Effect of culture media and incubators on zygote development.
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More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"4610",leadTitle:null,fullTitle:"Muscle Cell and Tissue",title:"Muscle Cell and Tissue",subtitle:null,reviewType:"peer-reviewed",abstract:"In order to complete tissue regeneration, various cells such as neuronal, skeletal, smooth, endothelial, and immune (e.g., macrophage) interact smoothly with each other. This book, Muscle Cells and Tissues, offers a wide range of topics such as stem cells, cell culture, biomaterials, epigenetics, therapeutics, and the creation of tissues and organs. Novel applications for cell and tissue engineering including cell therapy, tissue models, and disease pathology modeling are discussed. The book also deals with the functional role of autophagy in modulating muscle homeostasis and molecular mechanism regulating skeletal muscle mass. The chapters can be interesting for graduate students, postdocs, teachers, physicians, and for executives in biotech and pharmaceutical companies, as well as researchers in the fields of molecular biology and regenerative medicine.",isbn:null,printIsbn:"978-953-51-2156-5",pdfIsbn:"978-953-51-4218-8",doi:"10.5772/59347",price:139,priceEur:155,priceUsd:179,slug:"muscle-cell-and-tissue",numberOfPages:486,isOpenForSubmission:!1,isInWos:1,isInBkci:!0,hash:"f2719cb06d2a1327298528772eacec55",bookSignature:"Kunihiro Sakuma",publishedDate:"September 2nd 2015",coverURL:"https://cdn.intechopen.com/books/images_new/4610.jpg",numberOfDownloads:33170,numberOfWosCitations:39,numberOfCrossrefCitations:21,numberOfCrossrefCitationsByBook:1,numberOfDimensionsCitations:52,numberOfDimensionsCitationsByBook:3,hasAltmetrics:1,numberOfTotalCitations:112,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 1st 2014",dateEndSecondStepPublish:"October 22nd 2014",dateEndThirdStepPublish:"January 26th 2015",dateEndFourthStepPublish:"April 26th 2015",dateEndFifthStepPublish:"May 26th 2015",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,8,9",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"173502",title:"Dr.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/173502/images/system/173502.jpg",biography:"Associate professor Kunihiro Sakuma, Ph.D., currently works at the Research Center for Physical Fitness, Sports and Health in Toyohashi University of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded sports science diploma in 1995 by the University of Tsukuba and started scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. His interest later was turned to the molecular mechanism and the attenuating strategy of sarcopenia (age-related muscle atrophy). Preventing sarcopenia is important for maintaining a high quality of life in the aged population. His opinion is to attenuate sarcopenia by improving autophagic defect using nutrient- and pharmaceutical-based treatments.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Toyohashi University of Technology",institutionURL:null,country:{name:"Japan"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"980",title:"Tissue Engineering and Regenerative Medicine",slug:"tissue-engineering-and-regenerative-medicine"}],chapters:[{id:"48851",title:"Vascular Smooth Muscle as a Therapeutic Target in Disease Pathology",doi:"10.5772/60878",slug:"vascular-smooth-muscle-as-a-therapeutic-target-in-disease-pathology",totalDownloads:1723,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:0,abstract:"Our circulatory system is composed of numerous elements that are responsible for transport of blood and delivery of essential nutrients and gases to vital downstream tissues. Among these components that make up our circulation is vascular smooth muscle (VSM), the primary muscular and contractile element of blood vessels and regulator of many blood vessel functions. This is of particular importance as cardiovascular disease (CVD), the number one killer of individuals in America and worldwide, is primarily vascular in origin. Logically, identifying and characterizing feasible targets that could control CVD are highly appealing and much desired. With this in mind and given its centrality in control of vascular physiology, VSM has gained wide attention as a plausible target to combat elements of CVD. This book chapter focuses on VSM as a potential therapeutic target against CVD and will provide overview of vascular anatomy and physiology and brief discussions about the pivotal roles of VSM in CVD pathology, the influence of abnormal blood flow mechanics and hemodynamics in CVD, neural control of VSM and the vasculature, and possible novel cellular and molecular signaling targets that could be used to control and/or minimize CVD. This chapter hopes to serve as a valuable resource for basic and applied scientists as well as clinicians interested in understanding the crucial roles that VSM plays in vessel physiology and pathology.",signatures:"Andrew W. Holt and David A. Tulis",downloadPdfUrl:"/chapter/pdf-download/48851",previewPdfUrl:"/chapter/pdf-preview/48851",authors:[{id:"138308",title:"Prof.",name:"David",surname:"Tulis",slug:"david-tulis",fullName:"David Tulis"},{id:"173772",title:"Mr.",name:"Andrew",surname:"Holt",slug:"andrew-holt",fullName:"Andrew Holt"}],corrections:null},{id:"48338",title:"Vascular Wall-Resident Multipotent Stem Cells within the Process of Vascular Remodelling",doi:"10.5772/60561",slug:"vascular-wall-resident-multipotent-stem-cells-within-the-process-of-vascular-remodelling",totalDownloads:1799,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Processes of new vessel formation are central events in tissue development and repair. Therein, sprouting endothelial cells and/or endothelial progenitor cells form immature blood vessels that lack coverage by pericytes and other mural cells. Subsequently, vascular remodelling takes place, in which association with mural cells (pericytes and smooth muscle cells, SMC) stabilizes these immature vessels resulting in normalization of the vascular structures. Vascular remodelling is a dynamic and strictly regulated process; an ordered remodelling seems to be critical for proper vascular development, maintenance and stability of the vessel wall. The molecular and cellular changes associated with this process and its importance for tumour growth remain elusive. Up to now, the origin of vascular wall cells in tumours and the molecular mechanisms that govern their recruitment and association with angiogenic endothelial cells (vascular stabilization) are not well understood. There is some evidence that pericytes and SMC might originate from multipotent mesenchymal stem cells. This chapter aims to explore the role of tissue-resident multipotent stem cells of mesenchymal nature (VW-MPSCs) which putatively reside in the adventitia of adult blood vessels within the process of vascular remodelling of tumour blood vessels as well as of molecular factors that regulate VW-MPSC differentiation into pericytes and SMC.",signatures:"Diana Klein",downloadPdfUrl:"/chapter/pdf-download/48338",previewPdfUrl:"/chapter/pdf-preview/48338",authors:[{id:"173541",title:"Dr.",name:"Diana",surname:"Klein",slug:"diana-klein",fullName:"Diana Klein"}],corrections:null},{id:"48525",title:"Implications of MicroRNAs in the Vascular Homeostasis and Remodeling",doi:"10.5772/60740",slug:"implications-of-micrornas-in-the-vascular-homeostasis-and-remodeling",totalDownloads:1699,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Vascular remodeling or arterial remodeling is a process of adaptive alteration of vascular wall architecture and leads to the endothelial cell (EC) dysfunction and synthetic or contractile phenotypic change of VSMCs, and the infiltration of monocytes and Macrophages that promotes vascular diseases including atherosclerosis. Recent findings have demonstrated that microRNAs (miRNAs) are involved in regulating gene expression at posttranscriptional level and disease pathogenesis. A change of miRNA expression profiles plays key roles in the gene expressions and the regulation of cellular functions. In this chapter, we summarize the vascular remodeling-related miRNAs and their functions in vascular biology.",signatures:"Seahyoung Lee, Eunhyun Choi, Min-Ji Cha and Ki-Chul Hwang",downloadPdfUrl:"/chapter/pdf-download/48525",previewPdfUrl:"/chapter/pdf-preview/48525",authors:[{id:"173709",title:"Prof.",name:"Ki-Chul",surname:"Hwang",slug:"ki-chul-hwang",fullName:"Ki-Chul Hwang"},{id:"177754",title:"Dr.",name:"Seahyoung",surname:"Lee",slug:"seahyoung-lee",fullName:"Seahyoung Lee"},{id:"177755",title:"Dr.",name:"Eunhyun",surname:"Choi",slug:"eunhyun-choi",fullName:"Eunhyun Choi"},{id:"177756",title:"Dr.",name:"Min-Ji",surname:"Cha",slug:"min-ji-cha",fullName:"Min-Ji Cha"}],corrections:null},{id:"48770",title:"Lifestyle and Aging Effects in the Development of Insulin Resistance — Activating the Muscle as Strategy Against Insulin Resistance by Modulating Cytokines and HSP70",doi:"10.5772/60895",slug:"lifestyle-and-aging-effects-in-the-development-of-insulin-resistance-activating-the-muscle-as-strate",totalDownloads:1995,totalCrossrefCites:2,totalDimensionsCites:4,hasAltmetrics:1,abstract:"This chapter discusses about subclinical processes related to insulin resistance development that worsen the muscle metabolic functions, generated by factors such as lifestyle (bad quality food intake and sedentary behavior) and aging. Also discussed are the effects of regular physical exercise as a strategy to prevent the metabolic impairment in organisms, approaching since muscle subclinical molecular processes to the whole body’s integrative physiology. Insulin resistance development includes modification in the pattern of inflammatory cytokines, heat shock proteins, tissue- specific defects in insulin action and signaling, oxidative stress and ectopic lipid deposition. The exercise is a known modulator of all parameters listed above and has important role in the regulation of “immune-metabolic” homeostasis from the muscle to the whole body. This chapter aims to present a new molecular approach related to the control of metabolism and encourage scientists and students to propose new strategies against insulin resistance and diabetes type 2 developments.",signatures:"Thiago Gomes Heck, Mirna Stela Ludwig, Analu Bender dos Santos\nand Pauline Brendler Goettems-Fiorin",downloadPdfUrl:"/chapter/pdf-download/48770",previewPdfUrl:"/chapter/pdf-preview/48770",authors:[{id:"142388",title:"Dr.",name:"Thiago",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck"},{id:"155352",title:"Prof.",name:"Mirna",surname:"Stela Ludwig",slug:"mirna-stela-ludwig",fullName:"Mirna Stela Ludwig"},{id:"173960",title:"Prof.",name:"Pauline",surname:"Goettems-Fiorin",slug:"pauline-goettems-fiorin",fullName:"Pauline Goettems-Fiorin"},{id:"173961",title:"Dr.",name:"Analu",surname:"Bender Dos Santos",slug:"analu-bender-dos-santos",fullName:"Analu Bender Dos