Oxygen delivery devices [3].
\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\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:"1273",leadTitle:null,fullTitle:"Non-Flavivirus Encephalitis",title:"Non-Flavivirus Encephalitis",subtitle:null,reviewType:"peer-reviewed",abstract:"This book covers the different aspects of non-flavivirus encephalitises of different ethiology. The first section of the book considers general problems of epidemiology such as study of zoonotic and animal vectors of encephalitis causative agents and methods and approaches for encephalitis zoonoses investigations. The members of different virus species are known to be the causative agents of encephalitis, so the second section of the book is devoted to these viral pathogens, their epidemiology, pathology, diagnostics and molecular mechanisms of encephalitis development by such viruses as HIV/SIV, herpes simplex virus type 1 and equine herpesvirus 9, measles virus, coronaviruses, alphaviruses and rabies virus. The next section of the book concerns the study of protozoan pathogens such as toxoplasma and amoebae. The last section of the book is devoted to multicellular pathogen as human Filaria Loa Loa - a filarial worm restricted to the West Africa.",isbn:null,printIsbn:"978-953-307-720-8",pdfIsbn:"978-953-51-4400-7",doi:"10.5772/1740",price:139,priceEur:155,priceUsd:179,slug:"non-flavivirus-encephalitis",numberOfPages:374,isOpenForSubmission:!1,isInWos:1,isInBkci:!0,hash:"fa857119b76ce546ccf16503e982a08e",bookSignature:"Sergey Tkachev",publishedDate:"November 16th 2011",coverURL:"https://cdn.intechopen.com/books/images_new/1273.jpg",numberOfDownloads:45886,numberOfWosCitations:64,numberOfCrossrefCitations:11,numberOfCrossrefCitationsByBook:2,numberOfDimensionsCitations:46,numberOfDimensionsCitationsByBook:2,hasAltmetrics:1,numberOfTotalCitations:121,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 8th 2010",dateEndSecondStepPublish:"December 6th 2010",dateEndThirdStepPublish:"April 12th 2011",dateEndFourthStepPublish:"May 12th 2011",dateEndFifthStepPublish:"July 11th 2011",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,8,9",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"62638",title:"Dr.",name:"Sergey",middleName:null,surname:"Tkachev",slug:"sergey-tkachev",fullName:"Sergey Tkachev",profilePictureURL:"https://mts.intechopen.com/storage/users/62638/images/1875_n.jpg",biography:"Dr. Sergey Tkachev graduated from the Faculty of Natural Science, Novosibirsk State University, Russia in 1998. From 1996 till the present he has been working at the Laboratory of Microbiology, Institute of Chemical Biology and Fundamental Medicine SB RAS, Novosibirsk, Russia on tick-transmitted pathogens study including tick-borne encephalitis virus, its epidemiology, molecular genetics and biology. Scientific interests include virology, molecular biology and epidemiology of virus pathogens and especially flaviviruses and rabies virus. He is the lecturer and instructor of the Big Biochemical Workshop at the Faculty of Natural Science of Novosibirsk State University. In 2010 he had 2-weeks practice in Niigata University, Japan. 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Nitrogen-containing heterocyclic compounds are indispensable for life as they are part of essential building blocks like amino acids, nucleotides, etc. 1,2,3-Triazoles are one of the most important nitrogen-containing five-membered heterocycles and have a wide range of applications in pharmaceuticals, supramolecular chemistry, organic synthesis, chemical biology and industry [1, 2, 3, 4, 5, 6]. The 1,2,3-triazoles has numerous useful properties like high chemical stability (usually inert to acidic or basic hydrolysis as well as oxidizing and reducing conditions even at high temperature), aromatic character, strong dipole moment (4.8–5.6 Debye), and hydrogen bonding ability [7]. These spectacular features make the substituted 1,2,3-triazole motif structurally resembling to the amide bond, mimicking an E or a Z amide bond. Many prominent medicinal compounds having a 1,2,3-triazole core are available in the market like anticonvulsant drug Rufinamide, broad spectrum cephalosporin antibiotic cefatrizine, an anticancer drug carboxyamidotriazole and
Owing to its versatile applications, the synthesis of 1,2,3-triazoles has been a subject of extensive research. The synthetic methodologies for the preparation of this important scaffold can be broadly divided into four categories (Figure 1) [9]:
Huisgen 1,3-dipolar cycloaddition
Metal-catalyzed 1,3-dipolar cycloaddition
Strain-promoted azide alkyne cycloaddition
Metal-free synthesis of 1,2,3-triazoles
Strategy of the synthesis of 1,2,3-triazoles.
Huisgen 1,3-dipolar cycloaddition was the most straightforward and atom-economical synthesis of 1,2,3-triazoles. However, elevated reaction temperature and poor regioselectivity (mixtures of 1,4- and 1,5-isomers) make this process unsatisfactory [10].
In 2001, Sharpless et al. coined the term “Click Chemistry,” a set of highly reliable, practical, and selective reactions for the rapid synthesis of valuable new compounds and combinatorial libraries. The click reaction should be
In 2005, Fokin and coworkers devised an efficient approach for the construction of 1,5-disubstituted 1,2,3-triazoles by ruthenium cyclopentadienyl complexes (RuAAC). In addition, internal alkynes also effective in this protocol leading to fully substituted 1,2,3-triazoles [18].
The McNulty group reported a well-defined Ag(I) complex for the regioselective synthesis of 1,4-disubstituted 1,2,3-triazoles at room temperature [19].
An interesting Zn(OAc)2-catalyzed azide-alkyne cycloaddition was developed by Postnikov and his research group affording 1,4-disubstituted 1,2,3-triazoles [20].
In 2017, Kim et al. devised Cp2Ni/Xantphos catalytic method to access 1,5-disubstituted 1,2,3-triazoles under mild condition [21].
Sun and coworkers reported intermolecular iridium-catalyzed azide-alkyne cycloaddition reaction (IrAAC) of electron-rich internal alkynes [22].
Despite the overwhelming popularity of click chemistry in modern science and technology, the using of metals creates serious concern in biological system due to cellular toxicity. The Bertozzi group explored an interesting protocol of strain-promoted azide-alkyne cycloaddition (SPAAC) reaction for bioconjugation. The driving force for this reaction was the release of large ring strain in the cycloalkynes which proceeds under physiological condition without any catalyst [23].
Organocatalytic reactions has gained considerable attention in the synthesis of 1,2,3-triazoles using enamines, enolates as dipolarophiles. Besides, activated alkenes were established as a useful substrate for triazole formation.
Ramachary and coworkers developed L-proline-catalyzed synthesis of 1,2,3-triazoles via an enamine mediated [3 + 2]-cycloaddition reaction [24].
In 2011, the regioselective synthesis of 1,4,5-trisubstituted 1,2,3-triazoles was achieved by Wang et al. using an organocatalytic enamine azide reaction [25].
The Bressy group reported synthesis of substituted 1,2,3-triazoles from unactivated ketone and aromatic azide using microwave condition [26].
Wang and coworkers devised an organocatalytic method for the preparation of fully substituted 1,2,3-triazoles by diethylamine-catalyzed reaction of azides and allyl ketones [27].
Iodine mediated, oxidant free synthesis of 1,5-disubstituted 1,2,3-triazoles was reported by the Wan group using primary amines, enamines and tosylhydrazine [28].
Using potassium carbonate, Kannan and co-workers developed a protocol for the synthesis of 4-acetyl-5-methyl-1,2,3-triazoles from acetylacetone and aromatic azides [29].
The Ramachary group described an efficient methodology for the preparation of 1,4-disubstituted 1,2,3-triazoles using organocatalytic azide-aldehyde [3 + 2] cycloaddition reaction [30].
Paixão et al. reported the use of alkylidenemalononitriles in 1,3-dipolar cycloaddition with aromatic azides mediated by DBU [31].
In their another pioneering work, Ramachary and coworkers reported an interesting organocatalytic [3 + 2]-cycloaddition reaction of ketones with azides for synthesis of fully substituted 1,2,3-triazoles [32].
In a methodology published in 1986, Sakai et al. used primary amines and α,α-dichloro ketone derived tosylhydrazones for the metal free synthesis of 1,2,3-triazoles [33].
Westermann and co-workers developed a cascade reaction using α,α-dichlorotosylhydrazones and primary amines in the presence of diisopropylethylamine [34].
Metal free regioselective synthesis of 1,4,5-trisubstituted 1,2,3-triazoles was reported by Dehaen et al. from aldehydes, nitroalkanes and organic azides [35].
The Guan group developed p-toluenesulfonic acid-catalyzed 1,3-dipolar cycloaddition reaction for the synthesis of 4-aryl-NH-1,2,3-triazoles from nitroolefins with sodium azide [36].
1,2,3-triazoles are stable towards metabolic degradation and easily form hydrogen bonding which can increase solubility favoring the binding of biomolecular targets. Owing to their unique properties, 1,2,3-triazoles are attractive building blocks in drug discovery.
Cancer is a major public health concern and second leading cause of mortality globally. Despite that numerous anticancer agents including taxol, vincristine, vinblastine, camptothecin derivatives, topotecan are available, search for novel compounds with different modes of actions has received significant interest.
Kallander et al. reported 4-aryl-1,2,3-triazoles
Odlo and coworkers disclosed a series of cis-restricted 1,5-disubstituted 1,2,3-triazole analogues of combretastatin A-4. One of the triazole derivatives
The series of triazole-modified 20,30-dideoxy-20,30-diethanethioribonucleosides
Rangappa and coworkers prepared a series of 1,2-benzisoxazole tethered 1,2,3-triazoles
Using “click chemistry” approach, the Miller group prepared a series of N-((1-benzyl-1H-1,2,3-triazol-4-yl)methyl)arylamides and examined their antiproliferative activity. One of the compound
Lin and coworkers synthesized a series of heterocycle-fused 1,2,3-triazoles and evaluated their cytotoxic activity. With IC50 values lower than
1,2,3-triazole derivatives of betulinic acid were synthesized by Koul et al. and their cytotoxic activity against nine human cancer cell lines was evaluated (Figure 2). Two molecules
Some examples of 1,2,3-triazole containing molecules with anticancer activity.
Inflammation is particularly complex biological process of body tissues, where membrane-bound phospholipids release arachidonic acid (AA), followed by biotransformation processes using cycloxygenase (COX) and 5-lipoxygenase (5-LOX) pathways. Several non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin, ibuprofen, and naproxen block arachidonic acid metabolism by obstructing cycloxygenase. Nevertheless the side effects associated with these drugs prompted medicinal chemists to develop alternative scaffolds.
The Jung group synthesized twenty-four phenyl-1H-1,2,3-triazole derivatives and studied their biological activity. At the same dose of 25 mg/kg, compound
Yar and coworkers reported 1,2,3-triazole tethered Indole-3-glyoxamide derivatives for in vivo anti-inflammatory activity using click chemistry approach. Two compounds
Various examples of 1,2,3-triazole containing molecules with anti-inflammatory activity.
