\\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
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"5927",leadTitle:null,fullTitle:"Issues in Flap Surgery",title:"Issues in Flap Surgery",subtitle:null,reviewType:"peer-reviewed",abstract:"The development of flap surgery parallels the increasing complexity of soft-tissue defects needing reconstruction. Random and pedicled flaps as well as free muscle and fasciocutaneous flaps have helped to reconstruct single soft-tissue defects. The multiplicity of defects needing reconstruction and donor-site morbidity in addition to tailored reconstruction have called for a revision of flap concepts in favor of perforator flaps. Unfortunately, we are faced with increasingly complex reconstructive issues. New reconstructive techniques, such as the Ilizarov method, have made orthopedic reconstruction after high energy and complex trauma possible. Revision surgeries after tumor resection and plastic surgery have brought about soft-tissue defects associated with extensive fibrosis and necrosis. As a result, previously nonsalvageable limbs have been salvaged. The reconstructive surgeons are faced with the following situations: multiple soft-tissue defects, extensive fibrosis, possibility of major vessel loss, and possibility of damage of several perforators.",isbn:"978-1-78923-013-0",printIsbn:"978-1-78923-012-3",pdfIsbn:"978-1-83881-258-4",doi:"10.5772/66023",price:119,priceEur:129,priceUsd:155,slug:"issues-in-flap-surgery",numberOfPages:188,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"001d81ef8d1213b428ef9da8e29fb5e7",bookSignature:"Sherif Amr",publishedDate:"April 18th 2018",coverURL:"https://cdn.intechopen.com/books/images_new/5927.jpg",numberOfDownloads:11427,numberOfWosCitations:3,numberOfCrossrefCitations:7,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:12,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:22,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 31st 2016",dateEndSecondStepPublish:"December 5th 2016",dateEndThirdStepPublish:"September 17th 2017",dateEndFourthStepPublish:"October 17th 2017",dateEndFifthStepPublish:"December 17th 2017",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"179930",title:"Prof.",name:"Sherif",middleName:null,surname:"Amr",slug:"sherif-amr",fullName:"Sherif Amr",profilePictureURL:"https://mts.intechopen.com/storage/users/179930/images/7198_n.jpg",biography:"Sherif Mamdouh Amr is currently a professor of Orthopedics and Traumatology at the Faculty of Medicine, Cairo University. He is an orthopedic surgeon, a hand surgeon, a microsurgeon, a peripheral nerve surgeon, and a brachial plexus surgeon. He was born on March 31, 1961. He received his MBBCh degree from the Cairo University in 1985, MSc degree in 1989, and MD (PhD) degree in 1996. He further graduated from the Faculty of Law, Cairo University, with a bachelor’s degree in Law in 2000. He worked as an intern at the Faculty of Medicine, Cairo University, 1986; an orthopedic resident at the Department of Orthopedics, Cairo University, 1978–1990; an assistant lecturer at the Department of Orthopedics, Cairo University, 1990–1996; a lecturer at the same department, 1996–2001; and an assistant professor, 2001–2006, before being appointed as a full professor in 2006. Additionally, he worked as a visiting resident at the Department of Plastic Surgery Medical School Hannover (MHH), Germany, and a research worker at the Department of Engineering Biomechanics, Technical University Hamburg/Harburg, 1997. He was the director of the animal research facility at the Faculty of Medicine, Cairo University from 2007 to 2011. His main research interests are microsurgery, hand surgery, surgery of peripheral nerves, brachial plexus surgery, neuroscience, and experimental orthopedic biomechanics.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Cairo University",institutionURL:null,country:{name:"Egypt"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1149",title:"Oral and Maxillofacial Surgery",slug:"oral-and-maxillofacial-surgery"}],chapters:[{id:"56356",title:"Plasma Cytokine and Growth Factor Profiling during Free Flap Transplantation",doi:"10.5772/intechopen.70054",slug:"plasma-cytokine-and-growth-factor-profiling-during-free-flap-transplantation",totalDownloads:914,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Ischemia and reperfusion (I/R) is an unavoidable condition during free flap transplantation. Restoration of blood flow is usually associated with a profound inflammatory response. Cytokines and growth factors are the functional proteins which exert their specific influence on injury or repair during the healing period. Plasma concentrations of 18 cytokines and growth factor proteins (IL6, IL8, IP10, TNFα, MCP1, Fractalkine, GRO, bFGF, GMCSF, IFNg, MIP1a, VEGF, sCD40L, IL10, TGFα, IL1β, IL12P40, and TNFβ) have been analyzed with respect to I/R status during microsurgery tissue transplantation in both, artery and vein, from patients by multiplexed immunoassay. Both technical feasibility and biostatistics data analysis approaches were thoroughly assessed. It has been found that, from all investigated proteins, the venous plasma levels of IL6 significantly increased during the ischemia period and mostly sustained their high levels during reperfusion, while venous plasma levels of IL8 showed in general a significant increase in the ischemia period followed by a rapid decrease in the reperfusion period. In conclusion, these findings direct toward an active involvement of tissue-resting leukocytes which may become therapeutic targets for concomitant medication in flap surgery to improve wound healing.",signatures:"Juliane C. Finke, Jingzhi Yang, Marius Bredell, Uwe von Fritschen\nand Michael O. Glocker",downloadPdfUrl:"/chapter/pdf-download/56356",previewPdfUrl:"/chapter/pdf-preview/56356",authors:[{id:"205811",title:"Dr.",name:"Michael",surname:"O. Glocker",slug:"michael-o.-glocker",fullName:"Michael O. Glocker"},{id:"205812",title:"Dr.",name:"Juliane C.",surname:"Finke",slug:"juliane-c.-finke",fullName:"Juliane C. Finke"},{id:"205813",title:"MSc.",name:"Jingzhi",surname:"Yang",slug:"jingzhi-yang",fullName:"Jingzhi Yang"},{id:"205814",title:"Dr.",name:"Marius",surname:"Bredell",slug:"marius-bredell",fullName:"Marius Bredell"},{id:"205815",title:"Dr.",name:"Uwe",surname:"Von Fritschen",slug:"uwe-von-fritschen",fullName:"Uwe Von Fritschen"}],corrections:null},{id:"56213",title:"Experimental Rat Flap Models",doi:"10.5772/intechopen.69923",slug:"experimental-rat-flap-models",totalDownloads:1112,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Experimental flap surgery aims to increase our understanding of flap physiology and to test new surgical techniques to increase flap viability. Many experimental flap models have been described with the advancement of flap surgery and research. Most commonly used experimental flaps used in rats, including dorsal skin, flank, epigastric, oblique groin, pectoral, latissimus dorsi, rectus abdominis and fibula flaps, will be described.",signatures:"Merdan Serin and Mehmet Bayramicli",downloadPdfUrl:"/chapter/pdf-download/56213",previewPdfUrl:"/chapter/pdf-preview/56213",authors:[{id:"199977",title:"Dr.",name:"Merdan",surname:"Serin",slug:"merdan-serin",fullName:"Merdan Serin"}],corrections:null},{id:"57249",title:"Perforator Flaps: Principles and Techniques",doi:"10.5772/intechopen.71270",slug:"perforator-flaps-principles-and-techniques",totalDownloads:1753,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Evolution of flaps has continued after the introduction of fasciocutaneous and musculocutaneous flaps. Perforator flaps have evolved, and they have provided many new flaps with new pedicles all over the body presenting important advantages. Better understanding of vascular anatomy and pattern of skin circulation has become possible by numerous cadaveric studies. As a result, widespread use of perforator flaps, either pedicled or free, has become possible. Perforator flaps have provided freedom of flap design with over 350 perforators all over the body, reliability, and reduced donor site morbidity. However, success begins with planning and continues with operative procedure. Here, in this relatively new field of reconstructive surgery, the following are discussed: the correct planning of perforator flaps, microanatomy of perforators, and what to do during the operation based on previous reports. Lastly, some brief information and examples of perforator-based workhorse flaps are given.",signatures:"Goktekin Tenekeci",downloadPdfUrl:"/chapter/pdf-download/57249",previewPdfUrl:"/chapter/pdf-preview/57249",authors:[{id:"200651",title:"M.D.",name:"Goktekin",surname:"Tenekeci",slug:"goktekin-tenekeci",fullName:"Goktekin Tenekeci"}],corrections:null},{id:"55847",title:"Application of Free Flow‐Through Anterolateral Thigh Flap for the Reconstruction of an Extremity Soft Tissue Defect Requiring Vascularization",doi:"10.5772/intechopen.69404",slug:"application-of-free-flow-through-anterolateral-thigh-flap-for-the-reconstruction-of-an-extremity-sof",totalDownloads:1303,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Patients