Santos"}],corrections:null},{id:"48386",title:"Importance of Plasma Membrane Nanodomains in Skeletal Muscle Regeneration",doi:"10.5772/60615",slug:"importance-of-plasma-membrane-nanodomains-in-skeletal-muscle-regeneration",totalDownloads:2527,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Numerous studies showed the importance of skeletal muscle plasma membrane (sarcolemma) in the control of skeletal muscle biology. The emphasis in this review is on the sarcolemmal bioactive lipids decisive for survival, proliferation, differentiation, and function of skeletal muscle cells with the particular concern on muscle stem cells (resident satellite cells, RSC) responsible for muscle regeneration. Nowadays, it is obvious that cholesterol (CHOL), basic component of the lipid rafts (LR) through the control of assembled dystrophin–glycoprotein complexes (DGC), directs muscle fiber contractile properties. Another phospholipid, phosphatidylserine (PS), is a component of the inner plasma membrane leaflet, even though it allows the fusion of myoblasts when exteriorized. Sphingolipids, such as ceramide, sphingosine, sphingosine-1-phosphate, and ganglioside GM3, are important signaling molecules in the charge of RSC activation, their motility, and commitment to particular lineage (myoblasts and myofibroblasts). Phosphoinositides and phosphatidylinositol-4,5-biphosphate (PIP2) specifically establish protoplasmic platforms for protein interactions essential for cell viability and mitochondrial activity. Additionally, both prenylation and palmitoylation of certain proteins (i.e., heterotrimeric G proteins) determine their biological activity in signal transduction from G-protein coupled receptors (GPCR). Isoprenoids are therefore crucial for the recruitment and metabolic responses of RSC to physiological and pathological stimuli. Finally, iatrogenic modifications of sarcolemma with hydroxylamines and their derivatives lead to increased resistance of muscle cells to apoptotic stimuli and slow progression of some skeletal muscle dystrophies.",signatures:"Beata Pająk and Arkadiusz Orzechowski",downloadPdfUrl:"/chapter/pdf-download/48386",previewPdfUrl:"/chapter/pdf-preview/48386",authors:[{id:"173522",title:"Prof.",name:"Arkadiusz",surname:"Orzechowski",slug:"arkadiusz-orzechowski",fullName:"Arkadiusz Orzechowski"},{id:"173528",title:"Dr.",name:"Beata",surname:"Pająk",slug:"beata-pajak",fullName:"Beata Pająk"}],corrections:null},{id:"48820",title:"Molecular Mechanisms Controlling Skeletal Muscle Mass",doi:"10.5772/60876",slug:"molecular-mechanisms-controlling-skeletal-muscle-mass",totalDownloads:2327,totalCrossrefCites:5,totalDimensionsCites:7,hasAltmetrics:0,abstract:"The interplay between multiple signaling pathways regulates the maintenance of skeletal muscle. Under physiological conditions, a network of interconnected signals serves to coordinate hypertrophic and atrophic inputs, culminating in a delicate balance between muscle protein synthesis and proteolysis. Loss of skeletal muscle mass, termed “atrophy,” is a diagnostic feature of cachexia such as cancer, heart disease, and chronic obstructive pulmonary disease. Recent studies have further defined the pathways leading to gain and loss of skeletal muscle as well as the signaling events that induce post-injury regeneration. In this review, we summarize the relevant recent literature demonstrating these previously undiscovered mediators governing anabolism and catabolism of skeletal muscle.",signatures:"Kunihiro Sakuma and Akihiko Yamaguchi",downloadPdfUrl:"/chapter/pdf-download/48820",previewPdfUrl:"/chapter/pdf-preview/48820",authors:[{id:"173502",title:"Dr.",name:"Kunihiro",surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma"},{id:"177757",title:"Dr.",name:"Akihiko",surname:"Yamaguchi",slug:"akihiko-yamaguchi",fullName:"Akihiko Yamaguchi"}],corrections:null},{id:"48511",title:"Autophagy, a Highly Regulated Intracellular System Essential to Skeletal Muscle Homeostasis — Role in Disease, Exercise and Altitude Exposure",doi:"10.5772/60698",slug:"autophagy-a-highly-regulated-intracellular-system-essential-to-skeletal-muscle-homeostasis-role-in-d",totalDownloads:2280,totalCrossrefCites:5,totalDimensionsCites:7,hasAltmetrics:0,abstract:"Autophagy is an evolutionarily conserved intracellular system that selectively eliminates protein aggregates, damaged organelles, and other cellular debris. It is a self-cleaning process critical for cell homeostasis in conditions of energy stress. Autophagy has been until now relatively overlooked in skeletal muscle, but recent data highlight its vital role in this tissue in response to several stress conditions. The most recognized sensors for autophagy modulation are the adenosine monophosphate (AMP)-activated protein kinase (AMPK) and the mechanistic target of rapamycin (MTOR). AMPK acts as a sensor of cellular energy status by regulating several intracellular systems including glucose and lipid metabolisms and mitochondrial biogenesis. Recently, AMPK has been involved in the control of protein synthesis by decreasing MTOR activity and in the control of protein breakdown programs. Concerning proteolysis, AMPK notably regulates autophagy through FoxO transcription factors and Ulk1 complex. In this chapter, we describe the functioning of the different autophagy pathways (macroautophagy, microautophagy, and chaperone-mediated autophagy) in skeletal muscle and define the role of macroautophagy in response to physical exercise, a stress that is well assumed to be a key strategy to counteract metabolic and muscle diseases. The effects of dietary factors and altitude exposure are also discussed in the context of exercise.",signatures:"Anthony M.J. Sanchez, Robin Candau, Audrey Raibon and Henri\nBernardi",downloadPdfUrl:"/chapter/pdf-download/48511",previewPdfUrl:"/chapter/pdf-preview/48511",authors:[{id:"173735",title:"Dr.",name:"Henri",surname:"Bernardi",slug:"henri-bernardi",fullName:"Henri Bernardi"},{id:"175602",title:"Prof.",name:"Robin",surname:"Candau",slug:"robin-candau",fullName:"Robin Candau"},{id:"175603",title:"Dr.",name:"Audrey",surname:"Raibon",slug:"audrey-raibon",fullName:"Audrey Raibon"},{id:"175604",title:"Dr.",name:"Anthony Mj",surname:"Sanchez",slug:"anthony-mj-sanchez",fullName:"Anthony Mj Sanchez"}],corrections:null},{id:"48493",title:"Cell Composition of the Subendothelial Aortic Intima and the Role of Alpha-Smooth Muscle Actin Expressing Pericyte-Like Cells and Smooth Muscle Cells in the Development of Atherosclerosis",doi:"10.5772/60430",slug:"cell-composition-of-the-subendothelial-aortic-intima-and-the-role-of-alpha-smooth-muscle-actin-expre",totalDownloads:1634,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"The cell composition of the human arterial intima has been intensely studied but is still not well understood. The majority of cell population in normal and atherosclerotic intima is represented by cells expressing smooth muscle α-actin, which are thought to be smooth muscle cells. Some antigens, which are absent in medial smooth muscle cells, were detected in intimal smooth muscle cells. In particular, using 3G5 antipericyte antibody, presence of stellate-shaped pericyte-like resident cells in normal and atherosclerotic human aortic intima has been found. In all analyzed aortic tissue specimens, 3G5+ cells were found to account for more than 30% of the total intimal cell population of undiseased intima. In the atherosclerotic lesions, the number of 3G5+ cells becomes notably lower than that in undiseased intima. The use of 2A7 antibody that identifies activated pericytes revealed the presence of 2A7+ cells in atherosclerotic plaques, while no 2A7+ cells were detected in normal intima. The strongest correlation was established between the number of pericyte-like cells and the content of intimal lipids. The correlation coefficients between the number of pericyte-like cells and collagen content and intimal thickness were greater than the correlation coefficients for smooth muscle cells. On the basis of these findings, pericyte-like cells but not smooth muscle cells or other cell types have been declared to be the key cellular element driving the formation of atherosclerotic lesions. The present chapter aims to detail the abovementioned issues. The present chapter also aims to promote a view that α-smooth muscle actin+ pericyte-like cells represent the key players in the development of atherosclerotic lesions.",signatures:"Alexander N. Orekhov and Yuri V. Bobryshev",downloadPdfUrl:"/chapter/pdf-download/48493",previewPdfUrl:"/chapter/pdf-preview/48493",authors:[{id:"159026",title:"Prof.",name:"Alexander",surname:"Orekhov",slug:"alexander-orekhov",fullName:"Alexander Orekhov"},{id:"173729",title:"Dr.",name:"Yuri",surname:"Bobryshev",slug:"yuri-bobryshev",fullName:"Yuri Bobryshev"}],corrections:null},{id:"48724",title:"Dynamic Interplay Between Smooth Muscle Cells and Macrophages in Vascular Disease",doi:"10.5772/61089",slug:"dynamic-interplay-between-smooth-muscle-cells-and-macrophages-in-vascular-disease",totalDownloads:2101,totalCrossrefCites:0,totalDimensionsCites:3,hasAltmetrics:0,abstract:"Vascular smooth muscle cells (SMCs) and monocytes/macrophages represent major players in atherosclerotic vascular diseases. In addition to physiological and pathological roles of each cell type in atherosclerosis, dynamic interplay between SMCs and monocytes/macrophages may contribute to the pathogenesis of atherosclerosis more critically than previously understood. Activated macrophages accelerate pro-atherogenic functions of SMCs in vascular lesions. Activated SMCs promote additional accumulation of pro-inflammatory macrophages through expression of chemoattractants. More recent evidence suggests the interchangeability between SMC and monocyte/macrophage lineages. Future efforts to understand such dynamic interactions between SMCs and macrophages may provide novel insight into the pathogenesis of vascular disease and the development of new classes of medical solutions.",signatures:"Hiroshi Iwata and Masanori Aikawa",downloadPdfUrl:"/chapter/pdf-download/48724",previewPdfUrl:"/chapter/pdf-preview/48724",authors:[{id:"48818",title:"Dr.",name:"Hiroshi",surname:"Iwata",slug:"hiroshi-iwata",fullName:"Hiroshi Iwata"},{id:"164342",title:"Dr.",name:"Masanori",surname:"Aikawa",slug:"masanori-aikawa",fullName:"Masanori Aikawa"}],corrections:null},{id:"48576",title:"Current Challenges in Understanding the Story of Skin Pigmentation — Bridging the Morpho-Anatomical and Functional Aspects of Mammalian Melanocytes",doi:"10.5772/60714",slug:"current-challenges-in-understanding-the-story-of-skin-pigmentation-bridging-the-morpho-anatomical-an",totalDownloads:2613,totalCrossrefCites:2,totalDimensionsCites:12,hasAltmetrics:1,abstract:"Melanocytes are specialized dendritic melanin producing pigment cells, which have originated from the pluripotent embryonic cells and are termed as neural crest cells (NCC). The primary locations of these cells are basal layer of epidermis and hair follicles. Besides this, they are also found in the inner ear, nervous system, and heart with spatial specific functions. There are other cells able to produce melanin but of different embryonic origin (pigmented epithelium of retina, some neurons, and adipocytes). Melanocytes of the epidermis and hair are cells which share some common structural features but in general they form biologically different populations living in unique niches of the skin. Ultra structurally, melanocytes differ from each other on the basis of their locations and function. Principal function of epidermal melanocytes is photoprotection and thermoregulation by packaging melanin pigment into melanosomes and delivering them to neighboring keratinocytes. It is unfair to think that melanocytes reap all the glory for their role in pigmenting the skin and providing it critical protection against UV damage. They probably play a significant role in diverse physiological functions and their particular functions in all target places are much wider than the melanin synthesis only. Alternation in any structure and function of these pigmentary cells affects the process of pigmentation/melanogenesis which leads to pigmentary disorders like hyperpigmentation or hypopigmentation.",signatures:"Sharique A. Ali and Ishrat Naaz",downloadPdfUrl:"/chapter/pdf-download/48576",previewPdfUrl:"/chapter/pdf-preview/48576",authors:[{id:"141203",title:"Dr.",name:"Sharique A.",surname:"Ali",slug:"sharique-a.