Timeline of publications.
\r\n\t
",isbn:"978-1-80355-841-7",printIsbn:"978-1-80355-840-0",pdfIsbn:"978-1-80355-842-4",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,hash:"c8bc6f25678ec6a696adb8003e937432",bookSignature:"Dr. Wei Wu, Ms. Qiuqin Tang, Prof. Panagiotis Tsikouras, Prof. Werner Rath and Prof. Georg-Friedrich Von Tempelhoff",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11280.jpg",keywords:"Ultrasound, Biochemical Screening, Amniocentesis, Fetoscopy, Karyotype, Molecular DNA Testing, Congenital Malformation, Birth Defects, Biomarker, Protein, Prenatal Diagnosis, Prenatal Screening",numberOfDownloads:268,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 2nd 2021",dateEndSecondStepPublish:"February 23rd 2022",dateEndThirdStepPublish:"April 24th 2022",dateEndFourthStepPublish:"July 13th 2022",dateEndFifthStepPublish:"September 11th 2022",remainingDaysToSecondStep:"3 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"A pioneering researcher in reproductive medicine, appointed associate department chair of Department of Toxicology, Nanjing Medical University, Society of Toxicology full member and holder of eleven registered patents. Dr. Wei Wu has received awards from many national societies for the originality and quality of his projects. He has authored 70 peer-reviewed papers in international journals.",coeditorOneBiosketch:"A pioneering researcher in obstetrics and holder of three registered patents. Dr. Qiuqin Tang's research interests include genetic and epigenetic risk factors of reproductive and developmental health. She has authored over 20 papers in international journals.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"178661",title:"Dr.",name:"Wei",middleName:null,surname:"Wu",slug:"wei-wu",fullName:"Wei Wu",profilePictureURL:"https://mts.intechopen.com/storage/users/178661/images/system/178661.jpeg",biography:"Dr. Wei Wu is an associate professor and associate department\nchair in the Department of Toxicology, Nanjing Medical University, China, where he received his Ph.D. in Toxicology in 2012.\nHe was a guest researcher at the National Institute of Environmental Health Sciences (NIEHS) between 2017 and 2018. Dr.\nWu is a member of different national and international societies\nin the fields of human reproduction and toxicology and has\nreceived awards from many national societies for the originality and quality of his\nprojects. Dr. Wu has authored seventy-three peer-reviewed papers in international\njournals. He has edited four books and collaborated on ten others as well as seventeen patents and in the organization of three international conferences. He is a\nreviewer for ninety-eight journals.",institutionString:"Nanjing Medical University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"Nanjing Medical University",institutionURL:null,country:{name:"China"}}}],coeditorOne:{id:"184798",title:"Ms.",name:"Qiuqin",middleName:null,surname:"Tang",slug:"qiuqin-tang",fullName:"Qiuqin Tang",profilePictureURL:"https://mts.intechopen.com/storage/users/184798/images/13334_n.jpg",biography:"Qiuqin Tang is an attending doctor of The Women’s Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital). Her research interests include genetic and epigenetic risk factors of reproductive and developmental health. She has authored over 20 papers in international journals such as EBioMedicine, Clinical Epigenetics, Molecular Human Reproduction, Scientific Reports, and European Journal of Endocrinology. She has collaborated in four books and three patents. 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He is also the headmaster of the Family Planning Centre and Gynecological Cytology\nLaboratory at the same university. Dr. Tsikouras is a fellow of the\nInternational Academy of Clinical and Applied Thrombosis/Hemostasis. His scientific activities focus on paediatric and adolescence medicine, gynecological oncology, high-risk pregnancies. He is a reviewer for several international journals and has numerous scientific publications to his credit, including papers and book chapters. 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He\nis currently a professor in the Gynecology and Obstetrics Faculty\nof Medicine, University of Kiel, Germany, and honorary doctor\nat the Democritus University of Thrace, Alexandroupoli University Hospital He previously served as chief of the Department\nof Gynecology and Obstetrics at University Hospital RWTH Aachen,\nGermany. Dr. Rath is a reviewer for numerous journals and chief editor of Geburtshilfe und Frauenheilkunde (GebFra). He has several publications, including thirteen\nbook chapters, to his credit.",institutionString:"Kiel University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Kiel University",institutionURL:null,country:{name:"Germany"}}},coeditorFour:{id:"299669",title:"Prof.",name:"Georg-Friedrich",middleName:null,surname:"Von Tempelhoff",slug:"georg-friedrich-von-tempelhoff",fullName:"Georg-Friedrich Von Tempelhoff",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:"St. Vinzenz Krankenhaus",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:[{id:"79159",title:"Open Fetal Surgery and Fetoscopic Repair in Spina Bifida and Myelomeningocele in Romania",slug:"open-fetal-surgery-and-fetoscopic-repair-in-spina-bifida-and-myelomeningocele-in-romania",totalDownloads:61,totalCrossrefCites:0,authors:[null]},{id:"79947",title:"Endoscopic Approach to Ectopic Pregnancy",slug:"endoscopic-approach-to-ectopic-pregnancy",totalDownloads:59,totalCrossrefCites:0,authors:[null]},{id:"80212",title:"Diagnosis of Ectopic Pregnancy",slug:"diagnosis-of-ectopic-pregnancy",totalDownloads:74,totalCrossrefCites:0,authors:[null]},{id:"80756",title:"Medical Management of Ectopic Pregnancy",slug:"medical-management-of-ectopic-pregnancy",totalDownloads:32,totalCrossrefCites:0,authors:[null]},{id:"81269",title:"Fetal Craniospinal Malformations: Aetiology and Diagnosis",slug:"fetal-craniospinal-malformations-aetiology-and-diagnosis",totalDownloads:13,totalCrossrefCites:0,authors:[null]},{id:"81570",title:"Prenatal Diagnosis of Diaphragmatic Hernia",slug:"prenatal-diagnosis-of-diaphragmatic-hernia",totalDownloads:15,totalCrossrefCites:0,authors:[null]},{id:"81868",title:"Prenatal Diagnosis: The Main Advances in the Application of Identification of Biomarkers Based on Multi-Omics",slug:"prenatal-diagnosis-the-main-advances-in-the-application-of-identification-of-biomarkers-based-on-mul",totalDownloads:1,totalCrossrefCites:0,authors:[null]},{id:"81273",title:"Ectopic Pregnancy after Ipsilateral Salpingectomy",slug:"ectopic-pregnancy-after-ipsilateral-salpingectomy",totalDownloads:13,totalCrossrefCites:0,authors:[null]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"278926",firstName:"Ivana",lastName:"Barac",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/278926/images/8058_n.jpg",email:"ivana.b@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"63205",title:"Visual Loss in Neuro-Ophthalmology",doi:"10.5772/intechopen.80682",slug:"visual-loss-in-neuro-ophthalmology",body:'\nAccurate medical history is very important information, helping to evaluate the etiology of visual loss. Rapid onset is characteristic of optic neuritis, ischemic optic neuropathy, inflammatory (non-demyelinating), and traumatic optic neuropathy. On the other hand, gradual onset over months or even years is typical of compressive toxic/nutritional optic neuropathy. A history over years is seen in compressive and hereditary optic neuropathies. The ophthalmologist or neurologist can make the differential diagnosis according the symptoms, the age of onset, and the gender. Young age group (15–45 years) for optic neuritis women gender and pain on eye movement are more typical for optic neuritis versus. Elderly patients (older than 50 years), painless loss of vision without gender predisposition are typical for ischemic optic neuropathy. Additionally, in a young patient, history of neurological symptoms such as parenthesis, limb weakness, and ataxia is suggestive of demyelinating optic neuritis.
\nIn an elderly patient (more than 60 years mostly 70–80 years) with signs of severe optic neuropathy and the presence of preceding transient visual loss, temporal pain, jaw claudication, fatigue, fever, anemia, weight loss and myalgia, an arteritic ischemic optic neuropathy (AION) due to giant cell arteritis (GCA) should be suspected.
\nIn children, a history of recent flu-like illness or vaccination days or weeks before vision loss points to a para-infectious or postvaccinia optic neuritis, respectively.
\nTransient visual obscurations, transient diplopia, and headache should raise the suspicion of increased intra-cranial pressure.