with severe injury or vasculopathy of the extremities often require resurfacing of tissue defects as well as preservation of functional blood flow to distal areas. In conventional free flap transfer, the recipient vessel is sacrificed to facilitate pedicle anastomosis. On the other hand, a flow‐through flap can provide blood flow to distal tissues. In this chapter, we present cases of successful salvage and reconstruction of the extremities using free flow‐through flaps and highlight their advantages and applications. Free flow‐through flap use should be a good option in the following cases: (1) Gustilo‐Anderson IIIC type open fracture, (2) chronic ulcer resurfacing in the less vascularized extremities, and (3) additional blood supply for an ischemic flap. This flap facilitates not only the reconstruction of soft tissue defects, but also restores the functional vascular anatomy and maintains the original blood flow by interposing the T‐portion of the vessel. This technique enables both vascular and soft tissue reconstructions simultaneously with minimal donor site problems. The anterolateral thigh flap is recommended as a free flow‐through‐type flap due to its advantages, including the variety of flap sizes, adequate calibers of the vascular pedicle, and the lack of a need for position changing.",signatures:"Masaki Fujioka",downloadPdfUrl:"/chapter/pdf-download/55847",previewPdfUrl:"/chapter/pdf-preview/55847",authors:[{id:"53197",title:"Prof.",name:"Masaki",surname:"Fujioka",slug:"masaki-fujioka",fullName:"Masaki Fujioka"}],corrections:null},{id:"56466",title:"Emergent or Early Flap Resurfacing Is Required for Bone- Exposing Wounds of Gustilo-Anderson IIIB and IIIC Fractures",doi:"10.5772/intechopen.70147",slug:"emergent-or-early-flap-resurfacing-is-required-for-bone-exposing-wounds-of-gustilo-anderson-iiib-and",totalDownloads:1031,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Background: The wound treatment has progressed owing to the development of new medicine, instruments. Following these trends, can the bone-exposing wounds of severe open fractures be resurfaced without using flaps but only skin grafting? We evaluated a new medicine and instrument, for the resurfacing of bone-exposing complex wounds of Gustilo-Anderson IIIB and C fractures. Patients and methods: Patients with Gustilo-Anderson IIIB (five cases) and C (two cases) open fractures who underwent open reduction and external fixation were evaluated. Bone-exposing wounds were resurfaced with artificial dermis, and basic fibroblast growth factor was sprayed. We investigated the course and outcome. Result: In all of seven cases, abundant granulation tissue did not develop on the bone-exposing wound surface during 2–5 weeks, and 4 patients developed osteomyelitis. Subsequently, all cases required flap surgery to resurface the wound. All patients could walk; however, required a longer period for the complete union of bones. Conclusion: This study showed that it was impossible to prepare a favorable wound bed on the bone when the fracture was severe. Thus, early flap surgery was a recommendable resurfacing option. Furthermore, emergent bone resurfacing with flap, while performing rigid bone fixation with an internal fixation plate, was an ideal procedure.",signatures:"Masaki Fujioka",downloadPdfUrl:"/chapter/pdf-download/56466",previewPdfUrl:"/chapter/pdf-preview/56466",authors:[{id:"53197",title:"Prof.",name:"Masaki",surname:"Fujioka",slug:"masaki-fujioka",fullName:"Masaki Fujioka"}],corrections:null},{id:"56555",title:"Reconstruction for Mandibular Implant Failure",doi:"10.5772/intechopen.70166",slug:"reconstruction-for-mandibular-implant-failure",totalDownloads:971,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Mandibular defects may result from tumor ablations, trauma, or radiation necrosis. Significant segmental mandibular loss or hemimandibular loss may sometimes be replaced with mandibular implants by ENT surgeons/oral surgeons/head and neck surgeons. However, this may bring about mandibular implant failure in long-term follow-up. Mandibular implant failures usually manifest as: soft tissue atrophy, mandibular implant extrusion, infection, facial nerve involvement, facial asymmetry, derangement of occlusion and mastication, orocutaneous fistula, etc. Over 30 years, the authors have treated 102 patients with mandibular implant failure. Reconstruction may involve removal of the mandibular implant and immediate replacement of the mandibular defect with a piece of vascularized bone flap, not only to compensate for bone loss but also to replace neighboring soft tissue and possible skin defects. Frequently used flaps have been vascularized iliac bone (89/102) or vascularized fibula grafts (13/102). During follow-up, iliac bone flap reconstruction has yielded more favorable results due to its ample bone bulk and adequate soft tissue coverage. Fibula flaps with osteotomies have been associated with an increasing incidence of malunion/nonunion and subsequent easy deformation.",signatures:"Shih-Heng Chen, Hao-Chih Tai, Tai-Ju Cheng, Hung-Chi Chen, An-Ta\nKo, Tyng-Luan Roan, Yo-Shen Chen and Yueh-Bih Tang",downloadPdfUrl:"/chapter/pdf-download/56555",previewPdfUrl:"/chapter/pdf-preview/56555",authors:[{id:"202122",title:"Prof.",name:"Yueh-Bih",surname:"Tang",slug:"yueh-bih-tang",fullName:"Yueh-Bih Tang"}],corrections:null},{id:"60418",title:"Hand Coverage",doi:"10.5772/intechopen.74152",slug:"hand-coverage",totalDownloads:1624,totalCrossrefCites:1,totalDimensionsCites:4,hasAltmetrics:0,abstract:"Hand and finger soft tissue defects have always represented a surgical challenge at any accident and emergency department. Techniques may vary from just direct closure of the wound to free tissue transfer. Knowledge of the main locoregional hand flaps is paramount to solve most of the soft tissue defects at this level. Flaps vary depending on their blood supply and design. Their vascularity might be at random, they can be pedicled with anterograde or reversed flow or they can rely on simple or complex free tissue transfer whose blood flow depends on vascular anastomosis. This article reviews all the main soft tissue local or locoregional reconstructive techniques for hands and fingers.",signatures:"Francisco Martinez Martinez, M. Llanos Guerrero Navarro, Juan\nGarcia Navarro, Alberto Gimenez Ros and Alba Izquierdo\nRobledano",downloadPdfUrl:"/chapter/pdf-download/60418",previewPdfUrl:"/chapter/pdf-preview/60418",authors:[{id:"219563",title:"Dr.",name:"Francisco",surname:"Martinez Martinez",slug:"francisco-martinez-martinez",fullName:"Francisco Martinez Martinez"},{id:"222714",title:"Dr.",name:"Maria Llanos",surname:"Guerrero Navarro",slug:"maria-llanos-guerrero-navarro",fullName:"Maria Llanos Guerrero Navarro"},{id:"222914",title:"Dr.",name:"Juan",surname:"García Navarro",slug:"juan-garcia-navarro",fullName:"Juan García Navarro"},{id:"222915",title:"Dr.",name:"Alberto",surname:"Gimenez Ros",slug:"alberto-gimenez-ros",fullName:"Alberto Gimenez Ros"},{id:"222916",title:"Dr.",name:"Alba",surname:"Izquierdo Robledano",slug:"alba-izquierdo-robledano",fullName:"Alba Izquierdo Robledano"}],corrections:null},{id:"56394",title:"Omental Flap in Breast Reconstruction",doi:"10.5772/intechopen.70115",slug:"omental-flap-in-breast-reconstruction",totalDownloads:1244,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Objectives: The use of omental flap for breast reconstruction was reported by the Romanian surgeon Kiricuta in 1963, since that time some surgeons tried to use the omentum either pedicled or free for breast reconstruction. It can be used after partial or total mastectomy.",signatures:"Ashraf Khater, Adel Fathi and Hosam Ghazy",downloadPdfUrl:"/chapter/pdf-download/56394",previewPdfUrl:"/chapter/pdf-preview/56394",authors:[{id:"200042",title:"Ph.D.",name:"Ashraf",surname:"Khater",slug:"ashraf-khater",fullName:"Ashraf Khater"},{id:"205795",title:"Dr.",name:"Adel",surname:"Fathi",slug:"adel-fathi",fullName:"Adel Fathi"},{id:"205796",title:"Dr.",name:"Hosam",surname:"Ghazy",slug:"hosam-ghazy",fullName:"Hosam Ghazy"}],corrections:null},{id:"56236",title:"An Overview of Hypospadias Surgery",doi:"10.5772/intechopen.69924",slug:"an-overview-of-hypospadias-surgery",totalDownloads:1475,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Performed by urologists and paediatric surgeons, hypospadias procedures go unnoticed in many classical treatises of plastic surgery. Hypospadias is a very common malformation that occurs in nearly 1 in 250 male births. It consists of an abnormal opening of the urethral meatus at some point of its dorsal aspect. It is associated with an incomplete, semi‐circumferential foreskin and in nearly half of the patients it may be accompanied with a curvature of the penile shaft called chordee. Most classifications differentiate between distal, middle and proximal presentations. Different techniques have been proposed for its treatment; some of the most usual ones are briefly revised. Continued improvement in