-ali",fullName:"Sharique A. Ali"},{id:"174823",title:"Ms.",name:"Ishrat",surname:"Naaz",slug:"ishrat-naaz",fullName:"Ishrat Naaz"}],corrections:null},{id:"48855",title:"Ca2+ Dynamics and Ca2+ Sensitization in the Regulation of Airway Smooth Muscle Tone",doi:"10.5772/60969",slug:"ca2-dynamics-and-ca2-sensitization-in-the-regulation-of-airway-smooth-muscle-tone",totalDownloads:2499,totalCrossrefCites:2,totalDimensionsCites:7,hasAltmetrics:0,abstract:"Airway smooth muscle tone is ultimately generated by phosphorylation of myosin light chain, which is regulated by the balance between concentrations of Ca2+ and sensitivity to Ca2+ in the cytosolic side. The former is due to the Ca2+ influx passing through ion channels (Ca2+ dynamics), leading to activation of myosin light chain kinase, and the latter is due to Rho-kinase (Ca2+ sensitization), leading to the inactivation of myosin phosphatase. Alterations to contractility and to the proliferative phenotype, which are influenced by Ca2+ dynamics and Ca2+ sensitization, are involved in the pathophysiology of asthma and chronic obstructive pulmonary disease (COPD). Ca2+ dynamics are mainly due to store-operated capacitative Ca2+ influx and receptor-operated Ca2+ influx, and partly due to L-type voltage-dependent Ca2+ (VDC) channels. Large-conductance Ca2+-activated K+ (KCa, BKCa, Maxi-K+) channels are activated by Gs connected to β2-adrenoceptors, whereas these channels are inhibited by Gi connected to M2 muscarinic receptors. VDC channel activity regulated by KCa channels contributes to not only functional antagonism between β2-adrenoceptors and muscarinic receptors but also to synergistic effects between β2-adrenoceptor agonists and muscarinic receptor antagonists. Moreover, an increase in Ca2+ influx via the KCa/VDC channel linkage causes airflow limitation and β2-adrenergic desensitization. In contrast, an increase in sensitivity to Ca2+ via Rho-kinase causes airflow limitation, airway hyperresponsiveness, β2-adrenergic desensitization, and airway remodeling. These airway disorders are characteristic features of asthma and COPD. KCa channels are regulated by trimeric G proteins (Gs, Gi), and Rho-kinase is regulated by a monomeric G protein (RhoA). Therefore, Ca2+ dynamics due to G proteins/KCa/VDC channel linkage and Ca2+ sensitization due to RhoA/Rho-kinase processes are therapeutic targets for these diseases.",signatures:"Hiroaki Kume",downloadPdfUrl:"/chapter/pdf-download/48855",previewPdfUrl:"/chapter/pdf-preview/48855",authors:[{id:"173510",title:"Prof.",name:"Hiroaki",surname:"Kume",slug:"hiroaki-kume",fullName:"Hiroaki Kume"}],corrections:null},{id:"48787",title:"Research on Skeletal Muscle Diseases Using Pluripotent Stem Cells",doi:"10.5772/60902",slug:"research-on-skeletal-muscle-diseases-using-pluripotent-stem-cells",totalDownloads:1657,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The generation of induced pluripotent stem cells (iPSCs), especially the generation of patient-derived pluripotent stem cells (PSCs) suitable for disease modelling in vitro, opens the door for the potential translation of stem-cell related studies into the clinic. Successful replacement, or augmentation, of the function of damaged cells by patient-derived differentiated stem cells would provide a novel cell-based therapy for skeletal muscle-related diseases. Since iPSCs resemble human embryonic stem cells (hESCs) in their ability to generate cells of the three germ layers, patient-specific iPSCs offer definitive solutions for the ethical and histo-incompatibility issues related to hESCs. Indeed human iPSC (hiPSC)-based autologous transplantation is heralded as the future of regenerative medicine. Interestingly, during the last years intense research has been published on disease-specific hiPSCs derivation and differentiation into relevant tissues/organs providing a unique scenario for modelling disease progression, to screen patient-specific drugs and enabling immunosupression-free cell replacement therapies. Here, we revise the most relevant findings in skeletal muscle differentiation using mouse and human PSCs. Finally and in an effort to bring iPSC technology to the daily routine of the laboratory, we provide two different protocols for the generation of patient-derived iPSCs.",signatures:"Lorena de Oñate, Elena Garreta, Carolina Tarantino, Elena Martínez,\nEncarnación Capilla, Isabel Navarro, Joaquín Gutiérrez, Josep\nSamitier, Josep Maria Campistol, Pura Muñoz-Cánovas and Nuria\nMontserrat",downloadPdfUrl:"/chapter/pdf-download/48787",previewPdfUrl:"/chapter/pdf-preview/48787",authors:[{id:"170057",title:"Dr.",name:"Encarnación",surname:"Capilla",slug:"encarnacion-capilla",fullName:"Encarnación Capilla"},{id:"173781",title:"Ph.D.",name:"Nuria",surname:"Montserrat",slug:"nuria-montserrat",fullName:"Nuria Montserrat"},{id:"173946",title:"Prof.",name:"Joaquin",surname:"Gutiérrez",slug:"joaquin-gutierrez",fullName:"Joaquin Gutiérrez"},{id:"173947",title:"Prof.",name:"Isabel",surname:"Navarro",slug:"isabel-navarro",fullName:"Isabel Navarro"},{id:"173948",title:"Dr.",name:"Elena",surname:"Garreta",slug:"elena-garreta",fullName:"Elena Garreta"},{id:"173949",title:"Dr.",name:"Elena",surname:"Martínez",slug:"elena-martinez",fullName:"Elena Martínez"},{id:"173950",title:"Prof.",name:"Pura",surname:"Muñoz",slug:"pura-munoz",fullName:"Pura Muñoz"},{id:"173951",title:"BSc.",name:"Lorena",surname:"De Oñate",slug:"lorena-de-onate",fullName:"Lorena De Oñate"}],corrections:null},{id:"48727",title:"Smooth Muscle and Extracellular Matrix Interactions in Health and Disease",doi:"10.5772/60403",slug:"smooth-muscle-and-extracellular-matrix-interactions-in-health-and-disease",totalDownloads:2118,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Alterations in smooth muscle cell function and phenotype contribute to tissue remodeling in various pathologies including obstructive lung (e.g., asthma) and vascular (e.g., atherosclerosis) diseases. The extracellular matrix (ECM) is a major influence on the biology of smooth muscle cells, being an important support structure that provides signaling cues through its biochemical and biophysical properties. ECM factors activate biochemical and mechano-transduction signaling pathways, which modulate smooth muscle cell contraction, stiffness, survival, growth, cytokine production and migration (i.e., cellular processes which contribute to changes in tissue architecture). The interaction of the ECM with smooth muscle cells is a dynamic multi-directional process, as smooth muscle cells also produce ECM protein, as well as proteases and cross-linking enzymes which regulate ECM form and structure. Understanding the molecular basis of ECM modifications and their impact on smooth muscle cell function in disease may lead to the development of novel therapies. This chapter reviews interactions between the ECM and smooth muscle cell and how they become altered in disease, using obstructive lung and vascular diseases as examples. From a pharmacological and therapeutic perspective, strategies that alter the phenotype of the smooth muscle cell in disease will be discussed. Emphasis will be given to approaches that target the proteases and mediators of ECM-smooth muscle cell signaling as potential treatments for pulmonary and vascular disease. Proteases of the coagulation and plasminogen activation systems have been given particular attention as they not only have a role in forming and modifying ECM, but also can directly stimulate changes in smooth muscle cell function and phenotype via activating receptors such as the protease-activated receptor-1 (PAR-1) and integrins.",signatures:"Michael Schuliga",downloadPdfUrl:"/chapter/pdf-download/48727",previewPdfUrl:"/chapter/pdf-preview/48727",authors:[{id:"173789",title:"Dr.",name:"Michael",surname:"Schuliga",slug:"michael-schuliga",fullName:"Michael Schuliga"}],corrections:null},{id:"48782",title:"Novel Therapeutic Approaches for Skeletal Muscle Dystrophies",doi:"10.5772/60479",slug:"novel-therapeutic-approaches-for-skeletal-muscle-dystrophies",totalDownloads:1632,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Muscular dystrophies (MDs) are inherited diseases that affect skeletal and cardiac muscle tissues. Cases range from mild to very severe, resulting in respiratory or cardiac failures. No cures are available for MDs and corticosteroid treatments, mainly deflazacort and prednisolone, only help to control the inflammatory process and slightly delay the progression of the disease. This is due to the beneficial effect on pulmonary function and scoliosis. Walkers and wheelchairs are used to strengthen patients’ independence and walking ability. When respiratory and/or cardiac muscles become weak, mechanical ventilation is mandatory. In addition, hypertension, cataracts, excessive weight gain and vertebral fracture are often serious side effects of deflazacort and prednisolone treatments.",signatures:"Emanuele Berardi and Maurilio Sampaolesi",downloadPdfUrl:"/chapter/pdf-download/48782",previewPdfUrl:"/chapter/pdf-preview/48782",authors:[{id:"87287",title:"Prof.",name:"Maurilio",surname:"Sampaolesi",slug:"maurilio-sampaolesi",fullName:"Maurilio Sampaolesi"}],corrections:null},{id:"48842",title:"Use of Biomaterials and Biomolecules for the Prevention of Restenosis",doi:"10.5772/61081",slug:"use-of-biomaterials-and-biomolecules-for-the-prevention-of-restenosis",totalDownloads:1636,totalCrossrefCites:0,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Coronary