Tuberculosis (TB) caused by
Labadie and coworkers used click chemistry to synthesize a small library of 1,2,3-triazole derivatives and screened them against
Using click chemistry, the Boechat group reported 4-substituted N-phenyl-1,2,3-triazole derivatives for antimicrobial activity against
The Kantevari group described a molecular hybridization approach for the synthesis of triazole clubbed dibenzo[b,d]thiophene-based
Zhang et al. synthesized triazole-based library of benzofuran salicylic acid derivatives using click chemistry strategy. The compound
Representative examples of 1,2,3-triazole containing molecules with antitubercular activity.
Fungal and bacterial infections create severe apprehension for human and animal survival. The inefficacy of available drugs and rising resistant strains demand significant interest into new classes of antimicrobial agents.
Agarwal and coworkers synthesized 1,2,3-triazole derivatives of chalcones and flavones by click chemistry and screened their antimicrobial and antiplasmodial activity. Several compound including
The Murugulla group studied antimicrobial activity of theophylline containing 1,2,3-triazoles with variant nucleoside derivatives. Compound
Diaryl sulfone containing novel 1,2,3-triazoles were synthesized by Jørgensen and coworkers and their biological evaluation was carried out as well. Compound
Zhou et al. reported a series of 1,2,3-triazole-derived naphthalimides for potential antimicrobial activity. Bioactive assay revealed that
5-nitrofuran—triazole congener—was prepared by the Kamal group and its biological activity was studied. Among the other compounds,
Representative examples of 1,2,3-triazole containing molecules with antimicrobial activity.
Viral diseases are caused by viruses infecting an organism body. Although vaccines and antiviral drugs are used for treating viral infections, advance of novel viruses creates health risk over the world. Therefore development of alternative antiviral agents is of significant interest.
Boechat and coworkers reported the synthesis of 1,2,3-triazole nucleoside ribavirin analogs and studied their antiviral activity. The synthesized compound
Ribavirin analogues—4,5-disubstituted 1,2,3-triazole nucleosides—were synthesized by Zeidler et al. and screened for their biological activity. 5-ethynyl nucleoside
The Ding group targeted virus nucleoprotein and synthesized 1,2,3-triazole-4-carboxamide derivatives for anti-influenza drug development. The compound
Examples of 1,2,3-triazole containing molecules with antiviral activity.
In summary, 1,2,3-triazole moiety has proven to be a privileged scaffolds in medicinal chemistry. The exceptional properties of this promising heterocycle facilitate its wide range of applications from material science to bioconjugation. Thanks to Sharpless for introducing “Click Chemistry,” one of the most prevailing tools in drug discovery, chemical biology, and proteomic applications and undoubtedly opens new avenue to the scientific community towards the improvement of life.
The author is thankful for the financial support by CSIR, New Delhi, India.
There are no conflicts to declare.
Airway patency is crucial and vital for maintenance of life occurs naturally in the awake and conscious individuals or can be accomplished artificially in those becoming unable to maintain it. Incapacity of this might be intentional; as in medical procedures requiring deep sedation and/or general anesthesia or in pathological conditions; where there is an alteration in sensorium or elective airway protection needed.
Airway management is defined as an intervention using a technique, maneuver or a device to keep its patency, consequently its normal physiological functions have been achieved; providing oxygen and removing carbon dioxide.
Critical illness is a clinical condition belong to a group of medical situations sharing the need of intensive care unit (ICU) admission and have either single or multiple organ dysfunction. Critically ill patients showing different gradations of snags to maintain the airway and subsequently derangement of aerobic metabolism exists. Optimization of oxygen supply is needed, as dramatic rise of both work of breathing and oxygen demand exist.
Hypoxemia is a medical condition where the partial pressure of oxygen in the arterial blood (PaO2) is lower than normal. A PaO2 value of less than 60 mmHg in normal individuals with healthy lungs; corresponds to arterial oxygen saturation (SpO2) of 90%, is used as a cut point for hypoxemia treatment initiation. There are many causes and mechanisms of hypoxemia which required management via oxygen administration. Critically ill patients commonly showing hypoxemic status on the time of admission and oxygen supplementation should be considered in all with high flow delivery system (15 L/min) until becoming stable then reduction of inspired oxygen concentration (FIO2) to achieve a target of SpO2 of 94–98% or 88–92% for patients with risk of hypercapnic respiratory failure [1].
Airway is the natural passages of the airflow, inaugurated by nose and mouth downwards to the alveoli in the lungs, where the gas exchange takes place involuntary. Airway patency is mandatory for life and it’s the responsibility of pharyngeal-laryngeal muscles tonic control and muco-ciliary system’s clearance of mucus and foreign particles.
The airflow via the airway is intermittent and biphasic; inwards during inspiration and outwards during expiration. The work of breathing is a potential energy stored in the lung tissues during inspiration that exists by the work of overcoming the elastic forces and resistance in the airway to be enough for subsequent expiration. In compliant, healthy lung this work of breathing does not consume a portion of the body’s energy needs and its daily fraction is less than 3% of total body energy requirement [2].
Impaired consciousness, associated cervical spine trauma, burns and pulmonary shunt causing rapid desaturation and impedes preoxygenation. Besides, limited time for airway management before life-threatening hypoxia, hemodynamically (HD) unstable, imminent risk of collapse before intubation, tricky standard induction drugs effects provoke time pressure environment.
Cessation of the desirable airflow in critically ill patients could be due to a variety of reasons, foremost of those is the airway obstruction. Airway obstruction might occur at any, upper parts; due to foreign body, mucus, secretions, blood and decreased sensorium or lower parts; due to aspiration, infection and spasm of bronchial muscles. Different maneuvers and devices used to eliminate the airway obstruction thus maintenance of airflow will be gained.
Airway management in critically ill patient aimed for:
Improving the oxygenation.
Airway protection and prevention of pulmonary aspiration.
Adjunct for procedures; diagnostic e.g. bronchoscopy or therapeutic e.g. banding of bleeding esophageal varices.
Relieve the distress of dyspnea.
Reduce the work of breathing.
Improve CO2 clearance.
Altered sensorium, required airway protection.
Others in ICU.
Critical illness and its management protocols might hinder the airway anatomy, fluid resuscitation and capillary leak makes the airway edematous and distorted. Furthermore, the patient demography, body mass index (BMI), associated neurological and cardiopulmonary comorbidities, and the indication of ICU admission contribute to anatomical difficulties.
Oxygen (O2); is an inert gas essential for life, being inspired through the airway and transported via the lungs towards the blood to be used in cellular respiration and delivery of energy needed for body metabolism. Human body uptake of oxygen in concentration of 20.95% from air by natural airways; nose and mouth, transported down along the conductive airways to be resting in the alveoli where the gas exchange happening. Physiological and pathological conditions required an increased FIO2 to meet the body oxygen requirement and its high demand. Devices are designed to facilitate oxygen delivery from artificial oxygen sources in correspond to the target of FIO2, patient’s breathing effort and patient’s device compliance [3].
All critically ill patients must have high-flow oxygen delivery device (15 L/min), until stable status achieved, then oxygen requirement could be individually determined depending on the existing pathology. Patient’s breathing effort is the primary determinant for the oxygen delivery device selection. Critically ill patients might be one of two groups; spontaneous breathing group or assisted ventilation one and each group has a preference in oxygen delivery system [4].
Patients with breathing effort requiring O2 delivering device matched for their breathing power (Table 1).
O2 flow rate (L/min) | FIO2 | Example | |
---|---|---|---|
2 - 15 | Unknown; depend on patient’s effort and O2 flow rate | Simple face mask, face mask with reservoir bag, nasal cannula. (Figure 1) | |
High, up to 45 | Well-known, fixed. | All obey a principle of high airflow O2 enrichment (HAFOE). (Figure 2) |
Oxygen delivery devices [3].
Oxygen delivery devices (simple face mask with reservoir bag & nasal cannula).
Oxygen delivery devices (HAFOE).
In this group of critically ill patients, failure to maintain oxygenation and/or ventilation despite an increase in FIO2 or development of apnea and indicated mechanical ventilation (MV), airway supporting device might be perpetual or temporary as a bridge till the steady one is fixed. Noninvasive positive pressure ventilation (NIPPV), could have both properties as it might be a tie till improvement or securing definitive airway securing device suitable for MV.
Bag-mask with self-inflating reservoir bag; (Figure 3) is considered the simplest and commonest O2 delivery device used in critically ill patients for oxygenation until an airway securing device fixed. It provides FIO2 close to 100% while the only O2 delivery device able to provide 100% FIO2 is the anesthetic breathing system.
Oxygen delivery devices. (bag-mask with self-inflating reservoir bag).
Airway management in ICU is unlike that carried out in operation theater (OT) and higher in its complications; brain damage and death, and most of it is done on urgent and emergency basis in lack of experienced airway management professionals. In addition; critically ill patients showing limited cardiopulmonary reserve, this increases their risk of hypoxemia and hypotension upon exposure to airway management medications. Subsequently, tracheal intubation for those categories of patients could be life-threatening condition; up to 40% of patients are associated with increase in complication rates of hypoxemia (25%) [5] and hypotension (10–25%) [6], arrhythmia, cardiac arrest and death [7] upon exposure to airway stimulation or pharmacological agents used for it.
Incapacity to perform tracheal intubation at the first attempt “first pass success” has higher risk than that in OT and occurs in 30% of ICU intubations [8]. Many factors contribute to that; lack of competent and expert professional for intubation, patient’s factors and pharmacological agents’ dosage choices. This came with the conclusion of Fourth National Audit Project (NAP4), as it showed around 25% of airway management done in ICU & ED are associated with major adverse effects mostly due to the aforementioned factors [9]. Moreover, equipment unavailability, unfamiliarity and inadequate planning resulting in more stressful environment and subsequently delay in airway management with increasing morbidity and mortality.
ICU settings are not suitably planned for airway management due to several reasons. Limited access to the patient as the bed space is crowded by monitoring, ventilator and other equipment, (Figure 4) in addition of the ICU bed is less maneuverable compared to the OT table with unavailability of advanced airway management equipment making it more challenging. Moreover, varying team members of multi-professional backgrounds with non-enough time, experience, accompanying medical devices (collars, masks) and sensorium alteration lead to improper airway assessment beside and inability to ensure adequate preoxygenation necessary to avoid the hypoxia during airway instrumentation. Moreover, unavailability of trained assistance such as anesthesia nurse or technician and lack of structured airway management for ICU staff.
ICU bed vs. OT space (showed crowding with monitoring, equipment and ventilators).
Communication and proper documentation of the airway assessment and its management throughout different hospital facilities is crucial and it might affect the workflow performance. Checklist is the best method of communication among the healthcare professionals from different medical background. Equipment, medications preparation checklist and proper assignment of human forces could make the airway management scenario less stressful and empower its success among critically ill patients.
Quite few challenges could be integrated in airway management for ICU adults, so we can wrap up the considerations and specific precautions that must be accomplish making it less pressure and successfully performed procedure (Table 2).
Thorough clinical assessment and prediction of threats that may limit the success of airway management of critically ill patients could be addressed in this time. Also, optimization of all factors; position, preparation and preoxygenation, accentuates the accomplishment of proper airway management intervention.