\nThe use of any medications should be carefully noted, since some are either directly or indirectly toxic to the optic nerve. These include drugs as ethambutol, methanol, isoniazid, tobacco alcohol, and more. History of diabetes mellitus, systemic hypertension, hypercholesterolemia, coagulation deficit, and smoking is more common in patients with nonarteritic ischemic optic neuropathy (NAION). Patients who have history of malignancy may have infiltrative or para-neoplastic optic neuropathy. It is important to inquire into the patient’s general health, eating, and social habits (drinking and smoking) in suspected nutritional optic neuropathy (complex B–vitamins). In addition, a detailed family history is inquired in diagnosing hereditary autosomal and mitochondrial optic neuropathies.
\nThis chapter addresses the major diseases neuropathies accompanied by rapid visual loss: nonarteritic and arteritic optic neuropathy, traumatic optic neuropathy, and optic neuritis.
\nAnterior ischemic optic neuropathy (AION) is a medical condition involving insufficient blood supply of the pial vessels originating from the choroidal vessels to the optic disk. AION is generally divided into two types: arteritic AION (or AAION) and nonarteritic AION (NAION) [1, 2].
\nWe have to differentiate between two different etiologies, and therefore, workout prognosis and treatment possibilities are different.
\nNAION is the most common cause of sudden optic nerve-related vision loss. It is estimated that the incidence of NAION is about 8000/year in the USA and encountered for 90% of the optic neuropathies. NAION is mostly unilateral [3] and rare bilaterally. NAION is more frequent in Caucasians, no gender predisposition, and mean age at onset in most studies is from 57 to 65 years. No clinically effective treatment exists because little is known about its pathophysiology, and there are only few histopathological studies of the acute condition.
\nNAION [1, 2] typically presents suddenly upon awakening the painless patient notes seeing poorly in one eye. Vision in that eye is obscured by a dark shadow, often involving just the upper or lower half of vision. On examination, the patient is found with visual acuity reduction from 20/25 down to hand movement only, relative afferent pupillary defect (RAPD), swollen disk (segmental or diffuse) with splinter hemorrhages (see Figure 1), absent of large cup, and contralateral disk is small and crowded in 20–40% of the patents [4]. In approximately 6 months following the infarct visual acuity improves by 3 or more lines of vision on the Snellen chart in 42.7% of patients. In addition, vision had worsened by 3 lines or more in 12.4% of patients; some clinicians use the term “progressive ischemic optic neuropathy”. Second eye involvement occurs in approximately 20% of patients with NAION within 5 years. Furthermore, most cases of NAION involve the loss of an altitudinal hemifield (Figure 2) (either the upper or mostly lower half of the visual field, but not both), and visual acuity remains almost normal or slightly reduced.
\nFigure 2 shows a few cases of NAION, which involve almost total loss of vision. The mechanism of injury for NAION is used to be controversial. Experts have come to a consensus that most cases involve two main risk factors. The first is a predisposition in the form of a type of optic disk shape named crowded disk [4, 5] or “disk at risk,” where the cup/disk ratio is low (0.0–0.1), and secondly, cardiovascular risk factors as diabetes mellitus, hypertension, hypercholesterolemia, and coagulation deficits. Laboratory examinations at the presentation to differentiate between NAION and AAION include (erythrocyte sedimentation rate [ESR] that should be less than 40 mm/h) and C-reactive protein (CRP). It is advised to draw complete blood count and serum chemistry especially glucose, serum cholesterol and triglycerides, coagulophatic state, antitrombin III antiphospholipid antibody, and serum fibrinogen. Analysis of brain MRI suggests an increasing number of ischemic white matter lesions. Additional risk factor such as obstructive sleep apnea, migraine, and hyperhomocysteinemia, smoking and optic disk drusen [6]. Ipsilateral carotid disease does not seem to be a risk factor for NAION. Association between cerebral and cardiac vascular disease seems to be very circumstantial. Drugs associated with NAION are amiodarone, phosphodiesterase-5 inhibitors such as sildenafil [7], and interferon-a.
\nDisk appearance in nonarteritic ischemic optic neuropathy.
Visual field in NAION and lower altitudinal hemianopia.
Most experts throughout the world believe that there is no accepted treatment to reverse the damage. However, a recent large study by Hayreh has shown that if patients are treated with large doses of corticosteroid therapy during the early stages of NAION, in eyes with initial visual acuity of 20/70 or worse, seen within 2 weeks of onset, there was visual acuity improvement in 70% in the treated group compared to 41% in the untreated group [8]. Hayreh and Zimmerman performed a nonrandomized, open-label trial of systemic corticosteroids for acute NAION, and the untreated group had more vascular risk factors than the treated group, and therefore, this study was very criticized and not accepted by most neuro-ophthalmologists worldwide.
\n\n
Diphenylhydantoin
Intravitreal: anti-VEGF agents (e.g., Bevacizumab), (see more information)
Erythropoietin/erythropoietin receptor agonists
Surgical: optic nerve sheath fenestration, optic neurotomy (see more information)
Hyperbaric oxygen [13]
The trial was done to assess the safety and efficacy of optic nerve decompression surgery compared with careful follow-up alone in patients with nonarteritic anterior ischemic optic neuropathy (NAION). The ischemic optic neuropathy decompression trial (IONDT) is a randomized, single-masked, multicenter trial and was carried out in 1994. Study was done by 244 patients with NAION and visual acuity of 20/64 or worse.
\nFirst group of 125 patients had been randomized to careful follow-up, and second group with 119 patients had been randomized to surgery, with 6 months of follow-up.
\nPatients in the surgery group received optic nerve decompression surgery and follow-up ophthalmologic examinations; those in the careful follow-up group received ophthalmologic examinations at the same times as the surgery group. A parameter of gain and loss of three or more lines of visual acuity on the New York Lighthouse chart at 6 months after randomization was used by the research group and measured by technicians.
\nResults showed that patients assigned to surgery did no better when compared with patients assigned to careful follow-up regarding improved visual acuity of three or more lines at 6 months: 32.6% of the surgery group improved compared with 42.7% of the careful follow-up group. According to the results, IONDT indicates that optic nerve decompression surgery for NAION is not effective and may be harmful [14].
\nIntravitreal bevacizumab for the treatment of NAION neuropathy: a prospective trial [15].
\nIn this non-randomized controlled clinical trial, 1.25-mg intravitreal Bevacizumab was compared with natural history [15]. Twenty-five patients were enrolled (17 with treatment and 8 controls). Patients were examined at baseline, 1, 3, and 6 months with a full neuro-ophthalmic exam, automated perimetry, and optic nerve optical coherence tomography (OCT) measurements. The primary outcome measure was change in mean deviation on Humphrey visual field testing. Secondary outcome measures were changed in visual acuity and optic nerve OCT thickness.
\n(A) There was no significant effect of treatment on the primary outcome measure of mean deviation score (P = 0.4). (B) There was no effect of group assignment on the secondary outcome measures of change in mean Early Treatment Diabetic Retinopathy Study (ETDRS) letters (P = 0.33). (C) No change in nerve fiber layer thickness on OCT (P = 0.11).
\nResults show optic disc in NAION the results, there was no difference between Bevacizumab and natural history for change in visual acuity, visual field, or optic nerve OCT thickness [15].
\nNAION is still an enigma regarding pathogenesis and treatment. The current therapeutically efforts are to preserve vision and minimize the damage from the primary insult. QPI-1007 is a small interfering ribonucleic acid (siRNA) designed to temporarily block cells from making Caspase 2 (controls cell apoptosis). Quark pharmaceuticals and NORDIC collaborated in a study that uses the possible effect of this drug as a possible neuroprotection therapy for NAION.
\nDistinction between AAION and different etiologies of anterior ischemic optic neuropathy. will be discussed. AAION is due to temporal arteritis (also called giant cell arteritis (GCA)), an inflammatory disease of medium-sized blood vessels that occurs especially with advancing age (more than 60 years, mostly 70–80 years). Annual incidence rate in population age 50 years or older is estimated as 15–30/10,000. Female-to-male preponderance of 3.5:1 is prevalent in white population of European origin. GCA is associated with polymyalgia rheumatica. About 50% of the GCA patients have polymyalgia rheumatica, and 10–20% of the patients with polymyalgia rheumatica have GCA. Polymyalgia rheumatica may precede GCA or can occur simultaneously.