balloon angioplasty and coronary stenting are the procedures used in healing coronary artery disease. However, injury of arteries during angioplasty and stenting causes cell stimulations in tissue. Cell movement and thrombosis lead to re-narrowing of widened vessel called restenosis. Several new types of carriers and technology have been developed to suppress and/or prevent restenosis via prevention of migration/proliferation of smooth muscle cells (SMCs). The conventional approaches are not fully effective for inhibiting restenosis. In order to eliminate such problems, stent-based delivery methods are developed to replace traditional vascular approaches. A series of materials have been improved for controlled delivery/release of genes, miRNAs, peptide structures, siRNAs, miRNAs, and antisense molecules to the target tissue. Agents to be delivered are either attached to the materials or entrapped in polymeric structure. In particular, biodegradable polymers have held great interests in drug delivery for targeting or prolonging implantable drug release. This chapter summarizes the molecular mechanisms of in-stent restenosis, the role of SMCs and endothelial cells in restenosis, and recent researches about the polymeric materials featured in drug/gene carrier systems, nanovehicles, and stent coating materials to prevent restenosis.",signatures:"Nelisa Türkoğlu Laçin, Kadriye Kızılbey and Banu Mansuroğlu",downloadPdfUrl:"/chapter/pdf-download/48842",previewPdfUrl:"/chapter/pdf-preview/48842",authors:[{id:"173575",title:"Dr.",name:"Nelisa",surname:"Laçin",slug:"nelisa-lacin",fullName:"Nelisa Laçin"}],corrections:null},{id:"48942",title:"Three-Dimensional “Honeycomb” Culture System that Helps to Maintain the Contractile Phenotype of Vascular Smooth Muscle Cells",doi:"10.5772/60960",slug:"three-dimensional-honeycomb-culture-system-that-helps-to-maintain-the-contractile-phenotype-of-vascu",totalDownloads:1499,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Vascular smooth muscle cells (VSMCs) in the normal aorta are described as having a contractile phenotype because they can contract and do not proliferate. VSMCs in pathological conditions such as atherosclerosis and restenosis can proliferate and migrate, but lose their ability to contract, which is referred to as a synthetic phenotype. VSMCs show plasticity by changing their phenotype according to the surrounding environment. When VSMCs are cultured on a plastic plate, which is a normal two-dimensional culture system, they display the synthetic phenotype because they proliferate and migrate without contraction. Recently, we successfully cultured VSMCs that display features similar to the contractile phenotype, using type I collagen three-dimensional matrices, “honeycombs,” in the presence of abundant fetal bovine serum albumin. VSMCs cultured in honeycombs stop proliferating and can contract. The honeycomb culture system can maintain VSMCs in the contractile phenotype for a long period of time. In this chapter, we show the method of this new culture system and the characteristics of VSMCs in honeycombs. It is expected that the use of this culture system will generate new information on the characteristics of VSMCs.",signatures:"Itsuko Ishii and Masashi Uchida",downloadPdfUrl:"/chapter/pdf-download/48942",previewPdfUrl:"/chapter/pdf-preview/48942",authors:[{id:"173711",title:"Prof.",name:"Itsuko",surname:"Ishii",slug:"itsuko-ishii",fullName:"Itsuko Ishii"}],corrections:null},{id:"48557",title:"Role of Platelet-Activating Factor and Hypoxia in Persistent Pulmonary Hypertension of the Newborn — Studies with Perinatal Pulmonary Vascular Smooth Muscle Cells",doi:"10.5772/60728",slug:"role-of-platelet-activating-factor-and-hypoxia-in-persistent-pulmonary-hypertension-of-the-newborn-s",totalDownloads:1431,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Platelet-activating factor (PAF) plays an important physiological role of maintaining a high vasomotor tone in fetal pulmonary circulation. At birth, endogenous vasodilators such as nitric oxide and prostacyclin are released and facilitate pulmonary vasodilation via cAMP-dependent protein kinase (cAMP/PKA) and cGMP-dependent protein kinase (cGMP/PKG) pathways. Interaction between the cyclic nucleotides and PAF receptor (PAFR)-mediated responses in pulmonary arterial smooth muscle is not well understood. To further understand the interactions of PAF-PAFR pathway and the cyclic nucleotides in ovine fetal pulmonary arterial smooth muscle cells (FPASMC), effects of cAMP and cGMP on PAFR-mediated responses in pulmonary arterial smooth muscle cells (PASMC) were studied. Ovine FPASMC were incubated with 10μM cAMP or cGMP in normoxia (5% CO2 in air, pO2~100 Torr) or hypoxia (2% O2, 5% CO2, pO2~30-40 Torr). Proteins were prepared and subjected to Western blotting. Effect of cell permeable cAMP and cGMP on PAFR binding was also studied and effect of cAMP on cell proliferation was also studied by RNAi to PKA-Cα. cAMP and cGMP significantly decreased PAFR binding and protein expression in normoxia and hypoxia, more so in hypoxia, when PAFR expression was usually high. PKA-Cα siRNA demonstrated that inhibition of PAFR-mediated responses by the cyclic nucleotides occurred through PKA. These data suggest that the normally high levels of cyclic nucleotides in the normoxic newborn pulmonary circulation assist in the downregulation of postnatal PAFR-mediated responses and that under hypoxic conditions, increasing the levels of cyclic nucleotides will abrogate PAF-mediated vasoconstriction thereby ameliorating PAF-induced persistent pulmonary hypertension of the newborn.",signatures:"Mona Hanouni, Amy M. McPeak, Stephen M. Douglass, Rebecca\nDavis, Shaemion McBride and Basil O. Ibe",downloadPdfUrl:"/chapter/pdf-download/48557",previewPdfUrl:"/chapter/pdf-preview/48557",authors:[{id:"173958",title:"Prof.",name:"Basil",surname:"Ibe",slug:"basil-ibe",fullName:"Basil Ibe"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3348",title:"Tissue Engineering",subtitle:null,isOpenForSubmission:!1,hash:"39bb39271df3b373edb7d5e2cdeffb18",slug:"tissue-engineering",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/3348.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3361",title:"Regenerative Medicine and Tissue Engineering",subtitle:null,isOpenForSubmission:!1,hash:"fe914d49a96b3dcd00d27292ae23536e",slug:"regenerative-medicine-and-tissue-engineering",bookSignature:"Jose A. Andrades",coverURL:"https://cdn.intechopen.com/books/images_new/3361.jpg",editedByType:"Edited by",editors:[{id:"40914",title:"Prof.",name:"Jose A.",surname:"Andrades",slug:"jose-a.-andrades",fullName:"Jose A. Andrades"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"786",title:"Advances in Regenerative Medicine",subtitle:null,isOpenForSubmission:!1,hash:"06d8a9addc021349418ffcc670142467",slug:"advances-in-regenerative-medicine",bookSignature:"Sabine Wislet-Gendebien",coverURL:"https://cdn.intechopen.com/books/images_new/786.jpg",editedByType:"Edited by",editors:[{id:"65329",title:"Dr.",name:"Sabine",surname:"Wislet",slug:"sabine-wislet",fullName:"Sabine Wislet"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"560",title:"Bone Regeneration",subtitle:null,isOpenForSubmission:!1,hash:"293cde681a800f168d0b3ceb13bac38a",slug:"bone-regeneration",bookSignature:"Haim Tal",coverURL:"https://cdn.intechopen.com/books/images_new/560.jpg",editedByType:"Edited by",editors:[{id:"97351",title:"Prof.",name:"Haim",surname:"Tal",slug:"haim-tal",fullName:"Haim Tal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"637",title:"Tissue Engineering for Tissue and Organ Regeneration",subtitle:null,isOpenForSubmission:!1,hash:"5bef0b1c31f0555294c7d49580c8d241",slug:"tissue-engineering-for-tissue-and-organ-regeneration",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/637.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2631",title:"Current Basic and Pathological Approaches to the Function of Muscle Cells and Tissues",subtitle:"From Molecules to Humans",isOpenForSubmission:!1,hash:"34fa138dc948d7121e2915ac84ea30cf",slug:"current-basic-and-pathological-approaches-to-the-function-of-muscle-cells-and-tissues-from-molecules-to-humans",bookSignature:"Haruo Sugi",coverURL:"https://cdn.intechopen.com/books/images_new/2631.jpg",editedByType:"Edited by",editors:[{id:"140827",title:"Emeritus Prof.",name:"Haruo",surname:"Sugi",slug:"haruo-sugi",fullName:"Haruo Sugi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4486",title:"Cells and Biomaterials in Regenerative Medicine",subtitle:null,isOpenForSubmission:!1,hash:"1c333e655d47208db36f2a886b49c160",slug:"cells-and-biomaterials-in-regenerative-medicine",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/4486.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"824",title:"Tissue Regeneration",subtitle:"From Basic Biology to Clinical Application",isOpenForSubmission:!1,hash:"a7b540e4a2d901e0b3c940f69d0fc058",slug:"tissue-regeneration-from-basic-biology-to-clinical-application",bookSignature:"Jamie Davies",coverURL:"https://cdn.intechopen.com/books/images_new/824.jpg",editedByType:"Edited by",editors:[{id:"63994",title:"Prof.",name:"Jamie",surname:"Davies",slug:"jamie-davies",fullName:"Jamie Davies"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6609",title:"Muscle Cell and Tissue",subtitle:"Current Status of Research Field",isOpenForSubmission:!1,hash:"522e700080f9e908b6b330587f0f381d",slug:"muscle-cell-and-tissue-current-status-of-research-field",bookSignature:"Kunihiro Sakuma",coverURL:"https://cdn.intechopen.com/books/images_new/6609.jpg",editedByType:"Edited by",editors:[{id:"195829",title:"Prof.",name:"Kunihiro",surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],ofsBooks:[]},correction:{item:{id:"80207",slug:"corrigendum-to-aspects-regarding-thermal-mechanical-fatigue-of-shape-memory-alloys",title:"Corrigendum To: Aspects Regarding Thermal-Mechanical Fatigue of Shape Memory Alloys",doi:null,correctionPDFUrl:"https://cdn.intechopen.com/pdfs/80207.pdf",downloadPdfUrl:"/chapter/pdf-download/80207",previewPdfUrl:"/chapter/pdf-preview/80207",totalDownloads:null,totalCrossrefCites:null,bibtexUrl:"/chapter/bibtex/80207",risUrl:"/chapter/ris/80207",chapter:{id:"62954",slug:"aspects-regarding-thermal-mechanical-fatigue-of-shape-memory-alloys",signatures:"Petrică Vizureanu and Dragoș-Cristian Achiței",dateSubmitted:"April 12th 2018",dateReviewed:"April 25th 2018",datePrePublished:null,datePublished:"September 26th 2018",book:{id:"7213",title:"Shape-Memory Materials",subtitle:null,fullTitle:"Shape-Memory Materials",slug:"shape-memory-materials",publishedDate:"September 26th 2018",bookSignature:"Alicia Esther Ares",coverURL:"https://cdn.intechopen.com/books/images_new/7213.