Not only thorough assessment of the airway in critically ill patient is vital for successful and safe management but it is unique and carries challenges as compared to that done for patients undergoing daily elective or emergency airway management. Varieties airway assessment modalities, techniques and scoring system had been proposed to allow its safe and easy practice management. Despite the anesthesiologists’ or intensivists’predictions of anticipated airway difficulties are a strong diagnostic modality with high positive ratio, but the high proportion of unanticipated difficult endotracheal intubation and its low positive predictive values limits its reliability as a diagnostic test in medical practice [9].
Moreover, the proposed airway assessment scales vary from the simple, that often fail to address the many factors associated with a difficult airway, to the complex, which are impractical as a clinical tool. None have been shown to be accurate in predicting airway management problems, and none have been assessed in the ED setting [10].
NAP4 reports identified frequent airway management failure rate and the high-risk airway patient’s identification was not managed through an appropriate airway management approach [9].
Standard airway assessment in critically ill patients is usually unfeasible and difficult to be done especially in those dependent on oxygen delivery devices; face mask or nasal cannula, to avoid hypoxia and provide adequate preoxygenation. The only validated airway assessment scoring system reliable for critically ill patients is the MACOCHA score (Table 3) [11]. It has the advantage of being created with easy identifiable and clinically appropriate variables. Additionally, its used objectives are close to those identified in OT and include risk factors associated with difficult tracheal intubation [12]. Considering any investigations of the airway that already done; such as chest x-ray, CT scan and 3D and Virtual Endoscopy (VE) could be helpful in airway evaluation and might be derive the plan for airway management in critically ill patients [13].
Challenge | Consideration | Precaution | |
---|---|---|---|
ICU space; | • Ideal stuff positioning | ||
Equipment; | • Standard airway trolley availability • Advanced airway; VL, FOB, Bougie available | ||
Team member; | • Team members briefing and specific task assignment | ||
Physiological; | • HO instability | • Optimization & vasopressors proactively use. | |
• Pulmonary shunt | • Optimal preoxygenation with O2 delivery devices. | ||
• Limited reserve & time for airway management | • Systematic, logical, and strategic airway management techniques escalation. | ||
Anatomical; | Anticipation and plan for failure. | ||
Difficult airways; | • Recognition and readiness for difficulties. • MACOCHA score use. • Reduce number of attempts. • Appropriate induction medications, NMBS is routine. • Plan for failure. • Consider FONA. | ||
Urgency; | • Checklist in preparation and communication. • Follow up guidelines & standardized protocols. | ||
Pharmacological agents; | • Ketamine is recommended. • Avoid over sedation. • Routine use of NMBS. • Consider induction time longer than traditional. | ||
Aspiration risk; | • Modified RSI with cricoid pressure or DSI. • Head-up position. | ||
Red flag recognition; | • ETT obstruction, displacement. • Ventilators mechanics and Monitoring: ETT related. |
ICU airway management challenges, considerations and precautions.
Abbreviations definition;
Factors | Points | |
---|---|---|
Mallampati score III or IV Obstructive sleep apnea syndrome (OSA) Reduced mobility of cervical spine. Limited mouth opening <3cm. | 5 2 2 1 | |
Coma Sever hypoxemia (<80%) | 1 1 | |
1 | ||
MACOCHA score [11].
Abbreviations definition: MACOCHA= Mallampati score III or IV, Apnea syndrome, Cervical spine limitation, Opening mouth <3cm, Coma, Hypoxia, Anesthesiologist non-trained.
Score: 0-12 =easy; 12=difficult.
It’s recommended to define the cricothyroid membrane for possible front of neck airway (FONA) as a strategy of a plan for failure. This could be done by manual palpation; laryngeal handshake technique [14] (Figure 5) or using ultrasound that is accurately defining cricothyroid membrane site, measurements and surrounding structures such as thyroid gland and its vessels [15].
Laryngeal handshake technique.
Formerly it’s mentioned that; checklist, proper communication, documentation and team briefing with specific task assignment is a key for successful airway management in critical settings. Standard pre-intubation checklist has been developed via Difficult Airway Society (DAS), Intensive Care Society (ICS), Faculty of Intensive Care Medicine (FICM) and Royal College of Anesthetists (RCoA), United Kingdom solving this high-pressure situation (Figure 6).
Pre-management preparation; patient, equipment, team assignment.
Efficient preoxygenation with end-tidal oxygen concentration of more than 85% is the target [16] must be done in parallel to assessment and preparation. Traditional techniques are somewhat doing this task [17] and the choice of oxygen delivery device depends on the patient’s comfort, device availability and the indication for intervention. Although use FIO2 of 100% with high flow rate; 10–15 L/min in a tight-sealed facemask for 3 minutes could be enough in intact spontaneously breathing derive [18] but the use of simple face mask even with reservoir bag is not recommended [19]. Moreover, non-invasive positive pressure ventilation (NIPPV) and continuous positive pressure ventilation (CPAP) could be alternatives for preoxygenation in seriously hypoxic patients resulting in improved oxygenation and prevention of atelectasis associated with FIO2 of 100% via supporting the minute volume ventilation (MVV) [20].
High flow nasal oxygenation (HFNO) between 30 and 70 L/min is a suitable method for preoxygenation that showed safety to extend the safe apnea time during airway instrumentation and effectiveness when combined with NIPPV use [21]. Not only, continuous positive airway pressure (CPAP) delivery with a tight-sealed facemask of 5–10 cm H2O is recommended for preoxygenation, but also, the use of nasal oxygen with a flow of 5 L/min throughout airway management [19] and might be achieved by NIPPV especially in patients with respiratory failure [20].
Plan for failure must be the strategy of airway management planning, allowing logical and prepared expectations for different scenarios that might occur during the procedure. The guidelines resulted from collaborations of DAS/ICS/FICM/RCoA in United Kingdom with the aim of providing structured, standard and systematic approach of airway management in critically ill patients with the concern of not being a replacement of clinical judgment but rather an organizational and individual framework for clinical practice preparation and health care professionals training [19] (Figure 7).
DAS/ICS/FICM/RCoA guidelines for ETI in critically ill patients.
Providing the patient’s comfort, upper airway patency, optimizing functional residual capacity and decreasing aspiration risk; sniffing position is desirable as an initial position for airway management in critical settings, [22] while titration of bed head-up if cervical spine injury was suspected or confirmed [22, 23] and with prevalence of obesity among population, ramping position could be an alternative [24].
All airway management in critical settings must be carried out in presence of standard ASA monitoring; electrocardiogram (ECG)/heart rate (HR), non-invasive blood pressure (NIBP), pulse oximetry with oxygen saturation (SPO2), end-tidal carbon dioxide (EtCO2) [25]. Invasive blood pressure (IBP) is desirable either vasopressors in-use or HD instability is most likely expected and end-tidal oxygen concentration (EtO2) monitoring; if available.
Hypnosis, analgesia and skeletal muscle relaxation is a triad to commence general anesthesia required for airway management and instrumentation. A variety of pharmacological agents are described to achieve this task with specific considerations in dosing titration, delayed onset and extended effect duration.
Airway management of critically ill patients is mostly carried out in ICU while the risk to be done in non-ICU suites still considerable. Non-ICU suites include pre-hospital area, emergency department, radiology department and inpatient ward which carry the risk of difficultly and hence increase in adverse consequences of airway management, that will be discussed separately in corresponding chapters.
There are many factors recommended to reach the optimal airway management in critically ill patients including; intravenous induction agents, use of fast onset neuromuscular blocking agent (NMBA), precautions against pulmonary aspiration, laryngoscopic techniques aimed at first-pass success, and confirmation of successful tracheal intubation by waveform capnography.
Rapid sequence induction and intubation (RSII) is a technique commonly used to protect the airway against gastric contents aspiration and modified to be implemented in some clinical circumstances. A classic RSII consists of oxygen administration, application of cricoid pressure, and the avoidance of mask ventilation before insertion of an endotracheal tube (ETT) for airway securement [26].
A modified RSII in comparison to a classic RSII is to attempt for lung ventilation using positive-pressure ventilation via a facemask [27] before airway securement by ETT.
Delayed sequence intubation (DSI) seems to be safe, effective and could offer an alternative of rapid sequence induction in patients requiring emergency airway management who cannot tolerate preoxygenation or peri-intubation procedures [28]. The ideal DSI induction agent is Ketamine as it preserves airway reflexes and respiratory drive permitting preoxygenation and procedural sedation. DSI technique steps are; ensure the patient has a patent airway, place standard nasal cannula at 5 liters/min in awake patient and increases to 15 liters/min in unconscious one prior to placement of the preoxygenation device. Preoxygenation device choices based on the patient’s SpO2: if SpO2 > 95% use bag-valve-mask (BVM) with PEEP valve and a good seal at 15 L/min O2, or non-rebreather (NRB) mask and a good seal at 15 L/min O2 (or more) while SpO2 < 95%: use BVM with PEEP valve and a good seal and preoxygenate for at least 3 minutes [19].
Choice of induction drug is according to hemodynamic status of the patient; Ketamine is increasingly favored in most circumstances [29]. Administration of a rapidly acting opioids enables lower doses of hypnotics to be used, maintaining cardiovascular stability and minimizing changes of intracranial pressure.
Etomidate as an induction agent is not a first line for intubation in the critically ill patients because the other induction agents have been successfully used without risk of adrenal suppression. Its relative value of short-term hemodynamic stability that is accompanied by a potential adverse effect of adrenal suppression making its use as an anesthetic induction agent in critically ill patients is controversial, although it provides excellent intubating conditions [30]. Another meta-analysis also investigating non-intubation-related adverse effects of Etomidate in critically ill patients stated that its use is not worsening of mortality, organ dysfunction or resource utilization, even if it’s adverse effects on adrenal gland function [31]. It’s found that hypotension was more prevalent in patients receiving Etomidate compared with Ketamine in the first 24 hours after intubation and subsequent mechanical ventilation [32].
Moreover, Propofol has temporary hypotension episodes as compared to Etomidate, but there is no difference in patients requiring vasopressors after 24 hours [33]. Propofol and Ketamine mixture may have an improved hemodynamic profile compared with Etomidate. Few studies evaluated Etomidate versus Ketamine, finding no difference between them [34].
Dexmedetomidine, Remifentanil and Droperidol have been suggested as induction agents for DSI, but these agents do not have the same pattern of Ketamine as rapid onset, preservation of airway reflexes, intact respiratory drive and safety profile. Fentanyl have a significant sedative effect in addition to analgesia, that may be helpful when titrated to the desirable effect and to avoid over sedation.
NMBA improves intubating conditions, facemask ventilation, nasogastric tube insertion hence, reduction in the number of intubations attempts and optimizing chest wall compliance [35]. Succinylcholine has many side-effects including life-threatening hyperkalemia and its short duration of action can spared for difficult intubation scenarios. Rocuronium could be the choice in the critically ill patients, providing similar intubating conditions to Succinylcholine and can be antagonized using Sugammadex [36].
Graded sedation intubation without use of NMBA has also been proposed and clinically considered for technique of choice of airway management in critically ill patients [37].
This is the subsequent stage, that follows patient’s optimization achieved through concomitant preoxygenation, positioning and preparation of staff, equipment and medications. It is a highly stressful time and must be carried out in a strictly controlled and strategic manner.
