Confirmed species of shark implicated in unprovoked attacks around the world (1580–present) (source: [1]).
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
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The annual average number of fatal attacks increased from 4.3 persons per year (2001–2010) up to an average of 8.0 persons per year between 2011 and 2015 [1]. Such an unexpected trend can mainly be explained by a significant increase of the number of sea users that increases the probability of encounter between these marine predators and humans as shown in Australia [2]. In California, despite increasing records of white shark (
The triggers of shark attacks on humans are not well understood and still remain controversial. Such an understanding of attack motivation is jeopardized by the low number of attacks around the world, the scarcity of witnesses and the difficulty to observe an underwater event. A better understanding of shark motivations and behaviour through forensic analysis should at least partly help to avoid adverse outcomes in human encounters with these endangered creatures [4, 5]. If there is a witness to an attack, comparison of display features between the different species of potentially dangerous sharks can help in defining implications for shark-human interactions and suggests responses which may decrease the likelihood of attack for swimmers or divers faced with a postural display by a shark [6]. After the attack, the bite structure of the wounds may reflect the motivation and behaviour of the shark [7]. It can also allow the identification of the species involved in the attack and the accurate assessment of the animal size. The profiling (and potential elimination) of ‘problem individuals’ (see [8]) should be preferred to implementing inefficient blind culling of sharks (see [9]), whatever their species or size, as was recently the case in Western Australia and La Reunion island. In this French island of the Western Indian ocean, the decision to launch a culling campaign was adopted after five fatal attacks that occurred between 2011 and 2013; it not only removed tens of sharks (mainly tiger
The purpose of this chapter is to provide marine biologists or medical practitioners potentially involved in the postmortem analysis of a shark attack with the basic knowledge for assessing the species and size of a shark, based on bite features and tooth imprint. Our focus will remain on the data that should be collected and analysed from the wounds on a shark bite victim. This chapter does not include the ecological aspects (including life traits and behaviour of the sharks) which are a critical part of the holistic analysis of a shark attack in order to identify the shark species potentially involved in a fatal interaction. Neither does it include the problems that may appear when cadavers remain in the water for a significant period, creating several problems for diagnostics as shown by [10], nor forensic anthropology that examines taphonomic evidence of marine deposition and shark-feeding activities on human remains (see [11]). The focus remains on the postmortem analysis that can be conducted in the framework of an autopsy done in few hours that follow a fatal attack or the analysis conducted on photographs of the body, once quality images and suitable metrics are available.
\nMost sharks are predators that feed on other animals they capture, facilitated by adapted jaws holding several lines and rows of teeth. In contrast to mammalian teeth, shark teeth contain fluorapatite, Ca5(PO4)F, which is harder than hydroxyapatite [12]. Teeth may have different functions and thus different structures and hardness. For example, teeth of the mako shark
(A) Jaw of a tiger shark,
Whatever their sharpness and shape, these jaws and teeth constitute a potential threat to humans, also considering that certain species, such as the tiger shark, may produce biting forces of up to 3300 kg/cm2 [14, 15, 16].
\nThe dentitions of sharks are also well known for their ability to regenerate in a continuous conveyor-belt manner throughout life, displaying a high polyphyodontism [17], another characteristic of importance in the context of bite analysis. A tooth series is defined as the active teeth of a longitudinal jaw axis; a row is defined as the in-line teeth of any individual tooth of the active series [18] (Figure 2).
\n(A) Close-up of central lower jaw of a tiger shark,
For the 370 shark species described, only 32 were documented as attacking humans, and 3 seem mainly involved in fatal attacks over the world: the great white shark,
Common name | \nScientific name | \nNon-fatal unprovoked | \nFatal unprovoked | \nTotal | \n
---|---|---|---|---|
Great white shark | \n234 | \n80 | \n314 | \n|
Tiger shark | \n80 | \n31 | \n111 | \n|
Bull shark | \n73 | \n27 | \n100 | \n|
Blue shark | \n9 | \n4 | \n13 | \n|
Oceanic whitetip shark | \n7 | \n3 | \n10 | \n
Confirmed species of shark implicated in unprovoked attacks around the world (1580–present) (source: [1]).
The large, erect, strong, triangular, serrated teeth of
White sharks exhibit a typical lamnoid dental pattern, with the upper dentition featuring marked heterodonty with slender teeth in the lower jaw [20, 23]. It is important to note that white sharks do not have symphyseal teeth [24]. The first and second anterior teeth (UR1 and UR2) of white sharks are erect and nearly symmetrical, while the lateral teeth (UR4 and UR5) become progressively slanted towards the jaw corner [25]. As described by [20], the upper dentition of white sharks features reversed intermediate teeth (UR3 and UL3) (see Figure 4). The reversed intermediate teeth (UR3 or UL3) create a significantly larger interspace measurement between it and the first lateral teeth (UR4 or UL4) than between any other two teeth of the upper jaw (Figure 4). Generally the large gaps that exist between teeth frequently lead to torn flaps of the skin and flesh between clear-cut punctures. These features should of course be taken into consideration when analysing a bite potentially from a white shark (see Section 4.3).
\nWhite shark dentition and terminology: (A) jaw terminology, tooth identification and measurements, showing location (indicated by chord a^b) of the intermediate bar between the intermediate (UR3 or UL3) and first lateral (UR4 or UL4) teeth, and (B) dice diagram of interspace ratio between successive pairs of upper teeth, where vertical bar1 = range, horizontal bar1 = mean, white box1 = standard deviation and hashed box1 = 95% confidence limits. In both (A) and (B), the vertical dashed line indicates head axis through the jaw symphysis (adapted from Ref. [
Both jaws have large teeth with curved cusps and finely serrated edges. Each tooth has a deep notch on the outer margin lined with numerous cusplets. Upper and lower teeth are similar in shape and size and decrease in size as they move back towards the corners of the mouth. There are 18–24 teeth in each jaw, these teeth forming a single cutting edge (Figure 5). The teeth have large cusps, forming a cockscomb shape, with prominent serrations [26]. The strong enamel cusps and serrations help strengthen the tooth structure and dissipate the biting stresses [27]. This makes the tiger shark jaw an extremely efficient and unique cutting tool [28].
\n(A) General features of the tiger shark
The tiger shark is also unique because it has highly kinetic jaws that are exceptionally broad-based, heavily calcified and fused at the symphyses [29]. This allows for the single row of cusped, serrated teeth to extend out from the skull, seize the prey and begin to saw into the bone, performing the ‘saw-biting’ technique [30]. The broad, heavily calcified jaws, supported by the extra-strong symphyseal fusion, reinforce the entire jaw apparatus and enable the shark to bite through very hard objects such as shells of chelonids [26].
\nUpper teeth of the bull shark are broad, triangular and strongly serrated, with erect or slightly oblique cusps, and their bases overlap with each other (Figure 6); lower teeth have a broad base and are narrow and slender with fine serrations, but no overlap with adjacent teeth bases. Usually, there are 13/12 rows of anteroposterior teeth in each jaw half, but they vary from 12 to 14/12 to 13 [32] (Figure 6).
\n(A) General features of bull shark dentition, showing (B) upper and lower jaws; upper teeth (B2) form a continuous cutting edge with strong overlapping between teeth (C), while lower teeth (B1) are slender, displaying clear heterodonty. (D) Teeth from the upper jaw are usually more numerous than those from the lower jaw (adapted from Ref. [
As for many carcharhinids, upper teeth are primarily used to cut and saw (sideways movement along a surface when embedded in it, with ongoing perpendicular pressure); lower teeth are primarily used to puncture and hold prey item in position, with limited capability of cutting and sawing [7].
\nAlong with the jaw and teeth features of the main candidate species, wound examinations usually focus on the number of bites, margin structure, tooth imprints, wound depth and tissue loss in order to assess the species identity [34, 35]. However, most of the time, these data are insufficient for a reliable identification and must be considered with ecological data about the presence and behaviour of the species (pelagic vs. coastal affinities, seasonality, etc.) and/or, if available, data provided by potential witnesses of the attack.