\nThe symptoms and signs of severe optic neuropathy [16] include the presence of preceding transient visual loss, temporal pain, jaw claudications, fatigue, fever, anemia, weight loss, and myalgias are strongly suggestive of arteritic ischemic optic neuropathy (AAION). In contrast, NAION results from the coincidence of cardiovascular risk factors in a patient with “crowded” optic discs. Nonarteritic AION occurs in a slightly younger group and is much more common than AAION. Most cases of AAION involve nearly complete vision loss (light perception to no light perception), while only a few cases of NAION result in near total loss of vision (Figure 3). Swollen disk, elevated CRP, and ESR (60–120 mm/h) are highly suggestive of temporal arteritis (arteritic AION) [3, 17]. At times, the optic disk in AAION is characterized by a milk-pale edema that may extend to the retina. In some cases, even central retinal occlusion with “cherry -red spot” may occur. Diagnosis is confirmed by temporal biopsy, and if the histological result is negative, it is necessary to biopsy the other side. Biopsy is taken from several segments along the temporal artery because the inflammation is segmental and may be missed by one site biopsy. Another possibility for diagnosis is ultrasound of the temporal artery but it is less accurate compared to biopsy.
\nShock white disk in arteritic anterior ischemic optic neuropathy.Ó 2018 American Academy of Ophthalmology.
Neuroimaging is not usually required in patients with typical presentations of giant cell arteritis (GCA) and when performance is generally normal [18]. However, some patients have already undergone imaging before neuro-ophthalmic evaluation, and these studies may be abnormal. They report four main imaging findings described in the literature:
Nonspecific orbital enhancement.
Optic nerve parenchymal enhancement.
Perineural sheath enhancement.
Optic chasmal enhancement.
Other important MRI findings in GCA include those involving the vascular supply not only extracranially but also intracranial, particularly vessel wall enhancement of the intramural ICA. MRI findings may hold some diagnostic value in distinguishing between A-AION as in GCA and in nonarteritic AION, in which they are typically normal. Differential diagnosis for these MRI findings can lead to inappropriate testing and delay diagnosis and treatment [18].
\n\n
GCA is a vascular disorder that may result in devastating visual loss if not treated promptly.
Biopsy is the gold standard for diagnosing, and neuroimaging plays a role only in atypical presentations.
Neuroimaging findings in GCA are often nonspecific and can lead to delay in diagnosis and treatment.
Patients are hospitalized for evaluation and intravenous corticosteroid treatment with at least 1 g/day (3–5 days) of methylprednisolone followed by prednisone 1 g/kg for 10 days and then tapering down. The dosage is decreased to 20–40 mg/day in 3 weeks, and treatment is continued for 12–18 months. A steroid sparing agent is tocilizumab, a monoclonal humanized antibody against interleukin 6 receptor. The dosage is 1 g/day for 12–24 months, and it is not given in the first trimester of pregnancy. It can be combined with corticosteroids, and this allows decreasing the dosage of the later. During the follow-up period, the inflammatory parameters including sedimentation rate, CPR, platelets, etc. is monitored, and if they increase, the dosage is accordingly increased. Treatment is very urgent to avoid AAION in the fellow eye, as it can happen even within days or weeks after the first eye was affected. Treatment generally does not improve the vision of the affected eye.
\nOptic neuritis is a condition that produces abnormal vision loss without causing ocular abnormalities and we have to differentiate between typical and atypical optic neuritis.
Optic neuritis is a term used to refer to inflammation of the optic nerve, and it appears in two forms: (1) when associated with a swollen optic disk, it is called papillitis or anterior optic neuritis. (2) When the optic disk appears normal, the term retro bulbar optic neuritis is used. Acute optic neuritis is the most common type of optic neuritis that occurs throughout the world and is the most frequent cause of optic nerve dysfunction in young adults mostly women. In this chapter, we will provide information about the clinical profile of optic neuritis, its natural history, its relationship to multiple sclerosis (MS), and the efficacy of corticosteroid treatment according the Optic Neuritis Treatment Trial (ONTT) [19, 20, 21, 22].
\nThe annual incidence of acute optic neuritis is estimated in population-based studies to be between 1 and 5 per 100,000 people in the general population [23]. The majority of patients with acute optic neuritis are aged between 18 and 46 years, with a mean age of 30–35 years. However, optic neuritis can occur at any age, and females are affected more commonly than males by a ratio of 3:1 to 4:1.
\nClinically, there are three major symptoms in patients with acute optic neuritis: (A) central visual loss in 90% of the patients. (B) Pain especially is exacerbated by eye movement around the affected eye in more than 90% of patients. (C) Relative afferent pupillary defect (RAPD) in all patients with unilateral optic neuritis [24].
\nLoss of central visual acuity occurs within few hours to several days, and the degree of visual loss varies from very minimal reduction to counting fingers (in rare cases, complete blindness can be observed). The majority of patients describe central vision loss predominately, and some of them complain of peripheral field defects. The visual loss is monocular in most cases, but particularly in children, both eyes are simultaneously affected.
\nThe presence of pain is a very helpful, differentiating optic neuritis from other causes of optic neuropathies such as anterior ischemic optic neuropathy, which produces painless visual loss.
\nExamination of a patient with acute optic neuritis reveals evidence of optic nerve dysfunction [24]. In addition, color vision (especially red color) is typically impaired in almost all cases and is helpful to differentiate from other optic neuropathies.
\nA relative afferent pupillary defect (RAPD) is demonstrable with the swinging flashlight test in all unilateral cases of optic neuritis. Patients with optic neuritis may also have a reduced sensation of brightness and contrast sensitivity in the affected eye.
\nVisual field (VF) scotomas involve many forms of central or peripheral field disturbances such as ceco-central scotoma, inferior or superior altitudinal hemianopia, central scotoma, Bejerrum scotoma, hemianoptic defects, and more, almost any type of visual field defect (see Figure 4).
\nVisual field possibilities in optic neuritis.
Presentation of optic disk in the acute phase is mostly normal with sharp disk margins and reddish color. Some of the patients with acute optic neuritis have minor degree of disk swelling with no correlation to visual acuity or visual field loss [25]. Over approximately 4–6 weeks, the optic disk in an eye with acute optic neuritis may become or remain normal or become pale, and most parameters of vision improve. In the chronic phase, the pallor of the optic disk may be diffuse or sectorial from my personal experience often the temporal part (42%) because the papillo-macular bundle is damaged in many patients with optic neuritis [26].
\nImaging studies in patients with presumed acute optic neuritis are usually performed for the following reasons: (A) to rule out particularly a compressive lesion; (B) to determine if a cause other than demyelization is responsible for inflammation of the optic nerve; or (C) to determine the visual and neurologic prognosis of optic neuritis.
\nThe best imaging study can be done by magnetic resonance imaging (MRI), it can reveal demyelization lesions of the optic nerve, manifesting as foci of T2-bright signal, areas of enhancement, and even optic nerve enlargement. These lesions are nonspecific, and a similar appearance can be observed in patients with infectious and other inflammatory optic neuropathies. The most important application of MRI in patients with optic neuritis is the identification of signal abnormalities in the white matter of the brain, usually in the periventricular region, consistent with demyelization. MRI is the strongest predictor of the eventual development of MS in patients with acute isolated optic neuritis. It can show multiple white-matter lesions in both cerebral hemispheres, including the periventricular regions.
\nCerebrospinal fluid (CSF) analysis in the evaluation of patients with acute optic neuritis is not any more a strong predictor for MS. The presence of oligoclonal banding in the CSF is associated with the development of MS, but it can show false positive results. The powerful predictive value of brain MRI for MS is increased also because the Lumbar puncture examination is invasive. Therefore, CSF examination in the evaluation of patients with optic neuritis has been reduced. CSF studies in patients with optic neuritis are mostly useful to detect another inflammatory or infectious disorder.
\nThe presence of at least 1 lesion in the periventricular white matter of the brain MRI is highly predictive, family history of MS, white race, old neurologic complains, winter onset, and younger age of optic neuritis. Conversely, patients with acute optic neuritis who have a normal brain MRI, severe disk swelling, a macular star, or disk hemorrhages or older age of onset have a low risk of developing MS.
\nThe risk of developing MS [27, 28, 29] in a patient who experiences an attack of acute optic neuritis is about 75% in women and 34% in men over the subsequent 15–20 years, with the risk being greatest in the first 5 years after the first attack.
\nMultiple sclerosis can be diagnosed when the MRI [30, 31, 32] in a patient with optic neuritis reveals two or more typical lesions of multiple sclerosis, at least one of which is contrast enhancing. The demyelization foci in the brain commonly appear in the corpus callosum and periventricular white matter and are best seen on T2-flair images.