Current guidelines state four main routes or plans as standard practice and should be done in sequence. From practical point, we believe that algorism might be modified or interchanged according to the given circumstances, such as in ED and prehospital critical settings, health care professionals could go for plan B/C straight away bypassing plan A because of limited facilities and unsuitable environment that mandate minimal airway manipulation with accomplishment of securing airway patency, proper oxygenation and/or ventilation.
Plan A stresses on maintenance of oxygenation either via continuous nasal cannula or interrupted facemask application between laryngoscopic attempts and allowing enough time for desirable effect of pharmacological agents, laryngoscopy attempts using direct (DL) or video-laryngoscope (VL).
With a maximum of three trials, confirmed endotracheal intubation (ENI) through capnography with waveform trace and direct visualization of ETT pass beyond the vocal cords, the call for help of the appropriate help once failed first attempt is a must. Absence of wave trace capnography is a confirmation of failed ETI after exclusion of other causes such as ETT obstruction, pulmonary edema and cardiac arrest. Chest auscultation and its rise during inspiration are rarely used as indicator for successful ETI in critically ill patients [38].
First attempt of ETI, must be done by the most trained, proficient available and must have all team support and consideration of manoeuvers or manipulations with the aim of improving laryngoscopy is recommended after failed first attempt [19]. Operator replacement and equipment change; use of a different blade, addition of others; bougie and external laryngeal manipulation might be reasonable and helpful.
Despite of fulfilling all the available recourses to achieve an optimal laryngoscopic view, with failure of the ETI attempts, either three done or not, the team leader must swiftly proceed to the next airway management plan. DL is the standard use in ETI during daily clinical practice hence its use experience is granted. On the other hand, VL should be in preparation for difficult situation; MACOCHA score > 3 [11] and ensure its availability for critically ill patient management. DL versus VL is the choice of the professionals involved in the airway management scenario and could be the device selected for first attempt according to the institutional policy and training preferences [39].
Critically ill patients’ lifesaving by maintaining oxygenation during airway management is the priority and failed ETI [8] in the preceding plan A could resulted in sever hypoxemia [6, 40] that has several serious consequences. It’s the responsibility of the team leader to ensure maintenance of adequate oxygenation throughout the stages of airway management. ETT considered as a standard and definitive airway securing device while alternatives used to provide oxygenation in scenarios of failed ETI such as supraglottic airway (SGA) devices and facemask ventilation device.
SGA is considered as a plan B rescue device which consist of variety of devices used for the same purpose; securing upper airway patency that does not require long experience. Facemask ventilation used as a plan C with the purpose of providing O2 till an alternative being fixed. DAS/ICS/FICM/RCoA guidelines use SGA (plan B) and facemask ventilation (plan C) alternatively to ensure oxygenation after plan A failure confirmation with maximum three turn attempts [19].
Second-generation laryngeal mask airways (LMA) not only possess a design of providing oxygenation, reduce the aspiration risk and conduit for fiberoptic intubation (FOI) [40], but also, promising successful performance in critical areas have been reported [41] so, it’s the model of SGA devices to be considered in standard practice and should be available in the difficult airway management trolley. Provision of oxygenation, airway securing, avoidance of aspiration with minimal airway trauma, constantly remain the goals throughout the intervention and subsequent plan to awake patient, wait for airway expert, Fiberoptic Intubation (FOI) through LMA attempt for once or proceed to FONA remains the area of discussion among the airway management team [19].
Basically, it’s not recommended to proceed for blind ETI via LMA, [42] on the other hand, FOB accessibility in ICU should be granted [14, 43]. There are alternatives to perform LMA/FOI-guided either using small ETT 6.0 mm inner diameter mounted over the FOB to be advanced through LMA or using Aintree intubation catheter (Cook Medical, Bloomington, IN, USA), that permits ETT > 7.0 mm inner diameter without interruption of oxygenation. Blind ETI with use of either gum elastic bougie or tube exchange catheter (Frova catheter; Cook Medical, Bloomington, IN, USA) is not advisable in critically ill patients as it’s associated with tracheal injury, pharyngeal perforation, bronchial bleeding and accused for subsequent positive pressure ventilation-related pneumomediastinum [44].
Life-threatening hypoxemia development in critically ill patients is frequent [45] and might be encountered at any stage of airway intervention, hence its prevention though ETI (plan A), SGA and facemask (plan B/C) use is emphasized. Not only, plan of failure with serious hypoxemia elaboration could drive towards FONA (Figure 8) but also, inadequate minimal oxygenation, aspiration, difficult ventilation and failure of LMA/FOI are potential indications [46]. Forever, efforts to eliminate cannot intubate cannot oxygenate (CICO) scenario must be maintained and its causes must be corrected while preparation of FONA is being proposed. The possible reasons for CICO might be related to patient’s (airway; impacted foreign body or laryngeal narrowing either from inside as laryngeal edema or from outside as high cricoid pressure), cardiovascular collapse or related to equipment failure.
Plan D protocol in DAS/ICS/FICM/RCoA guidelines.
Late FONA during airway management scenario is common and is responsible for its associated morbidity and mortality [43, 47]. FONA setup prior to and at declaration of CICO occurred in three steps; immediate availability of FONA set, opening the set after one failed attempt of plan B/C and immediate FONA set use on CICO declaration [19].
FONA either scalpel cricothyroidotomy or other techniques; which need experience, specific preparations and include non-scalpel cricothyroidotomy, percutaneous tracheostomy and surgical tracheostomy. Scalpel cricothyroidotomy recommended in DAS guidelines offers the following advantages; timesaving, reliable, conducted in few steps with well-known immediately available equipment, high success rate, fitting for most of patients and providing definitive airway device [48]. For a brief technique steps of scalpel cricothyroidotomy and tracheostomy in ICU, will be discussed in another chapter.
Plan D (FONA) failure means a bad scenario that carries poor prognosis and must be avoided by follow-up FONA steps in a proper way as once it encountered, non-scalpel cricothyroidotomy by experienced professional, percutaneous dilatable tracheostomy and surgical tracheostomy have to be proposed immediately without delay.
Not only providing airway securing device in critically ill patients is highly challenging, but post airway securing maintenance is also important to prevent airway displacement or obstruction. In addition of airway care, sedation and/or muscle relaxation are typically administered. They are not only having high-risk during intubation but also afterwards in rates of 82%; airway displacement and blockage, with 25% leading to death [49].
Furthermore; postintubation hypoxia occurred from multiple attempts, interruption of oxygenation, alveolar de-recruitment and collapse, and changes in the alveolar gas exchange may indicate an increase in initial lung volumes settings and benefiting from recruitment manoeuvers [38].
Attention payed towards recognition of red flag in intubated patients such as absent air entry on auscultation, abnormal EtCO2, increasing peak airway pressure (PAP), unattained inhaled tidal volume and abnormal chest x-ray findings, mandate immediate management.
Airway securing device in critically ill patients might be temporary for bridging a reversible and treatable medical disorder or permanent for irreversible and long-term pathology that demanding it. The former, long-term medical conditions, alternative tracheostomy have to be considered with a debate of its timing, On the other hand in reversible and corrected medical conditions; weaning and extubation must be considered in due time to avoid complications of prolonged ETT. Critically ill patients’ intubation is challenging and extubation does too.
Tracheostomy might be an alternative of ETT as a definitive airway in critically ill patients in incidence of 7–19% [50] while extubation is the plan once the circumstances permit. Extubation is an elective procedure and mandates careful evaluation, preparation with the target of maintenance of oxygenation and stand-by intubation plan if extubation failure takes place.
DAS incorporated extubation guidelines in anesthesia practice and could derive that in ICU and summarized in four steps; [51].
Considering the reasons for intubation in addition of the complications of prolonged dependence on ETT and its anatomical and physiological consequences.
“At-risk” extubation is a term used to describe the possible hazards associated with extubation process and must be considered in the plan step, especially the pre-existing factors.
A difficult airway trolley equipment and monitors should be immediately available for use.
Target for optimization of airway and spontaneous ventilation to ensure the success of extubation.
This could be carried out by different methods such as ETT cuff leak test; to exclude laryngeal edema, spontaneously breathing trial (SBT), gastric decompression; as gastric distension results in diaphragmatic splint and breathing restriction. The plan for airway rescue must be considered and discussed in preparation.
Avoid interruption of oxygenation by pre-extubation oxygenation via FIO2 of 100% O2.
Patient’s position; without adequate supporting evidence any one over the other, it’s advisable extubation in head-up or semi-recumbent position especially in obese patients.
Gentle suctioning of oropharyngeal cavity and extubation in fully awake state or conscious-sedation state using Remifentanil [52] might be alternatives.
Beware of Warning signs of early airway compromise; stridor, obtunded breathing and agitation.
Standard monitoring should be continued in post-extubation phase.
Standard respiratory care for patients with airway compromise.
Upright position, and high-flow humidified oxygen administration.
Documentation and recommendations for future management.
Clinical details and instructions for extubation and post-extubation care should be recorded focusing on difficulties and details of airway management and future recommendations should be recorded.
Airway management for ICU procedures like bronchoscopy, please refer to other chapters.
Full stomach in ICU, will be discussed in another chapter.
Previous tracheostomy that recently disconnected, it’s advisable to re-cannulate the stoma but proceed for FONA should not be delayed [19].
ETT exchange in ICU remains common for many reasons that happening frequently such as ETT displacement or occlusion by crusted mucus, cuff rupture or surgical procedures mandate other ETT type. This task has to be taken seriously and reviewing the initial ETI documentation is essential and will provide a logical ETT exchange plan. Tube-exchange catheter is designed for that, providing its use with DL or VL which has superior glottic view, greater success rate and fewer complications [53]. New ETI could be another alternative but with the previous ETI documentation, all precautions and recommendations discussed earlier must be considered.
Varieties of abnormal clinical status might be accompanying the airway management in critically ill patients such as obesity, burn, pregnancy etc.… and required specific considerations, please review the book chapters for more details.
Specific alteration in airway management in COVID19 might be considered despite few data available. High Flow Nasal Cannula (HFNC) suggested to reduce the requiring supported ventilation [54] and NIV might reduce the rate of tracheal intubation [55]. Tracheal intubation in COVID 19 patients is considered as highest risk for health care professionals cross-infection and could be carried out in controlled environment [56]. More details about this topic will be available in specific chapter.
Critically ill patients usually are underestimated as specific airway difficulty and being at high risk of failure. Not only due to infrequent training of focused airway and crisis management but also, physicians may neither have anesthesia rotation nor airway skills required for difficult airway management. Training on sole skills performance is unsatisfactory to achieve maximum safety [57] and ineffective teamwork that includes poor communication, lack of shared targets, situational awareness, role assignment, leadership, coordination, mutual respect and post-event debriefings is associated with poor patients’ outcome [58].
Focused risk assessment training, prevention of hypoxia, airway red flags, early call for help and request for advanced airway skills in concomitant with specific protocols and guideline presented. Team training, focused airway management training courses and workshops including simulation-based education are crucial and step up for airway management in both ED and ICU suites.
