic liposuction. Dermatol Clin. 1990;8:381-383.\n'},{id:"B14",body:'\nPitanguy I. Trochanteric lipodystrophy. Plast Reconstr Surg. 1964;34:280-286.\n'},{id:"B15",body:'\nFischer G. Liposculpture: the correct history of liposuction: part 1. J Dermatol Surg Oncol. 1990;16:1087-1089\n'},{id:"B16",body:'\nColeman WP III. The history of Dermatologic liposuction. Dermatol Clin. 1990;8:381-383\n'},{id:"B17",body:'\nFischer A, Fischer G. First surgical treatment for molding body’s cellulite with three 5 mm incisions, Bull lnt Acad Cosmet Surg. 1976;3:35.\n'},{id:"B18",body:'\nKesselring UK, Meyer RA. Suction curette for removal of excess local deposits of subcutaneous fur. Plast Reconstr Surg. 1978:62:305-306.\n'},{id:"B19",body:'\nColeman WP III. The history of liposuction and fat transplantation in America. Dermatol Clin. 1999;7:723-727\n'},{id:"B20",body:'\nField LM. The dermatologist and liposuction – a history. J Dermatol Surg Oncol. 1987;13:1040-1041.\n'},{id:"B21",body:'\nHerter CP. The history of LSNA. Lipoplasty. 1999;16:9.\n'},{id:"B22",body:'\nKlein JA. The tumescent technique for liposuction surgery. Am J Cosmet Surg. 1987;4:263-267\n'},{id:"B23",body:'\nKlein JA. Tumescent technique for local anesthesia improves safety in large-volume liposuction. Plast Reconstr Surg. 1993;92:1085-1098.\n'},{id:"B24",body:'\nKlein JA. The history of tumescent liposuction. In: Klein J. Tumescent technique: tumescent anesthesia and microcannular liposuction. Sr. Louis: Mosby; 2000\n'},{id:"B25",body:'\nKlein JA. The tumescent technique. Anesthesia and modified liposuction technique. Dermatol Clin. 1990;8:425-437\n'},{id:"B26",body:'\nFodor P.B. Editorial. Wetting solutions in aspirative lipoplasty: A plea for safety in liposuction. Aesth Plast Surg. 1995;19:379-380.\n'},{id:"B27",body:'\nLockwood T. Superficial fascial system (SFS) of the trunk and extremities: a new concept. Plast Reconstr Surg. 1991;87:1009-1018.\n'},{id:"B28",body:'\nLockwood T. Lower body lift with superficial fascial system suspension. Plast Reconstr Surg. 1993;92:1112-1125\n'},{id:"B29",body:'\nLockwood T. Fascial anchoring technique in medial thigh lifts. Plast Reconstr Surg. 1988;82:299-304\n'},{id:"B30",body:'\nNeuber G. Fetttransplantation. Verh Dstch Ges Chir. 1893;22\n'},{id:"B31",body:'\nColeman SR. Structural fat grafts: The ideal filler? Clin Plast Surg. 2001;28:111\n'},{id:"B32",body:'\nTonnard, P. et.al. Nanofat Grafting: Basic Research and Clinical Applications. (Plast. Reconstr. Surg. 132: 1017, 2013\n'},{id:"B33",body:'\nWokes, James E.T., et. al. The Role of Tranexamic Acid in Aesthetic Plastic Surgery: A Survey of the British Association of Aesthetic Plastic Surgeons. Aesthetic Surg J. 2021 ,4 (2): 244-249\n'},{id:"B34",body:'\nSwanson, E. Caprini Scores, Risk Stratification, and Rivaroxaban in Plastic Surgery: Time to Reconsider our Strategy. Plast Reconstr Surg Glob Open 2016 Jun; 4(6): e733\n'},{id:"B35",body:'\nZocchi, M. Ultrasonic Liposculpturing. Aesthetic Plastic Surgery Fall 1992; 16(4): 287-98\n'},{id:"B36",body:'\nHoyos, A. Prendergast, PM. High Definition Body Sculpting, Springer, 2014\n'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Malcolm D. Paul",address:"mpaulmd@hotmail.com",affiliation:'
Department of Plastic Surgery, University of California, Irvine, USA
Department of Plastic Surgery, University of California, Irvine, USA
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However, a systematic analysis of chamber-specific changes in the expression of genes linked to cardiac function, apoptosis, fibrosis, receptor responsiveness, and inflammation is lacking. Postischemic remodeling was analyzed in rats that received STEMI in the closed chest mode. Rats were sacrificed at day 1, 3, 7, and 120 after surgery. The mRNA expression of genes was quantified by a real-time RT-PCR. Echocardiography was performed after 120 days. Organ weights and systemic blood pressure were determined in addition. Rats developed left and RV dysfunction within 7 days after ischemia/reperfusion and this lasted until the end of the experiments. However, adaptation to ischemia/reperfusion differed significantly between both ventricles. In the LV, a high expression of MMP12, a neutrophile-specific elastase, indicated a significant inflammatory responsiveness that did not occur in RV. A number of differentially regulated genes in the RV exceeded that of the LV at day 3. Postinfarction RV failure is common in rats with ischemia/reperfusion of the left arterial descending aorta. It is associated with severe RV remodeling that occurred delayed to that of the LV. Changes in RV are independent of the initial inflammation.",signatures:"Rolf Schreckenberg and Klaus-Dieter Schlüter",authors:[{id:"276177",title:"Prof.",name:"Klaus-Dieter",surname:"Schlüter",fullName:"Klaus-Dieter Schlüter",slug:"klaus-dieter-schluter",email:"klaus-dieter.schlueter@physiologie.med.uni-giessen.de"},{id:"288191",title:"Dr.",name:"Rolf",surname:"Schreckenberg",fullName:"Rolf Schreckenberg",slug:"rolf-schreckenberg",email:"Rolf.Schreckenberg@physiologie.med.uni-giessen.de"}],book:{id:"8629",title:"Visions of Cardiomyocyte",slug:"visions-of-cardiomyocyte-fundamental-concepts-of-heart-life-and-disease",productType:{id:"1",title:"Edited Volume"}}}],collaborators:[{id:"20043",title:"Dr.",name:"Katriina",surname:"Aalto-Setälä",slug:"katriina-aalto-setala",fullName:"Katriina Aalto-Setälä",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"221511",title:"Dr.",name:"Nisha",surname:"Arenja",slug:"nisha-arenja",fullName:"Nisha Arenja",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"221978",title:"Dr.",name:"Deborah P.",surname:"Schild",slug:"deborah-p.