\nHistorically, the size of the animal was assessed by comparing the length of the individual wound margins with jaws from known-sized animals [7]. Also, regressions that can provide the size of an animal based on the bite width (BW) are available (see Table 2 for a review of regressions available from the litterature for white and tiger sharks).
\nSpecies | \nGreat white shark | \nTiger shark | \n||
---|---|---|---|---|
Ref. | \n[36] | \n[37] | \n[38] | \n[39] | \n
Regression | \nTL = (BW + 2.4642)/0.0986 | \nBW = 10.4% TL +/− 1.3 | \nBW = 11,7% TL +/− 1.7 | \nBW = 0.12 TL +/− 7.99 | \n
n | \n6 (from 163 to 510 cm TL) | \n14 M + 19 F (from 170 to 391 cm TL) | \n10 M + 20 F (from 104 to 410 cm TL) | \n93 | \n
Estimated total length (TL) from bite width (BW) for the great white shark and the tiger shark using regressions from the literature.
However, inspired by studies conducted on cetaceans [39] and based on anatomical differences of jaws and teeth within shark species, Lowry et al. [40] proposed a forensic analysis method of shark bite wound patterns. It is based on the determination of a standard relationship between the measure of the average interdental distance (IDD) and the bite circumference (BC) of the jaw with the individual’s total length (TL). The IDD and BC are allometric with the global size and are accurate predictors of the TL of a species-individual. Indeed, one of the numerous elasmobranch characteristics is a continuous replacement of the teeth throughout life, allowing the jaw growth. The number of teeth remains constant, but each new tooth is slightly larger than the one it replaces [41].
\nThus, nowadays, in order to estimate length of a shark from an autopsy or file pictures, it might be rapid and reasonable to measure either interdental distances or bite radii from upper or lower jaws, whatever measurements are available, and apply them to established log–log regressions provided by [40] (see Table 3).
\nType | \nJaw | \nRegression | \np | \n|
---|---|---|---|---|
IDD | \nUpper | \nY = 1.005x−2.111 | \n0.98 | \n<0.001 | \n
Lower | \nY = 0.925x−1.808 | \n0.97 | \n<0.001 | \n|
BC | \nUpper | \nY = 1.007x−0.800 | \n0.98 | \n<0.001 | \n
Lower | \nY = 0.966x−0.743 | \n0.99 | \n<0.001 | \n
Log–log regression between average interdental distance (IDD) or bite circumference (BC) and total body length of white sharks,
Average interdental distance and bite circumference represent the dependent variables, whereas total length is the independent variable.
If the IDD and BC can provide critical information, they might be insufficient for a reliable result. It is therefore necessary to include other measurements of the wounds. Hereafter, we provide a series of case studies that indicate complementary tools that are available in regard to the situation and the available data.
\nA single large bite was made to the right thigh, from the hip to the knee, with a length of 38 cm (Figure 7A). The thigh was cut deeply, with the femur bone broken at the level of the hip. The muscular mass was sectioned but was still attached to the femur bone whose distal part was still articulated to the knee. Despite the large bite, almost no tissue was removed as shown by the repositioning of the scalloped muscular mass on the leg (Figure 7B); the inner and outer margins on the wound on the inner part of the thigh fit together well although they are somewhat swollen. The blood vessels were divided, and according to the medical certificate, the victim died from exsanguination and hypovolemic shock. Apart from this large bite on the right thigh, no other wounds were identified on the body.
\n(A) Shark bite on the right thigh of the victim. X shows the bite width (BW) and Y the bite circumference (BC) that were accurately measured on the victim and used for the assessment of the shark size. The bite is not total; the thigh was not removed but is still attached to the knee; the femur is broken at level of hip. (B) The repositioning of the thigh scalloped by the bite shows that there was no significant loss of soft tissue (photos courtesy of Gendarmerie de Lifou for strict scientific use).
Given the size of the BC, the hypothesis of the bull shark was rejected to favour either a large white or tiger shark. Table 4 provides regressions for these two species between the total length of the shark and the width of the mouth/jaw or that of the bite, from the literature. Considering the size of the bite width of 38 cm [44], the total length of the shark would range between 352 and 410 cm TL for a great white shark (for a similar bite width, a tiger shark would be between 250 and 383 cm TL) (Table 4).
\nSpecies | \nGreat white shark | \nTiger shark | \n||
---|---|---|---|---|
Ref. | \n[36] | \n[37] | \n[38] | \n[39] | \n
Formula | \nTL = (BW + 2.4642)/0.0986 | \nBW = 10.4% TL +/− 1.3 | \nBW = 11.7% TL +/− 1.7 | \nBW = 0.12 TL +/− 7.99 | \n
n | \n6 (from 163 to 510 cm TL) | \n14 M + 19 F (from 170 to 391 cm TL) | \n10 M + 20 F (from 104 to 410 cm TL) | \n93 | \n
BW (cm) | \nCalculated TL (cm) | \nCalculated TL (cm) | \nCalculated TL (cm) | \nCalculated TL (cm) | \n
38 | \n410.4 | \n352.9–377.9 | \n310.3–339.3 | \n250.1–383.3 | \n
Estimated total length (TL) from bite width (BW) for the great white shark and the tiger shark using regressions from literature.
Using a BC of 596 mm [44] and based on the regressions provided by [40], the species involved in this fatal attack seems to be a great white shark of about 3.5-m TL (Figure 8). However, these regressions also show that given a BW of 38 cm, the BC should be much lower than 59.6 cm for the attacker to be a tiger shark for which the TL would range from 250 to 383 cm TL (as shown in Table 4). The formula by [40] shows that a tiger shark with a 38-cm BC would have a TL >410 cm (Figure 8). This is due to the curvature of the BC which is different between the two species. The hypothesis of the white shark should then prevail. Also, based on behavioural features of the attack (provided by a witness), Clua and Séret [42, 43] concluded that the candidate species for this 2007 attack in Lifou Island was a white shark and not a tiger shark as supported by Tirard et al. [44]. This choice seems to be supported by the tools provided by Lowry et al. [40].
\nScreen copies of the results obtained through the excel table from Ref. [
As demonstrated by [40], the teeth sizes of some shark species vary directly with the total length (TL) of an individual, and a log-linear relationship exists between those two variables. The measure of the IDD can therefore give a reliable estimate of the TL of an individual for most species. The relationship between the BC and length gives a minimal estimate of a shark TL. It is less informative than the IDD because the marks left on the organism or object can be partials, as only a part of the jaw is often used during the bite.
\nThe IDD is measured between adjacent teeth in the first six tooth files (a tooth in the functional row and its replacing teeth are a tooth file) on each side of the symphysis. It is the measure between the tip of a functional tooth and the tip of the functional tooth of the adjacent file (see the interspace between teeth ends from Figure 4). The symphyseal teeth are excluded if present; they are often small, misshaped and randomly arranged. The IDD are measured on both sides of each jaw which leads to a total of 20 measurements for each individual [40].
\nBased on the body examination and the witness’ declaration, it was evident that the shark attack was violent and sustained, with several strikes (> 3). Four main wounds could be distinguished: the right thigh was fleshless from the hip to the knee (with exposed femur), the right arm was missing, the right calf showed a large wound with no loss of tissue and a smaller wound was located on the right ankle which displayed clear cuts on medial and lateral sides that had dislocated the joint (Figure 9). The autopsy physician determined that death was probably caused by a cardiopulmonary collapse due to the huge haemorrhage on the severing of the axial and femoral blood vessels. To conduct the analysis of the wounds, we mainly used the ‘interdental distance’ (IDD) and the ‘bite circumference’ (BC) for assessing the species and size of the shark. Accurate calculation of IDD is actually easier with partial bites, and there was only one photo that could be effectively used for this calculation, showing at the same time a partial bite and a measuring scale (Figure 9C).