The crisis resource management (CRM) techniques from aviation industry has been advocated for use in ICU to promote a team approach to patient care and safety in critical settings [59]. The committee on quality of healthcare in America believes that health care organization should accomplished team training programs for health care professionals in critical care areas using demonstrating message such as crew resources management techniques employed in aviation, including simulation as people make fewer errors when they work in teams [60].
Airway management in critically ill patient continues to be challenging for health care professionals even for expertise requiring implementation of specific guidelines and protocols to eliminate the its adverse consequences. Airway management tools and skills needed, could be attained through formal training by anesthesia clinical rotation, airway management courses, workshops and simulation training.
Teamwork is a key for success and must be proceeded by debriefing and specific task assignments. Plan of failure in a step wise approach for success and airway management should be considered early without delay that will be associated with more difficulties and unwanted outcome.
Optimization of oxygen delivery throughout the airway intervention is mandatory and should not be compromised for any reason. FONA should be considered in primary preparation and must be done in appropriate time without delay. Documentations and records must involve all stages of airway management and include details of difficulties.
IntechOpen aims to guarantee that original material is published while at the same time giving significant freedom to our Authors. We uphold a flexible Copyright Policy, guaranteeing that there is no transfer of copyright to the publisher and Authors retain exclusive copyright to their Work.
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\\n\\nThe Author shall obtain in writing all consents necessary for the reproduction of any material in which a third-party right exists, including quotations, photographs and illustrations, in all editions of the Work worldwide for the full term of the above licenses, and shall provide to IntechOpen, at its request, the original copies of such consents for inspection or the photocopies of such consents.
\\n\\nThe Author shall obtain written informed consent for publication from those who might recognize themselves or be identified by others, for example from case reports or photographs.
\\n\\nThe Author shall respect confidentiality during and after the termination of this Agreement. The information contained in all correspondence and documents as part of the publishing activity between IntechOpen and the Author and Co-Authors are confidential and are intended only for the recipients. The contents of any communication may not be disclosed publicly and are not intended for unauthorized use or distribution. Any use, disclosure, copying, or distribution is prohibited and may be unlawful.
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\\n\\nThe Author agrees to indemnify IntechOpen harmless against all liabilities, costs, expenses, damages and losses, as well as all reasonable legal costs and expenses suffered or incurred by IntechOpen arising out of, or in connection with, any breach of the agreed confirmations and warranties. This indemnity shall not apply in a situation in which a claim results from IntechOpen's negligence or willful misconduct.
\\n\\nNothing in this Publication Agreement shall have the effect of excluding or limiting any liability for death or personal injury caused by negligence or any other liability that cannot be excluded or limited by applicable law.
\\n\\nTERMINATION
\\n\\nIntechOpen has the right to terminate this Publication Agreement for quality, program, technical or other reasons with immediate effect, including without limitation (i) if the Author and/or any Co-Author commits a material breach of this Publication Agreement; (ii) if the Author and/or any Co-Author (being a private individual) is the subject of a bankruptcy petition, application or order; or (iii) if the Author and/or any Co-Author (as a corporate entity) commences negotiations with all or any class of its creditors with a view to rescheduling any of its debts, or makes a proposal for, or enters into, any compromise or arrangement with any of its creditors.
\\n\\nIn the event of termination, IntechOpen will notify the Author of the decision in writing.
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\\n\\nIntechOpen agrees to offer free online access to readers and use reasonable efforts to promote the Publication to relevant audiences.
\\n\\nIntechOpen is granted the authority to enforce the rights from this Publication Agreement on behalf of the Author and Co-Authors against third parties, for example in cases of plagiarism or copyright infringements. In respect of any such infringement or suspected infringement of the copyright in the Work, IntechOpen shall have absolute discretion in addressing any such infringement that is likely to affect IntechOpen's rights under this Publication Agreement, including issuing and conducting proceedings against the suspected infringer.
\\n\\nIntechOpen has the right to include/use the Author and Co-Authors names and likeness in connection with scientific dissemination, retrieval, archiving, web hosting and promotion and marketing of the Work and has the right to contact the Author and Co-Authors until the Work is publicly available on any platform owned and/or operated by IntechOpen.
\\n\\nMISCELLANEOUS
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\\n\\nThird Party Rights: A person who is not a party to this Publication Agreement may not enforce any of its provisions under the Contracts (Rights of Third Parties) Act 1999.
\\n\\nEntire Agreement: This Publication Agreement constitutes the entire agreement between the parties in relation to its subject matter. It replaces all prior agreements, draft agreements, arrangements, collateral warranties, collateral contracts, statements, assurances, representations and undertakings of any nature made by, or on behalf of, the parties, whether oral or written, in relation to that subject matter. Each party acknowledges that in entering into this Publication Agreement it has not relied upon any oral or written statements, collateral or other warranties, assurances, representations or undertakings which were made by or on behalf of the other party in relation to the subject matter of this Publication Agreement at any time before its signature (known as the "Pre-Contractual Statements"), other than those which are set out in this Publication Agreement. Each party hereby waives all rights and remedies which might otherwise be available to it in relation to such Pre-Contractual Statements. Nothing in this clause shall exclude or restrict the liability of either party arising out of any fraudulent pre-contract misrepresentation or concealment.
\\n\\nWaiver: No failure or delay by a party to exercise any right or remedy provided under this Publication Agreement or by law shall constitute a waiver of that or any other right or remedy, nor shall it preclude or restrict the further exercise of that or any other right or remedy. No single or partial exercise of such right or remedy shall preclude or restrict the further exercise of that or any other right or remedy.
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\\n\\nNo partnership: Nothing in this Publication Agreement is intended to, or shall be deemed to, establish or create any partnership or joint venture or the relationship of principal and agent or employer and employee between IntechOpen and the Author or any Co-Author, nor authorize any party to make or enter into any commitments for, or on behalf of, any other party.
\\n\\nGoverning law: This Publication Agreement and any dispute or claim, including non-contractual disputes or claims arising out of, or in connection with it, or its subject matter or formation, shall be governed by and construed in accordance with the law of England and Wales. The parties submit to the exclusive jurisdiction of the English courts to settle any dispute or claim arising out of, or in connection with, this Publication Agreement, including any non-contractual disputes or claims.
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\n\nCORRESPONDING AUTHOR'S GRANT OF RIGHTS
\n\nSubject to the following Article, the Author grants to IntechOpen, during the full term of copyright, and any extensions or renewals of that term, the following:
\n\nThe foregoing licenses shall survive the expiry or termination of this Publication Agreement for any reason.
\n\nThe Author, on his or her own behalf and on behalf of any of the Co-Authors, reserves the following rights in the Work but agrees not to exercise them in such a way as to adversely affect IntechOpen's ability to utilize the full benefit of this Publication Agreement: (i) reprographic rights worldwide, other than those which subsist in the typographical arrangement of the Work as published by IntechOpen; and (ii) public lending rights arising under the Public Lending Right Act 1979, as amended from time to time, and any similar rights arising in any part of the world.
\n\nThe Author, and any Co-Author, confirms that they are, and will remain, a member of any applicable licensing and collecting society and any successor to that body responsible for administering royalties for the reprographic reproduction of copyright works.
\n\nSubject to the license granted above, copyright in the Work and all versions of it created during IntechOpen's editing process, including all published versions, is retained by the Author and any Co-Authors.
\n\nSubject to the license granted above, the Author and Co-Authors retain patent, trademark and other intellectual property rights to the Work.
\n\nAll rights granted to IntechOpen in this Article are assignable, sublicensable or otherwise transferrable to third parties without the specific approval of the Author or Co-Authors.
\n\nThe Author, on his/her own behalf and on behalf of the Co-Authors, will not assert any rights under the Copyright, Designs and Patents Act 1988 to object to derogatory treatment of the Work as a consequence of IntechOpen's changes to the Work arising from the translation of it, corrections and edits for house style, removal of problematic material and other reasonable edits as determined by IntechOpen.
\n\nAUTHOR'S DUTIES
\n\nWhen distributing or re-publishing the Work, the Author agrees to credit the Monograph/Compacts as the source of first publication, as well as IntechOpen. The Author guarantees that Co-Authors will also credit the Monograph/Compacts as the source of first publication, as well as IntechOpen, when they are distributing or re-publishing the Work.
\n\nThe Author agrees to:
\n\nThe Author will be held responsible for the payment of the agreed Open Access Publishing Fee before the completion of the project (Monograph/Compacts publication).
\n\nAll payments shall be due 30 days from the date of issue of the invoice. The Author or whoever is paying on behalf of the Author and Co-Authors will bear all banking and similar charges incurred.
\n\nThe Author shall obtain in writing all consents necessary for the reproduction of any material in which a third-party right exists, including quotations, photographs and illustrations, in all editions of the Work worldwide for the full term of the above licenses, and shall provide to IntechOpen, at its request, the original copies of such consents for inspection or the photocopies of such consents.
\n\nThe Author shall obtain written informed consent for publication from those who might recognize themselves or be identified by others, for example from case reports or photographs.
\n\nThe Author shall respect confidentiality during and after the termination of this Agreement. The information contained in all correspondence and documents as part of the publishing activity between IntechOpen and the Author and Co-Authors are confidential and are intended only for the recipients. The contents of any communication may not be disclosed publicly and are not intended for unauthorized use or distribution. Any use, disclosure, copying, or distribution is prohibited and may be unlawful.
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\n\nThe Author and Co-Authors confirm that: (i) the Work is their original work and is not copied wholly or substantially from any other work or material or any other source; (ii) the Work has not been formally published in any other peer-reviewed journal or in a book or edited collection, and is not under consideration for any such publication; (iii) Authors and any applicable Co-Authors are qualifying persons under section 154 of the Copyright, Designs and Patents Act 1988; (iv) Authors and any applicable Co-Authors have not assigned, and will not during the term of this Publication Agreement purport to assign, any of the rights granted to IntechOpen under this Publication Agreement; and (v) the rights granted by this Publication Agreement are free from any security interest, option, mortgage, charge or lien.
\n\nThe Author and Co-Authors also confirm and warrant that: (i) he/she has the power to enter into this Publication Agreement on his or her own behalf and on behalf of each Co-Author; and (ii) has the necessary rights and/or title in and to the Work to grant IntechOpen, on behalf of themselves and any Co-Author, the rights and licences in this Publication Agreement. If the Work was prepared jointly by the Author and Co-Authors, the Author confirms that: (i) all Co-Authors agree to the submission, license and publication of the Work on the terms of this Publication Agreement; and (ii) the Author has the authority to enter into this biding Publication Agreement on behalf of each Co-Author. The Author shall: (i) ensure each Co-Author complies with all relevant provisions of this Publication Agreement, including those relating to confidentiality, performance and standards, as if a party to this Publication Agreement; and (ii) remain primarily liable for all acts and/or omissions of each Co-Author.
\n\nThe Author agrees to indemnify IntechOpen harmless against all liabilities, costs, expenses, damages and losses, as well as all reasonable legal costs and expenses suffered or incurred by IntechOpen arising out of, or in connection with, any breach of the agreed confirmations and warranties. This indemnity shall not apply in a situation in which a claim results from IntechOpen's negligence or willful misconduct.