-schild",fullName:"Deborah P. 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She obtained a degree in Molecular Diagnostics at Postgraduate Specialist Study at the Faculty of Pharmacy and Biochemistry at the University of Zagreb. Currently, she is an assistant professor and also head of the Histology, Genetics, Cellular, and Molecular Biology Laboratory at the Department of Biophysics, Biology, and Chemistry at the Faculty of Dental Medicine and Health, University of Osijek, Croatia. Her research fields are medical genetics and molecular biology studies in cardiovascular diseases and the circadian rhythm. She actively publishes original research work and has experience as a reviewer for international journals. 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On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. 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It is increasingly acknowledged that conventional sewer‐based sanitation cannot be the only solution for expanding urban areas. There are other objective reasons apart from the lack of capital. The lack of stable energy supplies, of spare parts and of human resources for reliable operation, and the increasing water scarcity are factors that seriously limit the expansion of centralised systems. This chapter argues that a new paradigm for urban sanitation is possible, if the heterogeneity within developing cities is reflected in the implementation of different sanitation systems, adapted to each urban context and integrated under one institutional roof. This new paradigm entails: (1) innovative management arrangements; (2) increased participation and the integration of individual, community and private sector initiatives; (3) thinking at scale to open new opportunities; (4) improved analysis of the situation and awareness raising. Moving beyond conventional approaches towards sustainable urbanisation needs to follow both a top‐down and a bottom‐up approach, with proper incentives and a variety of sanitation systems which, in a future perspective, will become part of the ‘urban ecosystem’.",book:{id:"5235",slug:"sustainable-urbanization",title:"Sustainable Urbanization",fullTitle:"Sustainable Urbanization"},signatures:"Philippe Reymond, Samuel Renggli and Christoph Lüthi",authors:[{id:"181079",title:"Dr.",name:"Christoph",middleName:null,surname:"Lüthi",slug:"christoph-luthi",fullName:"Christoph Lüthi"},{id:"182136",title:"Mr.",name:"Philippe",middleName:null,surname:"Reymond",slug:"philippe-reymond",fullName:"Philippe Reymond"},{id:"182137",title:"Mr.",name:"Samuel",middleName:null,surname:"Renggli",slug:"samuel-renggli",fullName:"Samuel Renggli"}]},{id:"70410",doi:"10.5772/intechopen.89617",title:"New Metrics for Spatial and Temporal 3D Urban Form Sustainability Assessment Using Time Series Lidar Point Clouds and Advanced GIS Techniques",slug:"new-metrics-for-spatial-and-temporal-3d-urban-form-sustainability-assessment-using-time-series-lidar",totalDownloads:776,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"Monitoring sustainability of urban form as a 3D phenomenon over time is crucial in the era of smart cities for better planning of the future, and for such a monitoring system, appropriate tools, metrics, methodologies and time series 3D data are required. While accurate time series 3D data are becoming available, a lack of 3D sustainable urban form (3D SUF) metrics, appropriate methodologies and technical problems of processing time series 3D data has resulted in few studies on the assessment of 3D SUF over time. In this chapter, we review volumetric building metrics currently under development and demonstrate the technical problems associated with their validation based on time series airborne lidar data. We propose new metrics for application in spatial and temporal 3D SUF assessment. We also suggest a new approach in processing time series airborne lidar to detect three-dimensional changes of urban form. Using this approach and the developed metrics, we detected a decreased volume of vegetation and new areas prepared for the construction of taller buildings. These 3D changes and the proposed metrics can be used to numerically measure and compare urban areas in terms of trends against or in favor of sustainability goals for caring for the