Summary of complications and rates associated with PRR, PGR, PBC, GKRS, and MVD [24].
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"4619",leadTitle:null,fullTitle:"Wastewater Treatment Engineering",title:"Wastewater Treatment Engineering",subtitle:null,reviewType:"peer-reviewed",abstract:"This book provides useful information about bioremediation, phytoremediation, and mycoremediation of wastewater and some aspects of the chemical wastewater treatment processes, including ion exchange, neutralization, adsorption, and disinfection. Additionally, this book elucidates and illustrates the wastewater treatment plants in terms of plant sizing, plant layout, plant design, and plant location. Cutting-edge topics include wet air oxidation of aqueous wastes, biodegradation of nitroaromatic compounds, biological treatment of sanitary landfill leachate, bacterial strains for the bioremediation of olive mill wastewater, gelation of arabinoxylans from maize wastewater, and modeling wastewater evolution.",isbn:null,printIsbn:"978-953-51-2179-4",pdfIsbn:"978-953-51-6390-9",doi:"10.5772/59384",price:119,priceEur:129,priceUsd:155,slug:"wastewater-treatment-engineering",numberOfPages:212,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"5799cd230809e143d51ba5bc5890cd17",bookSignature:"Mohamed Samer",publishedDate:"October 14th 2015",coverURL:"https://cdn.intechopen.com/books/images_new/4619.jpg",numberOfDownloads:41853,numberOfWosCitations:78,numberOfCrossrefCitations:74,numberOfCrossrefCitationsByBook:15,numberOfDimensionsCitations:150,numberOfDimensionsCitationsByBook:16,hasAltmetrics:1,numberOfTotalCitations:302,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 7th 2014",dateEndSecondStepPublish:"October 28th 2014",dateEndThirdStepPublish:"March 15th 2015",dateEndFourthStepPublish:"May 2nd 2015",dateEndFifthStepPublish:"June 30th 2015",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"175050",title:"Prof.",name:"Mohamed",middleName:null,surname:"Samer",slug:"mohamed-samer",fullName:"Mohamed Samer",profilePictureURL:"https://mts.intechopen.com/storage/users/175050/images/system/175050.jpeg",biography:"Prof. Dr. Mohamed Samer holds the position of Full Professor (tenured) and Director of the Biofuels Research Laboratory at the Department of Agricultural Engineering, Faculty of Agriculture, Cairo University. He is Laureate of the Cairo University Scientific Excellence Award (2019). He is recipient of The Privilege Medal of First Class (2017), issued by the President of Egypt. He is Laureate of the State Encouragement Award (2016), conferred by the Egyptian Government. He held the position of Research Scientist at the Leibniz Institute for Agricultural Engineering and Bioeconomy (ATB), Potsdam, Germany. He held several positions at Cairo University: Teaching Assistant, Senior Teaching Assistant, Assistant Professor, and Associate Professor through tenure-track process to Full Professor. He got a doctoral scholarship from the Ministry of Higher Education and Scientific Research, Egyptian Government. He was conferred the degree “Doctor scientiarum agrariarum” (Dr. sc. agr.) by the University of Hohenheim, Stuttgart, Germany. He attended more than 25 professional training courses. He led 14 research projects as principal investigator (PI), and he currently leads 3 research projects as PI. Besides, he participated in several other projects as Co-PI and as research team member. He established 5 research laboratories for biofuels research and greenhouse gas emissions research. He is skilled in using more than 30 scientific instruments. He has an h-index of 20 in Scopus, and h-index of 25 in Google Scholar. He has more than 120 publications, more than 70 thereof are peer-reviewed articles published in international high-impact journals. He edited 7 international books and authored 4 book chapters. He was granted one patent, and he applied for 19 other patents. He presented 37 research papers in 25 international conferences, where he participated in organizing 10 international conferences, workshops, and exhibitions. Furthermore, he is member of 13 international scientific societies. He is member of the National Arbitration Committee to evaluate the scientific production of faculty members to fill the positions of Associate Professors and Full Professors in the field of Engineering in Biosystems, Energy and Environment. He serves as peer reviewer for more than 30 international high-impact journals, where he reviewed more than 100 research papers. He serves as reviewer for 7 research funding agencies, where he reviewed more than 30 research project proposals. He supervised 7 postdoctoral fellows, 6 Ph.D. students, 7 M.Sc. students, 92 B.Sc. students, 2 trainees, 15 technicians, and 10 staff members. Additionally, he taught 15 undergraduate and postgraduate courses through his career. He visited several countries: USA, Canada, UK, Germany, France, Austria, Switzerland, The Netherlands, Belgium, Poland, and Greece. He speaks fluently four languages: English, German, French, and Arabic. His main research, teaching, extension, and outreach interests are: Biosystems Engineering, Bioresource Engineering, Bioeconomy, Environmental Engineering, Renewable Energy, Bioenergy, Biofuels (Biodiesel, Bioethanol, Biobutanol, Biogas, Biohydrogen), Microbial Fuel Cells, Pyrolysis (Biochar, Bio-Oil, Syngas), Gasification, Air Quality Engineering, Gaseous Emissions (Greenhouse Gases), Emissions Abatement Techniques, Agricultural Waste Management, Manure Management, Biological Waste Treatment, Slurry Treatment, Wastewater Treatment, Bioprocess and Bioproducts Engineering, Bio-Based Products, Biocement, Bioplastics, Artificial Intelligence in Agriculture, Information Technology in Agriculture, and Digitalization in the Bioeconomy.",institutionString:"Cairo University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"Cairo University",institutionURL:null,country:{name:"Egypt"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"779",title:"Ecohydrology",slug:"engineering-environmental-engineering-ecohydrology"}],chapters:[{id:"49024",title:"Biological and Chemical Wastewater Treatment Processes",doi:"10.5772/61250",slug:"biological-and-chemical-wastewater-treatment-processes",totalDownloads:27713,totalCrossrefCites:55,totalDimensionsCites:103,hasAltmetrics:1,abstract:"This chapter elucidates the technologies of biological and chemical wastewater treatment processes. The presented biological wastewater treatment processes include: (1) bioremediation of wastewater that includes aerobic treatment (oxidation ponds, aeration lagoons, aerobic bioreactors, activated sludge, percolating or trickling filters, biological filters, rotating biological contactors, biological removal of nutrients) and anaerobic treatment (anaerobic bioreactors, anaerobic lagoons); (2) phytoremediation of wastewater that includes constructed wetlands, rhizofiltration, rhizodegradation, phytodegradation, phytoaccumulation, phytotransformation, and hyperaccumulators; and (3) mycoremediation of wastewater. The discussed chemical wastewater treatment processes include chemical precipitation (coagulation, flocculation), ion exchange, neutralization, adsorption, and disinfection (chlorination/dechlorination, ozone, UV light). Additionally, this chapter elucidates and illustrates the wastewater treatment plants in terms of plant sizing, plant layout, plant design, and plant location.",signatures:"Mohamed Samer",downloadPdfUrl:"/chapter/pdf-download/49024",previewPdfUrl:"/chapter/pdf-preview/49024",authors:[{id:"175050",title:"Prof.",name:"Mohamed",surname:"Samer",slug:"mohamed-samer",fullName:"Mohamed Samer"}],corrections:null},{id:"49190",title:"Bioremediation of Nitroaromatic Compounds",doi:"10.5772/61253",slug:"bioremediation-of-nitroaromatic-compounds",totalDownloads:2440,totalCrossrefCites:4,totalDimensionsCites:10,hasAltmetrics:0,abstract:"Nitroaromatics are major pollutants released in the environment during the post-industrialization era and pose toxic effects to living organisms. Several bacterial strains have been isolated for the degradation of these nitroaromatic pollutants. Some of them have been used in field trial experiments for the removal of nitroaromatics from industrial water and groundwater. Very few bacterial pathways have been characterized at genetic and molecular levels. In this review, we cover all reported degradation pathways and their gene evolution. These studies for nitroaromatics clearly indicate that most of the involved genes have evolved from preexisting enzymes by using all means of gene evolution like horizontal gene transfer, mutation, and promiscuity principle. This information has been exploited for the creation of hybrid pathways and better biocatalysts for degradation.",signatures:"Deepak Singh, Keerti Mishra and Gurunath Ramanthan",downloadPdfUrl:"/chapter/pdf-download/49190",previewPdfUrl:"/chapter/pdf-preview/49190",authors:[{id:"174077",title:"Prof.",name:"Gurunath",surname:"Ramanathan",slug:"gurunath-ramanathan",fullName:"Gurunath Ramanathan"},{id:"178959",title:"Dr.",name:"Keerti",surname:"Mishra",slug:"keerti-mishra",fullName:"Keerti Mishra"},{id:"178961",title:"Dr.",name:"Deepak",surname:"Singh",slug:"deepak-singh",fullName:"Deepak Singh"}],corrections:null},{id:"48706",title:"Selection of Promising Bacterial Strains as Potential Tools for the Bioremediation of Olive Mill Wastewater",doi:"10.5772/60896",slug:"selection-of-promising-bacterial-strains-as-potential-tools-for-the-bioremediation-of-olive-mill-was",totalDownloads:1460,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"The main objective of this paper was the selection of promising bacterial strains to be used as potential tools to remove phenols in olive mill wastewater (OMW) or in other food wastes. Therefore, 12 OMW samples were analyzed and 119 isolates were collected. After a preliminary screening on a medium containing vanillic and cinnamic acids, three isolates were selected to evaluate their viability in presence of different compounds (cinnamic, vanillic and caffeic acids, rutin, tyrosol and oleuropein) and a possible bioremediation effect. The isolates generally survived with phenols added and exerted a significant bioremediation activity in some samples (reduction of phenols by 20%). The last step was focused on the evaluation of the combined effects of pH, cinnamic and vanillic acids on the viability of a selected isolate (13M); the combination of the acids exerted a strong effect on the target, but alkaline pH played a protective role.",signatures:"Daniela Campaniello, Antonio Bevilacqua, Milena Sinigaglia and\nMaria Rosaria Corbo",downloadPdfUrl:"/chapter/pdf-download/48706",previewPdfUrl:"/chapter/pdf-preview/48706",authors:[{id:"173309",title:"Dr.",name:"Antonio",surname:"Bevilacqua",slug:"antonio-bevilacqua",fullName:"Antonio Bevilacqua"},{id:"173661",title:"Dr.",name:"Daniela",surname:"Campaniello",slug:"daniela-campaniello",fullName:"Daniela Campaniello"},{id:"173662",title:"Prof.",name:"Milena",surname:"Sinigaglia",slug:"milena-sinigaglia",fullName:"Milena Sinigaglia"},{id:"173663",title:"Prof.",name:"Maria Rosaria",surname:"Corbo",slug:"maria-rosaria-corbo",fullName:"Maria Rosaria Corbo"}],corrections:null},{id:"48968",title:"Gelation of Arabinoxylans from Maize Wastewater — Effect of Alkaline Hydrolysis Conditions on the Gel Rheology and Microstructure",doi:"10.5772/61022",slug:"gelation-of-arabinoxylans-from-maize-wastewater-effect-of-alkaline-hydrolysis-conditions-on-the-gel-",totalDownloads:1800,totalCrossrefCites:3,totalDimensionsCites:13,hasAltmetrics:0,abstract:"The purpose of this research was to extract arabinoxylans (AX) from maize wastewater generated under different maize nixtamalization conditions and to investigate the polysaccharide gelling capability, as well as the rheological and microstructural characteristics of the gels formed. The nixtamalization conditions were 1.5 hours of cooking and 24 hours of alkaline hydrolysis (AX1) or 30 minutes cooking and 4 hours of alkaline hydrolysis (AX2). AX1 and AX2 presented yield values of 0.9% and 0.5% (w/v), respectively. Both AX samples presented similar molecular identity (Fourier Transform Infra-Red) and molecular weight distribution but different ferulic acid (FA) content. AX1 and AX2 presented gelling capability under laccase exposure. The kinetics of gelation of both AX samples was rheologically monitored by small amplitude oscillatory shear. The gelation profiles followed a characteristic kinetics with an initial increase in the storage modulus (G') and loss modulus (G\") followed by a plateau region for both gels. AX1 presented higher G' than AX2. In scanning electron microscopy (SEM) images, both gels present an irregular honeycomb microstructure. The lower FA content in AX2 form gels presenting minor elasticity values and a more fragmented microstructure. These results indicate that nixtamalization process conditions can modify the characteristics of AX gels.",signatures:"Rita Paz-Samaniego, Elizabeth Carvajal-Millan, Francisco Brown-\nBojorquez, Agustín Rascón-Chu, Yolanda L. López-Franco, Norberto\nSotelo-Cruz and Jaime Lizardi-Mendoza",downloadPdfUrl:"/chapter/pdf-download/48968",previewPdfUrl:"/chapter/pdf-preview/48968",authors:[{id:"22173",title:"Dr.",name:"Elizabeth",surname:"Carvajal-Millan",slug:"elizabeth-carvajal-millan",fullName:"Elizabeth Carvajal-Millan"},{id:"29653",title:"Dr.",name:"Agustín",surname:"Rascón-Chu",slug:"agustin-rascon-chu",fullName:"Agustín Rascón-Chu"},{id:"39809",title:"Prof.",name:"Norberto",surname:"Sotelo",slug:"norberto-sotelo",fullName:"Norberto Sotelo"},{id:"177936",title:"Ph.D. Student",name:"Rita",surname:"Paz-Samaniego",slug:"rita-paz-samaniego",fullName:"Rita