\n(A) The body of the 19-year-old victim showing the main two wounds in the right arm has been clearly severed 10 cm below the joint of the shoulder (top of the photo); all flesh and muscles have been removed from the right thigh, from the hip down to just above the knee (central and lower part of the photo). (B) Arcs B1 and B2 show the two main bites to the right calf, with tooth impression of the top jaw. For the left-hand arc (B1), it appears that the shark held the leg for a very short time, with a shallow holding bite, and then eased off before biting down and ripping with full force, just below the labelled marks (B2). On B2, we could define the first isolated tooth mark (top left) as the first upper left tooth (UL1), followed then on the right by the upper right teeth (UR1 to UR5). (C) The glove box (24 cm wide) gave us a scale allowing us to calculate bite width as approx. 17 cm, distances between UR1 and UR2 (D1) to be approx. 2.0 cm and UR2–UR3 as (D2) approx. 1.5 cm, UR3–UR4 (D3) approx. 2.4 cm and UR4–UR5 (D4) approx. 2.8 cm. The average IDD for the left bite arc is approximately 3 cm. The bite width probably represents the jaw width at the fifth tooth from the symphysis (photos courtesy of Gendarmerie de Bourail for strict scientific use).
The average IDD calculated on the partial bite of the right calf inflicted by teeth of the upper jaw of the shark (see Figure 9B) was 21.75 mm. Based on [40], only two shark species have upper jaw features fitting with such an IDD: a 2.65-total length (TL) white shark,
Besides the use of IDD and BC for assessing the species and size of the shark, the analysis of the pattern of the teeth marks, directly linked to the species-specific teeth characteristics of the shark, can also be compared with dental impressions of the three main candidate species. Rapid-curing vinyl polysiloxane impression material putty can be used to make these impressions using dried jaws from sharks of accurately measured total length (Figure 10). Such a process can help through the identification of specific marks and positioning of the teeth on the wounds, including the shape of tissue and flesh flaps that depend on the teeth position (see Case studies C and D).
\nTeeth impressions from the lower jaw of the three main candidate species of shark, potentially involved in a fatal attack (from left to right): (A) white shark,
On the basis of the body examination and the witnesses’ statements, it was evident that the shark approached the victim from below. A major wound (W1, 38 cm in length) with a significant loss of tissue was centred on both sides of the knee in the front and internal sides of the leg. Two other smaller wounds, with almost no loss of tissue, were inflicted on the back of the leg: one at the level of the thigh (W2, 18 cm in length and 10 cm in width) and another behind the knee and the top of the calf (W3, 30 cm in length and 7 cm in width) (Figure 11). As mentioned in the autopsy report, the death was undoubtedly caused by a cardiopulmonary collapse due to the huge haemorrhage following the severing of the left femoral blood vessel through the first wound.
\n(A) Lateral view of the lower part of the first wound (W1). Arrow 1 shows the specific parts of the wound with sharp and square corners, quasi-parallel cuts, that are characteristic of a tiger shark teeth impression. (a’) Close-up view on (a): showing a skin flap which results from two overlapping teeth (T and T + 1). (B) The third wound (W3) has an elongated frame with length 30 cm width 7 cm. (b’) Close-up view on (b): showing a skin flap which also results from two overlapping teeth. Arrows 2 and 3 indicate two superficial scratches inflicted by two symphyseal teeth (at the junction of the two jaw segments) (photos courtesy of Gendarmerie de Koumac for strict scientific use).
The analysis of the first wound (W1) revealed that it was probably the result of two different adjacent and overlapping bites or one single bite inflicted as the leg was bending (see [47] for details). Analysis of the lower bite showed that the orientation of the tooth impressions and their shape, together with the small, smoothly sliced flaps, and the very smooth arc of the upper jaw bite, indicate a tiger shark as probably responsible for this attack. This hypothesis was confirmed by the observation of the three teeth impressions from the bottom left of the bite corresponding to this wound. These impressions are more or less parallel and have sharp cut corners, which is consistent with a tiger shark (Figure 11A). Also, the shape of the tooth impressions shows no clear morphological differences between those from the upper and lower jaws, indicating dignathic homodont jaws [47], characteristic of the tiger shark, compared to the white shark and bull shark which have dignathic heterodont jaws. In addition to these elements, the shape of some flesh flaps showed that there was an almost overlapping between the teeth (Figure 11A and B). This detail eliminates the white shark, and regarding the bull shark hypothesis, the overlapping in teeth of the upper jaw is so efficient (see Figure 6) that the presence of flesh flaps is unlikely.
\nCase studies A and B also provide examples of evidence that support the identification of the attacking species. Actually, in both cases, the wounds presented large flesh flaps that are specific to the white shark, given the specific position of its teeth and the large interdental spaces (see Figures 3 and 4). In both case studies, it is possible to identify at least a large flesh flap that results from the space between the two first teeth of the upper jaw (UR1 and UL1), combined with the absence of symphyseal teeth (see Figure 12).
\n(A) Close-up of the wounds from case A that shows (X) a large flesh flap that seems to correspond to the symphyseal space of a white shark jaw, as well as (Y) and (Y′) flesh flaps that correspond to the large space that exist between UR3/UL3 and UR4/UL4 (see
The present research aims at introducing marine biologists and medical practitioners to the basic knowledge necessary for analysing the wounds left by a shark bite. The implementation of these techniques is dependent on directly observing the victim or of the availability of quality photographs. Unfortunately photographic images often do not include any scale measure which significantly lowers the probability of an accurate conclusion.
\nIn practice, these techniques can help but are often insufficient for species identification. It is then necessary to stress the benefit and utility of taking an interdisciplinary approach to forensic anthropological casework, specifically collaborating with a scientist with expertise in shark biology in cases of suspected shark attack. This type of integrated approach is common in taphonomic analyses and should be considered best practice [11].
\nIn the context of case studies A and D, we wish to thank M. Neko Hnepeune, Mayor of Lifou Island; M. Dominique Mole, General Secretary of Lifou Island; M. Afif Lazrak, General Secretary of the administrative subdivision of the Loyalties Islands; and M. H. Ansquer, the vice-coroner of the French Republic in Noumea for trusting us in investigating the case. We also thank the parents of the victim for their understanding and her friend (L.L.) for her collaboration. In the context of case study B, we wish to thank the victim’s mother, Rose-Marie Hannecart, for allowing us to conduct and publish this analysis. The file that allowed this analysis was kindly provided by the ‘Procureur de la République’, Tribunal de Noumea, Nouvelle-Calédonie, under the file reference ‘Parquet/A0904702’; additional high-resolution images were provided by the ‘Brigade de gendarmerie’ de Bourail. In the context of case study C, we wish to mention that the file that allowed this analysis was kindly provided by the ‘Procureur de la République’, Tribunal de Noumea, Nouvelle-Calédonie. We also specifically thank Thomas Vignaud, Douglas Seifert and Simon De Marchi for the use of their outstanding photographs.
\nThe stiff knee (SKN) is considered as a clinical situation that the range of motion (ROM) is less than a 50° arc of movement [1, 2]. SKN causes a variable level of functional disability, painful discomfort during scarce knee mobility, limp in the gait cycle, and hamper with activities of daily living [3]. Normal walking requires 70°–80° of ROM, stairs require 80°–90° of ROM, and squatting requires at least 130° of ROM [4].