\nThe number of inactive typical white-matter lesions is the most important criterion for estimating the risk that the patient will develop multiple sclerosis [31]. Optic neuritis with two or more noncontrast enhancing lesions typical of multiple sclerosis on MRI is called a “clinically isolated syndrome” and is associated with a high risk of MS. Multiple sclerosis arises in only 25% of patients in whom MRI reveals no foci of demyelination in the brain. If one or two such foci are initially present, the risk is 65%; if three or more are present, it is 78% [31].
\nMany studies have shown that there are no data to support the efficacy in any treatment to alter the final visual outcome during a period of a year after optic neuritis. Treatment with corticosteroids is the main treatment option for patients with acute idiopathic optic neuritis. The prognosis for visual recovery after acute optic neuritis is very good also without treatment. According the ONTT (IV regimen of corticosteroids) [19, 20, 21, 32], steroid treatment should be delivered in acute optic neuritis if symptoms of 8 days duration or less. Begin with 3 days of intravenous Methylprednisolone in a dose of 1 g/day followed by 11 days course of oral prednisone at a dose of 1 mg/kg/day with a taper over 3 days. The ONTT was done in randomizing 457 patients with acute optic neuritis, comparing a group of patients following the IV steroid regimen versus a group of patients receiving placebo. The results of the trial showed that this regimen does not affect the final visual outcome of a patient, but it accelerates the recovery of vision compared with no treatment in the first 2 years. In addition, patients who experience an attack of acute optic neuritis should not be treated with low-dose oral prednisone alone because it provide no effect of visual outcome and may double the recurrence rate for optic neuritis.
\nThe ONTT [19] results had another important aspect of treatment for acute optic neuritis regarding the possibility of having impact on the development of MS. Patients who were treated with the intravenous followed by oral corticosteroid regimen had a reduced rate of developing clinically definite MS during the first 2 years following treatment. MS developed in only 8% of patients who were treated according the corticosteroid regimen versus 17% of patients in the placebo group. This benefit of treatment was seen only in patients who had abnormal brain MRI at the time of onset of the optic neuritis. The protective effect was short and by 3 years after optic neuritis groups treated with ONTT IV regimen versus placebo groups had equal incidence to develop MS. These findings suggest that a patient with acute optic neuritis who has an abnormal brain MRI may benefit in the short term (2 years) from treatment with the IV/oral steroid regimen.
\nA number of agents other than or in addition to systemic corticosteroids have been found to reduce the risk of the development of MS following an attack of acute optic neuritis over a longer period of time than corticosteroids alone. The Controlled High-Risk Avonex MS [33] Prevention Study (CHAMPS), a randomized, double-blind, placebo-controlled trial that enrolled patients with a first demyelinating event, offer some help. Weekly intramuscular injection with 30 ug of beta interferon 1a (Avonex) to patients who had 2 or more white-matter lesions of at least 3 mm on a brain MRI together with a 14-day course of Methylprednisolone followed by prednisone lowered the probability for MS. The group of patients receiving interferon beta-1a had a 44% reduction in the 3-year risk of developing MS compared with those receiving placebo. In addition, patients in the interferon group had fewer new and enhancing brain MRI lesions.
\nTo conclude, a clinician should discuss with a patient having acute optic neuritis the treatment benefits comparing to no treatment emphasizing that there is a good chance (more than 80%) that visual acuity will recover to 20/20 within a year without treatment. It is important to explain the patient the relation between optic neuritis and the chances of developing MS. No treatment affects the final outcome of visual acuity.
\nThe natural history of acute idiopathic optic neuritis is to worsen over several days to 2 weeks and then to improve mostly rapidly. Improvement can continue to occur up to 1 year after the onset of visual symptoms. I had some patients of which improvement started only after 2 months but it is uncommon. The mean visual acuity 1 year after an attack of otherwise uncomplicated optic neuritis is 20/20, and less than 10% of patients have permanent visual acuity less than 20/40. Most parameters of visual function, including contrast sensitivity, color perception, and visual field, improve in conjunction with improvement in visual acuity. According to some investigators, most patients retain excellent vision for at least 15 years after their first attack [24].
\nAlthough the overall prognosis for visual acuity after an attack of acute optic neuritis is extremely good, some patients have persistent severe visual loss after a single episode. Furthermore, even patients with improvement in visual function to “normal” may complain of movement-induced photopias or transient loss of vision with overheating or exercise (Uhthoff symptom). The ONTT since 1992 has made it clear that the risk of a recurrence or a new attack is substantially higher in patients treated with low-dose oral prednisone as opposed to patients who receive no treatment or who are treated according the ONTT [19]. About 25% of patients who experience an attack of acute optic neuritis will experience a second attack in that eye or a new attack in the previously unaffected eye.
\nOptic neuritis that develops before the age of 15 years or after the age of 50 years may be atypical. Many of these cases have no periocular pain, and visual decline is over few weeks. Atypical optic neuritis should be divided to three categories: infectious, immune, and Sarcoid. Most of them appear with disk edema.
\nThis may occur in meningitis/encephalitis [34] and is treatable. The pathogens could be bacteria (Homophiles, Streptococcus, Staphylococcus, spirochetes, or mycobacteria), protozoa as Toxoplasmosis, fungi as Cryptococcus or Aspergillus, or herpes viruses [35, 36]. Syphilitic optic neuritis can develop very rapidly from every stage of the disease. Tuberculosis causes meningitis. Lyme optic neuritis is rare and mostly associated with those who visited near New Haven, Conn, USA.
\nAnother type of optic neuritis is called Leber’s stellate neuro retinitis caused by
Optic neuritis can appear within days or weeks after systemic influenza illness [34] or vaccination [38]; often binocular with good vision recovery [32]. Atypical optic neuritis is also associated with acute disseminated encephalomyelitis (ADEM), a condition in which multiple CNS manifestations occur at once; in most cases, patients recover and never recur. Some authors recommend high dose of corticosteroid treatment.
\nIn optic neuritis, if an underling cause is found, it should be treated with either corticosteroid or immunosuppressive medications.
\nOptic neuritis is rare in Guillain-Barre syndrome, Crohn’s disease, ulcerative colitis, behest’s disease, Wegener’s granulomatosis, and lupus erythematosus.
\nWhen the optic nerve is involved, the vision declines and the optic disk might be swollen, with or without systemic signs. Vision recovers with corticosteroid therapy. Relapses are common [39].
Recommended laboratory tests mostly for atypical cases
C-reactive protein
Complete blood count
Serum chemistry
Blood sugar
Vitamin B12
Rheumatoid factor
Antinuclear antibodies
Anti-phospholipids antibodies
Anti-ds-DNA antibodies
Lupus anticoagulant
Serum angiotensin-converting enzyme test
Urinalysis
Additional tests in case of “clinically possible differential diagnosis”
Anti-neutrophilic cytoplasmic antibodies (ANCA)
Extractable nuclear antibody (ENA) profile
Auto antibodies against aquaporin-4
HIV serology
Human T-lymphotropic virus type 1 (HTLV-1) serology
Urinary methylmalonate excretion
Traumatic optic neuropathy is the name given to the syndrome of an optic neuropathy after head or ocular trauma in the absence of other causes [40]. Like any other optic neuropathy, there are variable degrees of visual acuity and visual field loss and an afferent pupillary defect if unilateral or significantly asymmetric.
\nTraumatic optic neuropathy is either anterior or posterior and within each category can either be direct or indirect. Trauma to the anterior optic nerve usually injures the central retinal artery and vein, which enter or exit the nerve approximately 10 mm posterior to the globe. This vascular injury often results in retinal infarct. Hemorrhages are usually the result of severing the pial vessels with or without disk edema and rarely manifestations of central retinal or branch artery occlusion, central retinal vein occlusion, or anterior ischemic optic neuropathy. Axonal injury in the posterior optic nerve does not cause any acute effects on the disk, nerve fiber layer, or retinal ganglion cell layers. Axonal transport abnormalities posteriorly do not affect the more anterior nerve fibers, and so disk edema is not seen in posterior traumatic optic neuropathy. For these reasons, isolated posterior traumatic optic neuropathy is associated with a normal fundus examination at presentation. Only after a few weeks, we can see the structural signs of optic neuropathy evident, namely disk pallor and thinning of the retinal nerve fiber layer. A particular type of posterior traumatic optic neuropathy is when there is injury to the chiasm, in which case, there may be unilateral or bilateral temporal visual field defects respecting the vertical meridian. Rare chiasmal injury can be seen with posterior avulsion of the optic nerve, for example, traumatic enucleation, or penetration from a foreign body.