Paz-Samaniego"},{id:"177937",title:"Dr.",name:"Francisco",surname:"Brown-Bojorquez",slug:"francisco-brown-bojorquez",fullName:"Francisco Brown-Bojorquez"},{id:"177938",title:"Dr.",name:"Yolanda L",surname:"López-Franco",slug:"yolanda-l-lopez-franco",fullName:"Yolanda L López-Franco"},{id:"177939",title:"Dr.",name:"Jaime",surname:"Lizardi-Mendoza",slug:"jaime-lizardi-mendoza",fullName:"Jaime Lizardi-Mendoza"}],corrections:null},{id:"48751",title:"Perspectives on Biological Treatment of Sanitary Landfill Leachate",doi:"10.5772/60924",slug:"perspectives-on-biological-treatment-of-sanitary-landfill-leachate",totalDownloads:2721,totalCrossrefCites:5,totalDimensionsCites:13,hasAltmetrics:0,abstract:"Landfilling, one of the prevailing worldwide waste management strategies, is presented together with its benefits and environmental risks. Aside from biogas, another non-avoidable product of landfilling is landfill leachate, which usually contains a variety of potentially hazardous inorganic and organic compounds. It can be treated by different physico-chemical and biological methods and their combinations. The composition and characteristics of landfill leachate are presented from the aspect of biotreatability. The treatment with activated sludge, mainly consisting of bacterial cultures under aerobic and anaerobic conditions in various reactor systems, is explained, including an extensive literature review. The potential of fungi and their extracellular enzymes for treatment of municipal landfill leachates is also presented, with a detailed review of the landfill leachate treatment studies. The future perspectives of biological treatment are also discussed.",signatures:"Andreja Žgajnar Gotvajn and Aleksander Pavko",downloadPdfUrl:"/chapter/pdf-download/48751",previewPdfUrl:"/chapter/pdf-preview/48751",authors:[{id:"23280",title:"Dr.",name:"Aleksander",surname:"Pavko",slug:"aleksander-pavko",fullName:"Aleksander Pavko"},{id:"177753",title:"Dr.",name:"Andreja",surname:"Žgajnar Gotvajn",slug:"andreja-zgajnar-gotvajn",fullName:"Andreja Žgajnar Gotvajn"}],corrections:null},{id:"48758",title:"Wet Air Oxidation of Aqueous Wastes",doi:"10.5772/60935",slug:"wet-air-oxidation-of-aqueous-wastes",totalDownloads:3291,totalCrossrefCites:6,totalDimensionsCites:9,hasAltmetrics:0,abstract:"Wet air oxidation (WAO) is a key technology in the disposal of industrial and agricultural process wastewaters. It is often used coupled with activated sludge treatment at a wastewater treatment plant (WWTP) as preliminary conversion of toxic and/or non-biodegradable components. The process is based on a high temperature and pressure reaction of the oxidizable materials in water with air or oxygen, in most cases in a bubble column reactor. The oxidation is a chain type radical reaction. The intensification of this technology is possible with the application of homogeneous and heterogeneous catalysts, recently non-thermal radical generating methods (UV/H2O2, ozonization, Fenton type processes) gathered ground also. The most frequent use of the process is in sludge treatment and oxidation of spent caustic of refineries or ethylene plants.",signatures:"Antal Tungler, Erika Szabados and Arezoo M. Hosseini",downloadPdfUrl:"/chapter/pdf-download/48758",previewPdfUrl:"/chapter/pdf-preview/48758",authors:[{id:"173900",title:"Emeritus Prof.",name:"Antal",surname:"Tungler",slug:"antal-tungler",fullName:"Antal Tungler"},{id:"173902",title:"M.Sc.",name:"Erika",surname:"Szabados",slug:"erika-szabados",fullName:"Erika Szabados"},{id:"173981",title:"Dr.",name:"Arezoo",surname:"Hosseini",slug:"arezoo-hosseini",fullName:"Arezoo Hosseini"}],corrections:null},{id:"48765",title:"Modeling Wastewater Evolution and Management Options under Variable Land Use Scenarios",doi:"10.5772/60893",slug:"modeling-wastewater-evolution-and-management-options-under-variable-land-use-scenarios",totalDownloads:2432,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The development of a reliable decision support system and predictions for water quantity and quality often require a reasonable level of environmental and hydrological simulations at various geographic scales. The Soil and Water Assessment Tool (SWAT) model offers distributed parameter and continuous time simulation, and flexible watershed configuration and with the adoption of geographic information system (GIS) technology, a user-friendly and interactive decision support system can be developed for wastewater management. In this chapter, we evaluated the spatio-temporal evolution of wastewater contaminants in an environmentally degraded watershed through integrated field-based investigations and modeling approach. Later, management options were identified to improve the watershed health and agro-environment. The results of the modeling study exhibited variable responses of surface runoff and water quality to different scenarios of land use change. Temporal wastewater analysis indicated a significant impact of seasonality on the contaminants’ population levels. 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Most often, etiology is unknown and is not attributed to another disorder. This presentation is referred to as Type I or classic trigeminal neuralgia. Inflammatory causes (e.g., multiple sclerosis, infection, etc.), compression of the trigeminal roots (e.g., tumors and arteriovenous malformation), abnormalities of the skull base [2], or pain due to underlying disease processes comprise Type II or secondary trigeminal neuralgia. Atypical or mixed trigeminal neuralgia is when patients experience sensory loss or dull, burning pain in the trigeminal nerve distribution in between the characteristic paroxysms [2], and often without an identifiable trigger zone. Atypical disease is more commonly associated with a symptomatic presentation or background pain of milder intensity for up to 50% of the time [3].
\nPatients usually describe the pain as sudden and severe electric, shooting or shock-like, and superficial pain lasting anywhere from a few seconds to several minutes [2]. Attacks are considered paroxysmal, where frequency of episodes can range from a few to several dozens in 1 day [3]. Additionally, paroxysms are generally similar in nature for individual patients. The pain associated with the classic presentation can be precipitated by light mechanical stimulation to the face or oral mucosa (e.g., facial hair grooming and tooth brushing) or by thermal stimulation (e.g., cold or heat exposure) [2]. It is common for patients to develop an aversion to eating, drinking, or previous noxious stimuli for fear of triggering another episode. More so, the psychological impact may cause patients to appear distressed or anxious during physical examination [4]. For these reasons, the unique presentation with the absence of other neurologic abnormalities makes trigeminal neuralgia a clinical diagnosis [2]. Dental X-rays or MRIs may be warranted to clarify differential diagnoses or confirm a suspected etiology which may guide management.
\nOverall, trigeminal neuralgia is considered a rare disease according to population-based studies, with estimated 4–13 cases diagnosed per 100,000 individuals each year [5]. However, regional biases exist where countries with less stringent diagnostic criteria yield a higher incidence. For example, the annual incidence of disease in the United Kingdom (26.8 per 100,000 cases) is based off general practitioner lists and fewer diagnostic criteria, compared to the United States (5.9) and Netherlands (12.6), respectively [3].
\nAnatomically, the vast majority of cases affect either the maxillary or mandibular division (V2 or V3), alone or in combination. In approximately 5% of patients, the symptoms occur solely in the ophthalmic division (V1). In terms of disease onset, trigeminal neuralgia rarely manifests in individuals younger than age 40, with incidence peaking in the elderly and more than twice as many women affected than men [6]. However, it is important to note that trigeminal neuralgia is considered a progressive disease with symptomatic treatment with repeat procedures becoming less effective over time [3].
\nThe primary treatment for trigeminal neuralgia is pharmacologic. Pain associated with trigeminal neuralgia responds poorly to analgesics and favorably to antiepileptic drugs. First-line medical treatment is carbamazepine, with other adjuncts such as phenytoin, gabapentin, lamotrigine, or baclofen added for persistent pain [4].
\nPatients with intolerable medication side effects or who experience pain refractory to three attempted drug trials and are surgically fit as dictated by medical status/age may be considered for surgery [7]. Patients may first undergo preliminary nerve blocks either at the level of a trigeminal nerve branch or at the Gasserian ganglion to confirm the diagnosis of trigeminal neuralgia. If patients experience pain relief with this diagnostic procedure, patients may elect further therapeutic treatment with the same modality or discuss different surgical treatment options with their neurologist, neurosurgeon, anesthesiologist, or other physicians involved in their care [8].
\nSurgical methods for the treatment of trigeminal neuralgia can be separated into four broad categories—peripheral lesions to the terminal branches, lesions to the trigeminal (Gasserian) ganglion, lesions to the ganglion root by stereotactic radiosurgery or gamma knife radiosurgery (GKRS), and posterior fossa intervention with microvascular decompression (MVD) [9]. Alternatively, surgical intervention can be divided into non-ablative/nondestructive (MVD) and ablative (all other surgical interventions).
\nThe non-ablative MVD is a complex posterior fossa procedure requiring a craniotomy and thus is performed exclusively by neurosurgeons [10]. This approach is rapidly becoming the surgical intervention of choice when there is MRI-confirmed vascular compression by the nerve root as pain relief is significant, and severe complication risks such as death and relapse rate are among the lowest of all surgical treatment modalities [3]. If no compression is found, percutaneous rhizotomies via thermal (pulsed radiofrequency or thermocoagulation), chemical (glycerol), or mechanical (balloon compression) techniques or gamma knife radiosurgery (GKRS) are preferred. As sensory ablation by rhizotomy demonstrate similar pain relief results in comparison to MVD, it is important for patients to consider the slightly higher risk of complications and slightly lower patient satisfaction at 5-year follow-up with rhizotomies [10]. GKRS is also a safe and effective treatment; however, patients are counseled on the likelihood of a delayed onset of pain relief following treatment, and those with a significant surgical history involving the head may make poor candidates for GKRS [9].
\nUltimately, patient preferences for surgical intervention are always taken into consideration and only if medical status permits. For patients who wish to undergo intervention for management of their medically refractory disease and do not wish to have MVD, any form of rhizotomy, or GKRS, patients may elect to have other treatments such as peripheral neurectomy, botulinum toxin type-A (BTX-A) injections, or cryotherapy. Such interventions can be administered by a variety of physicians such as oral and maxillofacial surgeons, anesthesiologists, neurologists, and other certified providers in both inpatient and outpatient settings.
\nPeripheral or mental neurectomy under local anesthesia is still offered for management of pharmacologically resistant trigeminal neuralgia; however, it is most often used in rural areas where more advanced surgical options (MVD, rhizotomy, GKRS) are unavailable or unaffordable [11]. Neurectomies essentially are too underreported to gauge its actual utility compared to other treatments. BTX-A is another minimally invasive approach, which can be performed in an outpatient setting and repeated a number of times without significant adverse effects. However, the location (intradermal or intramuscular) and dosage (25–75 units) per injection have yet to be standardized [12]. Anecdotally, cryotherapy is one of the more painful procedures and does not appear to have significant long-term efficacy in pain relief compared to other interventions. It is maintained that cryogenic insult varies with nerve diameter and is thus associated with variable nerve regeneration and shorter pain-free intervals [13].
\nOften, patients electing these auxiliary interventions have major contraindications for neurosurgery, are unfit for general anesthesia, or simply prefer less invasive procedures [14, 15, 16]. However, the effectiveness, duration of pain relief, rate of relapse and complication, and overall patient satisfaction with auxiliary interventions are generally based on case reports and studies with small sample sizes; thus, overall impression of such modalities is less favorable compared to MVD, rhizotomy, and GKRS [17].
\nAs with any invasive procedure, patients must be counseled on postoperative risk for infection and bleeding (hematomas) at the site of needle entry or incision. With trigeminal nerve and Gasserian ganglion blocks, a small risk of dysesthesias or a loss of consciousness may occur if CSF is inadvertently injected with local anesthetic [8]. For patients undergoing MVD, rhizotomy procedures, or GKRS, postoperative hyperesthesia, facial asymmetry, masseter weakness, alteration in corneal sensation, and meningitis are extremely rare complications; however, patients must always be informed of potential risks [8]. As with the auxiliary intervention options, patients are educated on the similar complications such as dysesthesias, facial weakness, and asymmetry, albeit rare. Of note, cryotherapy is one technique that attempts to preserve sensation post-procedure.