\n\nNothing in this Publication Agreement shall have the effect of excluding or limiting any liability for death or personal injury caused by negligence or any other liability that cannot be excluded or limited by applicable law.
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\n\nIntechOpen has the right to terminate this Publication Agreement for quality, program, technical or other reasons with immediate effect, including without limitation (i) if the Author and/or any Co-Author commits a material breach of this Publication Agreement; (ii) if the Author and/or any Co-Author (being a private individual) is the subject of a bankruptcy petition, application or order; or (iii) if the Author and/or any Co-Author (as a corporate entity) commences negotiations with all or any class of its creditors with a view to rescheduling any of its debts, or makes a proposal for, or enters into, any compromise or arrangement with any of its creditors.
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\n\nUnless prevented from doing so by events beyond its reasonable control, IntechOpen, at its discretion, agrees to publish the Work attributing it to the Author and Co-Authors.
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\n\nIntechOpen agrees to offer free online access to readers and use reasonable efforts to promote the Publication to relevant audiences.
\n\nIntechOpen is granted the authority to enforce the rights from this Publication Agreement on behalf of the Author and Co-Authors against third parties, for example in cases of plagiarism or copyright infringements. In respect of any such infringement or suspected infringement of the copyright in the Work, IntechOpen shall have absolute discretion in addressing any such infringement that is likely to affect IntechOpen's rights under this Publication Agreement, including issuing and conducting proceedings against the suspected infringer.
\n\nIntechOpen has the right to include/use the Author and Co-Authors names and likeness in connection with scientific dissemination, retrieval, archiving, web hosting and promotion and marketing of the Work and has the right to contact the Author and Co-Authors until the Work is publicly available on any platform owned and/or operated by IntechOpen.
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\n\nThird Party Rights: A person who is not a party to this Publication Agreement may not enforce any of its provisions under the Contracts (Rights of Third Parties) Act 1999.
\n\nEntire Agreement: This Publication Agreement constitutes the entire agreement between the parties in relation to its subject matter. It replaces all prior agreements, draft agreements, arrangements, collateral warranties, collateral contracts, statements, assurances, representations and undertakings of any nature made by, or on behalf of, the parties, whether oral or written, in relation to that subject matter. Each party acknowledges that in entering into this Publication Agreement it has not relied upon any oral or written statements, collateral or other warranties, assurances, representations or undertakings which were made by or on behalf of the other party in relation to the subject matter of this Publication Agreement at any time before its signature (known as the "Pre-Contractual Statements"), other than those which are set out in this Publication Agreement. Each party hereby waives all rights and remedies which might otherwise be available to it in relation to such Pre-Contractual Statements. Nothing in this clause shall exclude or restrict the liability of either party arising out of any fraudulent pre-contract misrepresentation or concealment.
\n\nWaiver: No failure or delay by a party to exercise any right or remedy provided under this Publication Agreement or by law shall constitute a waiver of that or any other right or remedy, nor shall it preclude or restrict the further exercise of that or any other right or remedy. No single or partial exercise of such right or remedy shall preclude or restrict the further exercise of that or any other right or remedy.
\n\nVariation: No variation of this Publication Agreement shall have effect unless it is in writing and signed by the parties, or their duly authorized representatives.
\n\nSeverance: If any provision, or part-provision, of this Publication Agreement is, or becomes invalid, illegal or unenforceable, it shall be deemed modified to the minimum extent necessary to make it valid, legal and enforceable. If such modification is not possible, the relevant provision or part-provision shall be deemed deleted. Any modification to, or deletion of, a provision or part-provision under this clause shall not affect the validity and enforceability of the rest of this Publication Agreement.
\n\nNo partnership: Nothing in this Publication Agreement is intended to, or shall be deemed to, establish or create any partnership or joint venture or the relationship of principal and agent or employer and employee between IntechOpen and the Author or any Co-Author, nor authorize any party to make or enter into any commitments for, or on behalf of, any other party.
\n\nGoverning law: This Publication Agreement and any dispute or claim, including non-contractual disputes or claims arising out of, or in connection with it, or its subject matter or formation, shall be governed by and construed in accordance with the law of England and Wales. The parties submit to the exclusive jurisdiction of the English courts to settle any dispute or claim arising out of, or in connection with, this Publication Agreement, including any non-contractual disputes or claims.
\n\nPolicy last updated: 2018-09-11
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In this chapter, we have reviewed current research on the benefits of probiotics on gut microbial communities in ruminants and their impact on ruminant production, health and overall wellbeing.",book:{id:"6425",slug:"probiotics-current-knowledge-and-future-prospects",title:"Probiotics",fullTitle:"Probiotics - Current Knowledge and Future Prospects"},signatures:"Sarah Adjei-Fremah, Kingsley Ekwemalor, Mulumebet Worku and\nSalam Ibrahim",authors:[{id:"107905",title:"Prof.",name:"Salam",middleName:null,surname:"Ibrahim",slug:"salam-ibrahim",fullName:"Salam Ibrahim"},{id:"218786",title:"Dr.",name:'Mulumebet "Millie"',middleName:null,surname:"Worku",slug:'mulumebet-"millie"-worku',fullName:'Mulumebet "Millie" Worku'},{id:"218789",title:"Dr.",name:"Kingsley",middleName:null,surname:"Ekwemalor",slug:"kingsley-ekwemalor",fullName:"Kingsley Ekwemalor"},{id:"223195",title:"Dr.",name:"Sarah",middleName:null,surname:"Adjei-Fremah",slug:"sarah-adjei-fremah",fullName:"Sarah Adjei-Fremah"}]},{id:"49285",title:"Morphological Identification of Actinobacteria",slug:"morphological-identification-of-actinobacteria",totalDownloads:8512,totalCrossrefCites:19,totalDimensionsCites:45,abstract:"Actinobacteria is a phylum of gram-positive bacteria with high G+C content. Among gram-positive bacteria, actinobacteria exhibit the richest morphological differentiation, which is based on a filamentous degree of organization like filamentous fungi. The actinobacteria morphological characteristics are basic foundation and information of phylogenetic systematics. Classic actinomycetes have well-developed radial mycelium, which can be divided into substrate mycelium and aerial mycelium according to morphology and function. Some actinobacteria can form complicated structures, such as spore, spore chain, sporangia, and sporangiospore. The structure of hyphae and ultrastructure of spore or sporangia can be observed with microscopy. Actinobacteria have different cultural characteristics in various kinds of culture media, which are important in the classification identification, general with spores, aerial hyphae, with or without color and the soluble pigment, different growth condition on various media as the main characteristics. The morphological differentiation of actinobacteria, especially streptomycetes, is controlled by relevant genes. Both morphogenesis and antibiotic production in the streptomycetes are initiated in response to starvation, and these events are coupled.",book:{id:"5056",slug:"actinobacteria-basics-and-biotechnological-applications",title:"Actinobacteria",fullTitle:"Actinobacteria - Basics and Biotechnological Applications"},signatures:"Qinyuan Li, Xiu Chen, Yi Jiang and Chenglin Jiang",authors:[{id:"175852",title:"Dr.",name:"Chen",middleName:null,surname:"Jiang",slug:"chen-jiang",fullName:"Chen Jiang"}]},{id:"68772",title:"Multidrug-Resistant Bacterial Foodborne Pathogens: Impact on Human Health and Economy",slug:"multidrug-resistant-bacterial-foodborne-pathogens-impact-on-human-health-and-economy",totalDownloads:1043,totalCrossrefCites:3,totalDimensionsCites:7,abstract:"The drug abuse known to occur during growth of animals intended for food production, because of their use as either a prophylactic or therapeutic treatment, promotes the emergence of bacterial drug resistance. It has been reported that at least 25% of the foodborne isolates show drug resistance to one or more classes of antimicrobials (FAO 2018). There are diverse mechanisms that promote drug resistance. It is known that the use of sub-therapeutic doses of antibiotics in animals intended for food production promotes mutations of some chromosomal genes such as gyrA-parC and mphA, which are responsible for quinolone and azithromycin resistance, respectively. Also, the horizontal transfer of resistance genes as groups (“cassettes”) or plasmids makes the spread of resistance to different bacterial genera possible, among which there could be pathogens. The World Health Organization considers the emergence of multidrug-resistant pathogenic bacteria as a health problem, since the illnesses caused by them complicate the treatment and increase the morbidity and mortality rates. The complication in the illness treatment caused by a multidrug-resistant pathogen causes economic losses to patients for the payment of long stays in hospitals and also causes economic losses to companies due to the absenteeism of their workers.",book:{id:"8133",slug:"pathogenic-bacteria",title:"Pathogenic Bacteria",fullTitle:"Pathogenic Bacteria"},signatures:"Lilia M. Mancilla-Becerra, Teresa Lías-Macías, Cristina L. 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The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"13",title:"Veterinary Medicine and Science",doi:"10.5772/intechopen.73681",issn:"2632-0517",scope:"Paralleling similar advances in the medical field, astounding advances occurred in Veterinary Medicine and Science in recent decades. These advances have helped foster better support for animal health, more humane animal production, and a better understanding of the physiology of endangered species to improve the assisted reproductive technologies or the pathogenesis of certain diseases, where animals can be used as models for human diseases (like cancer, degenerative diseases or fertility), and even as a guarantee of public health. Bridging Human, Animal, and Environmental health, the holistic and integrative “One Health” concept intimately associates the developments within those fields, projecting its advancements into practice. This book series aims to tackle various animal-related medicine and sciences fields, providing thematic volumes consisting of high-quality significant research directed to researchers and postgraduates. It aims to give us a glimpse into the new accomplishments in the Veterinary Medicine and Science field. 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After almost 32 years of teaching at the University of Trás-os-Montes and Alto Douro, she recently moved to the University of Évora, Department of Veterinary Medicine, where she teaches in the field of Animal Reproduction and Clinics. Her primary research areas include the molecular markers of the endometrial cycle and the embryo–maternal interaction, including oxidative stress and the reproductive physiology and disorders of sexual development, besides the molecular determinants of male and female fertility. She often supervises students preparing their master's or doctoral theses. 