\nDirect anterior traumatic optic neuropathy is defined when there is penetration of the optic nerve by a foreign body or projectile. Anterior direct optic nerve injuries result from medial penetrating orbital trauma that damages the anterior optic nerve, for example, a knife transecting the optic nerve just posterior to the globe. This is because the optic nerve course transverses the medical part of the deep orbit and is not protected there by the bones or the eye. Posterior direct optic nerve injuries result from penetrating orbital or head trauma more posteriorly, for example, a bullet that passes just anterior to the chiasm. Direct injuries tend to produce severe and immediate visual loss, with little likelihood of recovery. The reason for this presumably is that a major element in these injuries is transection injury to retinal ganglion cell axons, which causes instantaneous loss of axonal conduction and an inability to regenerate axons later.
\nThis is diagnosed when traumatic optic neuropathy occurs without a history of foreign body. It occurs in anterior indirect injuries, which associated with sudden rotation of the globe from blunt trauma. Examples include a digit trauma to the globe or falling and hitting the eye on the corner of a table. Anterior indirect traumatic optic neuropathy can cause partial or total avulsion of the optic nerve, with associated peripapillary hemorrhage.
\nPosterior indirect injury is the most common cause of traumatic optic neuropathy. It results from blunt head trauma that transmits a concussive force to the optic nerve, resulting in contusion at the optic canal. There may be little or no evidence of significant head trauma; a fall from a bicycle may suffice. In other cases, there is multisystem trauma or significant brain injury. Loss of consciousness occurs in 40–72% of patients with traumatic optic neuropathy. Motor vehicle and bicycle accidents are the most frequent causes of traumatic optic neuropathy, accounting for 17–63% of cases. Traumatic optic neuropathy may be iatrogenic, especially after maxillofacial or endoscopic surgery as a result of inadvertent direct injury to the optic nerve or transmitted force fracturing the optic canal. The common site of posterior indirect optic nerve injury is at the optic canal; the intracranial optic nerve is the next most common site of injury. There may or may not be bone fractures. Despite being most common, posterior indirect traumatic optic neuropathies fortunately occasionally have the most favorable prognosis, its spontaneous visual recovery sometimes occurring at variable times after injury. Presumably, the injury causes concussion and focal blockade of axonal conduction without loss of its structural integrity. Once there is healing of the edema or other molecular events blocking conduction, axonal function can return. The severity of initial visual loss in patients with traumatic optic neuropathy varies from no light perception to 20/20, with sometimes only a visual field defect as functional evidence of disease. An afferent pupillary defect is always present and is the major clue for the diagnosis in the presence of otherwise normal eye. Patients with very poor vision (e.g., light perception only or no light perception) are less likely to improve, regardless of therapy, than patients with vision better than light perception. The reason is likely that severe injury causes axonal transection, membrane disruption, or cytoskeletal disorganization, any of which can lead to axonal dissolution and irreversible loss of conduction of visual information. In some cases, the visual loss only begins several hours to days after the injury. If this happens, the possibility of an intrasheath hemorrhage should be entertained, and neuroimaging should be repeated.
\nThe diagnosis is radiological. It is essential in the evaluation of a patient with traumatic optic neuropathy not only for demonstrating correlative signs of injury but also detection of pre-existing structural lesions and coincident intracranial effects of trauma, e.g., hematomas or carotid cavernous fistulas. CT scanning is superior to magnetic resonance imaging (MRI) in delineating fractures of bone. It is critical that CT be performed with very thin sections that are aimed to the optic canal, and reconstructions performed, particularly in the coronal plane. About 20 to 50% of patients with posterior traumatic optic neuropathy have evidence of an optic canal fracture by neuroimaging, and sometimes, the clue is a small loss of contour of bone. Although the displacement on neuroimaging may be small, it is possible that at the time of injury, there was a much larger displacement of the bone into the canal. Even in the absence of a fracture, blood in the sphenoid sinus should raise suspicion for optic nerve injury. MRI is better for imaging soft tissue, particularly the intracranial optic nerve and chiasm, and may be useful for delineating intrasheath hemorrhage that occurs at the orbital portion from penetrating injury (anterior direct TON). It is critical that MRI only be performed after a metallic intracranial, intraorbital, or intraocular foreign body has been ruled out by CT scanning or conventional radiography. If CT is used for screening, care should be taken to use thin slices and no interslice skip.
\nIn anterior and direct traumatic optic neuropathy, there is no evidence that treatment of anterior optic injuries or direct optic nerve injuries is efficacious. In the former, the concurrent vascular injuries cause direct ischemia and infarction to the neural retina and/or optic nerve head, and the time until irreversible neuronal death is measured in minutes to hours. In the latter, there is often sufficient direct axonal trauma to disrupt the integrity of the axon, up to and including its transection, and in the central nervous system of mammals, this is a point of no return for neuronal function. An exception is anterior traumatic optic neuropathy associated with neuroimaging evidence of an enlarged optic nerve sheath. In these cases, an optic nerve sheath fenestration should be performed in the hopes of evacuating an intrasheath hematoma.
\nWith respect to posterior indirect traumatic optic neuropathy, the three commonly used approaches that have been used are very high doses (“mega doses”) of corticosteroids [41], decompression of the optic canal, and observation alone; there is insufficient evidence from good quality randomized trials to guide decision-making on how to treat traumatic optic neuropathy. Because visual function often spontaneously improves in this disease, clinical trials are particularly necessary for physicians to select therapies based on evidence. Mega-dose corticosteroids experimental models of white matter trauma in animals showed that doses of 15–30 milligrams per kilogram of intravenous methylprednisolone are protective for injured neurons [41]. The NASCIS 2 and 3 studies found that patients treated within 8 hours of spinal cord injury with a loading dose of 30 milligrams per kilogram of intravenous methylprednisolone load followed by 5.4 ml/kg/hr continuous infusion for 48 hours had a better outcome than control patients [42, 43]. Extrapolating these results to traumatic optic nerve injury, it was thought reasonable to believe that similar doses should be used for injury to this comparable central nervous system white matter structure. However, over the years, there has been controversy about interpretation of the NASCIS data [44, 45], and its application to the treatment of spinal cord injury is not uniform [46, 47]. Furthermore, animal and cell culture data suggest that high doses of methylprednisolone may actually be toxic for the retinal ganglion cell and/or its axon [48, 49, 50]. Finally, the Corticosteroid Randomization After Significant Head Injury (CRASH) trial demonstrated that 48 hours of mega-dose methylprednisolone significantly increased the risk of death after head injury [51], with a hazard ratio at 6 months of 1.15 (95% CI 1.07–1.24) [52].
\nThe authors concluded that “These final results still provide clear evidence that treatment with corticosteroids following head injury affords no material benefit.”
\nDecompression of the optic canal is usually achieved through the transethmoidal route, most commonly via an external ethmoidectomy or endonasally [53]. The canal is then decompressed inferomedially from the superior lateral wall of the sphenoid sinus, with care taken to avoid the carotid artery. Although the canal can also be decompressed through an intracranial approach, the former is less invasive. However, if surgery in the area is being performed for other reasons necessitating unroofing of the canal, then an argument can be made that decompression of the canal should be done through this approach. However, there is also no evidence that optic canal decompression is efficacious. A recent Cochrane review concluded that there is no conclusive evidence that any particular form of surgical decompression improves the visual outcome in TON. The decision to proceed with surgery in TON remains controversial and each case needs to be assessed on its own merits. The final decision will inevitably reflect a combination of clinical judgment, the availability of local surgical expertise, and the patient’s perception of the possible risks and benefits. If surgery is to be considered, it should only be performed in centers with experience with the procedure. Because of the possibility that the carotid may be iatrogenic injured, there should be informed consent regarding the risk of death or stroke. Surgery should not be performed on an unconscious patient because of the difficulty in assessing visual function. Observation of traumatic optic neuropathy may improve without any treatment. There are no convincing randomized control trials to show a treatment benefit in traumatic optic neuropathy, and a nonrandomized concurrent comparative study did not demonstrate clear differences between treatments and observation. Therefore, when a patient cannot give informed consent for corticosteroid or surgical therapy, some neuro-ophthalmologists may simply observe the patient as none of these treatments have been proved to be superior.