\nIt is imperative that patients accurately assess pain levels before and after surgical intervention to better guide treatment options in the future if relapse occurs. Patients must understand that most of these surgical interventions may not rid their symptoms of trigeminal neuralgia permanently and that large, randomized controlled trials are needed to thoroughly predict the long-term efficacy of these interventions and disease prognosis. The paucity of standardization in the follow-up period for patients undergoing surgical treatment is generally physician-specific and on a case-by-case basis, depending on the severity of disease and wishes of the patient. However, the consensus in the literature is that surgical management for the treatment of medication-refractory trigeminal neuralgia is safe and effective.
\nGasserian ganglion, maxillary nerve, and mandibular nerve blocks play an integral role as a diagnostic block prior to trigeminal neurolysis, if indicated. Patients who report significant pain reduction (greater than 50% compared to preoperative baseline) from two consecutive diagnostic blocks are recommended subsequent percutaneous procedures for a more sustained therapeutic effect.
\nThe trigeminal nerve contains sensory and motor fibers. Somatic afferent fibers transmit pain, light touch, and temperature sensation from the skin of the face, the oral and nasal mucosa, the teeth, and the anterior two thirds of the tongue. Visceral efferent fibers innervate muscles of facial expression, the tensor tympani, and muscles of mastication. Also, the trigeminal nerve has multiple communications with autonomic nervous system through the ciliary, sphenopalatine, and optic and submaxillary ganglia.
\nThe trigeminal nerve travels as follows: brain stem, prepontine fossa, Meckel’s cave (trigeminal/Gasserian ganglion location), and extracranial. The ganglion (approximately 1 × 2 cm) can be found within a reflection of dura mater known as Meckel’s cave, which lies in the middle cranial fossa adjacent to the petrous bone. Superior to Meckel’s cave is the inferior surface of the temporal lobe, posterior is the brain stem, and medial is the cavernous sinus and internal carotid artery. After the Gasserian ganglion, the nerve separates somatotopically into the following divisions: ophthalmic (craniomedially), mandibular (caudolaterally), and maxillary in between [8].
\nIndications:
\nDiagnostic block to confirm clinical diagnosis of trigeminal neuralgia [8]
Therapeutic block in medically refractory cases
Prognostic indicator for planned neuroablative or surgical procedure
Diagnosis and management of various orofacial pain syndromes (e.g., cluster headache, persistent ocular pain, palliation of cancer pain)
Contraindications: the contraindications to Gasserian ganglion nerve block are the same as those for trigeminal nerve block: patient refusal, local infection, sepsis, coagulopathy, increased intracranial pressure, behavioral abnormalities, allergy to local anesthetics, and lack of patient cooperation.
\nApproach: the patient is positioned supine with the cervical spine extended. As the patient’s cooperation is paramount, the procedure is usually done under local anesthetic and sedation [18]. Under fluoroscopic guidance, submental (Figure 1a) and lateral (Figure 1b) views are obtained to identify the foramen ovale [18]. Approximately 2.5 cm lateral to the corner of the mouth, a needle is advanced perpendicular to the pupil of the eye in a cephalad direction toward the auditory meatus. Once the needle tip has made contact with the base of the skull, the needle is withdrawn slightly and walked posteriorly into the foramen ovale. The needle is carefully aspirated to confirm the absence of CSF/blood prior to therapeutic injection. After needle position is confirmed and aspiration is negative, an average volume of 0.4 mL of neurolytic solution is injected.
\nSubmental (a) and lateral (b) view of needle in foramen ovale [
Complications: due to the close relation between the Gasserian ganglion and the dural reflection, Meckel’s cave, inadvertent local anesthetic injection into CSF causing loss of consciousness is a feared complication of this procedure [19]. Additionally, dysesthesias [17] and hematoma formation upon needle entry into the foramen ovale are other complications associated with this technique.
\nOutcome: the overall therapeutic benefit of the Gasserian ganglion block is largely similar to that of trigeminal nerve block, with most patients reporting pain relief greater than 50% of baseline for up to 6–12 months [18] and much shorter duration if used as a diagnostic block.
\n\n
Its branches are divided into four groups, depending on the location where they branch off: the cranium, the pterygopalatine fossa, the infraorbital canal, or the face [20]. The intracranial group includes the middle meningeal nerve [20]. The pterygopalatine group includes the zygomatic nerve, the superior alveolar nerves, the nasopalatine nerve, the palatine nerves, and the pharyngeal nerve [21]. The infraorbital group includes the infraorbital nerve and the anterior superior alveolar nerve [8]. The facial group includes the inferior palpebral nerve, the superior labial nerve, and the lateral nasal nerve.
\n\n
Its branches are divided into three groups: the main trunk, the anterior division, and the posterior division [20]. The main trunk group includes efferent branches for the medial pterygoid, tensor tympani, tensor veli palatini muscles, and an afferent nerve for the meningeal branch [20]. The anterior group includes the efferent masseteric, deep temporal, and lateral pterygoid nerves and the afferent buccal nerve [21]. The posterior group includes the efferent/afferent inferior alveolar nerve and the afferent auriculotemporal and lingual nerves.
\nIndications:
\nDiagnostic block in assessment and management of trigeminal neuralgia and atypical facial pain [8]
Anatomic differential neural blockade when more selective nerve block needed for diagnosis of various orofacial pain syndromes
Therapeutic block for acute pain emergencies [18]
Diagnosis and management of various orofacial pain syndromes (e.g., cluster headache, persistent ocular pain, palliation of cancer pain)
Contraindications: the contraindications for performing maxillary and mandibular nerve blocks include but are not limited to the following: patient refusal, local infection, sepsis, coagulopathy, increased intracranial pressure, behavioral abnormalities, allergy to local anesthetics, and lack of patient cooperation.
\nApproach: patients are placed supine with cervical spine extended. The anesthesiologist should be at the patient’s side, approximately shoulder level. The site of needle puncture is medial to the masseter muscle (~3 cm lateral to the corner of the mouth) which can be identified by asking the patient to clench his or her teeth. Following the initial numbing, evidenced by the raised skin wheal, a 22-gauge, 10-cm needle is inserted with fluoroscopic guidance [19]. Needle insertion is aligned with the pupil to a depth of 4.5–6 cm to contact the infratemporal surface of the greater wing of the sphenoid, immediately anterior to the foramen ovale [19]. The needle is then retracted and advanced into the foramen ovale to a final depth of 6–7 cm, often resulting in mandibular paresthesia, followed by paresthesia in the ophthalmic and maxillary nerve distribution with further needle advancement. Injection of contrast will identify vascular uptake and extent of injectate spread [22]. Prior to injection with local anesthetic, the needle should be carefully aspirated to confirm the absence of CSF/blood. One millimeter of local anesthetic is generally adequate for a diagnostic nerve block to occur within 5–10 minutes.
\nThe coronoid approach may be utilized for selective maxillary and mandibular nerve block. The coronoid notch is identified by asking the patient to open and close the mouth several times and palpating the area just anterior and slightly inferior to the acoustic auditory meatus. A needle is inserted just below the zygomatic arch directly in the middle of the coronoid notch and placement verified on lateral view (Figure 2a). The needle is advanced 2.5–5 cm in a plane perpendicular to the skull until the lateral pterygoid plate is encountered. Needle placement is verified on PA view (Figure 2b). Injection of contrast will identify vascular uptake and extent of injectate spread. The needle is withdrawn slightly, and an incremental injection technique of 3–5 mL of local anesthetic is administered to each nerve [22].
\nLateral view (a): needle inserted (white arrow) coaxially in coronoid notch. PA view (b): needle (white arrow) advanced medially until contact is made with lateral pterygoid plate [
Complications: hematoma formation upon needle entry into the foramen ovale and local anesthetic toxicity are the major complications associated with this procedure [22]. However, dysesthesias, weakness of the muscles of mastication, secondary facial asymmetry, meningitis, intracranial hemorrhage with inadvertent intracranial needle placement, total spinal anesthesia, and anesthesia dolorosa are other complications associated with trigeminal nerve blocks [22].
\nOutcome: as a therapeutic block, effects of trigeminal nerve block are relatively short term, with most patients reporting pain relief greater than 50% of baseline for up to 6–12 months [18]. However, as trigeminal nerve blocks are primarily diagnostic, short-term pain relief is expected.
\nPeripheral lesions to the terminal branches with therapeutic intent are usually via radiofrequency thermocoagulation or highly concentrated alcohol injections [9] and less commonly with neurectomy, Botox injections, or cryolesions; however, adequate trials supporting these modalities are yet to surface [17].
\nPercutaneous lesions to the Gasserian ganglion are traditionally in the form of rhizotomies, radiofrequency, and chemical lesions by glycerol, phenol, or alcohol injection [18] but also via mechanical compression from balloon inflation. Ganglion-level procedures are generally preferred as they are safer and more effective than peripheral techniques [23], as all procedures are carried out under fluoroscopic guidance [9].
\nIndications:
\nTreatment of trigeminal neuralgia in a medically refractory or side-effect-intolerable patient
High-risk operative patients such as the medically ill or elderly [24]
Secondary trigeminal neuralgia due to multiple sclerosis [25]
Diagnostic procedure in patients with atypical disease (constant or near constant pain in addition to the classic sharp stabbing pains in trigeminal nerve distribution) [26]
Patient preference for minimally invasive procedure
Contraindications: contraindications for PRR are patient refusal, local infection, sepsis, coagulopathy, increased intracranial pressure, behavioral abnormalities, allergy to local anesthetics, and lack of patient cooperation. Radiofrequency thermocoagulation may be contraindicated in postherpetic neuralgia [25].
\nApproach: the patient is placed supine with cervical spine slightly extended. Procedure requires patient cooperation; thus, it is performed under local anesthetic and light sedation [18]. Under C-arm fluoroscopic guidance, a needle is introduced 2.5 cm lateral to the corner of the mouth. Advancement of the needle medial to the ramus of the jaw into the foramen ovale is verified on oblique view (Figure 3a). The use of bony landmarks and fluoroscopic guidance facilitates accurate radiofrequency needle placement to locate Meckel’s cave through the foramen ovale. Needle placement is confirmed with lateral fluoroscopic view (Figure 3b) prior to neurolysis [24].
\nOblique view (a) verifies needle placement medial to the ramus of the jaw prior to entry into the foramen ovale. Lateral view (b) confirms needle position prior to injuring the trigeminal nerve, a technique used with PRR, percutaneous glycerol rhizotomy (PGR), or percutaneous balloon compression (PBC) [
Through stepwise advancement of the needle toward the Gasserian ganglion, V3 is first encountered, followed by V2 and lastly V1 [26]. Once in Meckel’s cave, aspiration may yield CSF. The stylet is then replaced with the electrode to confirm that nerve root stimulation coincides with location of paresthesia felt by patient. Following accurate needle placement, the patient is anesthetized prior to thermal lesioning in cycles of 45–90 seconds at temperatures between 60 and 90°C [26]. Other parameters have utilized 60-second cycles at 70°C [8]. Pulsed radiofrequency is set to 42°C for 120-second cycles. Patient is awakened in between cycles for manual sensory testing throughout the face until complete pain resolution has been achieved.
\nComplications: complications associated with PRR are decreased corneal sensation with increased risk of keratitis, masseter weakness, hyperesthesia, and although very rare, anesthesia dolorosa.
\nOutcome: pain relief immediately following procedure is very high, with 97.6–99% of patients reporting full resolution. Pain relief was reported to be 61.8% at 1 year, 57.7% at 5 years, 52.3% at 10 years, and 41% at 20 years. PRR appears to be the only surgical intervention with long-term follow-up at 20 years [24].
\nIndications:
\nTreatment of trigeminal neuralgia in a medically refractory or side-effect-intolerable patient and other high-risk operative patients such as the medically ill or elderly [24]
Patients who have previously undergone MVD or have history of multiple sclerosis [27]
Diagnostic procedure in patients with atypical disease (constant or near constant pain in addition to the classic sharp, stabbing pains in trigeminal nerve distribution) [26]
Patient preference for a minimally invasive procedure
Contraindications: contraindications to PGR are patient refusal, local infection, sepsis, coagulopathy, increased intracranial pressure, behavioral abnormalities, allergy to local anesthetics, and lack of patient cooperation.
\nApproach: the patient is placed supine with the cervical spine slightly extended. Percutaneous techniques require patient cooperation during intermittent anesthetization; thus, procedures are performed under local anesthetic and sedation [18]. Under C-arm fluoroscopic imaging, a needle is introduced 2.5 cm lateral to the corner of the mouth. The needle is inserted into the trigeminal cistern through the foramen ovale. Precise needle placement must be ascertained prior to puncture as subarachnoid entry beneath the temporal lobe may yield significant complications. CSF may be encountered when the needle contacts the Gasserian ganglion, unless patient has previously received surgical intervention in this area [26]. Radiopaque contrast is then utilized to visualize the cistern prior to glycerol gangliolysis. Patient is repositioned to a sitting position for a test dose of sterile anhydrous glycerol, followed by dose escalation of 0.1–0.4 mL total. Patient must remain seated for approximately 2 hours postinjection [26].