surgical management has made currently practised one‐stage repairs possible. We provide an introduction to the current techniques, as well as operative tips and an overview of the most common pitfalls the surgeon must bear in mind when treating this condition.",signatures:"Wenceslao M. Calonge and Gianluca Sapino",downloadPdfUrl:"/chapter/pdf-download/56236",previewPdfUrl:"/chapter/pdf-preview/56236",authors:[{id:"202013",title:"M.D.",name:"Wenceslao M",surname:"Calonge",slug:"wenceslao-m-calonge",fullName:"Wenceslao M Calonge"},{id:"205276",title:"Dr.",name:"Gianluca",surname:"Sapino",slug:"gianluca-sapino",fullName:"Gianluca Sapino"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"2988",title:"A Textbook of Advanced Oral and Maxillofacial Surgery",subtitle:null,isOpenForSubmission:!1,hash:"b5d9f2be309d43646fca5ce2cd1e3d19",slug:"a-textbook-of-advanced-oral-and-maxillofacial-surgery",bookSignature:"Mohammad Hosein Kalantar Motamedi",coverURL:"https://cdn.intechopen.com/books/images_new/2988.jpg",editedByType:"Edited by",editors:[{id:"90148",title:"Dr.",name:"Mohammad Hosein",surname:"Motamedi",slug:"mohammad-hosein-motamedi",fullName:"Mohammad Hosein Motamedi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4553",title:"A Textbook of Advanced Oral and Maxillofacial Surgery",subtitle:"Volume 2",isOpenForSubmission:!1,hash:"4af81386d06d6e1495f564629f833620",slug:"a-textbook-of-advanced-oral-and-maxillofacial-surgery-volume-2",bookSignature:"Mohammad Hosein Kalantar Motamedi",coverURL:"https://cdn.intechopen.com/books/images_new/4553.jpg",editedByType:"Edited by",editors:[{id:"90148",title:"Dr.",name:"Mohammad Hosein",surname:"Motamedi",slug:"mohammad-hosein-motamedi",fullName:"Mohammad Hosein Motamedi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5112",title:"A Textbook of Advanced Oral and Maxillofacial Surgery",subtitle:"Volume 3",isOpenForSubmission:!1,hash:"9155af3479cbb41b2af5fc7e333d238f",slug:"a-textbook-of-advanced-oral-and-maxillofacial-surgery-volume-3",bookSignature:"Mohammad Hosein Kalantar Motamedi",coverURL:"https://cdn.intechopen.com/books/images_new/5112.jpg",editedByType:"Edited by",editors:[{id:"90148",title:"Dr.",name:"Mohammad Hosein",surname:"Motamedi",slug:"mohammad-hosein-motamedi",fullName:"Mohammad Hosein Motamedi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7157",title:"Bone Grafting",subtitle:"Recent Advances with Special References to Cranio-Maxillofacial Surgery",isOpenForSubmission:!1,hash:"536ef0d393c2af079dcc8b90dae0e68c",slug:"bone-grafting-recent-advances-with-special-references-to-cranio-maxillofacial-surgery",bookSignature:"Raja Kummoona",coverURL:"https://cdn.intechopen.com/books/images_new/7157.jpg",editedByType:"Edited by",editors:[{id:"93854",title:"Prof.",name:"Raja",surname:"Kummoona",slug:"raja-kummoona",fullName:"Raja Kummoona"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1170",title:"Maxillofacial Surgery",subtitle:null,isOpenForSubmission:!1,hash:"6925aedd650ca3255c43d0215a6eb837",slug:"maxillofacial-surgery",bookSignature:"Leon Assael",coverURL:"https://cdn.intechopen.com/books/images_new/1170.jpg",editedByType:"Edited by",editors:[{id:"100926",title:"Prof.",name:"Leon",surname:"Assael",slug:"leon-assael",fullName:"Leon Assael"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9523",title:"Oral and Maxillofacial Surgery",subtitle:null,isOpenForSubmission:!1,hash:"5eb6ec2db961a6c8965d11180a58d5c1",slug:"oral-and-maxillofacial-surgery",bookSignature:"Gokul 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The integration of experimental methods with computational methods is invaluable both in the development of promising new bioactive compounds and in the molecular characterization of protein-ligand or protein-protein interactions. Molecular docking, in one of these molecular modeling methods, is a unique approach to revealing key interactions in important molecular recognition processes and to accurately predict receptor-ligand binding free energies. Today, the molecular docking method has not only enabled the discovery of new drugs and therapeutic agents but also opened different windows to the submicroscopic world of interacting partner molecules by providing a unique atomistic perspective in the explanation of important intermolecular phenomena.
\r\n\r\n\tThe topics covered in this book are mainly:
\r\n\t1. Emphasizing the unique power of the molecular docking method in new drug discovery;
\r\n\t2. Demonstration of how the molecular docking technique has led to the discovery of new molecules in cancer therapy, proteasome, and STAT3 inhibition, and the treatment of Alzheimer's disease;
\r\n\t3. Underlining the importance of molecular docking-based modeling methods in the various branches of biotechnology
\r\n\tWe hope that this book will be a common point where researchers working in the fields of life sciences and drug development will eventually meet.
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Nondeterministic systems are divided into two categories: stochastic and random. A stochastic system has governing physical laws that even if the state at some point in time is known precisely, it is impossible to determine the state of the system at a later time precisely. It is possible to determine the probability of a state, rather than the state itself. A random system is one which has no apparent governing physical laws. Practically, we treat all unpredictable systems, stochastic or random as stochastic systems, since we employ the same methods to study them. While we are unable to predict the state of a random process, we can evolve a strategy to deal with such processes. Such a strategy is based on a branch of mathematics dealing with unpredictable systems, called statistics.
Estimation is the process of extracting information from data which can be used to predict the behavior of state variables in a system. The estimation uses statistical criteria to infer the actual value of unknown variables. Estimation models are used to process noisy measurements, filter them, and detect inaccuracies. When random signals are passed through a deterministic system, their statistical properties are modified. A deterministic system to which random signals are input, so that the output is a random signal with desired statistical properties is called a filter. Filters can be linear or nonlinear, time-invariant or time varying. However, for simplicity we will usually consider linear, time-invariant filters. Linear, time-invariant filters are commonly employed in control systems to reduce the effect of measurement noise on the control system. In such systems, the output is usually a superposition of a deterministic signal and a random measurement noise.
The output of a filter not only has a frequency content different from the input signal, but also certain other characteristics of the filter, such as a phase-shift or a change in magnitude. In other words, the signal passing through a filter is also distorted by the filter, which is undesirable. A filter would produce an output signal based upon its characteristics, described by the transfer-function, frequency or impulse response, or a state-space representation of the filter. However, a filter can be designed to achieve a desired set of performance objectives, i.e. the numerator and denominator polynomials of the filter’s transfer function, or coefficient matrices of the filter’s state-space model, can be selected by a design process to achieve the conflicting requirements of maximum noise attenuation and minimum signal distortion.
There are several prediction models to infer the system state, although, it can be shown that of all estimation tools Kalman Filter (KF) is the one that minimizes the variance of the estimation error which enables accurate estimation of the process.
The first application of state estimation was in the aerospace field to solve problems related to the prediction of position in aerospace vehicles. Nowadays, estimation has been applied in several fields of engineering and control systems. One common application is in data acquisition, to solve the problem of predicting the state of a system that cannot be measured directly due to the characteristics and complexity of the environment.
KF is an estimator proposed by Rudolph E. Kalman in 1960. It is an algorithm to estimate the evolution of a dynamic system, especially when data has a lot of noise. The principle of the filter is to find the probability of the hypothesis of predicted state and using the data from the measurement to correct it and improve the future estimation at each time. It is a suitable algorithm to apply in dynamic systems, linking real-time measurements and predicting the state of system parameters through time approaches. KF has been implemented in several fields, such as in navigation systems [1, 2, 3, 4], financial models [5, 6, 7], tracking vehicles [8, 9] and image processing [10, 11, 12]; only to mention some of them. Nevertheless, this statistical tool is useful for two main purposes: estimation and performance analysis of estimators.