The main causes of SKN are previous surgery on the knee, advanced primary knee ostearthritis, secondary posttraumatic ostearthrosis, reflex sympathetic dystrophy (RSD), neuromuscular disorder, sequelae of previous infection, inflammatory diseases (rheumatoid and psoriatic arthritis), arthrofibrosis, and hemofilic arthropathy. Ankylosis is more common in patients who had their knee immobilized or who are wheelchair bound. The common clinical characteristics in patients with SKN are patela baja, quadriceps contracture, intra-articular adhesions, posterior capsule contracture, poor patellar gliding, and heterotopic ossification [5, 6]. Total knee arthroplasty (TKA) in SKN is a challenging procedure. One of the goals of TKA is to improve knee mobility, including ambulatory ability in the gait [7, 8]. Other goals of TKA in patients with SKN are to relieve pain, improve the alignment to correct the knee deformity, and provide knee stability.
The most relevant factor that predicts knee mobility after TKA is preoperative range of motion [9, 10]. Young age, female sex, and obese patients are more susceptible to achieve less mobility after TKA [11, 12]. In patients with SKNs, the predominant symptom is not mechanical pain. Functional disabilities like impairments in stair climbing, unable to sit on a chair, and inability to walk a long distance are common complaints. Psychological and cosmetic harms are associated with decline in the quality life. TKA is considered a valuable option to improve functional capacity and obtain a mobile knee.
The SKN can be presented clinically in loss of extension (LOE), loss of flexion (LOF), mixed or ankylosed. The major troubles in LOE are adhesions in suprapatellar pouch and in medial and lateral gutters, contracture of extensor mechanism, patellofemoral joint fusion, and loss of tibiofemoral joint space. The SKN in LOF, the extensor mechanism that is elongated with posterior capsule, posterior cruciate ligament (PCL), and collaterals ligaments are contractured. The posterior osteophytes causes a mechanical barrier to achieve complete ROM. Ankylosed knee can be associated with knee arthrodesis, infection, reconstruction after tumor ressection, after severe trauma with distal femur, and tibial plateau fractures. The classification proposed by Sharma [13] is based on the degree of loss of ROM in the knee joint, as shown in Table 1.
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Classification for stiff/ankylosed knees proposed by Sharmal [13].
This classification provides a guidance for surgeons related to surgical approach, type of prosthetic implants, and helps to presume functional outcome after TKA.
Advanced primary knee osteoarthritis (Kellgren-Lawrence 3 or 4);
Posttraumatic knee osteoarthitis and/or previous knee surgery;
After knee osteotomy (distal femur and/or proximal tibia);
Arthrofibrosis (post-surgery and/or prolonged immobilization);
Inflammatory osteoarthritis (rheumatoid arthritis and psoriasis);
Hemophilic arthropathy;
Ankylosis (after knee arthrodesis);
Heterotopic ossification (HO);
Reflex sympathetic dystrophy (RSD);
Neurologic arthropathy;
Postinfection arthropathy.
Neuromuscular disease (s) with RSD;
Paralysis after brain vascular stroke;
Patient inability to follow the postoperative rehabilitation protocol;
Active infection without clinical control.
A through clinical history must include questions about previous conservative treatment and surgeries, period of time that stiffness started, comorbidities, medications, and psychological profile. The physical examination must comprise the preoperative passive and active ROM (flexion and extension), patellar gliding, the amount of flexion contracture, scars, type and flexibility of the angular deformity, gait pattern, and extensor mechanism status (elongated or contractured). Osteoporosis is frequent in SKNs. Complete motor, sensory, and vascular assessment should be performed. Ankle/brachial index and Doppler ultrasound can be useful to estimate the function of blood circulation in the legs.
The imaging exams of the knee should include radiographic evaluation in anteroposterior (AP) and lateral at 30° of flexion (Figures 1 and 2). Special views with maximal and minimal flexion in the sagittal plane should be documented. Long-axis anteroposterior (AP) view can be useful to determine the mechanical and anatomical axis of the lower limbs. The sunrise patellar view at 45° of flexion can demonstrate a severe arthritic involvement, where the patella usually is fused with the anterior femur [2, 5]. A stress view in the coronal plane can be helpful to determine if the angular deformity is rigid or correctable. Presence of hardware is not uncommon in STK patients. Computed tomography (CT) scan may be used to assess bone stock and rule out infections [3].
Radiography in anteroposterior view with stiff knee.
Radiography in lateral view with 30° of flexion.
The surgeon must select which type of knee prosthesis will be required. A broad assortment of modular systems are disposable according to each patient. More constrained implants can be considered in cases with bone loss, ligamentous insufficiency, or after extensive soft tissues releases. A custom prosthesis must be fabricated for a particular situation as a very small or large knees and ankylosed knees in rheumatoid patients. In a previous infected STK, a staged procedure can be recommended to decrease the risk of serious complications [14, 15].
The type of anesthesia should emphasize the muscle relaxation and minimize blood loss. Usually, the epidural anesthesia associated with peripheral nerve block as adductor canal provide decrease of narcotic usage and postoperative pain. The tranexamic acid (20–60 mg/kg) can be administrated intravenous during the anesthetic induction in attempt to reduce the blood loss. The use of tourniquet is questionable and can be avoidable in STK patients [16, 17]. The use of sterile drape is recommended, and the leg should be free to move during the TKA. The range of motion (ROM) and ligamentous stability should be addressed prior the incision and documented.
A straight midline incision should be used, if there is not prior surgical scar. If an anterior longitudinal knee scar is found, the skin incision starts more proximally. Usually, the skin is adherent to the subcutaneous tissue and careful dissection may be required to mobilize the skin. This step assists the deep subfascial dissection and facilitates the dermis and epidermis closure. A medial parapatellar arthrotomy is performed with capsule opening and releases the adhesions in the suprapatellar pouch and plane between anterior distal femur underneath the quadriceps tendon. After this step, cleaning the medial and lateral gutters may be required to gain adequate exposure. All the fibrotic tissues should be removed. The patellar tendon is identified and protected during the TKA, and the space posterior to the tendon freed by sharp dissection with the scalpel or eletrocautery.
The next step is the patellar eversion. The difficulty to dislocate the patella laterally, in SKN, remains a problem. The lateral retinacular release can be performed, if the knee remains stiff with flexion less than 40° and the lateral patellofemoral ligament is cut to assist the patellar eversion. An extensive transquadricipital approach, the rectus snip, can be performed to improve and provide good exposure with low risk related to the extensor mechanism damage. The rectus tendon is transected in an oblique fashion, around 45°, in a superior and lateral direction [18]. Orienting the rectus snip distally allows for conversion to a V-Y quadricepsplasty that the surgeon incises the rectus tendon and vastus lateralis, but not the lateral retinaculum [19, 20]. This approach preserves the superior lateral geniculate artery, which provides the major blood supply to the patella, when a medial arthrotomy has been performed. However, this technique is not recommended in the presence of subluxated or dislocated patella laterally. In this scenario, an extensive lateral retinacular release can be performed and the patella is everted and knee is flexed gently. It is recommended to be cautious during this maneuver to avoid patellar tendon avulsion from the tibia tubercle, bone avulsion, and medial collateral ligament (MCL) tear in the progression for the knee flexion [21]. The placement of a metallic pin through the tibial tubercle can decrease the stress over the patellar tendon and hinder the avulsion. The combination of a quadriceps snip and lateral release provides an adequate exposure for most SKNs. The rectus tendon and vastus lateralis muscle are repaired, but the lateral retinacular incision is left open. This approach has the advantage of not requiring modification of postoperative rehabilitation [22].
In the varus deformity, the subperiosteal medial release is then continued, with a sharp scalpel, an electrocautery or an osteotome, as the knee is further flexed and the tibia externally rotated. Dissection should begin in extension on the bone surfaces in attempt to mobilize the soft tissues. Then, skeletonization of the tibia and femur has been performed to allow knee flexion for adequate exposure. For severe varus SKNs, a medial transepicondylar femoral osteotomy may be required. In the valgus deformity with SKNs, a decision must be made to choose an anterior longitudinal traditional incision or lateral approach described by Keblish [23].