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"91095",title:"Dr.",name:"Alicia Esther",middleName:null,surname:"Ares",slug:"alicia-esther-ares",fullName:"Alicia Esther Ares"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"12354",title:"Prof.",name:"Petrică",middleName:null,surname:"Vizureanu",fullName:"Petrică Vizureanu",slug:"petrica-vizureanu",email:"peviz2002@yahoo.com",position:null,institution:{name:"Gheorghe Asachi Technical University of Iași",institutionURL:null,country:{name:"Romania"}}},{id:"209329",title:"Dr.",name:"Mirabela Georgiana",middleName:null,surname:"Minciuna",fullName:"Mirabela Georgiana Minciuna",slug:"mirabela-georgiana-minciuna",email:"mirabela.minciuna@yahoo.ro",position:null,institution:{name:"Gheorghe Asachi Technical University of Iași",institutionURL:null,country:{name:"Romania"}}},{id:"245668",title:"Dr.",name:"Dragos Cristian",middleName:null,surname:"Achitei",fullName:"Dragos Cristian Achitei",slug:"dragos-cristian-achitei",email:"dragos_adc@tuiasi.ro",position:null,institution:null},{id:"245669",title:"Dr.",name:"Manuela Cristina",middleName:null,surname:"Perju",fullName:"Manuela Cristina Perju",slug:"manuela-cristina-perju",email:"cryss_ela@yahoo.com",position:null,institution:null}]}},chapter:{id:"62954",slug:"aspects-regarding-thermal-mechanical-fatigue-of-shape-memory-alloys",signatures:"Petrică Vizureanu and Dragoș-Cristian Achiței",dateSubmitted:"April 12th 2018",dateReviewed:"April 25th 2018",datePrePublished:null,datePublished:"September 26th 2018",book:{id:"7213",title:"Shape-Memory Materials",subtitle:null,fullTitle:"Shape-Memory Materials",slug:"shape-memory-materials",publishedDate:"September 26th 2018",bookSignature:"Alicia Esther Ares",coverURL:"https://cdn.intechopen.com/books/images_new/7213.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"91095",title:"Dr.",name:"Alicia Esther",middleName:null,surname:"Ares",slug:"alicia-esther-ares",fullName:"Alicia Esther Ares"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"12354",title:"Prof.",name:"Petrică",middleName:null,surname:"Vizureanu",fullName:"Petrică Vizureanu",slug:"petrica-vizureanu",email:"peviz2002@yahoo.com",position:null,institution:{name:"Gheorghe Asachi Technical University of Iași",institutionURL:null,country:{name:"Romania"}}},{id:"209329",title:"Dr.",name:"Mirabela Georgiana",middleName:null,surname:"Minciuna",fullName:"Mirabela Georgiana Minciuna",slug:"mirabela-georgiana-minciuna",email:"mirabela.minciuna@yahoo.ro",position:null,institution:{name:"Gheorghe Asachi Technical University of Iași",institutionURL:null,country:{name:"Romania"}}},{id:"245668",title:"Dr.",name:"Dragos Cristian",middleName:null,surname:"Achitei",fullName:"Dragos Cristian Achitei",slug:"dragos-cristian-achitei",email:"dragos_adc@tuiasi.ro",position:null,institution:null},{id:"245669",title:"Dr.",name:"Manuela Cristina",middleName:null,surname:"Perju",fullName:"Manuela Cristina Perju",slug:"manuela-cristina-perju",email:"cryss_ela@yahoo.com",position:null,institution:null}]},book:{id:"7213",title:"Shape-Memory Materials",subtitle:null,fullTitle:"Shape-Memory Materials",slug:"shape-memory-materials",publishedDate:"September 26th 2018",bookSignature:"Alicia Esther Ares",coverURL:"https://cdn.intechopen.com/books/images_new/7213.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"91095",title:"Dr.",name:"Alicia Esther",middleName:null,surname:"Ares",slug:"alicia-esther-ares",fullName:"Alicia Esther Ares"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"11699",leadTitle:null,title:"Neonatal Surgery",subtitle:null,reviewType:"peer-reviewed",abstract:"This book will be a self-contained collection of scholarly papers targeting an audience of practicing researchers, academics, PhD students and other scientists. The contents of the book will be written by multiple authors and edited by experts in the field.",isbn:null,printIsbn:null,pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"e52adaee8e54f51c2ba4972daeb410f7",bookSignature:"",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11699.jpg",keywords:null,numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 30th 2021",dateEndSecondStepPublish:"October 21st 2021",dateEndThirdStepPublish:"December 20th 2021",dateEndFourthStepPublish:"March 10th 2022",dateEndFifthStepPublish:"May 9th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"8 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:1,editedByType:null,kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:null},relatedBooks:[{type:"book",id:"6550",title:"Cohort Studies in Health Sciences",subtitle:null,isOpenForSubmission:!1,hash:"01df5aba4fff1a84b37a2fdafa809660",slug:"cohort-studies-in-health-sciences",bookSignature:"R. 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Assisted reproductive technology (ART) including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) has now widely been used for the treatment of infertility. The successful application of this technology to human ART is mainly due to embryo culture environment innovation including culture media and incubators. So far, different culture systems have been successfully used for
Since the first rabbit embryo culture was described in 1912 [1, 2], mouse zygote could be cultured to form blastocyst stage embryos in a complex culture medium [3]. In 1985, an embryo culture medium called human tubal fluid medium (HTF) was first described as designed specifically for human IVF [4]. Since the development of HTF, many modifications and advancements have been made in the recipes for human embryo culture medium.
For many decades, optimization of culture media for the support of human and animal embryos has been a focus of considerable interest [5]. As the further understanding of both the physiological changes in oviduct and uterus and the different metabolic needs of cleavage and blastocyst stage embryos, the many novel embryo culture media are continually developed. Currently, several types of media are available in the market representing different strategies and generally fall into one of the three types: (1) simple salt solutions with added energy substrates, such as KSOM, P1, etc., [6, 7]; (2) complex tissue culture media, such as Ham’s F-10 [8]; and (3) sequential media, such as G1/G2, and developed G5 serious media [9]. More recently, sequential culture media have been produced to take into account the changing metabolic needs of the embryo from the cleavage to the blastocyst stage [10, 11]. So far, many commercial embryo culture media are available for human embryo culture and their effect for embryo culture is various [12]. At present, when we search with key words “human embryo culture medium comparison” in google.com, the 53,600 results will occur at 0.6 s. The studies comparing these medium effects on embryonic development have reported contradictory conclusion. Many studies did not find a significant difference or just tiny difference between various culture media [13, 14]. Recently, Mantikou et al. [15] used meta-analysis to evaluate 31 different comparisons for 20 different culture media and did not find what culture medium leads to the best success rates in IVF/ICSI.
We think that significant differences of various media for embryo culture may be difficult to be demonstrated because every commercial company for human embryo culture media must continuously improve the quality of its available culture media. Thus, most of the current commercial culture media may produce satisfied results for human embryo culture. Therefore, the choice of the best culture medium in each laboratory has been attributed to embryologist interesting and specific work conditions.
Also, incubators in the IVF laboratory play a pivotal role in providing a stable and appropriate culture environment required for optimizing embryo development and clinical outcomes. With technological advances, several types of incubators have been applied to human IVF laboratory. Recently, Swain [16] did a comparative analysis of embryo cultural incubators in human IVF laboratories and reviewed some incubator functions and key environmental variables controlled and the technology utilized in various units. This comparison indicates that smaller bench top/top load incubators provide faster recovery of environmental variables, but there is no clear advantage of any particular incubator based on clinical outcomes.
Based on the last decade practice of our IVF center, there was no any difference on embryo culture between Cook Minc incubator and front-door big-box incubator. However, we observed that the same patient’s sibling embryos for splitting into two medium cultures often have different development results under the condition of different incubators. Our question is whether patient’s embryos have a favorable selection for culture medium or incubator condition? The objective of this study is to determine whether specific differences of patient embryos in response to culture media and incubator are important in the human embryo culture system.
This study mainly used two media for embryo culture: P1 medium is from Irvine Scientific, Inc, CA, and Life-Global medium is from Life Global, LLC, Canada. Two kinds of media added 10% serum substitute supplement (SSS) (Irvine Scientific, Inc, CA) for embryo culture.
Forma water-jacketed CO2 incubator is from Thermal Forma Scientific, Inc, and this incubator is just connected to medical grade CO2 gas tank and is adjusted to 5% CO2 for embryo culture. Cook Benchtop Incubator was connected to the certified premixed tri-gas tank which contained 5% O2, 6% CO2, and 89% N (Figure 1). Although two incubators connected with different CO2 concentration, their pH tests showed the range from 7.21 to 7.38 and no significant difference was observed between two medium in two types of incubators.
Embryo culture incubators. Two kinds of incubators are shown as big-box incubator (left) and Cook Bench Minc incubator (right).
This was a prospective randomized study of infertility couples undergoing assisted reproductive procedures during 2012–2013 at the Arizona Center for Reproductive Endocrinology and Infertility. During this period, all patients (age 25–43) were treated by our standard stimulation protocol (LA/HMG, HCG 10,000 IU/ml) before oocyte retrieval. The retrieval oocytes were cultured in P1 medium (Irvine Scientific, Inc) with 3% human serum albumin (HSA, InVitoCare, Frederick, MD) for 4–6 h at 37°C with 5% CO2 incubator. Then, oocytes were routinely inseminated in 100 μl of P1 medium microdrops for in vitro fertilization or conducted by intracytoplasmic sperm injection depending on husband sperm quality (approximately 35% of cycles required ICSI). Fertilization was assessed on the following day, 18–20 h after insemination or ICSI. If two distinct pronuclei (2PN) were observed, the fertilization was confirmed. The zygotes per patient were randomly divided into two groups and cultured in either P1 medium or Life-Global medium in petri dishes with each drop of 50 μl culture medium for another 2 days (see experimental design, Figure 2).
Embryo culture method. A patient sibling fertilized zygotes were randomly divided into two media and two incubators for culture.