In the field of IC technology, it has been implemented for thermal estimation. Multicore processors use a dynamic thermal management mechanism that use embedded thermal sensors for monitoring the real-time thermal behavior of the processor, this kind of sensors are susceptible to a variety of source of noise and this causes the discrepancies between actual temperatures observed by on-chip thermal sensors. Therefore, to fix the discrepancies in sensing, Kalman’s prediction is used to estimate real values from noisy sensor readings [13]. Another novel application of KF is in the electric vehicle industry, the estimation of the charge state of lithium-ion battery is an important parameter in order to guarantee a safe operation of them. The battery performance is influenced by aging; this fact makes difficult to predict the battery state, to overcome this issue the application of KF in combination with other methods is a suitable methodology [14, 15, 16, 17].
Recently, KF has been applied in several industrial applications. With the development of manufacturing process, welding automation emerges as one important tool to speed up the production rate in the assembly line in stronger and high-quality welds. Nevertheless, there are several factors that could influence the welding quality and the most important is the arc length, which could be influenced by the irregular surface of the workpiece and the loss of the tungsten electrode. To enhance the quality during the Gas-Tungsten Arc Welding (GTAW) process, KF is applied in order to keep the arc length stable and minimize the external noise [18]. In the field of sensorless control, KF have been used in intelligence electrical drives. To control induction motor drives without mechanical speed sensor at the motor shaft allows reduced hardware complexity, and low costs. Additionally, the use of induction motors without position sensor is useful for applications with abrasive and hard surface. Thereby, the application of an estimation method it’s necessary in order to predict the position and velocity of the shaft [19, 20, 21].
In applications related with radio astronomy, KF has been applied for the analysis of Very-Long-Baseline Interferometry (VLBI) data, in order to analyze parameters such as base line lengths, earth orientation parameters, radio source coordinates and tropospheric delays. Nowadays, modern antennas are being constructed and equipped with highly accurate broadband receiving systems. Besides the accurate observations gotten by astronomic instruments, it is necessary to implement estimation methods in order to optimize the models applied in data analysis [22, 23]. In power systems, one of the main difficulties is power quality due to total harmonics distortion (THD) that is mainly caused by nonlinear loads. THD effects are strongly correlated with issues as device heating, break down electronic components, network interference, etc. Several filters have been performed to decrease the effect of harmonics; nevertheless, the application of KF has shown an important reduction in the effect of harmonics [24, 25, 26]. In the field of biomedicine KF is widely used over other estimation methodologies to overcome the different sources of noise. Specifically, KF has been used to smooth and predict signals from Electroencephalogram and Electrocardiogram signals [27, 28]. Recently in the literature there are reports on a new methodology to protect the confidentiality of the transmitted data based on a Kalman filter. This strategy proposes the implementation of encrypted algorithm using KF, and is suggested to be used in Industrial cyber–physical systems (ICPSs) to protected data privacy [29, 30].
As it has been mentioned above, KF has been used in diverse fields of science and technology to predict specific parameters of interest according to the application. Temperature evolution is an important parameter to measure and predict, in order to study or control the temperature in an environment [31, 32], device [13, 33, 34] and process [18]. It is well known that RTDs are commercial devices very useful to monitor the temperature due their stability and accuracy. However, RTDs are self-heating causing noisy readings making the RTD a suitable example to implement KF for temperature estimation. Importantly, we searched in the literature and found no evidence of previous work reporting the use of a KF to filter the noise and predict the temperature behavior from RTD readings.
The final objective of this study is to obtain the specification of a linear dynamic system (Wiener filter [35]) which accomplishes the prediction, separation, or detection of a random signal [36]. With the state-transition method, a single derivation covers a large variety of problems: growing and infinite memory filters, stationary and non-stationary statistics, etc. Having guessed the “state” of the estimation (i.e., filtering or prediction) problem correctly, one is led to a nonlinear difference (or differential) equation for the covariance matrix of the optimal estimation error. From the solution of the equation for the covariance matrix we obtain the coefficients characterizing the optimal linear filter [36]. The following is a simplified derivation described previously in the references [37, 38].
The initial state,
Thus
The correlation matrix,
The correlation matrix is the expected value of the matrix
Consider a plant which we cannot model accurately using only a deterministic model, because of the presence of uncertainties called process noise and measurement noise:
In the linear, time-varying state-space representation above,
Since we cannot predict the state-vector,
Since the state-vector,
If T < t, this is a data-smoothing (interpolation) problem. If T = t, this is called filtering. If T > t, we have a prediction problem. Since the original treatment is general enough, the collective term estimation is used [36].
Hence, the best estimate to obtain for
Taking in consideration the deviation of the estimated state- vector,
The best estimate of state-vector happens if
The state-equation of the Kalman filter is that of a time-varying observer, and can be written as follows:
If we substitute Eq. (4) into Eq. (12) we get:
Substituting Eq. (13) into Eq. (7)
Here
Using Eqs. (6) and (7), we obtain:
Eq. (16) is the error covariance update equation, where
The trace of the error covariance matrix is the sum of the mean squared errors. The mean squared error may be reduced by minimizing the trace of
We rewrite Eq. (16);
Taking the trace of this expression gives:
Then, we differentiate with respect to
Setting to zero and solving for
Substitution of Eq. (20) into [17], gives:
Eq. (21) is the update equation for the error covariance matrix with optimal gain.
State projection is derived using;
To project the error covariance matrix into the next time interval, k + 1 we first find an expression for the error based on the prior error;
Eq. (7) in time k + 1 is;
Assuming that
This completes the description of the filter.
An algorithm loop is required to make the program in MATLAB and in C-code for the microprocessor. The loop is summarized in the Figure 1.
Recursive algorithm for the Kalman filter.
The KF assumes that the system model is linear and known, the system and measurement noises are white, and the states have initial conditions with known means and variances. The power spectral densities used can be treated as tuning parameters to design an observer with excellent performance and robustness. The linear Kalman filter can also be used to design observers for nonlinear plants, by treating nonlinearities as process noise with appropriate power spectral density matrix.
Since the Kalman filter is an optimal observer the appearance of matrix Riccati equation is not surprising. We are interested in a steady Kalman filter, i.e. the Kalman filter for which the covariance matrix converges to a constant in the limit
From the projections into
Using Eq. 30 in Eqs. 31 and 32 we get:
Rewriting Eq. 34 we get:
When in steady state:
Then we arrive at the Riccati equation:
The iterative solution of the Riccati equation is not required in real time. The observer gain is calculated off-line for predictive control applications [40]. Riccati equations are mainly used to control large scale systems, estimation, and, detection processes.
In this work the discrete-time algebraic Riccati equation (DARE) was solved to obtain the covariance matrix P of the Kalman gain. The discrete-time algebraic Riccati equation is represented by the next form [41]:
Where
Eq. (38) can be written in the short form:
Where:
The application of the Kalman filter implies solving the DARE, which can be solved by several solution methods. Computational methods to solve Riccati equations can be categorized into three classes: invariant subspace methods, deflating subspace methods, and Newton’s methods. The generalized Schur method that is classified as a deflating subspace method is used to solve DARE. The generalized Schur algorithm is a strong algebraic tool that allows computing classical decompositions of matrices, such as the QR and LU factorizations [42]. The next algorithm was used to solve DARE [43]:
Input arguments:
Output arguments:
Form the pencil
Transform the pencil
Using an orthogonal transformation and reorder the generalized real Schur form. So that all the pencil
Form the matrix:
Resistive temperature detectors (RTD) have attracted attention to be employed as thermal health monitors. As clinical thermometers they are stable and reliable presenting high accuracy and resolution [44]. One of the most widely used RTD is the emerging thin-film resistor which has minimal impact on complex circuits due to its small size and due to their negligible mass.
The basic function of the sensor is determined by a proportional increment of resistance when temperature is applied. RTDs can be employed on a rigid or flexible substrate [45, 46, 47], the metal combination with a flexible o rigid substrate can cover conformal applications. RTD fabrication can be done by metals like Pt [48, 49, 50], Cu [51], Ag [52], and Ni [53], among other materials. Nickel presents a suitable option for RTD fabrication due to its wide temperature linear range of operation and its relatively low price.
Clinical thermometers require a high definition and reliability because less than 1°C difference can indicate a health problem. The thermometer signal can be amplified by electronic means, but it is desirable to filter such readings. This work is focused to the filtering and prediction of an highly sensitive Nickel based thin film RTD (range, 273–325 K), to be incorporated to complex circuits [54], we present the theoretical analysis about the relation sensibility-resistance that matches with experimental results.