\nComplications: complications associated with PGR are hyperesthesia, decreased corneal sensation, facial hematoma, aseptic meningitis, hearing loss, bacterial meningitis, buccal mucosa penetration, and carotid puncture.
\nOutcome: pain relief immediately following PGR is good, however, still below that from PRR and with greater variability; 71–97.9% of patients report full resolution immediately following procedure. Pain relief was reported to be between 53 and 63% at 1 year and 43.5% at 5 years [24]. No further time points have been collected for PGR.
\nIndications:
\nTreatment of trigeminal neuralgia in a medically refractory or side-effect-intolerable patient and other high-risk operative patients such as the medically ill or elderly [24]
Diagnostic procedure in patients with atypical disease (constant or near constant pain in addition to the classic sharp, stabbing pains in trigeminal nerve distribution) [26]
Patient preference for minimally invasive procedure
Contraindications: PBC may be relatively contraindicated in patients with underlying cardiac disease as trigeminal reflex bradycardia and hypotension may occur [28].
\nApproach: the patient is placed in a supine position with the neck and thorax slightly extended 29]. However, another approach involves the patient semi-seated with head retroflexed to obtain a submental vertical X-ray beam for a horizontal view of the foramen ovale [30]. Patient undergoes endotracheal intubation and general anesthesia. C-arm fluoroscopy is used for anteroposterior and lateral images to confirm needle placement. A 14-gauge needle is inserted approximately 2.5 cm lateral to the corner of the mouth, parallel to the sagittal plane to protect the oral mucosa. Under fluoroscopic guidance, the catheter is redirected to the foramen ovale. A no. 4 Fogarty catheter is then advanced to 10–15 mm beyond the needle tip. The balloon is inflated until proximal to the posterior fossa with approximately 300 mg of I2/mL iohexol [29]. Compression volume is patient specific, until pear-shaped balloon is achieved with respect to the nearby structures (e.g., clivus, sella, and petrous bones). The contrast medium is aspirated, catheter is withdrawn, and pressure is applied to needle entry site.
\nComplications: complications associated with PBC are hyperesthesia with persistent symptoms, masseter weakness, facial hematoma, hearing loss, anesthesia dolorosa, decreased corneal sensation, pseudoaneurysm, bacterial meningitis, septic meningitis, trigeminal reflex bradycardia, and hypotension.
\nOutcome: pain relief immediately following PBC is also promising, however, still below that from PRR; 82–93.8% of patients report full resolution immediately following procedure. Pain relief was reported to be between 74.6% at 1 year, 69.8% at 5 years, and between 30 and 51.5% at 10 years [24]. No further time points have been collected for PBC.
\nIndications:
\nPatients who are surgically unfit for MVD due to significant medical comorbidities
Patients who refuse to take anticonvulsants
Patients currently on anticoagulation therapy [31]
Contraindications: as this noninvasive outpatient procedure is considered one of the safest surgical techniques in the treatment of trigeminal neuralgia, few contraindications have been reported. Patients who have had an extensive history of surgical intervention may be at an increased risk of complications [24].
\nApproach: the patient is supine with mild oral or intravenous sedation. A Leksell Model G stereotactic frame is secured to the patient’s head with local anesthetic [26]. MRI maps the neurovascular compression at the entry zone of the trigeminal nerve. Once exact intracranial location is confirmed, a 4-mm collimator is used, with radiation dose prescribed to 100% isodose line [32]. The isocenter is placed near the pars triangularis and highly focused beams of radiation (70–90 Gy) to the trigeminal nerve root in the posterior fossa [7].
\nComplications: complications of GKRS are dose dependent, with increased rate of occurrence rate with cumulative radiation dose exceeding 115 Gy. Alternatively, the rate of complications increases when GKRS is performed following failed treatment with other surgical interventions [24]. Hyperesthesias were reported in 6–42% of patients, and anesthesia dolorosa occurred at a rate of 0.2% [33].
\nOutcome: pain relief associated with GKRS can be delayed up to 8 weeks [9] postoperatively (mean time of 1 month) and is highly dependent on the accuracy of the stereotactic system used [7]. Between 79 and 91.8% of individuals had pain relief; however, a mean delay of 10 days to 3.4 months was experienced prior to initial pain relief. Further follow-ups identified 75–90% of patients with pain relief at 1 year, 44–65% at 5 years, and 30–51.5% of individuals with pain relief at 10 years.
\nIndications:
\nMedically refractory patients who are deemed surgically fit as by medical status/age [7]
First-line treatment in younger patients due to long-term improvement in quality of life [34]
Contraindications: although advanced age is a relative contraindication, there is no age limit for this procedure as long as patients are fit to undergo general anesthesia [26].
\nApproach: the patient is placed in a lateral decubitus position, which allows for easier lumbar puncture and CSF drainage to decrease tension in infratentorial space. A suboccipital craniotomy is performed to enter the posterior fossa, targeting the trigeminal nerve-pons junction [26]. The infratentorial lateral supracerebellar approach accesses the trigeminal nerve within the superior portion of the cerebellopontine angle via the lateral aspect of the cerebellar tentorial surface [35]. Once the CSF is aspirated, retraction of the superolateral margin of the cerebellum facilitates contact with the nerve. Most commonly, the superior cerebellar artery (SCA) is responsible for nerve compression at the root entry zone and, less commonly, the anterior inferior cerebellar artery or superior petrosal veins [36]. Thus, the arachnoid membrane must be dissected from the trigeminal nerve all throughout its course through Meckel’s cavity in order to expose the compression. The SCA courses medial to the trigeminal nerve, which always compresses the nerve medially. Retraction of the cerebellum should be minimized as injury to the vestibulocochlear nerve is at risk. For transposition of the compressing artery, the sling retraction technique is used [37].
\nComplications: complications associated with MVD are trigeminal nerve deficit, facial weakness, hearing loss, anesthesia dolorosa, aseptic meningitis, hydrocephalus, mortality, and cerebellar infarct or hematoma [24].
\nOutcome: long-term pain relief from MVD has been found to be superior among existing surgical interventions for treatment of trigeminal neuralgia at this time; thus, it is generally considered to be first-line intervention for operative candidates [24]. Between 80.3 and 96% of patients experienced initial pain relief immediately following MVD, 84% at 1 year, 72–85% at 5 years, and 74% at 10 years [24] (Tables 1 and 2).
\nSummary of complications | \n||
---|---|---|
Procedure | \nComplication | \nRate (%) | \n
PRR | \nDecreased corneal sensation; keratitis | \n5.7–17.3; 0.6–1.9 [38] | \n
Masseter weakness | \n4 [39] | \n|
Hyperesthesia | \n3.3 [40] | \n|
Anesthesia dolorosa | \n0.6–0.8 [39] | \n|
PGR | \nHyperesthesia | \n23.3–72 [41] | \n
Decreased corneal sensation | \n6.3–15 [40] | \n|
Facial hematoma | \n7 [42] | \n|
Aseptic meningitis | \n0.12–3 [42] | \n|
Hearing loss | \n1.9 [42] | \n|
Bacterial meningitis | \n1.5–1.7 [42] | \n|
Buccal mucosa penetration | \n1.5 [42] | \n|
Carotid puncture | \n0.77 [42] | \n|
PBC | \nHyperesthesia; persistent symptoms | \n89–100; 4.6–40 [41] | \n
Masseter weakness | \n1.2–12 [39] | \n|
Facial hematoma | \n3.5–6.7 [43] | \n|
Hearing loss | \n2.4–6.3 [44] | \n|
Anesthesia dolorosa | \n0–3.4 [39] | \n|
Decreased corneal sensation | \n0–3.1 [40] | \n|
Pseudoaneurysm | \n1 [44] | \n|
Bacterial meningitis | \n0.7–1 [43] | \n|
Aseptic meningitis | \n0.7 [43] | \n|
Trigeminal reflex bradycardia | \n\n | |
Hypotension | \n\n | |
GKRS | \nHyperesthesia | \n6–42 [33] | \n
Anesthesia dolorosa | \n0.2 [33] | \n|
MVD | \nTrigeminal nerve deficit | \n1.6–22 [45] | \n
Facial weakness | \n0.6–10.6 [45] | \n|
Hearing loss | \n1.2–6.8 [45] | \n|
Anesthesia dolorosa | \n0–4 [46] | \n|
Aseptic meningitis | \n2 [47] | \n|
Hydrocephalus | \n0.15 [48] | \n|
Mortality | \n0.15–0.8 [24] | \n|
Cerebellar infarct or hematoma | \n0.075–0.68 [45] | \n
Summary of complications and rates associated with PRR, PGR, PBC, GKRS, and MVD [24].
Summary of outcomes | \n|||||
---|---|---|---|---|---|
Procedure | \nInitial response (%) rate | \n1-year | \n5-year | \n10-year | \n20-year | \n
PRR | \n97.6–99 | \n61.8 | \n57.7 | \n52.3 | \n41 | \n
PGR | \n71–97.9 | \n53–63 | \n43.5 | \n\n | \n |
PBC | \n82–93.8 | \n74.6 | \n69.8 | \n30–51.5 | \n\n |
GKRS | \n79–91.8 (Delayed 10 days–3.4 months) | \n75–90 | \n44–65 | \n30–51.5 | \n\n |
MVD | \n80.3–96 | \n84 | \n72–85 | \n74 | \n\n |
Summary of success rates of PRR, PGR, PBC, GKRS, and MVD immediately following procedure, 1-, 5-, 10-, and 20-year time points [24].
Indications:
\nMedically refractory trigeminal neuralgia in patients who are unable to undergo general anesthesia (frail, elderly, or medically unstable patients), as this can be performed as an outpatient procedure under local anesthesia [11]
Therapeutic for patients reluctant to undergo major neurosurgery or have contraindications for craniotomy when rhizotomies are not possible [49]
Rural settings where too large surgical facilities may be inaccessible
Contraindications: peripheral neurectomy may be contraindicated in those unable to tolerate general anesthesia, as other approaches are more invasive (e.g., maxillary sinus route) [49].
\nApproach: for procedures done under local anesthesia, a diagnostic nerve block with 2% lidocaine HCl plus adrenaline 1:200,000 concentration must completely resolve symptoms prior to neurectomy [14]. Infraorbital, inferior alveolar, and mental neurectomies usually require the following incisions: vestibular, Ginwalla’s, and crevicular incision, respectively. Clamping and avulsion of the mental nerve require an additional Y-shaped incision along the anterior border of the ascending ramus. After further blunt and sharp dissection on its medial aspect, the temporalis and medial pterygoid muscles are split, facilitating the clamping and avulsing of the mental nerve at the mental foramen. Sealing the infraorbital foramen with stainless steel screws is the final step [14].
\nFor procedures done under general anesthesia, patients are supine, and an intraoral mucoperiosteal incision is made between the buccal sulcus of the upper lateral incisor to the first molar on the symptomatic side [49]. Once the infraorbital fossa is exposed, access to the maxillary sinus is gained via bone window with a diameter of 2 cm in the anterior wall of the maxillary sinus. Further dissection completely liberates the entire neurovascular bundle in the maxillary sinus, and the removal of the inferior bone of the infraorbital canal and fissure ensues [49]. Another round bone window with 1.5 cm diameter is made at the upper 1/3 of the posterior wall of the maxillary sinus with extreme care as injury to the maxillary artery may occur. The superior bony wall of the maxillary sinus is removed to expose the pterygopalatine fossa segment of the maxillary nerve. The length of the maxillary nerve from the infraorbital foramen to the pterygopalatine fossa is removed, along with the branches of the infraorbital nerve [49].
\nComplications: anesthesia or paresthesia in the maxillary distribution postoperatively is common and short-lasting. The major complications regarding the pterygoid palatine fossa segment neurectomy of the maxillary nerve under general anesthesia are bleeding, infection, and eye or encephalic injuries.
\nOutcome: pain relief from peripheral neurectomies has been reported to an average of 26.5 months when obturated with fatty tissues [50] and greater than 24 months when obturated with stainless steel screws [14]. One case report from India of a 65-year-old female who underwent a mental neurectomy endorsed pain reduction from 8 to 1 on VAS score from pre-procedure to 2 years postoperatively, respectively [11]. In terms of recurrence rate, a Danish study evaluated patients at a mean follow-up time of 7 years and reported 78% of patients experienced a recurrence, with half of this group becoming symptomatic within the first month [51]. A study that evaluated 40 patients treated with neurectomy, of whom 28 had previously undergone radiofrequency lesions, 5 of these patients had recurrence after 2 years and were successfully treated with repeat neurectomy [52]. Thus, it can be inferred that mean follow-up time for neurectomy patients in the setting of trigeminal neuralgia is incredibly variable, with sparse reliable data to support findings.