Each embryo was cultured in an individual microdrop. The status of embryo cleavage and quality were assessed after a further 24 and 48 h of in vitro culture. The embryonic grade was evaluated according to the number and size equality of blastomeres, presence or absence of granularity, and the relative proportion of anucleate fragments by at least two experienced embryologists by 100X magnification on an inverted microscope. Based on our standard criteria, good-quality or top-quality embryos (Grade 5) were defined as regular, spherical blastomeres with less 10% extracellular fragmentations and had 6–10 blastomeres on day 3. Embryos with Grade 1–4 were defined as low quality. On the day of embryo transfer (ET), one to four embryos were selected for abdominal ultrasound-guided transfer to uterus according to patient age and embryo quality. The transferred embryos from each medium or incubator were recorded. The most of, most of the best quality embryos for transfer were selected from two media and two incubators. The remaining embryos, if any, were left in the culture dish to undergo cryopreservation. Clinical pregnancy was diagnosed by the presence of a gestational sac by ultrasound echographic screening approximately 5–6 weeks after the embryo replacement procedure.
Statistical analysis was performed using student
In 2008–2009, we often observed that the patient’s embryos had a different response to each medium. Some patient’s embryos favored to grow in the global medium, while some patient’s embryos preferred to live in the P1 medium and some embryos grew very well in both global medium and P1 medium, which means that embryos have a favorable selectivity to medium (Figure 3).
The patient’s embryo response to two media. On the same day, two patients’ embryos were placed in the two medium culture. Patient 1 embryos grew very well in the P1 medium (left), but they had a lot of fragmentation in global medium (right). However, the 10 embryos of patient 2 grew very well in both media.
In order to verify our former observation, two different commercially available media (P1 and Life-Global media) were used in this study. A total of 1850 normal fertilized 2PN zygotes from 220 consecutive patient cycles were studied. The cleavage rate and top-quality embryos on day 2 and day 3 were compared. Results indicated the same zygote cleavage rate for two media, and global medium seemed to yield slightly higher top-quality embryos on day 2 and day 3, but it was not statistically different between two media (
Embryo grade | Medium | Incubator | ||||||
---|---|---|---|---|---|---|---|---|
Global | P1 | Forma | Minc | |||||
Embryos/total | % | Embryos/total | % | Embryos/total | % | Embryos/total | % | |
Cleavage | 907/930 | 97.5a | 808/920 | 98.7a | 992/1025 | 96.8a | 807/825 | 97.8a |
Day 2 top-quality embryos | 633/845 | 74.9a | 624/836 | 74.6a | 730/988 | 73.9a | 598/800 | 74.8a |
Day 3 top-quality embryos | 564/857 | 65.8a | 477/768 | 62.1a | 573/902 | 63.3a | 478/726 | 65.8a |
Effect of culture media and incubators on zygote development.
aNo significant difference between two medium groups (
Some patient embryos were not observed on day 2 and were observed on day 3. Day 2 top-quality embryo shows 2–6 cells/Grade 5 and day 3 top-quality embryo shows 5–8 cells/Grade 5.
Patient embryos cultured in two medium did not show any significant difference on cleavage, day 2 and day 3 high-quality embryos.
Patient embryos cultured in two different incubators did not show any significant difference on cleavage, day 2 and day 3 high-quality embryos.
However, when the patient sibling embryos were cultured in two media, some patient embryos developed very well in the P1 medium, while some patient embryos grew well in global medium. Here, we gave four patient samples to show the responses of patient embryos to two culture media (Figures 6–9).
The four embryos of a 38-year-old woman showed very well growing in two media and two incubators. Day 3 embryos were displayed under the same microscope view.
The four embryos of a 23-year-old woman showed very poor growing in two media and two incubators. Day 3 embryos were displayed under the same microscope view.
The eight embryos of a 33-year-old woman showed very poor growing with P1 medium in two incubators and global medium in big-box incubator. However, three good-quality embryos were obtained in the global medium with Minc incubator.
The four embryos of a 41-year-old woman showed very good growing with global medium in two incubators and Pl medium in the Cook Minc incubator. Only one embryo was of poor quality in the P1 medium with big-box incubator.
Patient A was 38 years old. Five oocytes were retrieved on September 30, 2013, and four zygotes were individually cultured in P1 and global medium in Forma incubator and Cook Minc incubator, respectively. On day 3, all embryos showed a good quality under the various conditions
Patient B was 23 years old. Thirteen oocytes were retrieved on October 4, 2013, and four zygotes were individually cultured in P1 and global medium in Forma incubator and Cook Minc incubator, respectively. On day 3, all embryos showed a low quality and slow growing under the various conditions.
Patient C was 33 years old. Fourteen oocytes were retrieved on September 30, 2013, and 11 zygotes were cultured in P1 and global microdrop medium (one embryo in each drop) in Forma incubator and Cook Minc incubator, respectively. On day 3, only three good-quality embryos were obtained in the global medium in the Cook Minc incubator. Other eight embryos showed low quality under other three kinds of condition.
Patient D was 41 years old. Five oocytes were retrieved on October 4, 2013, and five zygotes were individually cultured in P1 and global medium in Forma incubator and Cook Minc incubator, respectively. On day 3, only one embryo in P1 medium with Forma incubator showed poor quality and other four embryos had good quality.
These results showed that the different patient’s embryos had different responses to media. In order to compare large number of data, 1875 embryos of 174 patients were divided into four groups. The first group contains 45% (78/174) patient’s embryos growing very well in either global medium or P1 medium. The second group contains 22% (38/174) patient’s embryos growing well only in global medium with poor quality in P1 medium. The third group contains 21% (37/174) growing well in the P1 medium but poorly in the global medium and the fourth group contains 12% (21/174) not good growing in both P1 and global media (Table 2). In order to clearly show the data of table, a bar graph was drawn (Figure 10). We may very clearly see some patient embryos growing very well in global medium or P1 medium, which showed patient embryo selectivity.
Embryo quality in medium | Patients/total patients (%) | Global medium | P1 medium | ||
---|---|---|---|---|---|
Embryo number | Top quality mean ±SD | Embryo number | Top quality mean ±SD | ||
Good in global and P1 | 78/174 (45%) | 391/448 | 87.6±16.3a | 359/425 | 84.5±16.2a |
Good in global but poor in P1 | 38/174 (22%) | 153/190 | 80.7±22.8a | 67/205 | 32.8±19.1b |
Good in P1 but poor in global | 37/174 (21%) | 51/185 | 27.7±20.6a | 137/200 | 68.3±22.5b |
Poor in global and P1 | 21/174 (12%) | 30/105 | 28.8±17.7a | 26/120 | 21.9±20.9a |
Patient sibling embryos in response to different culture media.
Growing distribution of patients’ embryos in two media for culture. The first bar in each group represents percentage of patient’s embryos in each group. P1 indicates P1 medium and G indicates global medium. The data indicate percentage.
The statistics of the pregnant rate showed 40% (10/25) in P1 medium and 42.5% (9/21) in global medium (
The statistics of patient pregnant rates in two media and two incubators.
In the last near four decades, assisted reproductive technologies have been widely applied to the treatment for infertile couples to realize their dream to have baby in their family. However, the current successful rate is still kept in low level about 40%. Thus, vast efforts have been undertaken to improve IVF pregnancy rate by continuously improving and modifying in vitro culture medium system and innovating in embryo selection techniques such as time-lapse, preimplantation embryo diagnosis and screening (PGD/PGS). So far, numerous studies have been reported on different culture medium formulations and their effects on embryo cleavage and blastocyst formation [12]. Although current commercial culture medium composition varies widely, all of them may support human embryo in vitro culture growing very well. Thus, the selection of embryo culture medium depends on laboratory embryologist’s favor and custom.
However, we are reporting a new observation which showed patient’s embryo-specific differences in response to culture media in clinical IVF-ET. Our results indicated that some patient’s embryos favored to grow in the global medium, while some patient’s embryos preferred to live in the P1 medium and some embryos grow very well in both the global medium and P1 medium; some patient’s embryos did not grow well in both P1 and global media, which means that different patient embryos have a favorable selectivity to culture medium. The aim of embryo culture after in vitro fertilization is to obtain good-quality embryos for transfer into women uterus. Because of patient’s embryo selectivity, when all embryos of a patient are placed in a single medium culture, it is possible that all embryos are either very good or very poor. If embryos show poor quality in the single medium, this patient may be a failure in this IVF cycle. However, when embryos are cultured in two media, some embryos may be poor quality in a medium, but some embryo may be good quality in another medium. Thus, this patient still has good-quality embryos for transfer in order to make sure an increase in pregnancy opportunity.
Our statistic results showed that 45% patient’s embryos grow very well in either global medium or P1 medium. Thus, the embryos from these 45% patients always grow very well no matter what media were used in either P1 or global medium. They are also easy to obtain successful pregnancy group. In addition, the embryos of about 12% patients could not grow well in both P1 and global media. These patients of this group are very difficult to get pregnancy because they cannot get any good-quality embryos for transfer using any medium. This may be due to patient oocyte quality or sperm quality. The embryos of remaining about 43% patients displayed a real medium selection. That means that 22% patient’s embryos were growing very well only in P1 medium but poor quality in global medium, while the embryos of 21% patients grew well in the global medium but poorly in the P1 medium. Thus, we may obtain high-quality embryos from this 43% patient group by the selection of two culture media. In this way, the best estimation of IVF successful rate may reach to 45 + 43 = 88% of patients under the current IVF technology. In our statistics based on various ages of transfer embryo women, the pregnant rate of each group in two media and two types of incubators are listed in Table 3. However, this very high pregnancy rate resulted in 20.7% twin and 3.74% triplet baby birth, which showed that two medium cultures really increased transfer embryo implantation opportunity. In clinical practice, the number of transfer embryos should be reduced significantly accordingly.
Patient age | Transfer embryo no. and range | Pregnant no. and rate (%) |
---|---|---|
<28 | 1.98 (1–2) | 20/23 (86.96%) |
28–34 | 2.64 (1–3) | 50/67 (74.63%) |
35–27 | 2.94 (2–4) | 24/33 (72.72%) |
38–40 | 3.12(1–4) | 21/32 (65.63%) |
>40 | 3.81 (2–4) | 9/21 (42.86%) |
The result of pregnancy with two media and two types of incubators for embryo culture and mixed embryo transfer.