All metals produce an increase in its resistance to an increase in specific temperature, which means that resistance is linearly proportional to temperature change. This dependence between electrical resistance and temperature is the principle of operation used by a resistance temperature detector (RTD). The relation between temperature-resistance for Pt wire (RTD), is described by the equation known as the Calendar-Van Dusen, Eq. 41) [50].
Where R0°C is the resistance at 0°C, α and β are temperature coefficients and T is temperature, the temperature coefficients depend only on material properties. In addition, the RTD resistance depends on its geometrical design, according to Eq. 42.
Where “σ” is the resistivity, “L” length, “A” lateral area, “w” channel width, and “t” channel height. Only by increasing the length “L” or decreasing the area “A” that means reducing the “t” film thickness or the “w” channel wide, the resistance can increase.
The estimation of the thermal system is represented by the linear stochastic state-space description
Generally, the RTD system is modeled as an RLC circuit, which consists of a resistor a capacitor and an inductor in series with an input voltage. The output that we analyzed is the voltage across the resistor which is related to temperature change. The RLC circuit is represented by a second-order differential equation
Also, we may simplify the response of the system to that of a first-order RC circuit. This implies to solve a first-order ordinary differential equation:
In this work, a Kalman Filter is proposed to decrease the time response to improve the speed feedback and filtering of the perturbations by signal noise from physical signals as thermal detectors. In some instances, a reduced model is advisable to use in an embedded system due to easy implementation and low computational complexity [2].
Kalman filter can be embedded in a temperature system made by Resistance Thermal Detectors (RTD).RTD’s are robust elements that require relatively easy measurement, as a consequence are a useful thermal sensor for industry and medical applications. Nevertheless, these devices are exposing to vibration, electrical noise, and measurement errors generated by the thermoelectric effect caused by the temperature difference between electrical contacts, which affects the response time of the sensor. The implementation of the Kalman filter in a temperature system produces an optimal estimative of thermal behavior and decreases the uncertainties about the prediction of the temperature.
In order to describe the system in the state space, it is necessary to apply system identification methods using MATLAB. Then, after obtaining the system’s state space model we are able to use the Kalman filter algorithm to estimate the future output of the system.
To study the dynamics of our system, we used MATLAB functions
Using MATLAB we are able to acquire the Discrete-time identified state-space model:
with:
Estimated using
System ID using MATLAB. Input output model for a step response defined problem.
Bode diagram indicating the system is a second order system as described by the system transfer function.
Systems model and measured evolutions in time. Fit to estimation data: 90.27%.
We modify the MATLAB example for the time-varying case found in [55] and we code our own function to solve the Discrete Algebraic Riccati Equation. MATLAB functions like predict or forecast were found useful to understand the problem at hand, however they were not used in the code we present here.
w(1:n) = sqrt(Q)*randn(n,1);
v(1:n) = sqrt(R)*randn(n,1);
systv = ss(A,B,C,0,Ts);
ytv(1:n) = lsim(systv,U(1:n) + w(1:n)).
yvtv(1:n) = ytv(1:n) + v(1:n);
Ptv(:,:) = B(:,:)*Q*B(:,:)’; % Initial error covariance.
x = zeros(order,1); % Initial condition on the state.
order = 2;
yetv(1:n) = zeros(n,1);
ycov(1:n) = zeros(n,1);
for i = 1:n.
% Measurement update.
Mn(:,:) = Ptv(:,:)*C(:,:)’/(C(:,:)*Ptv(:,:)*C(:,:)’ + R);
x = x + Mn(:,:)*(yvtv(i)-C(:,:)*x); % x[n|n].
Ptv(:,:) = (eye(order)-Mn(:,:)*C(:,:))*Ptv(:,:); % P[n|n].
yetv(i) = C(:,:)*x;
errcov(i) = C(:,:)*Ptv(:,:)*C(:,:)’;
% Time update.
x = A(:,:)*x + B(:,:)*U(i); % x[n + 1|n].
Ptv(:,:) = A(:,:)*Ptv(:,:)*A(:,:)’ + B(:,:)*Q*B(:,:)’; P[n + 1|n].
end
%% DARE. We coded our own dare function [X,L,G] = sdare(A,B,Q,R).
[P_inf,L,M_inf] = sdare(atv,ctv’,Q,R);
for i = 1:p
% Measurement update.
x = x + M_inf’*(yvtv(i)-ctv*x); % x[n|n].
yetv_inf(i) = ctv*x;
errcov_inf(i) = ctv*P_inf*ctv’;
% Time update.
x = atv*x + btv*U(i); % x[n + 1|n].
P_inf = atv*P_inf*atv’ + btv*Q*btv’; % P[n + 1|n].
end
function [SD] = sdare(A,B,Q,R).
At = transpose(A);
Bt = transpose(B);
S1 = size(A);
E = eye(S1);
Z = zeros(S1);
Ri = inv.(R);
S = B*Ri*Bt;
Pdare = [A Z; −Q E];
Ndare = [E S; Z At];
[AA,BB,L,Z] = qz(Pdare,Ndare);
[AAS1,BBS1,QS1,ZS1] = ordqz(AA,BB,L,Z,‘udi’);
O = ZS1(1:2,1:2);
P = ZS1(3:4,1:2);
H = inv.(O);
SD = P*H;
end
Matlab was used to simulate the response of an RTD modelled as a second order system. In Figure 5(A) we show the plot of the true response y (cyan line) and the filtered response (red line). In Figure 5(B) the plot compares the measurement error with the estimation error. As can be seen in Figure 5(C) the time-varying filter also estimates the covariance errcov of the estimation error at each sample which shows when the filter reached steady state. As it can be seen, we have the possibility to predict the state after approximately 8 seconds. Also, we show the evolution of the estimated temperature response showing an error of −0.0948°C in the best of the cases and less than 1°C in the worst of the cases after 45 seconds.
(A) Evolution of the estimated temperature response showing an error of −0.0948°C in the best of the cases and less than 1°C in the worst of the cases. (B) Evolution of the measurement and estimation errors. (C) Evolution of the covariance of the error showing the possibility to predict the state after approximately 8 seconds.
The unit step response depends on the roots of the characteristic equation. If both roots are real-valued, the second-order system behaves like a chain of two first-order systems, and the step response has two exponential components. If the roots are complex, the step response is a harmonic oscillation with an exponentially decaying amplitude [56]. In our case, the roots of the characteristic polynomial:
The state description for an RC system is described above. From there, we know that the dynamics are dependent only on the RC constant. In addition, there is an amplificator in the system electronics that has a gain of 260. To solve for the RC constant of the system we use the least-squares method (Chi square minimization). The system has a solution of the form
Which is a linear equation. Using a linear fitting program:
We obtain
readings[readIndex] = analogRead(inputPin); // read from the sensor.
total = total + readings[readIndex]; // add the reading to the total.
readIndex = readIndex +1; // advance to the next position in the array.
time_equis_readings[time_equis_readIndex] = time_equis_readIndex;
time_equis_readIndex = time_equis_readIndex +1;
if (readIndex > = numReadings) // if we’re at the end of the array.
{
for(i = 0;i < =numReadings-1;i++).
{
Y[i] = log(readings[i]);
time1[i] = time_equis_readings[i];
sumx = (sumx +time_equis_readings[i]);
sumx2 = (sumx2 + time_equis_readings[i]*time_equis_readings[i]);
sumy = (sumy +Y[i]);
sumxy = (sumxy +time_equis_readings[i]*Y[i]);
}
den = (numReadings*sumx2-sumx*sumx);
a = (sumx2*sumy -sumx*sumxy)/den;
Bc = (n*sumxy-sumx*sumy)/den;
// State description.
A = -Bc;B=Bc;C = 260;D = 0;
//wrap around to the beginning:
readIndex = 0;time_equis_readIndex = 0;
}
// KALMAN.
errcov = C*P*C;
for(i = 0;i < =numReadings-1;i++).
{
Mn = P*C/((C*P*C + R)); // initial estimate.
X = X + Mn*(readings[i]-C*X); // update estimate Average_readings[i].
P = (1-Mn*C)*P; // update covariance.
y_e[i] = C*X;
errcov = C*P*C;
X = A*X + B*U; // project into k + 1.
P = A*P*A + B*Q*B; // project into k + 1.
}
timer0_millis = millis();
// Solution to the Riccati equation.