environment.",book:{id:"7831",slug:"sustainability-in-urban-planning-and-design",title:"Sustainability in Urban Planning and Design",fullTitle:"Sustainability in Urban Planning and Design"},signatures:"Sara Shirowzhan, John Trinder and Paul Osmond",authors:[{id:"267958",title:"Prof.",name:"John",middleName:null,surname:"Trinder",slug:"john-trinder",fullName:"John Trinder"},{id:"273838",title:"Dr.",name:"Sara",middleName:null,surname:"Shirowzhan",slug:"sara-shirowzhan",fullName:"Sara Shirowzhan"},{id:"295989",title:"Prof.",name:"Paul",middleName:null,surname:"Osmond",slug:"paul-osmond",fullName:"Paul Osmond"}]},{id:"50306",doi:"10.5772/62784",title:"Landscape Ecology Practices in Planning: Landscape Connectivity and Urban Networks",slug:"landscape-ecology-practices-in-planning-landscape-connectivity-and-urban-networks",totalDownloads:2251,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"The increasing need to conserve the nature and biodiversity and to maintain human well-being has motivated landscape planners and researchers to seek different planning approaches in urban environments. In this context, different approaches to planning urban networks have been developed to promote the sustainable use and functioning of landscapes, to conserve the nature and species, and increase its use and enjoyment by people [1, 2]. In principle, these approaches have been founded on the conservation of natural areas/biodiversity and with a consensus on their benefits to nature, biodiversity and people [3–5]. However, they generally differ from each other with respect to their expected aims, and ecological and/or social functions [6]. 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Meanwhile, decision-making periods of location choice and determining areal densities are conducted without quantitative spatial/technical analyses. Those urban matters bring along new planning paradigms like smart growth (SG) and new urbanism. SG is a land use planning paradigm which indicates that traffic problems should be minimized by transit alternatives, effective demand management and providing a balance between land use and transportation planning. This study aims to apply SG strategies to the land use planning process and evaluate the accuracy of land use planning decisions in the perspective of sustainable transportation. In order to reveal the effects of land use planning decisions on the available transportation infrastructure, two scenarios are investigated for 2030. In the first scenario “do nothing” option is considered, while the residential area densities and trip generation rates are regulated based on SG strategies in the second scenario. 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An urban composition represents a form of the city in which it gets a formal order, so that the shape of any urban ensemble is not linked to a random phenomenon, but to an intervention mastered and understood as such. For the city, the urban composition represents what the architectural composition represents for a building. This concept regarding the composition is common both to the architecture and to the city. The main property of the composition is that it transforms a possibly dispersed ensemble into a whole, resolving the contradictions that arise when the requirements and conditions of the project are numerous. Spatial forms and urban compositions are built over time, longer than that of architectural composition. On the other hand, “design of the urban environment” is understood by us as a complex formation of public spaces of the city, located on the ground floor level of the city building and ensuring the vital activity of the urban community. This chapter will study the city phenomenon on a large scale.",book:{id:"7831",slug:"sustainability-in-urban-planning-and-design",title:"Sustainability in Urban Planning and Design",fullTitle:"Sustainability in Urban Planning and Design"},signatures:"Amjad Almusaed and Asaad Almssad",authors:[{id:"110471",title:"Prof.",name:"Amjad",middleName:"Zaki",surname:"Almusaed",slug:"amjad-almusaed",fullName:"Amjad Almusaed"},{id:"194040",title:"Associate Prof.",name:"Asaad",middleName:null,surname:"Almssad",slug:"asaad-almssad",fullName:"Asaad Almssad"}]},{id:"68452",title:"Lessons from Baghdad City Conformation and Essence",slug:"lessons-from-baghdad-city-conformation-and-essence",totalDownloads:1244,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"This chapter aims to address the emergence of Baghdad and the phases of its morphology and transformation. The first era began with the Round City; this originated the first nucleus that later formed Baghdad. 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Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. RELACION DE PONENCIAS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGIA. 10/2014.",institutionString:null,institution:null},{id:"243698",title:"Dr.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. 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