\nIndications:
\nMedically refractory trigeminal neuralgia in patients who desire minimally invasive procedures or are unable to general anesthesia (frail, elderly, or medically unstable patients)
Patients with contraindications to major neurosurgery
Patient preference for minimally invasive procedure, as this can be performed outpatient without anesthesia [12]
Contraindications: patients with pre-existing disease that may be exacerbated by exposure to BTX-A (e.g., myasthenia gravis, motor neuron disease, or Lambert-Eaton syndrome), superficial skin infection on treatment site, or the use of drug within 7 days of BTX-A injection that may adversely affect neuromuscular junction (e.g., quinine, aminoglycosides, and penicillamine) [12].
\nApproach: the number of units and sites to be injected varies per patient. One study approach used a 0.5-mL syringe with 5-/16-inch, 30-gauge needle for subcutaneous injection [53]. Other studies describe injection of unstandardized dosages intramuscularly in the region of the zygomatic arch or masseter [54]. A randomized, double-blind study showed no difference between 25 and 75 units, as both had sustained pain relief at 8 weeks postinjection [12]. Whereas, doses as large as 60 and 40 units of BTX-A diluted in 2.5-mL saline, administered to the external nasal trigger zone and right mental nerve region, respectively, showed sustained relief at 5 months [55].
\nComplications: as BTX-A injections are generally considered safe; few complications such as short-term (<6 weeks) asymmetry in the injection area during dynamic movement and transient facial edema (<5 days) have been noted [12]. In patients currently on a pharmacologic regimen for trigeminal neuralgia (either analgesic or prophylactic), no adverse effects were noted when combined with BTX-A injections [53].
\nOutcome: adequate pain control in patients treated with BTX-A has varied between 90 days [15] and 5 months [55]; however, results are largely based on case reports or studies with small sample size. One small, randomized, open-ended study with eight participants underwent BTX-A injections for intractable trigeminal neuralgia found a mean baseline pain score of 4 on VAS, which was reduced to 1.19 at 6 months following treatment [54]. Another study with 13 patients treated with BTX-A and followed at 10-, 20-, 30-, and 60-day postinjection reported pain relief and reduced need for pharmacotherapy in all patients over the course of their study [53]. However, this is often the case where follow-up periods in patients treated with BTX-A and other surgical interventions for their trigeminal neuralgia are not long enough to reliably deduce long-term efficacy.
\nIndications:
\nMedically refractory disease in patients limited to the supraorbital, infraorbital, and mental nerves and potentially the long buccal and lingual nerves
Elderly or medically compromised patients who are unfit for surgery
Patient preference for minimally invasive procedure [16]
Contraindications: negligible contraindications have been reported.
\nApproach: involved nerve branches are identified with test doses of local anesthesia. Upon complete pain abolition, cryotherapy blockades can proceed in an outpatient setting under local anesthesia and intravenous sedation [56].
\nThe approach to the inferior dental nerve cryoblockade utilizes C-arm radiographic guidance, image intensifier, and nerve stimulator on the cryoprobe. Lateral oblique films confirm accurate needle placement prior to alcohol injection around the inferior dental nerve [16].
\nThe approach of cryoblockade to other nerves such as the infraorbital, mental, and inferior alveolar nerves begins with the following incisions: intraoral Caldwell-Luc, intraoral low buccal in the premolar region, and intraoral Ginwalla, respectively. Exposed nerves are frozen with nitrous oxide via cryoprobe at a temperature of −700°C for 2-minute freezing cycles followed by 5 minutes of thawing. This is repeated three times [57].
\nComplications: potential complications associated with cryoblockade are infection, swelling, trismus, and paresthesia ranging from complete numbness or altered sensation, up to 3 months postoperatively [56]. In a study with 145 patients treated with cryotherapy, 58 patients experienced symptoms of atypical facial pain (symptoms described as burning, pins and needles, or dull ache) which responded to a short course of tricyclic antidepressants [58].
\nOutcome: duration of pain relief ranges from 6 [56] to 20 months, depending on the treated nerve. A study that looked at 145 patients with paroxysmal trigeminal neuralgia treated with cryotherapy demonstrated a mean relief period of 13 months for long buccal nerve, 17 months for mental, and 20 months for infraorbital nerves [58]. Although well tolerated by patients, multiple sessions of cryotherapy may be needed to achieve durable pain relief, due to regenerative capacity of nerves, albeit subsequent injections are rarely as effective as the first [58]. In a study that looked at 145 patients treated by cryotherapy, 56% of patients needed more than 1 treatment, with a number of patients needing up to 11 procedures. Of the 145 patients, pain relief at 6 months was achieved in half of the group, with only 27% pain-free at 1 year [58].
\nAs medical treatment with anticonvulsants has been the cornerstone of first-line management of trigeminal neuralgia, surgical interventions have been developed for more involved cases. Patients who continue to experience pain with three failed drug trials or encounter an intolerable side-effect profile from medications are generally considered for surgical evaluation. However, only patients who are deemed surgically fit per medical status/age shall be recommended for operative procedures.
\nDiagnostic blocks are fundamental in the surgical evaluation of a patient with medically refractory trigeminal neuralgia. Trigeminal nerve and Gasserian ganglion blocks confirm the clinical diagnosis before the patient can be considered for subsequent intervention. Additional nerve blocks administered to a terminal branch of the trigeminal nerve or at the Gasserian ganglion with therapeutic intent may offer adequate pain control for some patients. Most commonly, patients are treated with percutaneous rhizotomies (radiofrequency, glycerol, and balloon compression), stereotactic radiosurgery, and microvascular decompression for more sustained pain relief with minimal postoperative complications. Other procedures that have fallen out of favor but are still used are peripheral neurectomy include botulinum toxin type-A injections and cryotherapy on a case-by-case basis. It is thought that patients opting for modalities targeting peripheral branches of the trigeminal nerve, rather than the ganglion or nerve root, are more likely to become symptomatic as pain may break through in other nerves not previously treated [59].
\nUltimately, all surgical candidates are thoroughly counseled on available interventions and their individual risk-benefit profiles before undergoing further treatment. As all surgical techniques have demonstrated efficacy in the treatment of medically refractory trigeminal neuralgia, patient input on procedure invasiveness, repeatability, accessibility, and cost are all important factors to consider in choosing a treatment. More studies with larger sample size, randomized controlled design, and stricter diagnostic criteria for patients are needed to reliably comment on the prognostic value of each of the aforementioned treatment options. Regardless, it is with a patient-centric, multidisciplinary approach from all physicians involved in a patient’s care that the best treatment plan can be implemented for those with intractable trigeminal neuralgia.
\nGlobalization and sustainability has made life not only feasible but challenging too. Materials which are obtained from resources that are renewable tend to be suitable for sustainable development. These materials have a global value since they can act as a counter to the various environmental issues such as waste management problems, increase in global warming, the constant rise in oil prices and the deteriorating fossil resources. Different varieties of renewable materials have been used for many years across the food, furniture, and textile industry such as vegetable oils, starch and cellulosic based polymers, cotton, natural fibers, silk, and wool [1]. On the other hand, it is only recently that these materials have gained interest as a potential alternative to synthetic based polymers for different kinds of industrial applications like automotive, films, construction, paper coating, packaging and biomedical applications. The synthetic polymers pose many drawbacks towards the environment in ways such as the amount of vapors and toxic gases released after incineration and improper disposal, there has been more research work being focused on new green biopolymeric materials and their effective utilization in green composite applications.
Over the years, bioproducts have gained commercial importance. Chemical processes such as production of ‘green’ ethylene through dehydration of ethanol and further production of ‘green’ polyethylene, polyvinyl chloride and some other plastics have been reviewed. Certain technological developments have also been used to enhance certain material properties of polymers that are bio-based; an example of which is development of heat resistant polylactic acid, thereby allowing extensive applications. Bio-fibers with stable properties are being produced over time by optimizing plants. There have been numerous applications occurring lately such as packaging, biomedical products, textile, agriculture, construction where these biodegradable biopolymers and biocomposites are an appropriate sustainable replacement [1, 2].
Biospecific and biosimulation materials cover the whole field of biofunctional materials. Biofunctional materials are synthesized from the view point of functionality design. The functionality design is based on determination of the polymer structure that realizes the desired functionality and property of materials, and on exploration of the appropriate method of polymer synthesis, polymer reaction, and polymer modification that yields the designed polymer structure.
A composite is a structural material which includes a combination of different entities that are insoluble in each other and are mixed together at a macroscopic level [1]. One of the constituents is known as the reinforcing phase and the other one into which the reinforcing phase is embedded is called the matrix (Figure 1). The reinforcing phase materials are found to be made of varying textures that can be in the form of flakes, fibers or particles [2]. On the other hand, the matrix phase materials are generally made of continuous phases [3, 4]. One of the most common examples of naturally found composites includes wood (cellulose fibers are reinforced into lignin matrix) and bones (reinforcements of bone-salt plates consisting of phosphate and calcium ions are added to the soft collagen matrix). Each constituent of the composite has different roles giving rise to a strong structural material. The matrix component within composite materials gives a defined shape, protects the reinforcements from environmental damage, transfers loads to reinforcing phase and improves the toughness of material [5]. The reinforcements in composites get strength from the matrix, stiffness and other mechanical properties; contain a high thermal expansion coefficient, high conductivity and good thermal transport [6].
Concept of biocomposite.
Composite materials have various advantages that can be used for different applications. Composite materials are very lightweight and have a low density making it easier to mold into complex forms and modules like Modular construction. These materials have a high specific stiffness, creep resistance and strength with an improved friction and wear properties. Composites have low thermal expansion and electrical conductivity giving rise to good dumping properties and good fatigue resistance. These composite materials are easily bondable, have lower radar visibility and have the capability to store and release internal energy, leading to a lower overall system cost. Composite products are known to have excellent heat sink properties. The mechanical properties such as strength-weight ratio, stiffness-weight ratio and fatigue properties of the composite products are better than most of the common engineering metals like steel or aluminum. With improved corrosion resistance and a high resistance to impact damage, the composites have indefinite shelf life just like metals. Composites can be used to obtain a varied combination of properties which cannot be attained in other materials such as polymers, ceramics or metals alone. One of the major advantages of composites is the ability to incorporate sensors into the matrix which can be used to monitor and correct the material performance, giving rise to a range of applications towards Smart composites (Table 1).
The properties of bio composites | Characteristics | ||
---|---|---|---|
Mechanical | Physical | Chemical/Biological | |
Intrinsic properties (based on chemical composition) | Flow limit Tensile/compression resistance Poisson ratio Electricity modulus | Density Form and geometry Color esthetics | Flow limit Tensile/compression resistance Poisson ratio Electricity modulus |
Behaviour | Breaking strength Fatigue resistance Crack resistance Rigidity Wear resistance Shock resistance | Coefficient of thermal expansion Electrical conductivity Refractive index | Biofunctionality Bioinert Bioactive Biostability Biodegradation |
Surface properties | Bending modulus Hardness Shearing modulus Bending resistance Shearing resistance | Surface topology Texture Roughness Hardness Coefficient of friction | Adhesion |
Processing | Reproducibility, can be sterilized, Packaging feature |
Biocomposite properties different categories.
Though composite materials possess a huge number of advantages, there are certain limitations to the same. The composite materials are known to have a low ductility and have certain temperature limits. Due to the presence of more than one component, the material can be subjected to solvent or moister attack. The matrix component of the composite is generally weak giving rise to low toughness, higher brittleness, higher susceptibility to damage and weak transverse properties. The composite materials are difficult to attach onto other materials, requiring the need of additional materials such as fasteners. Repairing composites can introduce many other problems, making the disposal and reuse of composites very difficult. Composites have a limited shelf-life discouraging its usage for long term applications. Composite materials have a very complicated manufacturing and fabrication process requiring sophisticated tools and high cost raw materials. Composite materials require refrigerated transport and storage. In most of the cases, hot curing is necessary which takes time and requires special tools; overall adding to the high expense of producing composite materials.
Though smart materials and composite materials sound similar, they are fundamentally different. Smart materials have a minimum dual function whereas composite materials consist of dual or more components/phases (thereby being called hybrid materials).
Smart materials serve various functions within one product, some common instances of which include actuator/sensor ability in addition to having form, having the ability to bear structural weight without breaking. The classic example having huge industrial value is Nitinol, an alloy of Nickel-Titanium. This material can be mechanically deformed like bent and can be returned to the pre-deformed shape by heating the material. Another good example of a smart material will be Lead-Zirconate-Titanate (PZT) which is a ceramic that mechanically deforms when an electrical potential is generated. PZT alloy has found an actuator application because a reverse potential produces expansion of the material geometrically (Figure 2).
Classification of composite materials with respect to matrices.
As mentioned previously, composites consist of many different materials in two or more phases, which allow us to specifically engineer the composites to produce desired properties like enhancing mechanical stress, conductivity, etc. The compound will be considered a composite material as long as the base materials retain their physical morphology and characteristics.