F = -Bc;H = 260;
SQ = sqrt((H*H*Q*R) + (F*F*R*R));
SR = F * R;
P_inf = (SQ + SR)/(H*H);
M_inf = P_inf*C/(C*P_inf*C + R);
for(i = 0;i < =numReadings-1;i++).
{
// Measurement update.
// M_inf;
x_inf = x_inf + M_inf*(readings[i]-C*x_inf); // % x[n|n].
//P_inf; % P[n|n].
y_e_inf = C*x_inf;
errcov_inf = C*P_inf*C;
// Time update.
x_inf = A*x_inf + B*U;
P_inf = A*P_inf*A + B*Q*B;
}
}
The experiments were performed in a thermal bath giving step responses to the desired setup temperature. Figure 6 depicts the upward and downward evolution of the temperature, the Kalman filter and the two predictors (using two different Q and R settings). As can be seen the predictors follow the Temperature of the sensor closely, especially for the upward way, while the Kalman filter lags behind.
Implemented system. Step response for the upwards and downwards evolution. Two different Kalman filters were used to predict (by solving the DARE equation) the evolution of the future state with different Q and R to calibrate the desired response. In blue the evolution of the RTD sensor analog input, in Yellow and red the two Kalman predictors and the Kalman estimation in cyan color.
Sliding control [57] is an additional tool to predict the behavior of a second order system basically smoothing the system by boundary layers. The prediction of the system state trajectory is given using an uncertain model of the system. The subspace which represents the quantity of uncertainties in the prediction process, forces the estimate state trajectory to switching gain to converge the estimates to within a boundary of the real state values. To predict the state trajectory of our RLC system it’s possible to switch its gain by the subspace represented by a first-order RC model. The estimated state trajectory is forced to keep a switch back and forth within the boundary layer represented in our case by a RC model. By creating a boundary layer, the system is further constrained to have a solution existing in between two RC model solutions.
In Figure 7 it can be clearly seen that the use of two estimators may help predict the behavior of the RTD in a much better way. The system needs to be calibrated first in order to have the two Kalman filters enveloping the required solution. As can be seen in the upward direction, both predictors (yellow and red) envelope the desired response (blue), that of the RTD sensor improving the response of the Kalman filter without boundaries (cyan). Unfortunately, this is not the case in the downward evolution. From the nonlinear control systems point of view these two evolutions demark a region where the RTD stands thus making possible to program a better estimator. It is left as an outlook to program a third estimator using this boundary layer in order to have a better predictor, especially for the downward evolution.
Ascending and descending step responses of the Kalman filter and two Predictors which function in real time. In blue the RTD sensor response, in cyan the estimator response, in yellow and in red the two differently calibrated Kalman predictors.
As it can be shown the implementation of the Kalman filter brings the opportunity to estimate the forecast in real time of a second order system using first, MATLAB and second that of two first order systems using a simple RC system coded in C-language for a microprocessor. It has been shown that the program is able to predict the evolution of temperature for a RTD system. Even if the system is implemented using a first order system we can find evolving solutions for our estimation and prediction to be good enough. We predict the state after approximately 8 seconds showing an error of −0.0948°C in the best of the cases. In addition, a boundary layer may be programmed using two first order Kalman predictors which may be tuned by setting Q and R properly. We believe this is the first report on the use of a Kalman filter to predict the evolution of temperature from a RTD.
Chronic pain is classified as pain that lasts longer than three to 6 months. Besides medical treatment, it consists of many other issues, such as social, economic and psychological. The treatment of chronic pain is a chronic problem for many specialities; it is generally based on an approach with antidepressants, anti-epileptics and opioids as drugs of first choice. Still, there is no right choice for these patients and 60–70% remains untreated [1, 2].
Chronic pain management is arguably at its most effective when a multidisciplinary approach is used. Ketamine can optimise other (non-opioid) medications by reducing opioid requirements [3].
The socioeconomic burden due to chronic pain is another problematic issue and cannot be overestimated. In Europe, the reported burden of chronic pain is nearly equally steep, with the point prevalence estimated to be 25–30% [4].
Ketamine has been on the market as an alternative to phencyclidine since 1960s. In 1965, it is used as an anaesthetic. Ketamine produces dissociative anaesthesia as well as analgesia and amnesia. Because of its side effects like, the induction of a psychedelic state causing agitation, hallucinations and panic attacks, ketamine has limited use in contemporary anaesthesia.
Ketamine is a phenylpiperidine derivative structurally related to phencyclidine with 2(2-chlorophenyl)-2-(methylamino)-cyclohexanone as its chemical structure. There are two different forms of ketamine: the racemic mixture (Ketalar®, Pfizer Inc., available in the US since 1966) and the S(+) enantiomer (S-ketamine or Ketanest-S®, Pfizer Inc.).
Ketamine is a potent N-Methyl-D-aspartate (NMDA) antagonist and is generally used in the treatment of acute and chronic pain, sedation, induction and maintenance of anaesthesia and ICU sedation [5]. It exerts its NMDA antagonism by binding to the phencyclidine receptor site when the channel is open. Its property to inhibit these receptors, it is postulated that ketamine can help treat chronic neuropathic pain [6]. Also, ketamine can be used as an antidepressant, making it useful in the concomitant treatment of pain and depression [7].
Ketamine is known to prevent central sensitization, so infusions of ketamine started intraoperatively and continued into the early postoperative period might prevent chronic postoperative pain, which is a problem impacting approximately 20% of surgical patients [8]. Ketamine, by inhibition of the N-Methyl-D-aspartate receptor (NMDAR), causes strong analgesia in neuropathic pain. Also, NMDAR is involved in the process of chronification of pain [9].
Ketamine also interacts with other receptors such as opioidergic, muscarinic and mono aminergic receptors. But still, little is known about the contributions of these receptor systems to the various effects of ketamine [10].
There are many routes that ketamine can be given; IV, IM, SC, oral, rectal, nasal, transdermal, epidural, or intrathecal [11]. Orally administered ketamine undergoes extensive first-pass metabolism, primarily via N-demethylation, resulting in small ketamine concentrations and large nor-ketamine concentrations in blood and tissue [12].
One of the challenging concepts about chronic pain patients should be treated in an inpatient setting. When outpatient treatment is planned, other issues must be considered like lack of monitoring, increased risk of toxicity and abuse. Smart dosing regimens, patient (and doctor) training, frequent contact and close monitoring of drug are needed for home treatment of ketamine [13].
The multimodal approach is the most effective treatment of chronic pain. Ketamine is often administered together with opioid analgesics, post-operatively and in the treatment of chronic cancer pain.
Ketamine has been studied for central pain after spinal cord injury. Oral and parenteral ketamine was found to be effective. It reduced continuous and evoked pain in these patients, and it is related to only mild side effects [14]. Ketamine showed an analgesic effect in a case with neuropathic pain after cauda equina trauma [15]. Ketamine was found effective in a patient with central poststroke pain after subarachnoid haemorrhage, besides providing analgesia, ketamine also helped the opioids and anticonvulsants to be tapered and discontinued [16]. The authors used midazolam for premedication and used iv incremental dose. With 50 mg oral dosing nightly, increasing to 50 mg 3 times a day resulted in relief of allodynia and hyperalgesia.
Complex regional pain syndrome is a chronic pain condition having both autonomic and inflammatory features. It occurs acutely in about 7% of patients who have limb fractures, limb surgery, or other injuries. Only a small percentage of it turns into a chronic form. This transition is often paralleled by a change from ‘warm complex regional pain syndrome,’ with inflammatory characteristics dominant, to ‘cold complex regional pain syndrome’ in which autonomic features dominate. Many complex mechanisms take role in this period. This may include peripheral and central sensitization, autonomic changes and sympatho-afferent coupling, inflammatory and immune alterations, brain changes, and genetic and psychological factor. Effective management of the chronic form of the syndrome is often challenging. There are reports about epidural use of ketamine in patients with complex regional pain syndromes and refractory to other treatments [16, 17]. Dose for epidural ketamine suggested was 0.3 mg/kg followed by 25 mcg/kg/h with only transient side effects like headache and nausea.
Fibromyalgia is a disorder characterised by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Fibromyalgia is thought to amplify painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals. Symptoms usually appear after physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.
In patients with fibromyalgia, ketamine which is given 0.3 mg/kg iv, showed an increase in endurance and reduction in pain intensity, tenderness at trigger points, referred pain, temporal summation, muscular hyperalgesia, and muscle pain at rest. It is suggested that ketamine by reducing central sensitization, is effective in fibromyalgia.