Transferring embryos from two media may significantly improve human IVF pregnancy rate. Wirleitner et al. [17] ever reported an interesting observation in which the transfer of two embryos where one embryo was cultured in either medium resulted in a significantly high rate of twin pregnancies. Our research showed that two medium cultures might obtain 71% pregnancy rate. However, if single medium was used for culture, it may just produce about may produce about 40% pregnant rates. Using two media in one incubator for culture may increase to 60% pregnancy rate. When two media plus two incubators were used, the pregnancy might increase to 73%. Thus, the application of two media and two types of incubators may significantly improve human IVF/ICSI clinical pregnancy.
Patient-specific variability in response to commercially available media appears to play a significant role in clinic IVF practice, and the application of two media and two types of incubators for each patient embryo culture enables to ensure every patient to have sufficient high-quality embryos for transfer. The favorable response of individual patient’s embryos to media and incubators suggests that in IVF clinic practice, using two media and two incubators for embryo culture could significantly improve IVF/ICSI pregnant rates.
Today the younger neurosurgical generation has a reduced possibility for practical training in nearly all fields of neurosurgery. Accordingly, neurosurgical training models show increasing popularity. However, skull-base surgery often has a higher level of difficulty and is therefore rarely integrated into the basic surgical training of younger neurosurgeons. Even sophisticated modern, computer-based 3D models cannot adequately replace the important practical and hands-on surgical training. For this reason, we need realistic and gradually coordinated practical scenarios to learn and practice basic neurosurgical skills in sequential steps. Here we present some easy-to-implement practical examples that have proven themselves for operative training in skull-base surgery and for vascular microsurgery.
The number of skull-base procedures as well as microsurgical clipping of cerebral aneurysms is continuously decreasing. Meanwhile, the endovascular treatment of cerebral aneurysms has markedly reduced the number of microsurgical clipping procedures. The result will be a reduced possibility for practical training in aneurysm surgery, especially for the younger generation [1, 2, 3]. Stereotactic radiosurgery on one hand, and the increasing number of patients successfully treated by endovascular techniques on the other hand, will further reduce the overall caseload in skull-base and vascular microsurgery in the next years. However, especially huge, calcified or wide neck aneurysms will remain for microsurgical clip occlusion and will be a challenge for cerebrovascular neurosurgeons in the future. On the other hand, revascularisation and bypass techniques will be more and more in demand [4, 5]. Due to these conditions, concepts and realistic models for practical microsurgical training are necessary to improve the practical skills in neurosurgeons during their training, especially in the field of vascular and skull base surgery [6, 7, 8, 9, 10, 11, 12].
Various VD training models have been developed, tested and published [13, 14, 15]. Recently, we performed another prospective study to evaluate practices, pitfalls and traceability in a realistic but virtual set-up for simulating ventricular drainage (VD) placement as a practicable training model using our navigation system (Brainlab, Munich, Germany), the navigation pointer functioning as a virtual VD catheter to be placed in the cMRI of a healthy subject (Figure 1). We evaluated accuracy by repeated virtual freehand VD placement on the prone subject using anatomical landmarks by neurosurgeons-in-training and non-neurosurgical staff. The influence of the level of neurosurgical knowledge and training level were of overall interest, especially in narrow ventricles. It was found that accurate VD placement correlated with neurosurgical experience (Figures 2 and 3). These initial results are not yet published, however.
Study set-up for virtual VD placement. The navigation pointer functions as a virtual VD catheter to be placed in the cMRI of a healthy subject.
A selection of virtual VD trajectories by participants with neurosurgical experience including the ‘ideal trajectory’ in blue.
A selection of virtual VD trajectories by participants without neurosurgical experience including the ‘ideal trajectory’ in blue.
This simple set-up is an easy model for continuous neurosurgical training, with the aim of optimizing the medical care of our patients and constantly improving the level of education. Its set-up could be varied further, for example, as a good training module for simulating an intraoperative emergency puncture of the ventricle, exemplary in an atypical pterional positioning of the head. This poses an unusual situation that requires high surgical skills with an excellent three-dimensional spatial concept.
Navigation systems offer a multitude of technical options that can be used for training and further education [16, 17]. Brainlab has been offering the function of transparent reflection in a superimposed display of previously segmented anatomical structures for over 20 years (Figure 4). This head-up display, as an early AR tool, in which the pre-planned and segmented structures are faded into the ocular of the operating microscope or onto the screen, allows optimal orientation and is didactically very valuable. However, the accusation is justified that we generally use these technical possibilities of virtual reality or augmented reality, offered as multiplanar visualization or as 3D reconstruction view, far too little for teaching and training purposes [17].
Intraoperative screenshot during a skull base procedure performed on April 12, 2002, shows then state-of-the-art technology with intraoperative AR tools that were already available at the time. The preoperatively segmented relevant anatomical structures are demonstrated and the navigation pointer shows the trajectory to the clival meningioma via a combined antero-sigmoidal/sub-temporal approach. The dominant sigmoid and transverse sinus (green) and the lateralized basilar artery (magenta) displaced by the tumor are visualized.
Recently, our department has been working with AR 3D models (UpSurgeOn S.r.l., Milan, Italy) to improve surgical and anatomical skills as well as presurgical positioning of the patient (Figure 5). For this, the department acquired partially reusable 3D models of the most common cranial neurosurgical approaches including certain pathologies (e.g., intracranial aneurysms) (Figures 6–8). The 3D models are made of synthetic materials which render them extremely lifelike in haptics and handling. They can be used as are or in conjunction with an AR app (UpSurgeOn Neurosurgery S.r.l., Milan, Italy), which walks the surgeon through the entire procedure by fusing a virtual image with the actual model, starting with optimal positioning of the patient for the specific surgery (Figures 9–11). The app also allows an image of the patient awaiting the planned procedure to be projected into any space, allowing the surgeon a 360° view. Training sessions were held for neurosurgery residents, offering them the opportunity to practice neurosurgical approaches safely, including craniotomies, drilling with various bits, brain retraction, basic intradural dissection and even aneurysm clip placement. We acquired a navigational data set for one of the models by placing it in a CT-scanner and uploading the data set it into our navigation system (Brainlab, Munich, Germany), thereby giving participants the additional chance to practice the procedure image-guided in a non-bloody and risk-free manner whilst getting more familiar with the navigation system itself (Figure 12). Our results concerning the efficacy of this kind of modern training model have yet to be published; however, anecdotally, residents report feeling more secure in their surgical approaches, in choosing and handling surgical drills as well as in the positioning of patients for surgery. Some residents now use the UpSurgeOn App to plan surgeries in advance or to double-check the preoperative positioning of the patient by overlaying the actual patient with an AR model.
Our setup for a cadaver-free manual training session with AR 3D models (UpSurgeOn S.r.l., Milan, Italy).
Our setup for a cadaver-free manual training session with AR 3D models (UpSurgeOn S.r.l., Milan, Italy). The models can be reused by purchasing additional craniotomy covers as depicted here.
Close-up of the ‘aneurysm box’ including the craniotomy model, the synthetic brain and vessels and the associated QR code for use in conjunction with the Upsurgeon App for an AR component. The right-sided aneurysm is partially visible through the Sylvian fissure.
Retracting the synthetic brain to expose the right-sided MCA aneurysm. The materials used render the models extremely lifelike in haptics and handling.
The models can be used as are or in conjunction with an AR app (UpSurgeOn Neurosurgery S.r.l., Milan, Italy) via a QR code as pictured here. The materials used render the models extremely lifelike in haptics and handling. Depicted here is a right-sided pterional approach with craniotomy already performed. The underlying synthetic dura is visible.
Here the 3D model is fused with a virtual image via the accompanying QR code, allowing the surgeon to explore deeper intracranial structures of the specific surgical approach.
Hybrid view of one of the 3D models showing a right-sided ICA aneurysm.
The navigational data set for the 3D model of an MCA aneurysm.
Due to the relative ease and cost-effectiveness of implementing the aforementioned tools, we consider simulation-based cadaver-free training with AR a promising option to bring skull-base surgery training to a new level.
The intense occupation with radiological images, necessary for the segmentation of a tumour or any other lesion and the marking of the anatomical structures, already brings great didactic benefit to the colleagues who are in training. During surgery, the recognition value of the anatomical structures rendered in the CT or MRT as a three-dimensional surgical site under the surgical microscope provides the greatest learning value. The use of navigation data for the dedicated operation planning and the daily discussion of the surgical cases are essential for this. Particularly, in the case of complex skull base operations, the position, craniotomy, microsurgical strategy and resulting operation-specific risks should routinely be discussed with the assistant physicians on the day before the surgical procedure in a pre-op conference. In particular, the discussion of surgery-specific anatomy on the basis of the 3D navigation data provides optimal preparation for these complex neurosurgical interventions [17]. So the following day, the display of the operation-specific anatomical structures via the head-up display during surgery will provide a much higher didactic benefit for complex skull base procedures (Figure 13).
The operating microscope (Neuro NC4, Carl Zeiss) was linked and registered with the navigation system (Brainlab VectorVision). After the combined craniotomy and opening of the dura, AR overlay head-up display depicts the dominant sigmoid and transverse sinus (green), the basilar artery (magenta) and the clival meningioma below.
Here we present two sophisticated in-vitro artificial plastic models which closely mimic real vascular conditions and a more complex in-vivo experimental animal bifurcation aneurysm model in rabbits [18]. For initial and basic microvascular training, the poly-vinyl-chloride (PVC) rat model (Microsurgical Developments Foundation, Maastricht, The Netherlands) shows itself to be more or less sufficient [19]. For a more realistic haptic feeling and enhanced specific microvascular training, a model with highly elastic polyvinyl alcohol (PVA) vessels and an anatomical plastic head (Kezlex, Ono & Co., Ltd., Tokyo, Japan) is available [18, 20]. Additionally, our highly sophisticated in-vivo experimental animal model (rabbit carotid artery bifurcation model) is demonstrated and discussed [21, 22, 23].
Using the PVC rat model for ‘unbloody training’ of microsurgical techniques and improvement of practical skills is a perfect example of the replacement of living animals (Figure 14). The number of live animals used for in-vivo training will likely be reduced in the future, therefore these in-vitro methods will be needed to make the transition to in-vivo models easier. The PVC rat model (Microsurgical Developments Foundation, Maastricht, The Netherlands) should be the first step in the practical education and allow various microsurgical training situations. The replacement of the plastic vessels is easy and relatively cheap [19]. Using a specific nozzle at the back of the rat model, the colored vessels can be filled with water, thus permitting an easy check of patency and quality of the anastomosis.
In-vitro model with plastic vessels of the abdominal cavity of the PVC rat (Microsurgical Developments Foundation, Maastricht, The Netherlands).