Electrical, Electronics |
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Buildings and Public Works |
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Road and Rail Transports |
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Marine and Cable Transports |
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Air and Space Transports |
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Mechanical applications |
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Sports and Recreation |
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Biocomposite materials are a hybrid of a reinforcement material made of natural fibers (plants or from cellulose derivatives) and a matrix material (resin). The resin is generally a polymer matrix made of either renewable or non-renewable resources. The natural fibers, also called biofibres, can be made from wood fibers (softwood and hardwood) or from non-wood fibers (hemp, wheat, flax, jute, sisal, kenaf, etc).
The classification of composite materials can be done into different classes based on the phases:
One of the most commonly used classifications is based on the material of the matrix. The major classes include Organic Matrix Composites (OMCs), Ceramic Matrix Composites (CMCs) and Metal Matrix Composites (MMCs).
The class Organic Matrix Composite is a more general term which includes subclasses, including Carbon matrix composites or carbon–carbon composites and Polymer Matrix Composites (PMCs).
Another commonly used classification is based on the material of the reinforcement used. The classes are namely fiber reinforced composites, particulate composites, and structural composites.
Fiber Reinforced Composites, as the name suggests, are made from fibers that are embedded into the matrix material. The Fiber Reinforced composites (FRP) can be further classified into 2 types - Short-fiber reinforced composites (those containing discontinuous fibers) and Long-fiber reinforced composites (those with continuous fibers). A fiber composite can be called a discontinuous one when the properties of the material vary according to the fiber length. On the other hand, the composite can be called continuous fiber if further increase in the fiber length has zero effect on the elastic modulus of the composite. The fiber particles are small in diameter. Although these fibers tend to have really good tensile properties, they can be bent easily when pushed axially. Hence, to prevent buckling and bending of the individual fibers, they must be constantly supported externally.
Structural Composites consist of different layers of material with different orientations, held intact because of the matrix. Sandwich structures and Laminates are important examples in this category.
Particulate Composites are made of a dispersed phase, which is in the form of particles, embedded in a matrix body. The dispersed phase particles may have preferred orientation (flakes) or have random orientation (powder form). Some examples that fall under this category include concrete and wood particle boards.
The major functions of polymer based matrices in biocomposites are to permit the transference of tension between fibers, to prevent mechanical abrasion of surface fibers and to act as an effective barrier against hostile environments. The structural composites’ tensile load carrying capacity is influenced by the function of the matrix. Key component of the biocomposite is the matrix or binding agent. Polymer, metallic, ceramic, and carbon are the various kinds of matrices generally used. Presently, polymer based matrices are highly utilized in industrial applications and these polymer resins are available in two kinds [6]:
Thermosetting: Upon heating application, the thermoset being a firm and inflexible cross linked component does not get molded [7]. They are pretty rigid and non-elastic in nature unlike elastomers and thermoplastics. Natural fiber composites use different kinds of polymers as matrices. Epoxy based resins such as fiberglass, phenols, polyamides, acids etc., are the frequently used thermoset polymers [3]. Due to their unique properties and their use in various applications, unsaturated polyesters are most preferred to be used as a matrix in a biocomposite. Owing to the polymer benefits such as room temperature curing property, decent mechanical characteristics, and clearness, they are manufactured more industrially in comparison to thermoplastic based resins. Studies have stated about cellulose fibers being reinforced with polyesters [8]. Few other systems which have similar potential are polyesters combined with pineapple leaf fibers, sisal, jute, coir, straw etc. [4].
Thermoplastics: These polymers tend to mold when heat is applied and can regain their shape after cooling. Their properties do not get affected even if they are reheated and reshaped numerous times. Polymethacrylate, high density polyethylene, polyvinyl chloride, low density polyethylene, polystyrene etc. remain the commonly used thermoplastics as matrix in biocomposites.
The kinds of thermoplastics that can be utilized for biocomposites are the ones whose processing temperature does not exceed above 230°C such as polyolefins, polypropylene, and polyethylene. Some of the technical based thermoplastics which need temperature > 250°C for processing cannot be utilized for creating biocomposites. The fibers have to be degraded initially for further use. Examples: polyesters, polyamides, and polycarbonates.
Reinforced phase plays a very important role in determining the overall properties of the composite. Natural fibers can be broadly classified into 3 categories: Plant - based fibers, Animal - based fibers, Mineral - based fibers. One of the commonly used reinforcements is the mineral - based fibers, including carbon, fiberglass and Aramid [9].
Carbon fibers are unidirectional reinforcements. Due to this unique structural property of Carbon fibers, they can be structured in a way wherein the composite is stronger in a particular direction making it easier for the composite to bear heavy loads. The physical properties of carbon fiber can be modified by controlling different parameters such as the alignment of fiber, nature of the matrix, fiber-matrix volume fraction and the molding conditions.
Glass is known to be extensively used as reinforcement in most of the polymeric matrix composites (PMCs). The main advantages observed during usage of glass fibers include low cost of production, good chemical resistance, high tensile strength, and excellent insulating properties.
Kevlar fibers are known to belong to highly crystalline aramid (aromatic amide) fibers. These fibers have a very high ratio of tensile strength to weight and the lowest specific gravity among the currently used reinforcing fibers. Due to their superior mechanical properties, they tend to find major applications in marine and aerospace industries.
Boron fibers are especially known for having extremely high tensile modulus. Another prominent feature of these fibers is the buckling resistance that results in a high compressive strength for boron fiber reinforced composites (Figures 3 and 4).
Different types of natural fibers used as reinforcement in polymer composites.
Classification of various fibers of different origin and types with examples [
Though the present composite industry majorly depends on synthetic reinforcement fibers, the use of natural fibers have been gaining attention in recent years for academic as well as industrial purposes. In the present time, many different plant-based natural fibers have been explored and researched upon to identify unique properties. Some of these are used in plastics as an reinforcement; some examples of which include hemp, kapok, jute straw, paper mulberry, oil palm empty fruit bunch, wood, wheat, barley, kenaf, rye, rice husk, cane (sugar and bamboo), flax, reeds, oats, sisal, grass, coir, pennywort, water hyacinth, raphia, ramie, pineapple leaf fiber, banana fiber and papyrus [5].
One of the on-demand natural fiber reinforced composite is the thermoplastic matrix containing reinforcements made of special wood fillers due to them being light in weight, possessing reasonable stiffness and strength. Natural fibers have shown immense potential to be used in replacement to non-renewable materials due to their low cost, promising thermoplastic properties, minimal to zero health hazards and can act as a solution for environmental pollution [10, 12]. Some plant proteins have also been used as reinforcements. One such example is the wheat gluten, which when plasticized have a unique ability to form a strong cohesive blend with high viscoelastic properties [13, 14, 15]. Due to these distinctive properties, wheat gluten has been tremendously used in the making of packaging materials and edible biodegradable films.
Composites based on biologically degradable polyester amide and different plant fibers like flax and cottons, have been investigated thoroughly. These composites generally possess good mechanical properties, such as high biodegradability and good water resistance. Kenaf is a biodegradable and environmentally friendly crop belonging to the hibiscus family (
Plant - based fibers, also called vegetable fibers, are classified into different types based on their origin [17]. The characteristics of plant fibers majorly depend on certain factors such as the type of plant used, the area where it is grown, the plant’s botanical age, and the protocol of extraction used. One such example is coir which is known to be a tough and hard fiber with multicellular layers, with the central portion called as “lacuna”. Another familiar example is Sisal leaf fibers which are observed to have a high mechanical strength. Pineapple leaf fiber extracts are soft and are rich in cellulose. Oil palm fibers, having a similar cellular structure to coir, are hard and tough. Cellulose molecules make the major constituents in most of these plant fibers. The hydroxyls groups present in the basic unit of cellulose have the ability to form intra-molecular hydrogen bonds where the bonding is within the macromolecule, or intermolecular hydrogen bonding between two different cellulose macromolecules and or form hydrogen bonds with hydroxyl groups present in the atmosphere [18, 19]. It can be observed that all plant fibers have a high hydrophilicity, with their amount of retained moisture reaching about 8–13% [20]. Though cellulose is present in a huge quantity inside a plant, they also contain other natural substances such as lignin. The major role of lignin is to act as a cementing or bonding material between the cells of plant fibers. The content of lignin fibers influences a plant’s structure, its morphology and its properties.
An important property of vegetable fiber influencing its reinforcement properties is the degree of polymerization (DP). The fibers differ drastically from each other due to the presence of cellulose molecules with differing DPs. Most of these fibers generally consist of a mixture of a base polymer homolog with the configuration (C6H10O5)n. The plant fiber known to illustrate the highest DP among other plant fibers is Bast fibers, with values nearing 10,000. In the olden times, these fibers found tremendous applications as packaging materials such as gunny bags and sacks, for making ropes, as a geo-textile material, for making twines and cords, and as carpet-backing [21, 22]. The most common bast fiber found in Cannabis sativa plants is Hemp, which is a lingo cellulosic fiber, repeatedly used as reinforcement in biodegradable composites. It is used in the making of various items such as shoes, toys and clothing, due to its non-toxicity, biodegradability and its ease for recycling [23].
As mentioned earlier, natural fibers being used as reinforcement in composite materials tend to display good mechanical properties, thereby gaining a lot of attention in recent years. They are known to be fully biodegradable, renewable, environmentally friendly, cheap, available in abundance and have a low density [24]. Plant fibers are observed to be considerably light in weight when compared with mineral-based fibers. Due to their organic origins, plant fibers tend to possess high biodegradability which contributes to maintaining a healthy balance in the ecosystem. Due to the considerable low cost and high performance, these fibers can be termed as economically superior to other counterparts and can find huge applications in the industries. When natural fiber-reinforced plastics are combusted at the end of their life cycle, the amount of CO2 released from the combustion process is equal in amount assimilated during their growth [25]. Plant fibers have very low abrasivity which makes the recycling process of the composite materials much easier. Plastics reinforced with natural fibers, when used along with biodegradable polymers as matrix material, are considered to be the most environmentally friendly compounds because of their ability to be completely decomposed at the end of their life cycle [26, 27]. Natural fiber composites are used as a substitute to glass in non-structural applications. One such example is the automotive components that were initially manufactured with glass are now replaced with natural fiber reinforced composites [11]. Most of the plant fibers, when used in the unmodified form inside a composite, tend to produce unsatisfactory mechanical characteristics. To avoid this problem, the surface of plant fibers are treated with certain chemicals or compatibilizing agents prior to the fabrication of composite. The properties of these plant fibers can be further improved either by physical treatments such as corona treatment and cold plasma treatment, or by chemical treatments using peroxide, sodium hydroxide permanganate, isocyanates and maleic anhydride organosilanes [28]. In terms of mechanical properties of natural fibers, the values are quite low when compared to glass fibers or other mineral based fibers. When it comes to specific properties, especially stiffness, natural fibers values are near to those of glass fibers [29, 30]. Natural fibers have shown high tensile strength and stiffness values. Tensile strength within composites are majorly governed by the reinforcement used. Hence, natural fibers along with matrices can prove to produce the desired mechanical properties needed for the specific application [6, 9].
Biocomposites function and quality majorly relies on biofibre characteristics. On the other hand, when biofibres are used for applications related to building materials, the composites have shown some disadvantages such as possessing high moisture absorption, low modulus elasticity, faster decomposition when surrounded by basic conditions, during microbial encounter, and visible variability in mechanical characteristics. In order to overcome these limitations, natural fibers need to be thoroughly studied to produce better performing fibers in future. Even though biofibers have various advantages for their usage in composites, they do possess certain disadvantages like being incompatible with other matrices, reduced wettability etc. [31, 32]. As mentioned briefly, the physical and chemical characteristics of biofibres are determined by cell wall based polymers and their matrix component (Table 2). The major properties of the fibers such as flammability, dimensional stability and biodegradability can be directly altered using external factors such as acids, bases, and UV rays by converting the green composite into carbon dioxide and water [30]. Therefore, to effectively overcome these limitations, there is a requirement to improve biofibre properties through altering the cell wall polymers chemistry [28].