Peripheral vascular disease is a common reason of limb pain-causing considerable suffering. In its early stages, it can present as intermittent claudication, but with multiple levels of occlusion rest pain can develop. Patients presenting with critical limb ischemia face a 13% risk of primary amputation. The pain often responds poorly to different treatment strategies including opioids.
As ischemic pain of arteriosclerosis may consist of both nociceptive and neuropathic components, it is generally poorly responsive to opioids. When compared with ketamine with a potent dose dependent analgesic effect (0.15, 0.3, o.45 mg/kg iv) in clinical ischemic pain but with a narrow therapeutic window, ketamine may show better analgesia in these patients [18]. Also dose dependent side effect such as disturbed cognition and perception recorded for these patients.
According to aetiology, neuropathic pain syndromes are heterogeneous; in clinical aspect, they have many similarities. Pain, dysesthesias and hyperalgesia are the main features of neuropathic pain syndromes. Unfortunately, standard pharmacologic therapies are generally insufficient.
Current interest in ketamine focuses on its ability to alleviate chronic pain, especially when chronic pain has a neuropathic component. Chronic neuropathic pain is the most widely investigated indication for IV ketamine. Different doses have been tried between 0.25 and 0.75 mg/kg iv. Most side effects are observed with high doses. Neuropathic pain results from lesions of the somatosensory nervous system causing alterations in structure and function so that pain occurs spontaneously and responses to noxious and innocuous stimuli are amplified [19].
Another condition that generally manifests with neuropathic pain is chronic diabetes. In mice, this can be modelled with high-dose injection of streptozotocin which selectively kills pancreatic beta cells through DNA alkalization. Ketamine when given systemic infusion at 20 mg/kg/day for 5 days showed to reduce heat and mechanical hyperalgesia for several weeks following treatment.
Ketamine is frequently used for managing acute episodes of refractory neuropathic pain. In these situations, generally, large doses of opioids are used which leads to development of severe hyperalgesia. The mechanism of opioid induced hyperalgesia is not certain, one of the leading theories is overactivation and stimulation of the NMDA-receptor, so this proposed mechanism would explain why NMDA receptor modulators such as ketamine are effective in treating the condition. Ketamine with 10 mg/h iv suggested for opioid hyperalgesia. Also, subcutaneous administration can be a good alternative for these patients to get time for finding iv access.
Neuropathic pain related to ‘nerve damage in the trigeminal region’ is one of the chronic pain topics, which generally needs many interventions for pain relief. Ketamine can be an alternative for these kinds of pain issues. NMDA receptor inhibition by ketamine might change the sensitization, so ketamine causes pain relief even after ketamine has been eliminated from the body. The optimal dose suggested as 60 mg per oral, 6 times a day found [20]. Some side effects like dizziness and fatigue were well tolerated.
After amputation of a limb, most amputees suffer from stump and phantom limb pain. Many medical and surgical therapies have been tried, but only a few treatments have been found to be effective. Both peripheral and spinal mechanisms have been accused of underlying mechanism. Studies show that C-fibre input may induce a central hyperexcitability in dorsal horn neurons. There is evidence that this hyperexcitability in part is mediated by excitatory amino acids acting at NMDA receptor sites and that excitatory amino acid receptor antagonists may block this central hyperexcitability and its clinical manifestations.
Case series and case reports support ketamine use in stump and phantom pain. Ketamine showed a significant increase in pressure thresholds and reduced hyperpathia. Especially for patients who did not benefit from conventional treatments, iv ketamine was very effective. Doses such as 0.1 mg/kg iv over 5 min then infusion of 7 g/kg/min for 45 min and 0.125–0.3 mg/kg iv then continuous sc infusion 0.125–0.2 mg/kg/h for maintenance showed effective results. Also, other papers support the use of oral ketamine to control phantom pain (50 mg/6 hr) [21].
Nerve injury may lead to persistent pathological pain with hyperalgesia and pain evoked by non-noxious stimuli. Long-lasting hyperexcitability in nociceptive neurons initiated by increased activity in primary afferents may play a role in the pathogenesis of nerve injury pain. In particular, the N-methyl-o-aspartic acid receptors may be important for the development of long-lasting changes in neuronal excitability. NMDA receptor blockers inhibit the progressive increase in action potential discharge (wind-up) and neuronal hyperexcitability produced by repeated stimulation of small-diameter primary. NMDA receptor blockers also inhibit nociceptive behaviour in animals caused by nerve injury.
Ketamine is effective for pain relief in postherpetic neuralgia. Ketamine produces significant pain relief and also reduces allodynia and hyperpathia [22]. Relief of continuous pain was observed at the smallest dose but was most marked at the largest (0.05, 0.075, 0.1, 0.15 mg/kg/h. sc). The number and severity of spontaneous pain attacks are also reduced. Ketamine administration showed even complete resolution of ophthalmic postherpetic neuralgia [23].
Patients with refractory chronic migraine suffer from continuous pain and nonpainful symptoms, substantial disability, and have generally failed treatments with multiple medications. Patients with severe pain have often failed typically inpatient or outpatient infusion treatment, so few options remain for them.
Ketamine use for headaches has demonstrated benefits. Subcutaneous ketamine of 80 μg/kg was associated with an approximately 50% reduction in acute migraine-related pain and an approximate 75% reduction in chronic migraine-related pain [24].
Unfortunately, there was weak or no evidence supporting ketamine infusions for immediate improvements in pain management of mixed neuropathic pain, PLP, PHN, fibromyalgia, cancer pain, ischemic pain, migraine headache and low-back pain. Evidence only supports ketamine infusions for intermediate or long-term improvements in pain management of CRPS [25].
Some reports suggest that ketamine decreases the rate of chronic postoperative pain when administered as a pre-incisional dose (0.15–1 mg/kg iv) followed by an intraoperative infusion, and intravenous ketamine has been shown to significantly reduce chronic pain incidence following certain types of surgeries [26].
Multimodal approach to chronic pain is found to be the most effective treatment. In general, ketamine is administered with opioids, post-operatively and in the treatment of chronic cancer pain. A Cochrane review showed that ketamine is effective in reducing morphine consumption, and is related to less pain and less nausea and vomiting [27]. Also, ketamine positively affect opioid treatment in cancer pain [28]. The ability of ketamine to reduce the incidence (and severity) of opioid side effects is important as side effects reduce patient compliance. So, an opioid-ketamine combination may be useful in non-neuropathic pain states (e.g., in the palliative setting) or in mixed nociceptive/neuropathic pain states (e.g., in cancer pain).
Studies show that ketamine has also anti-depressant effects [29]. In fact, clinical studies showed that a subanaesthetic dose of ketamine produces antidepressant effects Ketamine has a positive effect on depressive symptoms in otherwise therapy-resistant patients. Because depression and chronic pain share common mechanistic pathways, Most chronic pain patients face depression or depression-like symptoms.
In fact, the treatment of chronic pain may serve two purposes, treating the pain and ameliorating the depressive symptoms. When the pain is treated and the depression simultaneously resolves, or the reverse is true.
Some experimental reports conclude that ketamine has also anti-inflammatory, neuroprotective and anti-tumour effects [30].
Intravenous ketamine infusions have the advantages of avoiding first-pass metabolism and also controlling the way of administration. But this requires inpatient settings allowing the healthcare team to monitor for adverse conditions and track treatment efficacy.
A meta-analysis including seven different studies examining both neuropathic and non-neuropathic pain conditions showed a significant analgesic effect for intravenous ketamine infusions. The median ketamine dose of 0.35 mg/kg was reached after 5 h. In these studies, maximum analgesic effect was observed between 48 h and 2 weeks post-infusion. The studies showed no efficacy difference between ketamine as a sole agent or adjuvant therapy [31]. This meta-analysis reported that ketamine shows significant promise for the treatment of a wide variety of chronic pain conditions, including neuropathic and non-neuropathic. Due to the long-acting nature of ketamine’s analgesia, outpatients treatments could be effective with visits required as frequently as infusions are needed.
Ketamine can be used as a third-line agent in intractable cancer pain. In a case study of cancer patients with intractable pain, ketamine infusions at a rate of 1.5 mg/kg/day reduced total daily morphine use by 50% after patients were sent home with ketamine/morphine pain pumps [32].
Oral and nasal formulations generally do not need are direct physician supervision in contrast to infusions, so oral and nasal formulations are more desirable for management of long-term pain conditions. Despite requiring higher doses due to extensive metabolism, oral administrations have also been found to be effective in providing analgesia.
A study with a daily dose of 2 mg/kg, ketamine showed reduction in pain in two-thirds of patients while one-half of patients reported some adverse event [33].