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A dynamic career research platform which is based on the thematic areas of comparative vertebrate physiology, stress endocrinology, reproductive endocrinology, animal health and welfare, and conservation biology. \nEdward has supervised 40 research students and published over 60 peer reviewed research.",institutionString:null,institution:{name:"University of Queensland",institutionURL:null,country:{name:"Australia"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"258334",title:"Dr.",name:"Carlos Eduardo",middleName:null,surname:"Fonseca-Alves",slug:"carlos-eduardo-fonseca-alves",fullName:"Carlos Eduardo Fonseca-Alves",profilePictureURL:"https://mts.intechopen.com/storage/users/258334/images/system/258334.jpg",institutionString:null,institution:{name:"Universidade Paulista",institutionURL:null,country:{name:"Brazil"}}},{id:"191123",title:"Dr.",name:"Juan José",middleName:null,surname:"Valdez-Alarcón",slug:"juan-jose-valdez-alarcon",fullName:"Juan José Valdez-Alarcón",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBfcQAG/Profile_Picture_1631354558068",institutionString:"Universidad Michoacana de San Nicolás de Hidalgo",institution:{name:"Universidad Michoacana de San Nicolás de Hidalgo",institutionURL:null,country:{name:"Mexico"}}},{id:"161556",title:"Dr.",name:"Maria Dos Anjos",middleName:null,surname:"Pires",slug:"maria-dos-anjos-pires",fullName:"Maria Dos Anjos Pires",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS8q2QAC/Profile_Picture_1633432838418",institutionString:null,institution:{name:"University of Trás-os-Montes and Alto Douro",institutionURL:null,country:{name:"Portugal"}}},{id:"209839",title:"Dr.",name:"Marina",middleName:null,surname:"Spinu",slug:"marina-spinu",fullName:"Marina Spinu",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRLXpQAO/Profile_Picture_1630044895475",institutionString:null,institution:{name:"University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca",institutionURL:null,country:{name:"Romania"}}},{id:"92185",title:"Dr.",name:"Sara",middleName:null,surname:"Savic",slug:"sara-savic",fullName:"Sara Savic",profilePictureURL:"https://mts.intechopen.com/storage/users/92185/images/system/92185.jfif",institutionString:'Scientific Veterinary Institute "Novi Sad"',institution:{name:'Scientific Veterinary Institute "Novi Sad"',institutionURL:null,country:{name:"Serbia"}}}]},{id:"20",title:"Animal Nutrition",coverUrl:"https://cdn.intechopen.com/series_topics/covers/20.jpg",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. 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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. 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He is currently the Director of the Postgraduate Program in Implantology of the Bioface/UCAM/PgO (Montevideo, Uruguay), Director of the Cathedra of Biotechnology of the Catholic University of Murcia (Murcia, Spain), an Extraordinary Full Professor of the Catholic University of Murcia (Murcia, Spain) as well as the Director of the private center of research Biotecnos – Technology and Science (Montevideo, Uruguay). Applied biomaterials, cellular and molecular biology, and dental implants are among his research interests. He has published several original papers in renowned journals. In addition, he is also a Collaborating Professor in several Postgraduate programs at different universities all over the world.",institutionString:null,institution:{name:"Universidad Católica San Antonio de Murcia",country:{name:"Spain"}}},{id:"342152",title:"Dr.",name:"Santo",middleName:null,surname:"Grace Umesh",slug:"santo-grace-umesh",fullName:"Santo Grace Umesh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/342152/images/16311_n.jpg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"333647",title:"Dr.",name:"Shreya",middleName:null,surname:"Kishore",slug:"shreya-kishore",fullName:"Shreya Kishore",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333647/images/14701_n.jpg",biography:"Dr. Shreya Kishore completed her Bachelor in Dental Surgery in Chettinad Dental College and Research Institute, Chennai, and her Master of Dental Surgery (Orthodontics) in Saveetha Dental College, Chennai. She is also Invisalign certified. She’s working as a Senior Lecturer in the Department of Orthodontics, SRM Dental College since November 2019. She is actively involved in teaching orthodontics to the undergraduates and the postgraduates. Her clinical research topics include new orthodontic brackets, fixed appliances and TADs. She’s published 4 articles in well renowned indexed journals and has a published patency of her own. Her private practice is currently limited to orthodontics and works as a consultant in various clinics.",institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"323731",title:"Prof.",name:"Deepak M.",middleName:"Macchindra",surname:"Vikhe",slug:"deepak-m.-vikhe",fullName:"Deepak M. Vikhe",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/323731/images/13613_n.jpg",biography:"Dr Deepak M.Vikhe .\n\n\t\n\tDr Deepak M.Vikhe , completed his Masters & PhD in Prosthodontics from Rural Dental College, Loni securing third rank in the Pravara Institute of Medical Sciences Deemed University. He was awarded Dr.G.C.DAS Memorial Award for Research on Implants at 39th IPS conference Dubai (U A E).He has two patents under his name. He has received Dr.Saraswati medal award for best research for implant study in 2017.He has received Fully funded scholarship to Spain ,university of Santiago de Compostela. He has completed fellowship in Implantlogy from Noble Biocare. \nHe has attended various conferences and CDE programmes and has national publications to his credit. His field of interest is in Implant supported prosthesis. Presently he is working as a associate professor in the Dept of Prosthodontics, Rural Dental College, Loni and maintains a successful private practice specialising in Implantology at Rahata.\n\nEmail: drdeepak_mvikhe@yahoo.com..................",institutionString:null,institution:{name:"Pravara Institute of Medical Sciences",country:{name:"India"}}},{id:"204110",title:"Dr.",name:"Ahmed A.",middleName:null,surname:"Madfa",slug:"ahmed-a.-madfa",fullName:"Ahmed A. Madfa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204110/images/system/204110.jpg",biography:"Dr. Madfa is currently Associate Professor of Endodontics at Thamar University and a visiting lecturer at Sana'a University and University of Sciences and Technology. He has more than 6 years of experience in teaching. His research interests include root canal morphology, functionally graded concept, dental biomaterials, epidemiology and dental education, biomimetic restoration, finite element analysis and endodontic regeneration. Dr. Madfa has numerous international publications, full articles, two patents, a book and a book chapter. Furthermore, he won 14 international scientific awards. Furthermore, he is involved in many academic activities ranging from editorial board member, reviewer for many international journals and postgraduate students' supervisor. Besides, I deliver many courses and training workshops at various scientific events. Dr. Madfa also regularly attends international conferences and holds administrative positions (Deputy Dean of the Faculty for Students’ & Academic Affairs and Deputy Head of Research Unit).",institutionString:"Thamar University",institution:null},{id:"210472",title:"Dr.",name:"Nermin",middleName:"Mohammed Ahmed",surname:"Yussif",slug:"nermin-yussif",fullName:"Nermin Yussif",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210472/images/system/210472.jpg",biography:"Dr. Nermin Mohammed Ahmed Yussif is working at the Faculty of dentistry, University for October university for modern sciences and arts (MSA). Her areas of expertise include: periodontology, dental laserology, oral implantology, periodontal plastic surgeries, oral mesotherapy, nutrition, dental pharmacology. She is an editor and reviewer in numerous international journals.",institutionString:"MSA University",institution:null},{id:"204606",title:"Dr.",name:"Serdar",middleName:null,surname:"Gözler",slug:"serdar-gozler",fullName:"Serdar Gözler",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204606/images/system/204606.jpeg",biography:"Dr. Serdar Gözler has completed his undergraduate studies at the Marmara University Faculty of Dentistry in 1978, followed by an assistantship in the Prosthesis Department of Dicle University Faculty of Dentistry. Starting his PhD work on non-resilient overdentures with Assoc. Prof. Hüsnü Yavuzyılmaz, he continued his studies with Prof. Dr. Gürbüz Öztürk of Istanbul University Faculty of Dentistry Department of Prosthodontics, this time on Gnatology. He attended training programs on occlusion, neurology, neurophysiology, EMG, radiology and biostatistics. In 1982, he presented his PhD thesis \\Gerber and Lauritzen Occlusion Analysis Techniques: Diagnosis Values,\\ at Istanbul University School of Dentistry, Department of Prosthodontics. As he was also working with Prof. Senih Çalıkkocaoğlu on The Physiology of Chewing at the same time, Gözler has written a chapter in Çalıkkocaoğlu\\'s book \\Complete Prostheses\\ entitled \\The Place of Neuromuscular Mechanism in Prosthetic Dentistry.\\ The book was published five times since by the Istanbul University Publications. Having presented in various conferences about occlusion analysis until 1998, Dr. Gözler has also decided to use the T-Scan II occlusion analysis method. Having been personally trained by Dr. Robert Kerstein on this method, Dr. Gözler has been lecturing on the T-Scan Occlusion Analysis Method in conferences both in Turkey and abroad. Dr. Gözler has various articles and presentations on Digital Occlusion Analysis methods. He is now Head of the TMD Clinic at Prosthodontic Department of Faculty of Dentistry , Istanbul Aydın University , Turkey.",institutionString:"Istanbul Aydin University",institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"240870",title:"Ph.D.",name:"Alaa Eddin Omar",middleName:null,surname:"Al Ostwani",slug:"alaa-eddin-omar-al-ostwani",fullName:"Alaa Eddin Omar Al Ostwani",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/240870/images/system/240870.jpeg",biography:"Dr. Al Ostwani Alaa Eddin Omar received his Master in dentistry from Damascus University in 2010, and his Ph.D. in Pediatric Dentistry from Damascus University in 2014. Dr. Al Ostwani is an assistant professor and faculty member at IUST University since 2014. \nDuring his academic experience, he has received several awards including the scientific research award from the Union of Arab Universities, the Syrian gold medal and the international gold medal for invention and creativity. Dr. Al Ostwani is a Member of the International Association of Dental Traumatology and the Syrian Society for Research and Preventive Dentistry since 2017. He is also a Member of the Reviewer Board of International Journal of Dental Medicine (IJDM), and the Indian Journal of Conservative and Endodontics since 2016.",institutionString:"International University for Science and Technology.",institution:{name:"Islamic University of Science and Technology",country:{name:"India"}}},{id:"42847",title:"Dr.",name:"Belma",middleName:null,surname:"Işik Aslan",slug:"belma-isik-aslan",fullName:"Belma Işik Aslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/42847/images/system/42847.jpg",biography:"Dr. Belma IşIk Aslan was born in 1976 in Ankara-TURKEY. After graduating from TED Ankara College in 1994, she attended to Gazi University, Faculty of Dentistry in Ankara. She completed her PhD in orthodontic education at Gazi University between 1999-2005. Dr. Işık Aslan stayed at the Providence Hospital Craniofacial Institude and Reconstructive Surgery in Michigan, USA for three months as an observer. She worked as a specialist doctor at Gazi University, Dentistry Faculty, Department of Orthodontics between 2005-2014. She was appointed as associate professor in January, 2014 and as professor in 2021. Dr. Işık Aslan still works as an instructor at the same faculty. She has published a total of 35 articles, 10 book chapters, 39 conference proceedings both internationally and nationally. Also she was the academic editor of the international book 'Current Advances in Orthodontics'. She is a member of the Turkish Orthodontic Society and Turkish Cleft Lip and Palate Society. She is married and has 2 children. Her knowledge of English is at an advanced level.",institutionString:"Gazi University Dentistry Faculty Department of Orthodontics",institution:null},{id:"178412",title:"Associate Prof.",name:"Guhan",middleName:null,surname:"Dergin",slug:"guhan-dergin",fullName:"Guhan Dergin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178412/images/6954_n.jpg",biography:"Assoc. Prof. Dr. Gühan Dergin was born in 1973 in Izmit. He graduated from Marmara University Faculty of Dentistry in 1999. He completed his specialty of OMFS surgery in Marmara University Faculty