The tibial tubercle osteotomy (TTO) can be performed to extend the incision distally for the most difficult SKNs. The osteotomy should encompass at least 8 centimeters (cm) distal to the top of the tibial tubercle. The bone cut is made with an oscillating saw from medial to lateral, and then the lateral cortex is transected with an osteotome. Muscle attachments to the lateral tibial crest with a periosteal soft tissues hinge are left preserved. Two or three wires are passed to encompass the tubercle during closure [24]. Furthermore, two or three screws can be used to stabilize the TTO, in patients with good bone quality. In osteoporotic bone, TTO is not recommended. Before wound closure, the knee was taken through a passive ROM to assure osteotomy fixation and patellofemoral tracking. Postoperatively, the patients wore a protective knee immobilizer while up and walking for the first 6 weeks.
For the ligament balancing, sequential soft tissue release can be performed to correct the angular deformity; if posterior cruciate ligament (PCL) appears to be functional and balanced, cruciate retaining (CR) prosthesis can be used, but this is an uncommon scenario. For a rigid or severe flexion, contracture may be necessary to cut more distal femur (2 mm) to achieve a straight knee in extension. It is not a feasible solution to cut more distal femur than 2 mm due to the high risk to raise the joint line. Then, the tibial and femoral bone cuts are recommended to place the laminar spreaders in extension and flexion in 90°. A curved osteotome is used to remove the posterior osteophytes and release the posterior capsule (Figure 3). This maneuver is essential to open the flexion gap [25](Figures 4 and 5).
Removal of posterior osteophytes in the femoral condyles.
Narrow flexion gap prior the posterior release.
Opening of the flexion gap with laminar spreaders.
Moreover, more constrained implants as posterior stabilized (PS) models with an elevated polyethylene post are considered as the implant of choice due to the PCL contracture in SKNs. If during insertion of trial components, the knee is unstable in both coronal and sagittal plane, and a more constrained modular component with augments and stems or hinged prosthesis can be chosen. It is recommended to place the femoral component more posterior to decrease the flexion gap, mainly in PS implants. The level of constriction will depend the extent of the ligamentous releases and the amount of bone loss encountered during the TKA. A tumor prosthesis or custom implants may be needed in extremely SKNs, especially in extension. The prosthesis chosen should have options available for femoral and tibial implants in attempt to re-establish the anatomic joint line with available metallic augments (Figures 6 and 7). Care should be taken to avoid overstuff in the patellofemoral articulation that can lead to a flexion contracture and anterior knee pain.
Postoperative radiography in anteroposterior view after TKA in stiff knee.
Postoperative radiography in lateral view after TKA in stiff knee.
In ankylosed and after knee arthrodesis, the patellar and proximal tibial cut can be performed in the beginning to obtain more space and promote a better exposure during the TKA. A posterior capsule release with the electrocautery and the laminar spreaders positioned in extension can help after the bone cuts to achieve zero degrees. For a more severe contracture above 30°, the quadricepsplasty may be needed in attempt to elongate the extensor mechanism and to re-establish the joint line. In patients with MCL insufficiency and bone loss in the metaphysis, a hinge TKA can be considered.
The closure of the quadriceps tendon should be performed between 30° and 60° of knee flexion, depending on the preoperative gravity of the SKN. The type of quadriceps release or TTO performed should be taken into account to consider the angulation of knee flexion during the closure. The intraoperative ROM after this surgical step should be documented with a photograph to demonstrate for the patient and the physiotherapist [26].
A light pressure dressing is applied, and cryotherapy can be used to reduce swelling and knee pain. The effectiveness of rehabilitation on functional outcomes depends on the appropriate timing, intensity, and progression of the ROM, accounting for the patient’s ability and level of pain. The use of the removable knee orthosis is debatable. It can be used in static or dynamic manner in attempt to avoid loss of motion after TKA [27]. The patient is immediately placed in a continuous passive motion (CPM) machine from 0° to 30° of flexion in the recovery room. The flexion is increased 10° a day or as tolerated. The physical therapy can be prescribed in the early stage of the postoperative rehabilitation protocol intercalated with the CPM to optimize the gain of knee motion [28]. The pain control is crucial to achieve the progressive ROM. The use of spinal or epidural catheters with analgesic infusion can be helpful after TKA in SKNs. The early quadriceps activation is recommended with physical methods (sensory transcutaneous electrical stimulation), active isometric contraction, and early deambulation with walker or crutches. After TTO and V-Y quadricepsplasty, the rehabilitation protocol is delayed to preserve bone and soft tissue healing, mainly between 4 to 6 weeks. A long orthosis is recommended in the lower limb to keep the gait secure. The recovery of quadriceps function is essential to achieve a satisfactory outcome during the day life activities, improve ROM, and obtain a stable gait [29].
The clinical results of TKA in SKNs are inferior in comparison with non-stiff knees with higher complication rates [21, 30]. The rate of complications ranges from 21–35% [31, 32]. The common complications are patellar tendon avulsion, partial or complete tear of MCL, bone fracture or avulsion (epicondyle (s), patella), stiffness after TKA, wound dehiscence, ligamentous imbalance between extension, and flexion gap. Gentle knee flexion and progressive subperiosteal soft tissue releases with the electrocautery can prevent intraoperative bone fracture. It is not uncommon a painful TKA in SKNs that can be a challenging situation to achieve a better functional outcome. Extension lag is associated with V-Y quadricepsplasty [32]. Aseptic loosening in the tibial component has been described in some SKNs [32, 33]. Osteoporotic bone can be considered as a risk factor for fractures around the knee.
The functional scores applied after TKA like Hospital for Special Surgery (HSS), Knee Society Score (KSS), Knee Society Functional Score (FS) have improved due to gain in postoperative ROM in comparison with preoperative status [11, 30, 31, 32, 33]. The range of improvement in ROM after TKA in SKNs is around 50°–70°. The range of improvement in KSS after TKA is between 30 and 45 points [30, 31, 32, 33]. In spite of the enhancement in motion, some residual flexion contracture is predictable in type 2 and 3 SKNs and can affect the pattern of the gait. A limp with overload in the lumbar spine can be expected in this scenario.
The TKA in SKNs is technically demanding with a time-consuming rehabilitation protocol. Patient expectation should be realistic according to the level of SKNs. The complication rate is greater than conventional TKA. A good preoperative evaluation is mandatory to avoid unexpected intra- and postoperative hassle.