Fiber | Density (g/cm3) | Elongation (%) | Tensile Strength (MPa) | Elastic Modulus (GPa) |
---|---|---|---|---|
Hemp | 1.47 | 2–4 | 550–1110 | 70 |
Banana | 1.2 | 1.8 | 400 | 13–24 |
Ramie | 1.47 | 3.6–3.8 | 400–938 | 61.4–128 |
Flax | 1.4 | 2.7–3.2 | 500–1500 | 27.6 |
Kenaf | 1.45 | 1.6 | 930 | 53 |
Jute | 1.4 | 1.5–1.8 | 393–773 | 10–55 |
Sisal | 1.3–1.5 | 2.0–2.5 | 511–635 | 9.4–22 |
Coir | 1.2 | 30 | 287–800 | 4.0–6.0 |
Kraft | 1.5 | 4.4 | 1000 | 40 |
Cotton | 1.5–1.6 | 7.0–8.0 | 287–800 | 5.5–12.6 |
Bamboo | 1.41 | 3.5 | 593 | 18–26 |
Kapok | 1.69 | 0.7 | 100–1500 | 3–5 |
Phormium | 1.2–1.4 | 0.9 | 250–310 | 26.5 |
Pine apple | 1.1–1.3 | 1.2 | 188–308 | 11 |
Bagasse | 1.2–1.3 | 1.3 | 300–350 | 12 |
In general, for achieving a decent function of short fiber reinforced polymer composites (SFRP), the content of fiber in the composite should be considerably higher [4]. The tensile characteristics of fiber reinforced is usually affected by occurrence of fiber and other materials used in the matrix [3]. Therefore, researchers are heavily focussed on studying the biofibers used in biocomposites and how they affect it [4].
Natural fibers are generally known to be hydrophilic in nature and the polymer matrix tends to be more on the hydrophobic side. Due to this difference in their polarity, the composite material usually inclines to aggregate. There is increased water absorption as a result of hydrophilic fibers, showing a weak resistance to moisture. This further leads to producing poor tensile property reinforced composites. In addition to the basic cellulose unit, fiber surfaces contain wax coating and non-cellulosic compounds like lignin, pectin, and hemi-cellulose resulting in weak bonding among the biofibers and matrix.
Hydrophilicity being an undesirable property for obtaining natural fiber reinforced composite having good tensile properties, the fiber’s hydrophobicity needs to be increased by using surface modifications (surface treatment). The natural fibers are modified for enhancing hydrophobic nature, roughness, interface bonding among the biofibres and matrix, and wettability. The modifications of the fiber also decrease the moisture absorption of the composite which gives us enhanced tensile properties [10, 12, 16, 17, 23].
Food Industry
The two main areas having applications in this sector are food packaging and edible films. The aim of food packaging is to enhance shelf life, ensure food safety, minimize food losses, improves the organoleptic properties of food like appearance, odor, and flavor. To replace the synthetic polymers, starch based biodegradable polymers could be utilized as an effective alternative with better properties. Although, the constituents involved in synthetic starch based packaging materials aren’t fully inert. There is a possibility of migration of toxic substances into the food product which can affect humans. Due to this problem, alternative packaging materials are being studied [29, 32]. For example, investigations have led to the formation of starch or clay based nanocomposites that have shown low movement of polymeric substances, enhanced mechanical properties that can be utilized as a food packaging material. The characteristics of biodegradable films are colorless, flavorless, odorless, non-poisonous, and ecological. In low humidity conditions, these films exhibit very little penetrability to oxygen and help in increasing shelf life and quality of food product without compromising consumer acceptability. The compressed films or trays can be easily degraded by microbes as they readily dissolve in water medium. Therefore, starch based biodegradable polymers are of potential interest for food industry applications.
Agriculture
In this sector, the key applications of biocomposites are greenhouse covering, mulch film, and fertilizer controlled release materials. Agricultural films are mainly consumed. Traditional films are disposed of by landfill, recycling or incineration. These processes take a lot of time, are not cost effective and pollute the environment. The important factor in developing agriculture productions is the effective usage efficiency of fertilizers. But, the fertilizers tend to escape to the environment because of surface runoff, leaching and vaporization thereby causing economic disadvantages and environmental issues. Starch based biodegradable polymers come into the picture to overcome these limitations [2]. The biocomposite can be utilized as a fertilizer controlled release matrix to release the fertilizer in the desired way. The films can be disposed of later after plowed into the soil. Due to their use, toxic residue formation does not take place after degradation. More studies are being explored involving starch based films in this sector. For instance, bio-nanocomposites are created by merging starch based film with additives like titanium dioxide, silicate or MMT to enhance mechanical characteristics.
Medical industry
Starch based biocomposites can be utilized as an effective raw material due to their benefits such as biodegradability, biocompatibility, non-toxic, decent mechanical properties and degradation as needed.
Their usage in bone tissue engineering has been studied [22]. Structural framework support and degradation from the area of application is fastly offered by starch based biodegradable bone cements. Due to binning with bioactive particles, bone growth occurs at the bone cement interface and some amount resides because of polymer degradation. Bone tissue engineering scaffold involves the usage of these polymers. In drug delivery applications, starch based biopolymers are used. After drug depletion, this device does not have to be removed surgically. The starch based hydrogels or microspheres are used in different biomedical applications because of their novel properties like hydrophilicity, penetrability, biodegradability that mimics biological structures to some extent. Starch based biocomposites are of particular interest when it comes to biomedical applications [7, 11, 17].
There is a lot of progress happening in the current field of research and development. Due to extensive usage of petroleum products, petroleum resources are getting exhausted and this also affects the environment and water bodies due to accumulation of plastics [7]. This is a huge concern as it affects the survival of human beings and animals. Because of these limited petroleum based resources, there is an urgent need to switch over to produce biodegradable alternatives. Biodegradable plastics are being produced to replace the synthetic polymers due to excessive usage of non-renewable polymer resources. Plants and crops can be used as suitable resources that can effectively replace the existing petroleum based products [11]. Biocomposites which are biopolymers reinforced with natural or biofibers can be utilized instead of synthetic composites such as glass fiber. Scientists are eyeing different approaches by merging biofibers like sisal, hemp, flax etc. with polymer matrix to produce biocomposites [11].
Composites are anisotropic in nature according to their structure. A matrix component (resin) is usually mixed with natural fibers obtained from plant based sources or cellulose to form biocomposites. Wood based fibers and non-wood fibers such as hardwood, softwood, jute, kenaf etc. are used as biofibres. The biocomposite’s main constituent is the biofiber and it is obtained from tree, plant, or shrub sources [3]. The structure of biocomposites looks and functions similarly to living materials during the process and also enhances the strength properties of the matrix being used, thereby providing biocompatibility, for instance in forming scaffolds in bone tissue engineering. Structure and service environment are two important factors that determine the biodegradability rate in biopolymers. Natural/biofiber composites are suitable candidates as a potential replacement to the synthetic composites especially in various industries such as automotive, packaging, construction, and consumer products. It can also be used as an additive for thermoplastics. Additional investigations involve studying biological-inorganic interfaces to merge biological and inorganic materials while emphasizing on the design, production, and classification of novel amalgams [31]. Starch and cellulose are the most suitable renewable resources to create bioplastics. The cheapest source of biodegradable polymer in the marketplace today is starch and has applications in non-food industries as well. Cellulose plastics can be made by using cellulose from plant sources as an alternative to petroleum feed stocks [3, 7]. Vegetable oils have immense potential as a raw material to create biodegradable plastics, for example: plant oils and fats of sunflower, walnut, canola, sesame etc. Biocomposites created through biofibers and plant based bioplastics could be utilized in rigid packing, building, and transportation applications [3].
To manufacture products like decking, fencing, siding, window and door profiles etc., green composites are utilized. Some of the benefits obtained when biocomposites are utilized as construction materials are their low-cost, light in weight, eco-friendly, durability, and biorenewable [11].
The bio composite was made using the waste materials. Billion-ton resource assessment conducted in 2011 has predicted sufficient supply of plant residues and wastes within various price ranges. A supply of 180 million dry tons is expected at the end of 2030. When compared to primary plant residues, this supply seems low excluding animal manure. Corn stover, wheat straw accounts for at least three fourth of the residue resources whereas grains such as barley, sorghum, and wheat covers the rest. Availability of primary crop residues are enhanced by achieving continuous crop production and growth, large plots with less tillage, and no-till farming.
Green composites can be produced from different raw materials which are abundant in nature such as non-food crops and biorenewable sources. With recents trends in this particular field, biocomposite products could definitely find its place in the market across various applications. Different processing techniques and reinforcements of fibers/fillers allow the fiber at the correct price. Currently, there have been certain developments in the biopolymer industry.
In a study, the biocomposite ratio involving coconut blended with wheat husk was 15:85. Durability or toughness is affected by coconut husk due to it being fibrous in nature. Mixtures of wheat husk and water act as the matrix phase and binder. In terms of its mechanical properties, the product had displayed a strain of 26%, 7 N/mm2 tensile strength along with a stair-step stress strain curve. The sample’s performance might be because of various factors like how the axis is loaded, the relative motion among fibers through steady development across the loading axis. Crack proliferation due to interlinking of coconut husk has shown decent physical properties. A hybrid material is created by involving corn in the composite. Water absorption increases with increase in corn weight (Figure 5) [3].
Synthesis of ecofriendly biocomposite using the organic waste and analysis of water potential, elongation and tensile strength of composite material.
Construction and automotive industry are the key markets for biocomposite materials. However, new prospects and applications will arise with certain future innovations and performance enhancement. Due to the accumulation of waste generated by this industry and their harmful effect on the environment which remains a growing concern, a lot of opportunities are going to emerge in this particular sector. Instances such as off-site construction method, for better quality and effortless installation and build, eco-friendly resources are required; although, these prospects could be affected by guidelines based on the present resources. A key target would be in replacing preservative-treated wood which provides a huge market growth. By placing strict limitations on utilization of preservatives such as arsenic containing products, provides immense opportunities for biocomposites to be used in applications especially when there is a threat of microbial attack.
Biocomposites can be incorporated into certain various complex technological applications by enhancing their mechanical functions such as producing new fiber types, processing methods, addition of additives etc. Solvent spinning process when applied to liquid crystalline cellulose creates high strength fibers which has been quite a hopeful research study. Resins can be formed by changing or enhancing the content of particular triglycerides and oils in produces by using biotechnology tools. The resins if altered appropriately would be cost effective and biodegradable compared to existing ones (Figure 6). Studies are being conducted to produce cheap biodegradable resins having decent mechanical characteristics by using novel methods. If successfully produced, the synthetic complexes can be replaced with these biodegradable alternatives.
Scheme for hypothesizing for engineering and biocomposites.
Hybrid materials and products offer scope such as utilization of bio resins and bioplastics adhesives by replacing the existing fossil-based adhesives. Reclaimed fiber provides a decent opportunity to develop various eco-friendly, inexpensive products by utilizing medium density fibreboards or the watercourses of the papermaking industry. Although sufficient prospects are there for these products to be in the market, cost effectiveness is a very important factor for its commercial production and hence the marketing strategy has to be made stronger accordingly. For successful commercialization, the biocomposites should be demonstrated through widespread training and education.