Intranasal ketamine, although now mostly taken part in the treatment of depression, has also been tried for management of cancer pain. Intranasal ketamine was found to be successful in 65% of breakthrough cancer pain patients and achieved a Numerical Pain Intensity Scale (NPIS) score that was at least 40% lower than pre-treatment levels [34].
Ketamine as a topical agent may be preferred for patients in whom systemic ketamine administration via oral or IV routes is not desirable administration. Topical application provides the benefit of keeping plasma concentrations and therefore potential side effects at a minimum.
Topical ketamine has been tried in chronic regional pain syndrome, studies reported effective reduction in pain measures, tactile allodynia and Visual Analog Scale pain score. Besides being a good alternative in pain management, still, there is concern about the systemic levels of ketamine [35].
Ketamine besides being an anaesthetic is used to treat various chronic pain syndromes, especially those that have a neuropathic component. Inhibition of the N-methyl-D-aspartate receptor and probably some other mechanisms like enhancement of descending inhibition and anti-inflammatory effects at central sites results in strong analgesia even with low doses.
The side effects of ketamine noted in clinical studies include psychedelic symptoms (hallucinations, memory defects, panic attacks), nausea/vomiting, somnolence, cardiovascular stimulation and hepatoxicity. There are also risks ranging from the bladder and renal complications to persistent psychological behaviour and memory defects by the increase in ketamine usage. Also, abuse is another problem.
Cognitive side effects of ketamine frequently limit its use. Since its discovery, ketamine was known to produce dissociative and psychomimetic effects. These effects are also responsible for the continued abuse of ketamine [36].
Studies showed that ketamine produces structural and physiological changes in the brain, even a decrease in grey and white matter volumes in the pre-frontal cortex and white matter degeneration in the left temporoparietal lobe has been reported [37].
Regardless of the mechanism of these cognitive disorders, many research has been done to find out what drugs may be able to prevent them. Several of these studies have demonstrated that benzodiazepines, specifically midazolam and haloperidol, reduced undesired psychotic side effects and nausea associated with ketamine administration [38].
Cystitis related to ketamine use is another problem, especially for long term users. The increase in neurotrophin in bladder tissue accused to cause the chronic inflammation of the bladder and urinary tract in ketamine cystitis [39].
Elevation of serum liver enzymes has been reported in patients receiving ketamine infusions, but these levels decreased back to baseline within 10–14 days following treatment [40].
Due to ketamine’s central inhibition effect of norepinephrine reuptake in adrenergic nerves, an increase in cardiac output via elevations in heart rate, systolic blood pressure, and diastolic blood pressure can be observed. Also, ketamine acts as a sympathomimetic on the cardiovascular system [41].
Because of dissociative and hallucinogenic effects of ketamine, it has been abused. Even therapeutic doses are generally less than street-use doses, ketamine still maintains addictive potential.
In clinical settings, ketamine is generally well tolerated, especially when benzodiazepines are used to suppress the psychotropic side effects. Patients receiving ketamine should be monitored closely, especially for CNS, haemodynamic, renal and hepatic symptoms as well as abuse. Until definite proof is obtained ketamine administration should be restricted to patients with therapy-resistant severe neuropathic pain.
Ketamine as an analgesic can be used for several indications and in many ways. It may be used most effectively to reduce the symptoms of allodynia, hyperalgesia and hyperpathia rather than acting as a traditional analgesic. This could be consistent with NMDA receptor blockade limiting or reducing central sensitization, although the ability of ketamine to interact with such a wide variety of receptors means that this is currently only speculative.
There are various dose regimens for different application ways for ketamine. Most of the data is based on case reports. Still, there are also concerns about side effects and with different premedication like lorazepam or midazolam, most of the side effects may resolve.
The data provides encouraging suggestions about ketamine for chronic pain situations. To talk about pros of ketamine for chronic pain management:
Ketamine is tried for many types of pain and found most useful
Pain related to neuropathies can be relieved by ketamine
Ketamine can be effective for pain where opioids are ineffective, and hyperalgesia occurred cause of opioids.
Ketamine can be used during the perioperative period both for acute analgesia management and for preventing chronic pain.
Ketamine can be applied by many routes; epidural, subcutaneous, intravenous.
Ketamine has an antidepressant effect, which plays an important role in the management of chronic pain.
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',metaTitle:"Terms and Conditions",metaDescription:"These terms and conditions outline the rules and regulations for the use of IntechOpen Website at https://intechopen.com and all its subdomains owned by Intech Limited located at 7th floor, 10 Lower Thames Street, London, EC3R 6AF, UK.",metaKeywords:null,canonicalURL:"/page/terms-and-conditions",contentRaw:'[{"type":"htmlEditorComponent","content":"By accessing the website at www.intechopen.com you are agreeing to be bound by these Terms of Service, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. Use and/or access to this site is based on full agreement and compliance of these Terms. All materials contained on this website are protected by applicable copyright and trademark laws.
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\n\nThe following terminology applies to these Terms and Conditions, Privacy Statement, Disclaimer Notice, and any or all Agreements:
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He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. 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He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. 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She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. 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His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}},{id:"338856",title:"Mrs.",name:"Nur Alvira",middleName:null,surname:"Pascawati",slug:"nur-alvira-pascawati",fullName:"Nur Alvira Pascawati",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universitas Respati Yogyakarta",country:{name:"Indonesia"}}},{id:"441116",title:"Dr.",name:"Jovanka M.",middleName:null,surname:"Voyich",slug:"jovanka-m.-voyich",fullName:"Jovanka M. Voyich",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Montana State University",country:{name:"United States of America"}}},{id:"330412",title:"Dr.",name:"Muhammad",middleName:null,surname:"Farhab",slug:"muhammad-farhab",fullName:"Muhammad Farhab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"349495",title:"Dr.",name:"Muhammad",middleName:null,surname:"Ijaz",slug:"muhammad-ijaz",fullName:"Muhammad Ijaz",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Veterinary and Animal Sciences",country:{name:"Pakistan"}}}]}},subseries:{item:{id:"20",type:"subseries",title:"Animal Nutrition",keywords:"Sustainable Animal Diets, Carbon Footprint, Meta Analyses",scope:"An essential part of animal production is nutrition. Animals need to receive a properly balanced diet. One of the new challenges we are now faced with is sustainable animal diets (STAND) that involve the 3 P’s (People, Planet, and Profitability). We must develop animal feed that does not compete with human food, use antibiotics, and explore new growth promoters options, such as plant extracts or compounds that promote feed efficiency (e.g., monensin, oils, enzymes, probiotics). These new feed options must also be environmentally friendly, reducing the Carbon footprint, CH4, N, and P emissions to the environment, with an adequate formulation of nutrients.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/20.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11416,editor:{id:"175967",title:"Dr.",name:"Manuel",middleName:null,surname:"Gonzalez Ronquillo",slug:"manuel-gonzalez-ronquillo",fullName:"Manuel Gonzalez Ronquillo",profilePictureURL:"https://mts.intechopen.com/storage/users/175967/images/system/175967.png",biography:"Dr. Manuel González Ronquillo obtained his doctorate degree from the University of Zaragoza, Spain, in 2001. He is a research professor at the Faculty of Veterinary Medicine and Animal Husbandry, Autonomous University of the State of Mexico. He is also a level-2 researcher. He received a Fulbright-Garcia Robles fellowship for a postdoctoral stay at the US Dairy Forage Research Center, Madison, Wisconsin, USA in 2008–2009. He received grants from Alianza del Pacifico for a stay at the University of Magallanes, Chile, in 2014, and from Consejo Nacional de Ciencia y Tecnología (CONACyT) to work in the Food and Agriculture Organization’s Animal Production and Health Division (AGA), Rome, Italy, in 2014–2015. He has collaborated with researchers from different countries and published ninety-eight journal articles. He teaches various degree courses in zootechnics, sheep production, and agricultural sciences and natural resources.\n\nDr. Ronquillo’s research focuses on the evaluation of sustainable animal diets (StAnD), using native resources of the region, decreasing carbon footprint, and applying meta-analysis and mathematical models for a better understanding of animal production.",institutionString:null,institution:{name:"Universidad Autónoma del Estado de México",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,series:{id:"13",title:"Veterinary Medicine and Science",doi:"10.5772/intechopen.73681",issn:"2632-0517"},editorialBoard:[{id:"175762",title:"Dr.",name:"Alfredo J.",middleName:null,surname:"Escribano",slug:"alfredo-j.-escribano",fullName:"Alfredo J. 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