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His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. 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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The literature source was Web of Science and SSCI, SCI-EXPANDED, A&HCI, CPCI-S, CPCI-SSH, and ESCI indexes. Fifty-two articles were reviewed; however, 14 of them were not been included in the study. As a result, 38 articles were examined. Level of education, field of education, and material types of AR used in education and reported educational advantages of AR have been investigated. All articles are categorized according to target groups, which are early childhood education, primary education, secondary education, high school education, graduate education, and others. AR technology has been mostly carried out in primary and graduate education. “Science education” is the most explored field of education. Mobile applications and marker-based materials on paper have been mostly preferred. The major advantages indicated in the articles are “Learning/Academic Achievement,” “Motivation,” and “Attitude”.",book:{id:"6543",slug:"state-of-the-art-virtual-reality-and-augmented-reality-knowhow",title:"State of the Art Virtual Reality and Augmented Reality Knowhow",fullTitle:"State of the Art Virtual Reality and Augmented Reality Knowhow"},signatures:"Rabia M. Yilmaz",authors:[{id:"225838",title:"Dr.",name:"Rabia",middleName:null,surname:"Yilmaz",slug:"rabia-yilmaz",fullName:"Rabia Yilmaz"}]},{id:"63639",doi:"10.5772/intechopen.81086",title:"Cooperative Learning: The Foundation for Active Learning",slug:"cooperative-learning-the-foundation-for-active-learning",totalDownloads:3491,totalCrossrefCites:18,totalDimensionsCites:25,abstract:"The role of instructors is evolving from the presenter of information to the designer of active learning processes, environments, and experiences that maximize student engagement. The more active a lesson, the more students tend to engage intellectually and emotionally in the learning activities. Cooperative learning is the foundation on which many of the active learning procedures are based. Cooperative learning is the instructional use of small groups so that students work together to maximize their own and each other’s learning. Most of the active learning procedures, such as problem-based learning, team-learning, collaborative learning, and PALS, require that students work cooperatively in small groups to achieve joint learning goals. Cooperative learning is based on two theories: Structure-Process-Outcome theory and Social Interdependence theory. Four types of cooperative learning have been derived: formal cooperative learning, informal cooperative learning, cooperative base groups, and constructive controversy. There is considerable research confirming the effectiveness of cooperative learning. To be cooperative, however, five basic elements must be structured into the situation: positive interdependence, individual accountability, promotive interaction, social skills, and group processing.",book:{id:"6929",slug:"active-learning-beyond-the-future",title:"Active Learning",fullTitle:"Active Learning - Beyond the Future"},signatures:"David W. Johnson and Roger T. Johnson",authors:[{id:"259976",title:"Dr.",name:"David",middleName:null,surname:"Johnson",slug:"david-johnson",fullName:"David Johnson"},{id:"263004",title:"Dr.",name:"Roger",middleName:null,surname:"Johnson",slug:"roger-johnson",fullName:"Roger Johnson"}]},{id:"58060",doi:"10.5772/intechopen.72341",title:"Pedagogy of the Twenty-First Century: Innovative Teaching Methods",slug:"pedagogy-of-the-twenty-first-century-innovative-teaching-methods",totalDownloads:8833,totalCrossrefCites:17,totalDimensionsCites:23,abstract:"In the twenty-first century, significant changes are occurring related to new scientific discoveries, informatization, globalization, the development of astronautics, robotics, and artificial intelligence. This century is called the age of digital technologies and knowledge. How is the school changing in the new century? How does learning theory change? Currently, you can hear a lot of criticism that the classroom has not changed significantly compared to the last century or even like two centuries ago. Do the teachers succeed in modern changes? The purpose of the chapter is to summarize the current changes in didactics for the use of innovative teaching methods and study the understanding of changes by teachers. In this chapter, we consider four areas: the expansion of the subject of pedagogy, environmental approach to teaching, the digital generation and the changes taking place, and innovation in teaching. The theory of education, figuratively speaking, has two levels. At the macro-level, in the “education-society” relationship, decentralization and diversification, internationalization of education, and the introduction of digital technologies occur. At the micro-level in the “teacher-learner” relationship, there is an active mix of traditional and innovative methods, combination of an activity approach with an energy-informational environment approach, cognition with constructivism and connectivism.",book:{id:"5980",slug:"new-pedagogical-challenges-in-the-21st-century-contributions-of-research-in-education",title:"New Pedagogical Challenges in the 21st Century",fullTitle:"New Pedagogical Challenges in the 21st Century - Contributions of Research in Education"},signatures:"Aigerim Mynbayeva, Zukhra Sadvakassova and Bakhytkul\nAkshalova",authors:[{id:"201997",title:"Dr.",name:"Aigerim",middleName:null,surname:"Mynbayeva",slug:"aigerim-mynbayeva",fullName:"Aigerim Mynbayeva"},{id:"209208",title:"Dr.",name:"Zukhra",middleName:null,surname:"Sadvakassova",slug:"zukhra-sadvakassova",fullName:"Zukhra Sadvakassova"},{id:"209210",title:"Dr.",name:"Bakhytkul",middleName:null,surname:"Akshalova",slug:"bakhytkul-akshalova",fullName:"Bakhytkul Akshalova"}]},{id:"59468",doi:"10.5772/intechopen.74344",title:"Virtual and Augmented Reality: New Frontiers for Clinical Psychology",slug:"virtual-and-augmented-reality-new-frontiers-for-clinical-psychology",totalDownloads:2364,totalCrossrefCites:13,totalDimensionsCites:21,abstract:"In the last decades, the applied approach for the use of virtual reality (VR) and augmented reality (AR) on clinical and health psychology has grown exponentially. These technologies have been used to treat several mental disorders, for example, phobias, stress-related disorders, depression, eating disorders, and chronic pain. The importance of VR/AR for the mental health field comes from three main concepts: (1) VR/AR as an imaginal technology, people can feel “as if they are” in a reality that does not exist in external world; (2) VR/AR as an embodied technology, the experience to feel user’s body inside the virtual environment; and (3) VR/AR as connectivity technology, the “end of geography’. In this chapter, we explore the opportunities provided by VR/AR as technologies to improve people’s quality of life and to discuss new frontiers for their application in mental health and psychological well-being promotion.",book:{id:"6543",slug:"state-of-the-art-virtual-reality-and-augmented-reality-knowhow",title:"State of the Art Virtual Reality and Augmented Reality Knowhow",fullTitle:"State of the Art Virtual Reality and Augmented Reality Knowhow"},signatures:"Sara Ventura, Rosa M. Baños and Cristina Botella",authors:[{id:"106036",title:"Dr.",name:"Rosa Maria",middleName:null,surname:"Baños",slug:"rosa-maria-banos",fullName:"Rosa Maria Baños"},{id:"227763",title:"Ph.D.",name:"Sara",middleName:null,surname:"Ventura",slug:"sara-ventura",fullName:"Sara Ventura"},{id:"229056",title:"Dr.",name:"Cristina",middleName:null,surname:"Botella",slug:"cristina-botella",fullName:"Cristina Botella"}]},{id:"64583",doi:"10.5772/intechopen.81714",title:"Evaluating a Course for Teaching Advanced Programming Concepts with Scratch to Preservice Kindergarten Teachers: A Case Study in Greece",slug:"evaluating-a-course-for-teaching-advanced-programming-concepts-with-scratch-to-preservice-kindergart",totalDownloads:1422,totalCrossrefCites:13,totalDimensionsCites:18,abstract:"Coding is a new literacy for the twenty-first century, and as a literacy, coding enables new ways of thinking and new ways of communicating and expressing ideas, as well as new ways of civic participation. A growing number of countries, in Europe and beyond, have established clear policies and frameworks for introducing computational thinking (CT) and computer programming to young children. In this chapter, we discuss a game-based approach to coding education for preservice kindergarten teachers using Scratch. The aim of using Scratch was to excite students’ interest and familiarize them with the basics of programming in an open-ended, project-based, and personally meaningful environment for a semester course in the Department of Preschool Education in the University of Crete. For 13 weeks, students were introduced to the main Scratch concepts and, afterward, were asked to prepare their projects. For the projects, they were required to design their own interactive stories to teach certain concepts about mathematics or physical science to preschool-age students. The results we obtained were more satisfactory than expected and, in some regards, encouraging if one considers the fact that the research participants had no prior experiences with computational thinking.",book:{id:"6936",slug:"early-childhood-education",title:"Early Childhood Education",fullTitle:"Early Childhood Education"},signatures:"Stamatios Papadakis and Michail Kalogiannakis",authors:null}],mostDownloadedChaptersLast30Days:[{id:"58060",title:"Pedagogy of the Twenty-First Century: Innovative Teaching