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The standard method for soil salinity assessment is based on a laboratory method that is cumbersome and gives rise to limitations for data-intensive works. The use of sensors for the assessment of the apparent electrical conductivity (EC) of soils offers a way to overcome these constraints. These sensors are based on three electromagnetic phenomena, namely, electrical resistivity, electromagnetic induction, and reflectometry. Each class of sensors presents its own advantages and drawbacks. In the following chapter, these are presented along with the most popular commercial EC sensors used in nowadays agriculture, equations for the assessment of soil salinity on basis sensor measurements, some examples of application, and present and future development trends.",book:{id:"4622",slug:"new-trends-and-developments-in-metrology",title:"New Trends and Developments in Metrology",fullTitle:"New Trends and Developments in Metrology"},signatures:"Fernando Visconti and José Miguel de Paz",authors:[{id:"79081",title:"Dr.",name:"Fernando",middleName:null,surname:"Visconti",slug:"fernando-visconti",fullName:"Fernando Visconti"}]},{id:"51245",doi:"10.5772/63734",title:"THz Measurement Systems",slug:"thz-measurement-systems",totalDownloads:1610,totalCrossrefCites:6,totalDimensionsCites:11,abstract:"The terahertz (THz) frequency region is often defined as the last unexplored area of the electromagnetic spectrum. Over the past few years, the full access has been the objective of intense research efforts. Progress in this area has played an important role in opening up the possibility of using THz electromagnetic radiation (T-waves) in science and in real-world applications. T-waves are not perceptible by the human eye, are not ionizing, and have the ability to cross many non-conducting materials such as paper, fabrics, wood, plastic, and organic tissues. Moreover, the use of THz radiation allows non-destructive analysis of the materials under investigation both by study of their “fingerprint” via spectroscopic measurements and by high-resolution spatial imaging operations, exploiting the see-through capability of T-waves. Such technology can be applied in diverse areas, spanning from biology to chemical, pharmaceutical, environmental sciences, etc. In this chapter, we will present the typical architecture of measurement systems based on the THz technology, detailing what are the parameters that define their performance, the measurement methods, and the related errors and uncertainty, and focusing at the end on the use of time-domain spectroscopy for the evaluation of different material properties in this specific frequency region.",book:{id:"4622",slug:"new-trends-and-developments-in-metrology",title:"New Trends and Developments in Metrology",fullTitle:"New Trends and Developments in Metrology"},signatures:"Leopoldo Angrisani, Giovanni Cavallo, Annalisa Liccardo, Gian\nPaolo Papari and Antonello Andreone",authors:[{id:"2330",title:"Dr.",name:"Leopoldo",middleName:null,surname:"Angrisani",slug:"leopoldo-angrisani",fullName:"Leopoldo Angrisani"},{id:"179111",title:"Prof.",name:"Antonello",middleName:null,surname:"Andreone",slug:"antonello-andreone",fullName:"Antonello Andreone"},{id:"186826",title:"MSc.",name:"Giovanni",middleName:null,surname:"Cavallo",slug:"giovanni-cavallo",fullName:"Giovanni Cavallo"},{id:"186827",title:"Dr.",name:"GianPaolo",middleName:null,surname:"Papari",slug:"gianpaolo-papari",fullName:"GianPaolo Papari"},{id:"186828",title:"Prof.",name:"Annalisa",middleName:null,surname:"Liccardo",slug:"annalisa-liccardo",fullName:"Annalisa Liccardo"}]},{id:"49823",doi:"10.5772/60442",title:"Microwave Power Measurements: Standards and Transfer Techniques",slug:"microwave-power-measurements-standards-and-transfer-techniques",totalDownloads:2151,totalCrossrefCites:5,totalDimensionsCites:5,abstract:"In this chapter, precision power measurement, which is probably the most important area in RF and microwave metrology, will be discussed. Firstly, the background of RF and microwave power measurements and standards will be introduced. Secondly, the working principle of primary power standard (i.e., microcalorimeter) will be described, followed by the discussions of direct comparison transfer technique. Finally, there will be some discussions about the performance evaluation and uncertainty estimation for microwave power measurements.",book:{id:"4622",slug:"new-trends-and-developments-in-metrology",title:"New Trends and Developments in Metrology",fullTitle:"New Trends and Developments in Metrology"},signatures:"Xiaohai Cui, Yu Song Meng, Yueyan Shan and Yong Li",authors:[{id:"100680",title:"Dr.",name:"Yueyan",middleName:null,surname:"Shan",slug:"yueyan-shan",fullName:"Yueyan Shan"},{id:"135408",title:"Dr.",name:"Xiaohai",middleName:null,surname:"Cui",slug:"xiaohai-cui",fullName:"Xiaohai Cui"},{id:"173971",title:"Dr.",name:"Yu Song",middleName:null,surname:"Meng",slug:"yu-song-meng",fullName:"Yu Song Meng"}]},{id:"51241",doi:"10.5772/63547",title:"Innovative Theoretical Approaches Used for RF Power Amplifiers in Modern HDTV Systems",slug:"innovative-theoretical-approaches-used-for-rf-power-amplifiers-in-modern-hdtv-systems",totalDownloads:1330,totalCrossrefCites:4,totalDimensionsCites:4,abstract:"The essential purpose of this chapter is to introduce theoretical and numerical approaches that can be used for modeling nonlinear effects that appear intrinsically in the design of power amplifiers that have been used widely in many modern high-density television (HDTV) architectures. Important effects like the pre-distortion using adaptive techniques, with distinct characteristics like amplitude, phase, and frequency, as well as, their specific nature such as AM/AM, AM/PM, PM/AM, and PM/PM, and constitute one of the main directions of this research. All theoretical and technological approaches have been supported by a consistent set of numerical data performed with one of the most important platform of simulations used in the great area of Radio Frequency (RF) and Microwave structures. As a direct application, we are introducing some efficient processes that can be used for the characterization of RF systems with a set of consistent laboratorial measures that permit us to visualize the effective cost and a complete architecture for the characterization of high-power amplifiers. With the continuous and innovative technological demand that is imposed by the international marketing has a great importance to find versatile systems that are capable of measuring several amplifier characteristics, as gain, output power, inter-modulation distortion of different signals, efficiency, current, and temperature that constitute another direction of research that has been demanded strongly for news advanced technologies used widely in modern HDTV systems.",book:{id:"4622",slug:"new-trends-and-developments-in-metrology",title:"New Trends and Developments in Metrology",fullTitle:"New Trends and Developments in Metrology"},signatures:"Daniel Discini Silveira, Marcos Paulo de Souza Silva, Marcel Veloso Campos and Maurício Silveira",authors:[{id:"179507",title:"Dr.",name:"Mauricio",middleName:null,surname:"Silveira",slug:"mauricio-silveira",fullName:"Mauricio Silveira"},{id:"179508",title:"Dr.",name:"Daniel",middleName:null,surname:"Discini Silveira",slug:"daniel-discini-silveira",fullName:"Daniel Discini Silveira"},{id:"179792",title:"Dr.",name:"Marcos Paulo De Souza",middleName:null,surname:"Silva",slug:"marcos-paulo-de-souza-silva",fullName:"Marcos Paulo De Souza Silva"},{id:"180084",title:"Dr.",name:"Marcel Veloso",middleName:null,surname:"Campos",slug:"marcel-veloso-campos",fullName:"Marcel Veloso Campos"}]},{id:"49840",doi:"10.5772/60467",title:"Silent Speech Recognition by Surface Electromyography",slug:"silent-speech-recognition-by-surface-electromyography",totalDownloads:1782,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"For some time, new methods based on a different than acoustic signal analysis are used for speech recognition. The purpose of nonacoustic signals is to allow silent communication. One of these methods based on the electromyography signal is generated by the human speech articulation system. This article presents a device for electromyographic (EMG) signal acquisition and the first measurements from its use.",book:{id:"4622",slug:"new-trends-and-developments-in-metrology",title:"New Trends and Developments in Metrology",fullTitle:"New Trends and Developments in Metrology"},signatures:"Andrzej B. Dobrucki, Piotr Pruchnicki, Przemysław Plaskota, Piotr Staroniewicz, Stefan Brachmański and Maciej Walczyński",authors:[{id:"173718",title:"Prof.",name:"Andrzej",middleName:null,surname:"Dobrucki",slug:"andrzej-dobrucki",fullName:"Andrzej Dobrucki"},{id:"173719",title:"Dr.",name:"Przemysław",middleName:null,surname:"Plaskota",slug:"przemyslaw-plaskota",fullName:"Przemysław Plaskota"},{id:"173720",title:"Dr.",name:"Piotr",middleName:null,surname:"Pruchnicki",slug:"piotr-pruchnicki",fullName:"Piotr Pruchnicki"},{id:"173721",title:"Dr.",name:"Stefan",middleName:null,surname:"Brachmański",slug:"stefan-brachmanski",fullName:"Stefan Brachmański"},{id:"173722",title:"Dr.",name:"Piotr",middleName:null,surname:"Staroniewicz",slug:"piotr-staroniewicz",fullName:"Piotr Staroniewicz"},{id:"173724",title:"MSc.",name:"Maciej",middleName:null,surname:"Walczyński",slug:"maciej-walczynski",fullName:"Maciej Walczyński"}]}],mostDownloadedChaptersLast30Days:[{id:"49823",title:"Microwave Power Measurements: Standards and Transfer Techniques",slug:"microwave-power-measurements-standards-and-transfer-techniques",totalDownloads:2151,totalCrossrefCites:5,totalDimensionsCites:5,abstract:"In this chapter, precision power measurement, which is probably the most important area in RF and microwave metrology, will be discussed. Firstly, the background of RF and microwave power measurements and standards will be introduced. Secondly, the working principle of primary power standard (i.e., microcalorimeter) will be described, followed by the discussions of direct comparison transfer technique. Finally, there will be some discussions about the performance evaluation and uncertainty estimation for microwave power measurements.",book:{id:"4622",slug:"new-trends-and-developments-in-metrology",title:"New Trends and Developments in Metrology",fullTitle:"New Trends and Developments in Metrology"},signatures:"Xiaohai Cui, Yu Song Meng, Yueyan Shan and Yong Li",authors:[{id:"100680",title:"Dr.",name:"Yueyan",middleName:null,surname:"Shan",slug:"yueyan-shan",fullName:"Yueyan Shan"},{id:"135408",title:"Dr.",name:"Xiaohai",middleName:null,surname:"Cui",slug:"xiaohai-cui",fullName:"Xiaohai Cui"},{id:"173971",title:"Dr.",name:"Yu Song",middleName:null,surname:"Meng",slug:"yu-song-meng",fullName:"Yu Song Meng"}]},{id:"50396",title:"Electrical Conductivity Measurements in Agriculture: The Assessment of Soil Salinity",slug:"electrical-conductivity-measurements-in-agriculture-the-assessment-of-soil-salinity",totalDownloads:4382,totalCrossrefCites:9,totalDimensionsCites:21,abstract:"Soil salinity is an important issue constraining the productivity of irrigation agriculture around the world. The standard method for soil salinity assessment is based on a laboratory method that is cumbersome and gives rise to limitations for data-intensive works. The use of sensors for the assessment of the apparent electrical conductivity (EC) of soils offers a way to overcome these constraints. These sensors are based on three electromagnetic phenomena, namely, electrical resistivity, electromagnetic induction, and reflectometry. Each class of sensors presents its own advantages and drawbacks. In the following chapter, these are presented along with the most popular commercial EC sensors used in nowadays agriculture, equations for the assessment of soil salinity on basis sensor measurements, some examples of application, and present and future development trends.",book:{id:"4622",slug:"new-trends-and-developments-in-metrology",title:"New Trends and Developments in Metrology",fullTitle:"New Trends and Developments in Metrology"},signatures:"Fernando Visconti and José Miguel de Paz",authors:[{id:"79081",title:"Dr.",name:"Fernando",middleName:null,surname:"Visconti",slug:"fernando-visconti",fullName:"Fernando Visconti"}]},{id:"51435",title:"Objectifying the Subjective: Fundaments and Applications of Soft Metrology",slug:"objectifying-the-subjective-fundaments-and-applications-of-soft-metrology",totalDownloads:1721,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"The aim of the interdisciplinary research was to facilitate the understanding of a specific topic passing by different disciplinary perspectives. Soft metrology is the perfect example of a scientific field that needs that sort of approach. Seeking to provide a reproducible basis for qualifying and quantifying what are essentially ‘soft’ measurements (subject to human perception and interpretation) is a particularly challenging scientific endeavour. This chapter presents a theoretical overview of main concepts around soft metrology and, in the second instance, proposes a mathematical model for the measurement of a soft measurand through a dedicated index (IPER—influence on performance index).",book:{id:"4622",slug:"new-trends-and-developments-in-metrology",title:"New Trends and Developments in Metrology",fullTitle:"New Trends and Developments in Metrology"},signatures:"Laura Rossi",authors:[{id:"187245",title:"Dr.",name:"Laura",middleName:null,surname:"Rossi",slug:"laura-rossi",fullName:"Laura Rossi"}]},{id:"50379",title:"Uncertainty of Measurement in Medical Laboratories",slug:"uncertainty-of-measurement-in-medical-laboratories",totalDownloads:3804,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"The “Guide to the Expression of Uncertainty in Measurement” (GUM) is not systematically used in medical laboratories, for what the laboratorian should understand the Uncertainty Approach and its importance to recognize the level of realism of results. This chapter presents, discusses, and recommends the models fulfilling GUM principles. An example is given to a single test for an easier understanding of the determination of measurement uncertainty. All the practice uses a freeware. Results with larger measurement uncertainty intervals have a significant probability of being unrealistic, arising a high risk of the uncorrected clinical decision. A flow chart to the selection of models for the determination of measurement uncertainty in a medical laboratory is recommended.",book:{id:"4622",slug:"new-trends-and-developments-in-metrology",title:"New Trends and Developments in Metrology",fullTitle:"New Trends and Developments in Metrology"},signatures:"Paulo Pereira",authors:[{id:"178637",title:"Dr.",name:"Paulo",middleName:null,surname:"Pereira",slug:"paulo-pereira",fullName:"Paulo Pereira"}]},{id:"51241",title:"Innovative Theoretical Approaches Used for RF Power Amplifiers in Modern HDTV Systems",slug:"innovative-theoretical-approaches-used-for-rf-power-amplifiers-in-modern-hdtv-systems",totalDownloads:1330,totalCrossrefCites:4,totalDimensionsCites:4,abstract:"The essential purpose of this chapter is to introduce theoretical and numerical approaches that can be used for modeling nonlinear effects that appear intrinsically in the design of power amplifiers that have been used widely in many modern high-density television (HDTV) architectures. Important effects like the pre-distortion using adaptive techniques, with distinct characteristics like amplitude, phase, and frequency, as well as, their specific nature such as AM/AM, AM/PM, PM/AM, and PM/PM, and constitute one of the main directions of this research. All theoretical and technological approaches have been supported by a consistent set of numerical data performed with one of the most important platform of simulations used in the great area of Radio Frequency (RF) and Microwave structures. As a direct application, we are introducing some efficient processes that can be used for the characterization of RF systems with a set of consistent laboratorial measures that permit us to visualize the effective cost and a complete architecture for the characterization of high-power amplifiers. 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