In the prospective part of our published study [18], end-to-end and end-to-side anastomoses were performed with three different levels of difficulty in the PVC rat model. In total six surgeons with different expertises and different levels of vascular training and surgical skills performed these microsurgical procedures. Different sizes of plastic tubes of various lengths and diameters were used for reduction of the surgical approach and the workspace, to adapt the experimental set-up to a scenario with different degrees of difficulty (Figure 15). Those plastic tubes reduce the operative field and consecutively the surgical working space and determine the trajectory and the direction for the instruments. Due to this focused working channel, the degree of freedom for using the instruments is restricted and therefore, the level of difficulty to perform an adequate anastomosis increases significantly (Figure 15). The different sizes of the plastic tubes mimic intraoperative conditions in a narrow and deep surgical field. Plastic tube I (Advanced) has a diameter of 40 mm and a depth of 15 mm. Tube II (Expert) has a diameter of 30 mm and a depth of 35 mm (Figure 15). Tube III (Master) has a diameter of 25 mm and a depth of 45 mm. For the anastomoses, we used conventional microsurgical instruments and monofile polyamid sutures 8/0 (BV 2 needle), respectively, 10/0 (BV 100-4 needle) Ethilon (Ethicon, Johnson & Johnson MEDICAL GmbH, Norderstedt, Germany).
A transparent plastic tube was brought into the operative field and fixed to a conventional flexible retractor system to reduce the working space and mimic surgical conditions in deeper approaches. In this narrow workspace, the level of difficulty to perform an anastomosis significantly increases.
In this experimental set-up, the increase of surgical complexity by reducing the workspace with the different plastic tubes clearly demonstrates that the time of surgery to perform the anastomosis increased significantly (Figure 15). In addition, the rate of incorrect sutures of the vessel wall increased, the narrower the surgical field became due to the decreasing diameter of the tube. Therefore, the overall patency rate of the anastomosis was clearly reduced with increasing grade of complexity [18].
The wet PVA vessels of the vascular anastomosis practice kit are transparent, highly flexible and soft [20]. However, they have to be kept moist and tend to dry out and lose their elasticity, especially under the high-energy xenon light of the operating microscope. At present, we have used the PVA vessels of the vascular anastomosis practice kit for various experimental anastomoses. Compared to the PVC vessels in the rat model, the preparation and handling of the PVA vessels, especially the grasping with a forceps or the insertion of the needle into the vessel wall is much more realistic and closely mimics human conditions.
An even more realistic scenario is provided by the plastic skull model with relatively soft and deformable silicone brain material and the vascular anastomosis practice kit with highly elastic plastic (PVA) vessels (Kezlex, Ono & Co., Ltd., Tokyo, Japan). The very soft and elastic plastic vessels of the vascular anastomosis practice kit are available in three different diameters: 1 mm, 2 mm and 3 mm. The vascular kit with the humid PVA vessels has a perfect haptic feeling during preparation, cutting and suturing of the vessels. The whole set-up with the deformable plastic brain, the realistic feeling of retraction and especially the optical impression under the microscope generate an overall aspect of a real microsurgical scenario closely mimicking human conditions.
The 3D model with pterional craniotomy and the deformable frontal and temporal lobe (Kezlex, Ono & Co., Ltd., Tokyo, Japan) is a perfect in-vitro model to simulate an opened Sylvian fissure for experimental bypass, as well as aneurysm surgery training.
This set-up allows a realistic retraction of the Sylvian fissure, its handling and preparation closely imitating human conditions (Figure 16).
This plastic skull and silicone brain model shows an extended pterional approach with slight retraction and opening of the Sylvian fissure. An end-to-side anastomosis was performed using highly elastic PVA-vessels (Kezlex, Ono & Co., Ltd., Tokyo, Japan). This set-up allows for a realistic scenario and the handling of the vessels during the anastomosis, closely mimicking human conditions during bypass surgery.
We also used 3D printed aneurysms made from soft PVA tubing that could be clipped for training purposes. The 3D printed hollow aneurysms were positioned in the depth of the Sylvian fissure and so microsurgical clip application could be simulated adequately (Videos 1 and 2, https://bit.ly/3AeRgNk). Then the experimental plastic aneurysm could be removed from the site to assess the success of the clipping maneuver (Video 3, https://bit.ly/3AeRgNk). These realistic human skull and brain models are relatively expensive but could be used repeatedly [24, 25]. If the models are integrated into practical teaching and training, they help to establish a realistic microsurgical scenario and are definitively superior to computer-based animations alone [26].
The materials and methods of the experimental aneurysm bifurcation model in rabbits (Figure 17) were described in great detail in previous publications [21, 22, 23]. The developed and previously described animal bifurcation aneurysm model is a perfect and highly realistic vivisection model for education and practical training for microsurgical handling and preparation of cerebral vessels. However, this model should be used as a final education tool in an advanced stage of training. The blood flow, the vessel diameter, the haptic feedback, even the induced vasospasms by manipulating too roughly, and the tension of the vessel walls, all of this can be compared to vascular microsurgery in humans (Figures 17 and 18). Therefore, it is an optimal training tool for all cerebrovascular reconstructive surgical procedures and maintains expert status in bypass surgery [27].
In-vitro model in a rabbit. An end-to-side anastomosis of both carotid arteries was created using 10/0 sutures to generate an arterial bifurcation.
The insertion of a venous pouch into the bifurcation finally results in an experimental bifurcation aneurysm, comparable to a 6 mm MCA aneurysm with a broad neck. The in-vivo bifurcation aneurysm model is a perfect training tool for clip application, especially if a plastic tube (schematic drawing) creates a narrow workspace with limited access for the clip applicator. Due to the determined trajectory, the clip occlusion of the aneurysm mimics human conditions. This set-up is a sophisticated in-vivo training model for active teaching and practical training for bypass surgery, as well as aneurysm clipping.
Additionally, this experimental aneurysm model allows an optimal practical training of clip application and is a realistic teaching model for optimizing clip occlusion of cerebral aneurysms. As described in the PVC rat model study conditions, the different sizes of plastic tubes were also integrated into our experimental animal model (Figure 18). The tubes were fixed to a conventional and flexible retractor system and could be removed easily if difficulties arise, especially inadvertent bleeding intraoperatively. The transparent plastic tubes create a narrow and deep surgical approach by restricting the angle of view and determining the trajectory of the clip occlusion of the aneurysm as in real aneurysm surgery. After clipping of the experimental bifurcation aneurysm, the plastic tube was removed and the aneurysm could be inspected easily from all sides and the clip position could be checked adequately.
For repeated training, the clip was removed from the experimental aneurysm and the procedure could be repeated, for example, with a narrower, longer or differently angled plastic tube, creating a completely new situation with a different view and access to the experimental bifurcation aneurysm. This high-end in-vitro animal model is an excellent and realistic set-up for intensive practical training and teaching of aneurysm clipping. However, it takes a great deal of logistical and technical effort to produce such an experimental animal aneurysm.
VR and AR are currently established in many areas of medical education and should increasingly become the standard in modern neurosurgical advanced teaching and training as well. Therefore, these tools should also be used regularly for surgical training and further education of young neurosurgeons. With modern navigation systems, diverse software and hardware components are generally available and should consequently be used and strictly integrated into our daily clinical routine. This technology thus forms the basis for highly qualified practical training in skull base surgery. In addition, it facilitates the necessary interdisciplinary cooperation between faculties and offers the opportunity for lifelong learning for all surgically active colleagues in skull base surgery.
In-vitro models, like the AR 3D models, the PVC rat model or the PVA vascular model combined with the realistic brain and craniotomy site, allow for a perfect set-up for the advanced training of microsurgery and microvascular anastomoses. The main advantages of these artificial plastic models are their overall availability, the low price and the lack of a specific OR set-up or instruments, compared to training in in-vivo models. The costs and logistical considerations, as well as the ethical and legal aspects involved in maintaining living animals for education and training, make in-vivo models a relatively impractical tool.
These in-vitro models are easily adaptable to the respective circumstances and allow unhindered practical training under almost realistic operating conditions. The surgical complexity with end-to-end and end-to-side anastomoses could be adapted in models and the success rate is easy to check. Parameters like the time of surgery, the rate of incorrect sutures of the vessel wall and the overall patency rate of the anastomoses can be clearly monitored, as well as the learning curve. Therefore, these in-vitro models form the basis for the first step in basic practical training and are a prerequisite for a successful career in vascular neurosurgery and skull base surgery.
In-vivo models should be the last step of practical education. Like our experimental animal model with the insertion of a venous pouch within the microsurgically created arterial bifurcation represents an advanced training model very close to realistic human conditions. In the first step of this model, microvascular anastomoses are trained and secondly, the resulting bifurcation aneurysm is a perfect training tool to learn clip application. Especially, if a plastic tube is positioned over the surgical field and creates a narrow approach with restricted workspace and limited scope for manipulation for the correct clip occlusion of the aneurysm. Our experimental animal model represents a higher level of surgical vascular expertise and additionally is a perfect model to practice bypass surgery, as well as the appropriate handling of clip application and clip occlusion of cerebral aneurysms.
The authors have no financial relationship with the organizations mentioned in the paper. All authors declare that they have no conflict of interest.
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He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. 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Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. 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He also obtained an MSc in Molecular and Genetic Medicine, and a Ph.D. in Clinical Immunology and Human Genetics from the University of Sheffield, UK. He also completed a short-term fellowship in Pediatric Clinical Immunology and Bone Marrow Transplantation at Newcastle General Hospital, England. Dr. Rezaei is a Full Professor of Immunology and Vice Dean of International Affairs and Research, at the School of Medicine, Tehran University of Medical Sciences, and the co-founder and head of the Research Center for Immunodeficiencies. He is also the founding president of the Universal Scientific Education and Research Network (USERN). Dr. Rezaei has directed more than 100 research projects and has designed and participated in several international collaborative projects. He is an editor, editorial assistant, or editorial board member of more than forty international journals. He has edited more than 50 international books, presented more than 500 lectures/posters in congresses/meetings, and published more than 1,100 scientific papers in international journals.",institutionString:"Tehran University of Medical Sciences",institution:{name:"Tehran University of Medical Sciences",country:{name:"Iran"}}},{id:"180733",title:"Dr.",name:"Jean",middleName:null,surname:"Engohang-Ndong",slug:"jean-engohang-ndong",fullName:"Jean Engohang-Ndong",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180733/images/system/180733.png",biography:"Dr. Jean Engohang-Ndong was born and raised in Gabon. After obtaining his Associate Degree of Science at the University of Science and Technology of Masuku, Gabon, he continued his education in France where he obtained his BS, MS, and Ph.D. in Medical Microbiology. He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. 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