Methods",slug:"pedagogy-of-the-twenty-first-century-innovative-teaching-methods",totalDownloads:8845,totalCrossrefCites:17,totalDimensionsCites:23,abstract:"In the twenty-first century, significant changes are occurring related to new scientific discoveries, informatization, globalization, the development of astronautics, robotics, and artificial intelligence. This century is called the age of digital technologies and knowledge. How is the school changing in the new century? How does learning theory change? Currently, you can hear a lot of criticism that the classroom has not changed significantly compared to the last century or even like two centuries ago. Do the teachers succeed in modern changes? The purpose of the chapter is to summarize the current changes in didactics for the use of innovative teaching methods and study the understanding of changes by teachers. In this chapter, we consider four areas: the expansion of the subject of pedagogy, environmental approach to teaching, the digital generation and the changes taking place, and innovation in teaching. The theory of education, figuratively speaking, has two levels. At the macro-level, in the “education-society” relationship, decentralization and diversification, internationalization of education, and the introduction of digital technologies occur. At the micro-level in the “teacher-learner” relationship, there is an active mix of traditional and innovative methods, combination of an activity approach with an energy-informational environment approach, cognition with constructivism and connectivism.",book:{id:"5980",slug:"new-pedagogical-challenges-in-the-21st-century-contributions-of-research-in-education",title:"New Pedagogical Challenges in the 21st Century",fullTitle:"New Pedagogical Challenges in the 21st Century - Contributions of Research in Education"},signatures:"Aigerim Mynbayeva, Zukhra Sadvakassova and Bakhytkul\nAkshalova",authors:[{id:"201997",title:"Dr.",name:"Aigerim",middleName:null,surname:"Mynbayeva",slug:"aigerim-mynbayeva",fullName:"Aigerim Mynbayeva"},{id:"209208",title:"Dr.",name:"Zukhra",middleName:null,surname:"Sadvakassova",slug:"zukhra-sadvakassova",fullName:"Zukhra Sadvakassova"},{id:"209210",title:"Dr.",name:"Bakhytkul",middleName:null,surname:"Akshalova",slug:"bakhytkul-akshalova",fullName:"Bakhytkul Akshalova"}]},{id:"61746",title:"Facilitation of Teachers’ Professional Development through Principals’ Instructional Supervision and Teachers’ Knowledge- Management Behaviors",slug:"facilitation-of-teachers-professional-development-through-principals-instructional-supervision-and-t",totalDownloads:3392,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"With the rise of global competition and the focus on teacher quality, teacher professional development is becoming increasingly crucial, and the stress and challenges for principals are more severe than ever. Teachers can improve their professional abilities through principals’ instructional supervision and their own knowledge-management (KM) behaviors to benefit students. Thus, this chapter analyzes the relationship among principals’ instructional supervision, teachers’ KM, and teachers’ professional development. The author believes that principals’ instructional supervision and effective KM can facilitate the professional development of teachers. The author also believes the readers can know the relationships among them, and teachers’ professional development can be improved through principal’s instructional supervision and teachers’ KM behaviors.",book:{id:"6674",slug:"contemporary-pedagogies-in-teacher-education-and-development",title:"Contemporary Pedagogies in Teacher Education and Development",fullTitle:"Contemporary Pedagogies in Teacher Education and Development"},signatures:"Chien-Chin Chen",authors:[{id:"232569",title:"Ph.D.",name:"Chien Chih",middleName:null,surname:"Chen",slug:"chien-chih-chen",fullName:"Chien Chih Chen"}]},{id:"75908",title:"From the Classroom into Virtual Learning Environments: Essential Knowledge, Competences, Skills and Pedagogical Strategies for the 21st Century Teacher Education in Kenya",slug:"from-the-classroom-into-virtual-learning-environments-essential-knowledge-competences-skills-and-ped",totalDownloads:520,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"As teachers in Kenya begin to migrate from the classroom to virtual learning spaces following COVID 19 pandemic, there is pressing need to realign Teacher Education to requisite Knowledge, competences, skills, and attitudes that will support online teaching. This chapter explores these needs using a combination of lived experiences and literature review that captured a meta-analysis of research trends on e-learning. While trends in Teacher Education indicate progression towards adoption of technology, there are disparities between the theory and practice. Evidence from recent research and reports; and the recollected experiences confirmed knowledge, competence, skills and pedagogical gaps in the implementation of online learning, that have been exacerbated by COVID-19. The researcher recommends that teacher education should sensitize and train teacher trainees on how to access, analyze and use new knowledge emerging with technology; they also should be coached on how learners learn with technology and on fundamentals of the communication process. Particularly the course on educational technology, should focus on how to create and manage online courses. The 5-stage E-Moderator Model and Universal Design for Learning (UDL) are recommended as effective pedagogical scaffold for online teaching.",book:{id:"10229",slug:"teacher-education-in-the-21st-century-emerging-skills-for-a-changing-world",title:"Teacher Education in the 21st Century",fullTitle:"Teacher Education in the 21st Century - Emerging Skills for a Changing World"},signatures:"Catherine Adhiambo Amimo",authors:[{id:"333482",title:"Dr.",name:"Catherine Adhiambo",middleName:null,surname:"Amimo",slug:"catherine-adhiambo-amimo",fullName:"Catherine Adhiambo Amimo"}]},{id:"75224",title:"Decoding the Digital Gap in Teacher Education: Three Perspectives across the Globe",slug:"decoding-the-digital-gap-in-teacher-education-three-perspectives-across-the-globe",totalDownloads:593,totalCrossrefCites:0,totalDimensionsCites:4,abstract:"Educational use of technology is regularly assessed, and results often show a gap between educational policies and what is actually practiced. This chapter will help clarify how teacher educators experience the changing educational contexts due to the digital revolution, how their meaning-making shifts, and how outside forces influence those processes. The results are based on comparative international studies. Central for this study is practitioners’ professional digital competence, their attitudes towards digital technology and the use of digital technology in education. We found that the influence and contribution of digital practice is carried out quite differently across the globe. Our research questions were: How do practitioners experience teaching in a rapidly changing context? How do attitudes change due to top-down governing of education? and What motivates teacher educators to implement digital technology?",book:{id:"10229",slug:"teacher-education-in-the-21st-century-emerging-skills-for-a-changing-world",title:"Teacher Education in the 21st Century",fullTitle:"Teacher Education in the 21st Century - Emerging Skills for a Changing World"},signatures:"Steinar Thorvaldsen and Siri Sollied Madsen",authors:[{id:"332624",title:"Associate Prof.",name:"Siri Sollied",middleName:null,surname:"Madsen",slug:"siri-sollied-madsen",fullName:"Siri Sollied Madsen"},{id:"332626",title:"Prof.",name:"Steinar",middleName:null,surname:"Thorvaldsen",slug:"steinar-thorvaldsen",fullName:"Steinar Thorvaldsen"}]},{id:"75416",title:"Self-Study Research: Challenges and Opportunities in Teacher Education",slug:"self-study-research-challenges-and-opportunities-in-teacher-education",totalDownloads:783,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"This article aims to describe what self-study research is, why self-study can be a good approach to teacher educators’ professional development and improvements in practice and highlight some challenges and opportunities in this research approach. In addition, the article will shed light on some methodological aspects related to self-study. Self-study refers to teacher educators who in an intentionally and systematically way examine their practice to improve it, based on a deeper understanding of practice, as well as the context practice takes place. In the article, I argue that engaging in self-study is a learning and development process and an approach to developing personal professionalism, collective professionalism and improvements in practice.",book:{id:"10229",slug:"teacher-education-in-the-21st-century-emerging-skills-for-a-changing-world",title:"Teacher Education in the 21st Century",fullTitle:"Teacher Education in the 21st Century - Emerging Skills for a Changing World"},signatures:"Kåre Hauge",authors:[{id:"332053",title:"Associate Prof.",name:"Kåre",middleName:null,surname:"Hauge",slug:"kare-hauge",fullName:"Kåre Hauge"}]}],onlineFirstChaptersFilter:{topicId:"265",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:11,numberOfPublishedChapters:91,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:333,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:11,numberOfPublishedChapters:144,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:125,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:23,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"August 17th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:33,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:6,paginationItems:[{id:"22",title:"Applied Intelligence",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",isOpenForSubmission:!0,editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",slug:"carlos-travieso-gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",biography:"Carlos M. Travieso-González received his MSc degree in Telecommunication Engineering at Polytechnic University of Catalonia (UPC), Spain in 1997, and his Ph.D. degree in 2002 at the University of Las Palmas de Gran Canaria (ULPGC-Spain). He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. He won the “Catedra Telefonica” Awards in Modality of Knowledge Transfer, 2017, 2018, and 2019 editions, and awards in Modality of COVID Research in 2020.