of Dentistry and obtained his PhD degree in 2006. In 2005, he was invited as a visiting doctor in the Oral and Maxillofacial Surgery Department of the University of North Carolina, USA, where he went on a scholarship. Dr. Dergin still continues his academic career as an associate professor in Marmara University Faculty of Dentistry. He has many articles in international and national scientific journals and chapters in books.",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"178414",title:"Prof.",name:"Yusuf",middleName:null,surname:"Emes",slug:"yusuf-emes",fullName:"Yusuf Emes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178414/images/6953_n.jpg",biography:"Born in Istanbul in 1974, Dr. Emes graduated from Istanbul University Faculty of Dentistry in 1997 and completed his PhD degree in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery in 2005. He has papers published in international and national scientific journals, including research articles on implantology, oroantral fistulas, odontogenic cysts, and temporomandibular disorders. Dr. Emes is currently working as a full-time academic staff in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery.",institutionString:null,institution:{name:"Istanbul University",country:{name:"Turkey"}}},{id:"192229",title:"Ph.D.",name:"Ana Luiza",middleName:null,surname:"De Carvalho Felippini",slug:"ana-luiza-de-carvalho-felippini",fullName:"Ana Luiza De Carvalho Felippini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192229/images/system/192229.jpg",biography:null,institutionString:"University of São Paulo",institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"256851",title:"Prof.",name:"Ayşe",middleName:null,surname:"Gülşen",slug:"ayse-gulsen",fullName:"Ayşe Gülşen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256851/images/9696_n.jpg",biography:"Dr. Ayşe Gülşen graduated in 1990 from Faculty of Dentistry, University of Ankara and did a postgraduate program at University of Gazi. \nShe worked as an observer and research assistant in Craniofacial Surgery Departments in New York, Providence Hospital in Michigan and Chang Gung Memorial Hospital in Taiwan. \nShe works as Craniofacial Orthodontist in Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, University of Gazi, Ankara Turkey since 2004.",institutionString:"Univeristy of Gazi",institution:null},{id:"255366",title:"Prof.",name:"Tosun",middleName:null,surname:"Tosun",slug:"tosun-tosun",fullName:"Tosun Tosun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255366/images/7347_n.jpg",biography:"Graduated at the Faculty of Dentistry, University of Istanbul, Turkey in 1989;\nVisitor Assistant at the University of Padua, Italy and Branemark Osseointegration Center of Treviso, Italy between 1993-94;\nPhD thesis on oral implantology in University of Istanbul and was awarded the academic title “Dr.med.dent.”, 1997;\nHe was awarded the academic title “Doç.Dr.” (Associated Professor) in 2003;\nProficiency in Botulinum Toxin Applications, Reading-UK in 2009;\nMastership, RWTH Certificate in Laser Therapy in Dentistry, AALZ-Aachen University, Germany 2009-11;\nMaster of Science (MSc) in Laser Dentistry, University of Genoa, Italy 2013-14.\n\nDr.Tosun worked as Research Assistant in the Department of Oral Implantology, Faculty of Dentistry, University of Istanbul between 1990-2002. \nHe worked part-time as Consultant surgeon in Harvard Medical International Hospitals and John Hopkins Medicine, Istanbul between years 2007-09.\u2028He was contract Professor in the Department of Surgical and Diagnostic Sciences (DI.S.C.), Medical School, University of Genova, Italy between years 2011-16. \nSince 2015 he is visiting Professor at Medical School, University of Plovdiv, Bulgaria. \nCurrently he is Associated Prof.Dr. at the Dental School, Oral Surgery Dept., Istanbul Aydin University and since 2003 he works in his own private clinic in Istanbul, Turkey.\u2028\nDr.Tosun is reviewer in journal ‘Laser in Medical Sciences’, reviewer in journal ‘Folia Medica\\', a Fellow of the International Team for Implantology, Clinical Lecturer of DGZI German Association of Oral Implantology, Expert Lecturer of Laser&Health Academy, Country Representative of World Federation for Laser Dentistry, member of European Federation of Periodontology, member of Academy of Laser Dentistry. Dr.Tosun presents papers in international and national congresses and has scientific publications in international and national journals. He speaks english, spanish, italian and french.",institutionString:null,institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",biography:"Zühre Akarslan was born in 1977 in Cyprus. She graduated from Gazi University Faculty of Dentistry, Ankara, Turkey in 2000. \r\nLater she received her Ph.D. degree from the Oral Diagnosis and Radiology Department; which was recently renamed as Oral and Dentomaxillofacial Radiology, from the same university. \r\nShe is working as a full-time Associate Professor and is a lecturer and an academic researcher. \r\nHer expertise areas are dental caries, cancer, dental fear and anxiety, gag reflex in dentistry, oral medicine, and dentomaxillofacial radiology.",institutionString:"Gazi University",institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"256417",title:"Associate Prof.",name:"Sanaz",middleName:null,surname:"Sadry",slug:"sanaz-sadry",fullName:"Sanaz Sadry",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256417/images/8106_n.jpg",biography:null,institutionString:null,institution:null},{id:"272237",title:"Dr.",name:"Pinar",middleName:"Kiymet",surname:"Karataban",slug:"pinar-karataban",fullName:"Pinar Karataban",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272237/images/8911_n.png",biography:"Assist.Prof.Dr.Pınar Kıymet Karataban, DDS PhD \n\nDr.Pınar Kıymet Karataban was born in Istanbul in 1975. After her graduation from Marmara University Faculty of Dentistry in 1998 she started her PhD in Paediatric Dentistry focused on children with special needs; mainly children with Cerebral Palsy. She finished her pHD thesis entitled \\'Investigation of occlusion via cast analysis and evaluation of dental caries prevalance, periodontal status and muscle dysfunctions in children with cerebral palsy” in 2008. She got her Assist. Proffessor degree in Istanbul Aydın University Paediatric Dentistry Department in 2015-2018. ın 2019 she started her new career in Bahcesehir University, Istanbul as Head of Department of Pediatric Dentistry. In 2020 she was accepted to BAU International University, Batumi as Professor of Pediatric Dentistry. She’s a lecturer in the same university meanwhile working part-time in private practice in Ege Dental Studio (https://www.egedisklinigi.com/) a multidisciplinary dental clinic in Istanbul. Her main interests are paleodontology, ancient and contemporary dentistry, oral microbiology, cerebral palsy and special care dentistry. She has national and international publications, scientific reports and is a member of IAPO (International Association for Paleodontology), IADH (International Association of Disability and Oral Health) and EAPD (European Association of Pediatric Dentistry).",institutionString:null,institution:null},{id:"202198",title:"Dr.",name:"Buket",middleName:null,surname:"Aybar",slug:"buket-aybar",fullName:"Buket Aybar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202198/images/6955_n.jpg",biography:"Buket Aybar, DDS, PhD, was born in 1971. She graduated from Istanbul University, Faculty of Dentistry, in 1992 and completed her PhD degree on Oral and Maxillofacial Surgery in Istanbul University in 1997.\nDr. Aybar is currently a full-time professor in Istanbul University, Faculty of Dentistry Department of Oral and Maxillofacial Surgery. She has teaching responsibilities in graduate and postgraduate programs. Her clinical practice includes mainly dentoalveolar surgery.\nHer topics of interest are biomaterials science and cell culture studies. She has many articles in international and national scientific journals and chapters in books; she also has participated in several scientific projects supported by Istanbul University Research fund.",institutionString:null,institution:null},{id:"260116",title:"Dr.",name:"Mehmet",middleName:null,surname:"Yaltirik",slug:"mehmet-yaltirik",fullName:"Mehmet Yaltirik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/260116/images/7413_n.jpg",biography:"Birth Date 25.09.1965\r\nBirth Place Adana- Turkey\r\nSex Male\r\nMarrial Status Bachelor\r\nDriving License Acquired\r\nMother Tongue Turkish\r\n\r\nAddress:\r\nWork:University of Istanbul,Faculty of Dentistry, Department of Oral Surgery and Oral Medicine 34093 Capa,Istanbul- TURKIYE",institutionString:null,institution:null},{id:"172009",title:"Dr.",name:"Fatma Deniz",middleName:null,surname:"Uzuner",slug:"fatma-deniz-uzuner",fullName:"Fatma Deniz Uzuner",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/172009/images/7122_n.jpg",biography:"Dr. Deniz Uzuner was born in 1969 in Kocaeli-TURKEY. After graduating from TED Ankara College in 1986, she attended the Hacettepe University, Faculty of Dentistry in Ankara. \nIn 1993 she attended the Gazi University, Faculty of Dentistry, Department of Orthodontics for her PhD education. After finishing the PhD education, she worked as orthodontist in Ankara Dental Hospital under the Turkish Government, Ministry of Health and in a special Orthodontic Clinic till 2011. Between 2011 and 2016, Dr. Deniz Uzuner worked as a specialist in the Department of Orthodontics, Faculty of Dentistry, Gazi University in Ankara/Turkey. In 2016, she was appointed associate professor. Dr. Deniz Uzuner has authored 23 Journal Papers, 3 Book Chapters and has had 39 oral/poster presentations. She is a member of the Turkish Orthodontic Society. Her knowledge of English is at an advanced level.",institutionString:null,institution:null},{id:"332914",title:"Dr.",name:"Muhammad Saad",middleName:null,surname:"Shaikh",slug:"muhammad-saad-shaikh",fullName:"Muhammad Saad Shaikh",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Jinnah Sindh Medical University",country:{name:"Pakistan"}}},{id:"315775",title:"Dr.",name:"Feng",middleName:null,surname:"Luo",slug:"feng-luo",fullName:"Feng Luo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Sichuan University",country:{name:"China"}}},{id:"423519",title:"Dr.",name:"Sizakele",middleName:null,surname:"Ngwenya",slug:"sizakele-ngwenya",fullName:"Sizakele Ngwenya",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"419270",title:"Dr.",name:"Ann",middleName:null,surname:"Chianchitlert",slug:"ann-chianchitlert",fullName:"Ann Chianchitlert",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"419271",title:"Dr.",name:"Diane",middleName:null,surname:"Selvido",slug:"diane-selvido",fullName:"Diane Selvido",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"419272",title:"Dr.",name:"Irin",middleName:null,surname:"Sirisoontorn",slug:"irin-sirisoontorn",fullName:"Irin Sirisoontorn",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"355660",title:"Dr.",name:"Anitha",middleName:null,surname:"Mani",slug:"anitha-mani",fullName:"Anitha Mani",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"355612",title:"Dr.",name:"Janani",middleName:null,surname:"Karthikeyan",slug:"janani-karthikeyan",fullName:"Janani Karthikeyan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"334400",title:"Dr.",name:"Suvetha",middleName:null,surname:"Siva",slug:"suvetha-siva",fullName:"Suvetha Siva",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}}]}},subseries:{item:{id:"22",type:"subseries",title:"Applied Intelligence",keywords:"Machine Learning, Intelligence Algorithms, Data Science, Artificial Intelligence, Applications on Applied Intelligence",scope:"This field is the key in the current industrial revolution (Industry 4.0), where the new models and developments are based on the knowledge generation on applied intelligence. The motor of the society is the industry and the research of this topic has to be empowered in order to increase and improve the quality of our lives.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11418,editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",slug:"carlos-travieso-gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",biography:"Carlos M. Travieso-González received his MSc degree in Telecommunication Engineering at Polytechnic University of Catalonia (UPC), Spain in 1997, and his Ph.D. degree in 2002 at the University of Las Palmas de Gran Canaria (ULPGC-Spain). He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. 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