\nThe history of mankind access to information has never been easier than it is in this contemporary world, but easy access to information does not necessarily guarantee access to quality, genuine, reliable and truthful information. The Internet is an open platform where many people can ventilate and publicize their opinion, idea, impression and views, without necessarily going through peer review mechanism by expert in different fields of knowledge or the opinion be subjected to rational scrutiny, before accepting it ex cathedra. Regrettably, the inability to separate fake, counterfeit and forged information can be a major source of embarrassment. Wrong sources of information can lead to erroneous and costly decision to organizations and professional body. Therefore, to reduce and limit this predicament, it becomes imperative to acquire skill that will empower individual on how to identify trustworthy sources of information on the Internet especially by teachers whose roles and responsibility is to expand the frontiers of knowledge. In view of this, many scholars are of the opinion that metacognitive dexterity equips people with high level of thinking capable of boosting higher-order thinking [1]. In order not to fall into the error of using unreliable sources of information, it is worthwhile to source for information from accredited academic databases that has been endorsed and certified collectively by professional body; this ensures to establish quality control particularly within the academic community.
Metacognitive skill is the knowledgeable ability that empowers information seekers to pursue their information need with critical mind, evaluate information resources meticulously, make inferences and deduce evidence in the perspective of one’s own information needs and, finally, make evaluative judgment about sourced information. A characteristic of this set of thinking is the awareness that information seekers have of their own thinking procedure, which is referred to as metacognitive knowledge, which is a vital piece of ability to resolve information literacy puzzle [1, 2, 3].
This article embarks on content and in-depth analysis of the subject matter of information literacy, metacognitive abilities and self-concept.
The purpose of this study is to evaluate the characteristic necessary to overcome the challenges of the contemporary period associated with information overload. Information literacy is a twenty-first tool to help in managing and circumnavigating the ocean of information. It can also be compared to an instrument or compass to help navigate the world of abundant information resources. The challenges of information overload are acknowledged as a source of anxiety for today’s information seekers as they are frequently being overwhelmed by information from countless sources. Without the knowledge of metacognitive ability which is an aptitude to strengthen the ability to ratiocinate and make a reliable choice based on valued judgment anchored on the process of logical reasoning, metacognitive strategies are centred on organization, monitoring and appraisal which are qualities that can be applied in seeking, utilizing and communicating information. Information age requires self-confident and self-regulating learners fortified with lifelong learning skills. Independent learning ability and information literacy are fundamental expertise necessary not only for lifelong learning but also for attainment in the information-centred societies.
This chapter addresses scholars’ views from different backgrounds on their perspectives on the information literacy skills and special abilities like self-concept and metacognitive ability. The chapter therefore reviews literature in the subject area of the evolution of information literacy, perceptions of information literacy and information search strategy; the chapter also identifies a significant correlation linking of self-concept and information literacy skills, investigates the level of self-concept and personal abilities and identifies a significant correlation between this abilities and information literacy skill acquisition for teaching purposes.
This research is guided by interpretive research paradigm in which concepts are discussed to bring in-depth understanding. This research uses qualitative content analysis as a method of data collection in which previous recorded document were studied systematically; journal, conference papers, reliable online resources and policy document were carefully evaluated in relation to the subject matters of information literacy, self-concept and metacognitive abilities that were reviewed. This is done in order to identify gap in research and bring out new knowledge. The identified keyword above was used in search of information resources from manly web of science and EBSCOhost. The researcher left out other databases for this research because of easy accessibility to the selected database, namely, web of science and EBSCOhost, which the researcher has access to in the place of work. The synthesis in the review of literature was achieved by combining important keyword that forms the bedrock of this research, that is, metacognitive ability, self-concept and information literacy; these keywords were evaluated to bridge the knowledge gap and established a new knowledge.
There is paucity of research contribution in the area of metacognitive learning; therefore, it poses a great deal of challenge in getting sufficient research material to embarking on this research in relation to information literacy and self-concept. The purpose of this research is to also close the research gap, for instance, embarking on informetric evaluation of the available information resources using web of science which is a database that has up-to-date and retrospective coverage from 1900 to the present, which includes 34,200 journals along with numerous books, proceedings, patents and data sets. The informetric result generated shows that within the span of 27 years (1992–2019), research output in metacognitive leaning is 395 (see Table 1) out of which research articles are 263 followed by conference proceeding with 138. Countries leading in these research areas are the United States (57), People’s Republic of China (46) and England (24). Therefore, for the sake of this study, 55 research articles were selected starting from 1979 to 2018, and most of the selected articles were relatively recent (see the timeline in Table 1 and Figure 1).
Timeline of publication used | % | |
---|---|---|
Years | Number | |
1979 | 1 | 1.82 |
1995 | 1 | 1.82 |
1998 | 2 | 3.63 |
2002 | 1 | 1.82 |
2003 | 2 | 3.63 |
2004 | 2 | 3.63 |
2005 | 3 | 5.45 |
2006 | 4 | 7.27 |
2007 | 2 | 3.63 |
2008 | 1 | 1.82 |
2009 | 6 | 10.91 |
2010 | 5 | 9.09 |
2011 | 5 | 9.09 |
2012 | 5 | 9.09 |
2013 | 8 | 14.55 |
2014 | 4 | 7.27 |
2015 | 2 | 3.63 |
2018 | 1 | 1.82 |
Timeline of publications.
Graphic representation of timeline of publication.
Technology, especially the Internet, has amplified the quantity of information accessible, but this also comes with challenges associated with seeking and using information resources [4, 5]. The author observed controversies among librarians and information professionals in some countries yearning for new literacy to enable access and use of information resources in many formats from an increasing information environment [5]. Access to overwhelming information resources has undermined the need for libraries across the globe to serve as gatekeepers between those who seek for information and information resources. This new revolution in information atmosphere and the skills that promote independent information seeking have stimulated the academic debate on teaching and learning information literacy [6]. It was affirmed that information seekers are dazed by the enormousness of information available to them from different sources. Taking decisive action to know when information accessible is adequate is a foremost reason for apprehension and doubt often experienced by information seekers [5].
Information can be seen as that which reduces doubt, uncertainty and ambiguity in decision-making [7]. The quality of information is critical for efficient operation and decision-making and important to modern society in carrying out daily productive activities. Thus, information need is described as a personal or collective aspiration to find and acquire information to fulfill a conscious or unconscious need. Information need occurs when an individual is faced with a dilemma in which knowledge acquired over a period of time is not adequate to help his/her objective. As a result, the need for information will trigger the curiosity to seek for it and thus satisfy the need [8].
Various other studies have discussed information need, for example [9, 10, 11]. In the opinion of the researcher, information needs or question formations can be viewed from four basic progressions, namely, visceral need (need as dictated by intuition or instinct), conscious need (the result of deliberate effort), formalized need (the product of human invention) and compromised need (need as expressed verbally) [9]. Various researches have also been carried out on the need for information, for instance, to embark on an evaluation of the changing need for information among professionals [12]. The study suggested that there is a need for curricular change in coping with current information need. A study analyses the information needs and pattern of information-seeking behaviour of professionals and observe that information is needed in order to obtain more knowledge. The authors also observe that professionals need to be familiar with and improve the availability of and accessibility to the Internet in the workplace for better job performance, supporting innovation and sustaining economic development [10]. There are stable and unstable information needs to explain the perpetual change in needs over a period of time and differentiate between a changing world, types of information need and interpretation of data [11].
An information literate person is proficient in determining the nature and scope of information needed to meet personal and professional requirements [13]. The present information background is rich and categorized by an abundance of information sources and providers, a multiplicity of methods for accessing information and a redundancy of content from numerous sources [14]. In this information-saturated environment, many information users tend to experience a sense of inadequacy and anxiety [15]. The prevailing difficulty is how to navigate this intricate landscape of information to enable satisfaction of information need.
The awareness of information overload symptoms and causes would help scholars in meeting and satisfying information needs, as the flood of potentially relevant information has become pervasive [16]. In an attempt to meet daily information needs, individuals are compelled to consider more information and opportunities than they can effectively process. This information overload is made worse by “data smog”, which is a concept describing the proliferation of low-value information, which can also lead to anxiety, stress, alienation and potentially dangerous errors of judgment, which can adversely affect productivity [17].
One of the major consequences of meeting information need has been the exponential growth of the Internet and information and communication technologies, which is the prime reason for information overload, and the speed and complexity of developments in society. A study contends that people find it more complicated to handle the amount of new information they receive, regular changes in the organizations and technologies they use and the increasingly complex and unpredictable side effects of their actions [18].