\n\nPublic References:\nResearcher ID http://www.researcherid.com/rid/N-5967-2014\nORCID https://orcid.org/0000-0002-4621-2768 \nScopus Author ID https://www.scopus.com/authid/detail.uri?authorId=6602376272\nScholar Google https://scholar.google.es/citations?user=G1ks9nIAAAAJ&hl=en \nResearchGate https://www.researchgate.net/profile/Carlos_Travieso",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"23",title:"Computational Neuroscience",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",isOpenForSubmission:!0,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null},{id:"24",title:"Computer Vision",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",isOpenForSubmission:!0,editor:{id:"294154",title:"Prof.",name:"George",middleName:null,surname:"Papakostas",slug:"george-papakostas",fullName:"George Papakostas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hYaGbQAK/Profile_Picture_1624519712088",biography:"George A. 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He has (co)authored more than 150 publications in indexed journals, international conferences and book chapters, 1 book (in Greek), 3 edited books, and 5 journal special issues. His publications have more than 2100 citations with h-index 27 (GoogleScholar). His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. Dr Ventura also holds the positions of Affiliated Professor at Virginia Commonwealth University (Richmond, USA) and Distinguished Adjunct Professor at King Abdulaziz University (Jeddah, Saudi Arabia). Additionally, he is deputy director of the Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI) and heads the Knowledge Discovery and Intelligent Systems Research Laboratory. He has published more than ten books and over 300 articles in journals and scientific conferences. Currently, his work has received over 18,000 citations according to Google Scholar, including more than 2200 citations in 2020. In the last five years, he has published more than 60 papers in international journals indexed in the JCR (around 70% of them belonging to first quartile journals) and he has edited some Springer books “Supervised Descriptive Pattern Mining” (2018), “Multiple Instance Learning - Foundations and Algorithms” (2016), and “Pattern Mining with Evolutionary Algorithms” (2016). He has also been involved in more than 20 research projects supported by the Spanish and Andalusian governments and the European Union. He currently belongs to the editorial board of PeerJ Computer Science, Information Fusion and Engineering Applications of Artificial Intelligence journals, being also associate editor of Applied Computational Intelligence and Soft Computing and IEEE Transactions on Cybernetics. Finally, he is editor-in-chief of Progress in Artificial Intelligence. He is a Senior Member of the IEEE Computer, the IEEE Computational Intelligence, and the IEEE Systems, Man, and Cybernetics Societies, and the Association of Computing Machinery (ACM). Finally, his main research interests include data science, computational intelligence, and their applications.",institutionString:null,institution:{name:"University of Córdoba",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"26",title:"Machine Learning and Data Mining",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",isOpenForSubmission:!0,editor:{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. 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He previously worked as a post-doctoral fellow at the Ben-Gurion University of Negev, Israel; University of the Free State, South Africa; and Central University of Technology Bloemfontein, South Africa. He obtained his Ph.D. in Organic Chemistry from Nagaoka University of Technology, Japan. He has published more than seventy-four journal articles and attended several national and international conferences as speaker and chair. Dr. Kendrekar has received many international awards. He has several funded projects, namely, anti-malaria drug development, MRSA, and SARS-CoV-2 activity of curcumin and its formulations. He has filed four patents in collaboration with the University of Central Lancashire and Mayo Clinic Infectious Diseases. His present research includes organic synthesis, drug discovery and development, biochemistry, nanoscience, and nanotechnology.",institutionString:"Visiting Scientist at Lipid Nanostructures Laboratory, Centre for Smart Materials, School of Natural Sciences, University of Central Lancashire",institution:null},{id:"428125",title:"Dr.",name:"Vinayak",middleName:null,surname:"Adimule",slug:"vinayak-adimule",fullName:"Vinayak Adimule",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428125/images/system/428125.jpg",biography:"Dr. Vinayak Adimule, MSc, Ph.D., is a professor and dean of R&D, Angadi Institute of Technology and Management, India. He has 15 years of research experience as a senior research scientist and associate research scientist in R&D organizations. He has published more than fifty research articles as well as several book chapters. He has two Indian patents and two international patents to his credit. Dr. Adimule has attended, chaired, and presented papers at national and international conferences. He is a guest editor for Topics in Catalysis and other journals. He is also an editorial board member, life member, and associate member for many international societies and research institutions. His research interests include nanoelectronics, material chemistry, artificial intelligence, sensors and actuators, bio-nanomaterials, and medicinal chemistry.",institutionString:"Angadi Institute of Technology and Management",institution:null},{id:"284317",title:"Prof.",name:"Kantharaju",middleName:null,surname:"Kamanna",slug:"kantharaju-kamanna",fullName:"Kantharaju Kamanna",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284317/images/21050_n.jpg",biography:"Prof. K. Kantharaju has received Bachelor of science (PCM), master of science (Organic Chemistry) and Doctor of Philosophy in Chemistry from Bangalore University. He worked as a Executive Research & Development @ Cadila Pharmaceuticals Ltd, Ahmedabad. He received DBT-postdoc fellow @ Molecular Biophysics Unit, Indian Institute of Science, Bangalore under the supervision of Prof. P. Balaram, later he moved to NIH-postdoc researcher at Drexel University College of Medicine, Philadelphia, USA, after his return from postdoc joined NITK-Surthakal as a Adhoc faculty at department of chemistry. Since from August 2013 working as a Associate Professor, and in 2016 promoted to Profeesor in the School of Basic Sciences: Department of Chemistry and having 20 years of teaching and research experiences.",institutionString:null,institution:{name:"Rani Channamma University, Belagavi",country:{name:"India"}}},{id:"158492",title:"Prof.",name:"Yusuf",middleName:null,surname:"Tutar",slug:"yusuf-tutar",fullName:"Yusuf Tutar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/158492/images/system/158492.jpeg",biography:"Prof. Dr. Yusuf Tutar conducts his research at the Hamidiye Faculty of Pharmacy, Department of Basic Pharmaceutical Sciences, Division of Biochemistry, University of Health Sciences, Turkey. He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",biography:"Martins Emeje obtained a BPharm with distinction from Ahmadu Bello University, Nigeria, and an MPharm and Ph.D. from the University of Nigeria (UNN), where he received the best Ph.D. award and was enlisted as UNN’s “Face of Research.” He established the first nanomedicine center in Nigeria and was the pioneer head of the intellectual property and technology transfer as well as the technology innovation and support center. Prof. Emeje’s several international fellowships include the prestigious Raman fellowship. He has published more than 150 articles and patents. He is also the head of R&D at NIPRD and holds a visiting professor position at Nnamdi Azikiwe University, Nigeria. He has a postgraduate certificate in Project Management from Walden University, Minnesota, as well as a professional teaching certificate and a World Bank certification in Public Procurement. Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"436430",title:"Associate Prof.",name:"Mesut",middleName:null,surname:"Işık",slug:"mesut-isik",fullName:"Mesut Işık",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/436430/images/19686_n.jpg",biography:null,institutionString:null,institution:{name:"Bilecik University",country:{name:"Turkey"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a scientist and Principal Investigator at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering the lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via artificial intelligence-based analyses of exosomal Raman signatures. Dr. Paul also works on spatial multiplex immunofluorescence-based tissue mapping to understand the immune repertoire in lung cancer. Dr. Paul has published in more than sixty-five peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award and the 2022 AAISCR-R Vijayalaxmi Award for Innovative Cancer Research. He is a senior member of the Institute of Electrical and Electronics Engineers (IEEE) and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. 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