The need for information is as important as blood in the human system, because without information, transformation will not be possible. Information is essential in all human endeavors for problem-solving. Information need triggers information search, the practice by which a person seeks knowledge about a difficult circumstance constituting a major impediment, which leads to seeking for information on the Internet by millions of users [19]. The web is now a primary source of information for many people, motivating a critical need to understand how users search or employ search engines [20]. Information need and information seeking are different but related concepts because both of them are components of information behaviour [21]. The adventure to seek for information begins with the need for information, and to meet that need, an individual must be aware of the various information sources available.
A body committed to promotion of educational development worldwide has also been keenly upholding the perception of knowledge societies in which information literacy plays a prime role in structuring comprehensive, pluralistic, just and participatory societies by enabling people to understand and make valued judgments as active users of information and become producers and distributors of information and knowledge in their own right [22]. It was also affirmed that information literacy enables citizens to make informed choices to meet the information needs which will help them achieve their full potential and it enables them to maintain their political, economic and social development [23].
There is a dire need for information literacy training of teachers; researchers [24, 25] affirmed that the need is particularly required in rural areas for students in training and working adults and could be addressed by considering the approach of ICT for development and the need for international standards and curricula for information literacy. This approach should be followed by action based on the prevailing circumstances of teachers, a wide and systematic review of supporting literature and encouraging critical inquiry.
It is evident from studies conducted by many researchers that there are teachers who have the right view of online education as they are aware of its usefulness to the education system. Although personal issues like time constraints, perceived usefulness, perceived ease of use and low enthusiasm are a relatively common phenomenon, awareness, capacity building and enabling environments should be provided to encourage the use of online information resources among teachers [26].
Examinations of teachers’ competence in developing countries have revealed that they gain information literacy knowledge and ICT skills through personal efforts aided by families or friends to gain training outside the schools. The implication of this, in the view of scholars, is that much of the training provided by the schools for student teachers does not meet the need for them to integrate information literacy skills into their teaching. This underscores the need for more emphasis to be placed on exposing student teachers to advanced courses in information literacy skill and ICT knowledge [27]. Schools and indeed universities in the developing nations must improve on their information literacy skills and ICT technique in line with the UNESCO recommendation. Therefore, metacognitive ability and strategies can lead to positive information research experiences and, consequently, should be imparted during library instruction and orientation programme, to trigger metacognitive strategies [22].
Metacognition can be defined as the ability to think about one’s thinking process, which combines two components of knowledge and regulation about oneself in relation to factors that might affect performance, strategic knowledge and knowledge to be applied based on present challenges [28]. Metacognitive ability has been seen as having knowledge, understanding and control over mental activities and appropriate use of the acquired knowledge [29]. Metacognitive regulation is the monitoring of one’s cognition and includes planning activities, awareness of comprehension and task performance and evaluation of the efficacy of monitoring processes and strategies [28]. Metacognition refers to sophisticated thinking which comes with dynamic mechanism over the intellectual methods engaged in learning.
According to a researcher, information literacy is a foremost metacognitive skill; i.e. information literacy skills are exactly the expertise people require to be able to take control of their own thinking and learning in order to find the best information for their needs. To be information literate demands self-awareness. This refers to an attentiveness towards and understanding of learning processes [30]. Learners who possess highly developed metacognitive skills are more likely to acquire information literacy skills as a precondition for modern learning [31]. It was also explained that metacognitive ability reinforces information literacy as a reiterative, holistic process where individuals continually assess their own ability to increase their information literacy [32].
John H. Flavell, the progenitor of metacognition, describes it as purposeful, planful, deliberate, goal-directed, future-oriented intellectual behaviour that can be directed at achieving cognitive tasks [33]. Metacognitive ability also refers to knowledge concerning cognitive ability and affective states and control over knowledge in order to achieve a specific goal. Such knowledge can be classified into declarative, procedural and conditional knowledge which are the overall qualities expected to advance knowledge acquisition [34]. Metacognitive experiences involve awareness of one’s own cognitive ability and affective processes. These experiences are retrieved by actively monitoring one’s own mental processes [34]. A metacognitive ability integrates, among other things, ability in time management, limits information searching to the most pertinent rather than the most available and considers conflicting viewpoints and emotional intelligence, which means that learning can involve complex moods of uncertainty, frustration and doubt [35].
Metacognitive strategies include a variety of simple processes such as underlining, outlining, notetaking, summarizing, self-questioning and more complicated methods such as hierarchical summaries, conceptual maps, thematic organizers and metaphorical thinking [36]. In investigating how to efficiently teach information literacy and reliability assessment skills in the use of online information atmosphere, in the context of students’ dependence on the use of Internet resources. The lack of information in literacy skills can limit critical appraisal. It was therefore suggested that innovative instructive techniques are necessary for effective online information literacy skill and to integrate scaffolding and metacognitive support [37].
Metamemory refers to the ability of people to demonstrate the capacity to search the content of memories, either prospectively or retrospectively, out of which judgements or clarification are drawn. Metamemory is not memory per se, but depends on it [38]. Understanding memory reveals that memory can fall short of the expected need in two diverse ways: the first involves forgetting or being incapable of retaining information despite one’s best efforts. The other involves “misremembering” or remembering something incorrectly [39].
According to a research, metacomprehension means the capability to examine the degree to which one understands information being communicated, to recognize the reason for failure to comprehend and to employ repair strategies when failures are identified [40]. It was observed that metacomprehension derives from two keywords: meta and comprehension. For example, metadata would mean that data is being analyzed about data. Comprehension means an ability to understand or show lack of understanding. Metacomprehension thus means an ability to be aware of or understand one’s understands of a topic [41].
Self-regulation, colloquially known as willpower, refers to self-directed competence for altering behaviour. It helps to increase the flexibility and adaptability of human behaviour, helping people to adjust their actions to a remarkably broad range of social and situational demands [42]. Thinking about the importance of self-regulation can help individuals to become objective and to understand in responding to behaviour.
Understanding the impact of temperament and considering goodness of fit can assist teachers in selecting strategies that support the development of self-regulation [43].
Personal knowledge refers to knowledge applied in the profession which has been accumulated and proved over time to possess permanent value, worldwide application and universal truth. It is acquired mainly through formal and informal training [44]. The process of gaining knowledge is a method essential to survival which begins early and continues all through life. Metacognitive knowledge involves consciousness and manifestation of the content of an individual’s thought, ranging from simple awareness of the content of one’s immediate and prior thought [45].
The importance of knowledge cannot be over-emphasized in any profession, especially in the area of classroom management techniques. Knowledge is a set of skills and information obtained through experience and/or education, giving someone the ability to perform well in a specific field or ability [46]. Personal knowledge can be translated into a progressive classroom environment capable of boosting the intellectual ability of students and fostering intelligent behaviour for problem-solving purposes, decision-making and creative thinking. Figuratively, the intelligence friendly classroom serves as a caring companion and mindful guide to the intellect of each and every learner in it [47].
In the opinion of researchers, people constantly become skilled because of the knowledge acquired from years of experience, but since personal experience is always insufficient, people tap from the experiences of relatives, friends and colleagues in an attempt to enlarge their knowledge or solve problems [48].
Procedural knowledge is the knowledge that is demonstrated through the procedure of doing it. It shows how people understand things and how the mind works to gain, recall and use the knowledge. This is often unconscious knowledge: though someone may demonstrate it, it can be something otherwise not considered by the person. For example, a teacher may know when to apply a particular technique in the classroom but may not be able to precisely explain this to his colleagues. In other words, it can be considered a trade secret that makes one individual distinct from others [49].
Declarative knowledge is known as the ability to recall stored or acquired information. This procedure entails three stages of learning declarative knowledge: first, establishing a link between new information and an existing body of knowledge, which means learning how to remember new information; second, categorizing information by putting new information into groups, placing it into different parts of the memory; and third, elaborating information by making connections among the information being received as well as connecting new information to existing knowledge [50].
Learning strategies are devices used by learners to aid acquisition of knowledge and skills. Instruction should guide the learner in the choice of appropriate learning strategies for particular learning tasks. Facilitating the learning of declarative knowledge, concepts, procedures, principles, problem-solving, cognitive attitudes and psychomotor skills begins with decisions on what content should be presented, how it should be presented and in what sequence the instruction should follow [51].
It has been claimed that the ability to decide when and why a particular approach is necessary for the purpose of problem-solving is conditional knowledge. A teacher can do a wonderful job in passing knowledge across to students but may find it difficult to teach them how to weigh up options available to them and make informed decisions about when to employ this skill [51].
Many researchers have pointed to the fact that personal abilities can no longer be overlooked when investigating information literacy skill. For instance [52, 53, 54], postulate that personal abilities are vital in scrutinizing the connection between information literacy and the self-concept which is the bedrock of personal ability and academic attainment. Such scrutiny is necessary in order to salvage those who may be victims of self-destructive beliefs which may also be damaging to students [55].
The most important attribute of modern societies is that everything is in a perpetual state of flux. At the same time, the quantity of information is now overwhelming, and technology has become relevant to every aspect of human life. There is hardly any professional calling today which has not felt the positive influence of this change. It is therefore almost mandatory for all who wish to be relevant in any career to embrace this new technique. Societies of the information age must be confident in the application of modern technology to be able to access information to foster independent, self-regulated learners equipped for lifelong learning. The manpower needed by today’s societies can be described as effective consumers of information who can find, evaluate, use, produce and share information and make use of technology in all these activities [56].
Satisfactory self-perception of scholarly capability is fundamental for the recognition of intellectual ability, thereby promoting learning of complex skills like information-seeking skills. It was also suggested that academic self-concept should moderate the connection between intelligence and information literacy: a constructive relationship between intelligence and information literacy is expected for an academic self-concept. Thus, it is accepted that this moderator effect is mediated by personal effort. Whenever people are able to distinguish between personal deficits or strengths, they will come to understand how to develop the level of confidence they aspire to have [57].
Self-concept is characterized as the sum total of a person’s mental and physical features and evaluation of self. As such it has three aspects: the cognitive (thinking), affective (feeling) and the psychomotor (action). It is important to consider the self-concept as developing in these three areas. It can also be seen as individual awareness of self and awareness of identity [58]. It was also noted that it has become an acceptable fact that one’s self-concept is a way in which one sees oneself. This is not restricted to physical appearance, which is reflected in one’s academic, professional and social existence, but includes private and personal awareness [59].
Personal confidence in the use of modern technology is important for effective use of expertise. Scholars affirm that skill acquisition is insufficient unless individuals develop self-confidence in the application of what is learnt. In other words, success based on the possession of required skills for performance also requires the confidence to use these skills effectively [60]. Therefore, apart from possessing information literacy skills, individuals in modern society must also be convinced about their proficiency in the use of these skills. Information literacy self-efficacy is capable of motivating academic performance; information literacy can help in predicting academic achievement, while self-concept is considered a major factor in developing information literacy [61].
Psychological factors affect human ability to learn new skills. Therefore, in addition to attaining information literacy skills, it is also important to develop perceived self-efficacy concerning these skills [56]. This will help in better appreciation of self-efficacy as a way to boost problem-solving capacity as a needed feature for lifelong learning. Self-concept is a vital component of teaching, not just to help with academic performance; it supports social skills and makes it easier for teachers to influence positive behaviour. Students are also better equipped to cope with mistakes, disappointment and failure if the mental attitude of teachers is positive; they are more likely to stick with challenging tasks and complete learning activities [61].
The self-concept of teachers has lifelong impact in the overall performance of learners, because it has positive effects on their self-esteem. This is because reinforcing the self-esteem of students is a direct consequence of increased motivation and learning. Teachers’ positive attitudes can create a satisfying teaching environment and help to give students the impression that they belong and are welcome in the school setting. Teachers with positive mental attitudes must constantly communicate to students that mistakes are part of the learning process and that no student should ever feel embarrassed to ask questions if he or she does not understand something [62].
Self-concept comprises an individual’s perception, emotion and attitude towards him or herself and is usually shaped in the course of familiarity with and understanding of one’s environment. It was affirmed that self-concept is a combination of environmental and psychological conditions [63]. These two factors can affect human behaviour, as people become vulnerable to social factors in their search for independence [60]. Self-concept is a multidimensional entity which consists of very different cognitive and affective components [64, 65].
Perception of self can be a consequence of cumulative effects during biological, social and psychosocial transitions. Constructive transitions result in healthy self-concept developments, which make possible the achievement of many advantageous outcomes. Positive educational environments, family, school and community youth groups can shape personal qualities, which support cognitive, psychological, psychosocial and socio-emotional achievement. Positive outcomes will motivate the desire to attain high educational goals that are integral in self-concept formation [66].
Eight elements form the foundation of a person’s self-concept; they are morality and ethics, personal and physical attributes, family, identity, social satisfaction and behaviour [67]. Self-concept also refers to an act of self-evaluation or self-perception, and it signifies the total sum of a person’s belief about his or her own qualities. Self-concept reflects how people evaluate themselves in domains in which they consider success important [68].
The thematic analysis of this qualitative research emphasizes the importance and complimentary relationship between the selected variables for this research. For instance, metacognition is inherently part of ability needed to be mindful in planning, regulating and evaluating of one’s intellectual processes such as the one needed in navigating the overabundance of information resources available from different sources; the study emphasizes the role of personal knowledge, task and procedural knowledge, strategic and declarative knowledge and, finally, conditional knowledge and the role they play in helping to shape activities channel towards information acquisition. Metacognitive control supports the ability to help in managing learning and fostering problem-solving skills.
At the heart of modern problem is information overload; therefore, it is imperative to acquire the skill that will lessen the burden of having access to genuine sources of information and be able to separate chaff from wheat in the world of information; otherwise, complex decision-making process influenced will be negatively affected. Incorrect, erroneous or misinformation, particularly on social media which are deliberately spread with intension to deceive, can be costly and lead to consequences that may be difficult to reverse; therefore, it should be a modern requirement for the knowledge of information literacy to be acquired. Since most of the modern information resource is driven by technology, it is important for any establishment to be restructured to accommodate these changes, which is often replaced with newer model, and consequently it is vital for the information literacy to become a lifelong skill. Doing this also requires self-concept which is the ability to demonstrate confidence and self-assurance in the handling of this modern tools and techniques, which comes with persistence and irrepressibility in the face of daunting and overwhelming challenge. Metacognitive skill is the ability to ponder seriously on any line of action before ultimately reaching decision; in view of the abundance of inaccurate information abundantly available, this quality becomes a sine qua non for survival in the information age and empowers individual to effectively search and navigate the world of information.
The authors declare no conflict of interest.
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Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University, Kuwait. His research interests include optimization, computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, and intelligent systems. Prof. Sarfraz has been a keynote/invited speaker at various platforms around the globe. He has advised/supervised more than 110 students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He has authored and/or edited around seventy books. Prof. Sarfraz is a member of various professional societies. He is a chair and member of international advisory committees and organizing committees of numerous international conferences. He is also an editor and editor in chief for various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:null},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:"Beijing University of Technology",institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Lakhno Igor Victorovich was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPhD – 1999, Kharkiv National Medical Univesity.\nDSc – 2019, PL Shupik National Academy of Postgraduate Education \nLakhno Igor has been graduated from an international training courses on reproductive medicine and family planning held in Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor of the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s a professor of the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics and gynecology department of Kharkiv Medical Academy of Postgraduate Education . He’s an author of about 200 printed works and there are 17 of them in Scopus or Web of Science databases. Lakhno Igor is a rewiever of Journal of Obstetrics and Gynaecology (Taylor and Francis), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for DSc degree \\'Pre-eclampsia: prediction, prevention and treatment”. Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: obstetrics, women’s health, fetal medicine, cardiovascular medicine.",institutionString:"V.N. Karazin Kharkiv National University",institution:{name:"Kharkiv Medical Academy of Postgraduate Education",country:{name:"Ukraine"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"243698",title:"M.D.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. Dr. Wang was awarded two research project grants focused on multimodal optical coherence tomography imaging and deep learning in cataract and retinal disease, from the National Natural Science Foundation of China. He has published around 30 peer-reviewed journal papers and four book chapters and co-edited one book.",institutionString:"Shanxi Eye Hospital",institution:{name:"Shanxi Eye Hospital",country:{name:"China"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRZkkQAG/Profile_Picture_2022-05-09T12:55:18.jpg",biography:null,institutionString:null,institution:null},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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Among them are those associated with pollution, resource extraction and overexploitation, loss of biodiversity, soil degradation, disorderly land occupation and planning, and many others. These anthropic effects could potentially be caused by any inadequate management of the environment. However, ecosystems have a resilience that makes them react to disturbances which mitigate the negative effects. It is critical to understand how ecosystems, natural and anthropized, including urban environments, respond to actions that have a negative influence and how they are managed. It is also important to establish when the limits marked by the resilience and the breaking point are achieved and when no return is possible. 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