Gender and age distribution.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"6591",leadTitle:null,fullTitle:"Proctological Diseases in Surgical Practice",title:"Proctological Diseases in Surgical Practice",subtitle:null,reviewType:"peer-reviewed",abstract:'The prevalence of anorectal disorders in the general population is probably much higher than that seen in clinical practice. Anorectal diseases have for a long time been considered of little interest, with their treatment considered of little prestige despite the social impact they cause to patients. Proctology was initiated late and developed slowly over the years. However, in the last 20 years, a renewed interest has begun, and today, we can say that proctology is a specialized branch of general surgery. This book "Proctological Diseases in Surgical Practice" provides a practical introduction to proctology, with a particular attention to the topics that have not yet been investigated. This book may be useful for the general physician as well as for the specialist.',isbn:"978-1-78923-635-4",printIsbn:"978-1-78923-634-7",pdfIsbn:"978-1-83881-575-2",doi:"10.5772/intechopen.71454",price:119,priceEur:129,priceUsd:155,slug:"proctological-diseases-in-surgical-practice",numberOfPages:170,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"df22314ee5125fe03618cc962080552f",bookSignature:"Pasquale Cianci",publishedDate:"August 29th 2018",coverURL:"https://cdn.intechopen.com/books/images_new/6591.jpg",numberOfDownloads:7931,numberOfWosCitations:5,numberOfCrossrefCitations:2,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:4,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:11,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"December 14th 2017",dateEndSecondStepPublish:"January 11th 2018",dateEndThirdStepPublish:"March 5th 2018",dateEndFourthStepPublish:"May 24th 2018",dateEndFifthStepPublish:"July 23rd 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"196218",title:"Dr.",name:"Pasquale",middleName:null,surname:"Cianci",slug:"pasquale-cianci",fullName:"Pasquale Cianci",profilePictureURL:"https://mts.intechopen.com/storage/users/196218/images/system/196218.png",biography:"General Surgeon at 'Lorenzo Bonomo” Hospital-Department of Surgery and Traumatology-ASL BAT-Andria-Puglia (Italy), and Ph.D. at the Department of Medical and Surgical Sciences, University of Foggia (Italy), Fellow of American College of Surgeons (FACS). Contract Professor in General and Emergency Surgery, Gastroenterology and Human Physiology, Faculty of Medicine - Nursing Science and Physiotherapy Courses. Professor in surgical anatomy at the specialty school in general surgery. Contract Professor of I Level Masters: Intestinal stoma care nurse, Operating room nurse and Emergency medicine and critical area. Member of some of the most important Italian Scientific Surgical Societies: EAES, SICE, ACOI, SPIGC, SIUCP, ACS. Author of 70 national and international scientific papers, books and book chapters which are well appreciated in the health community. Editorial Board member of Frontiers in Surgical Oncology, BMC Surgery, Annals of Medicine, WJSP, Asian Journal of Research and Reports in Endocrinology, IntechOpen Edition. Reviewer of major international scientific journals such as Medicina, the Turkish Journal of Gastroenterology, Medical Principles and Practice, IntechOpen Edition, World Journal of Surgical Procedures, Oxford Medical Case Reports, BMJ Case Reports, Austin Pancreat Disord, World Journal of Gastroenterology, Case Studies in Surgery, World Journal of Surgical Oncology, Journal of Cancer and Tumor International, Journal of Basic and Applied Research International, International Journal of Medical and Pharmaceutical Case Reports, British Journal of Medicine and Medical Research, Faculty and Speaker at numerous national and international Surgical Congresses. Special interest in laparoscopic surgery, robotic surgery, endocrine surgery and coloproctology.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"University of Foggia",institutionURL:null,country:{name:"Italy"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1142",title:"Colorectal Surgery",slug:"surgery-colorectal-surgery"}],chapters:[{id:"62658",title:"Introductory Chapter: A Surgical Point of View on Proctology",doi:"10.5772/intechopen.79661",slug:"introductory-chapter-a-surgical-point-of-view-on-proctology",totalDownloads:651,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Pasquale Cianci",downloadPdfUrl:"/chapter/pdf-download/62658",previewPdfUrl:"/chapter/pdf-preview/62658",authors:[{id:"196218",title:"Dr.",name:"Pasquale",surname:"Cianci",slug:"pasquale-cianci",fullName:"Pasquale Cianci"}],corrections:null},{id:"61779",title:"Applications of Anorectal Ultrasound in Anorectal Disorders",doi:"10.5772/intechopen.78326",slug:"applications-of-anorectal-ultrasound-in-anorectal-disorders",totalDownloads:988,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Endoanal ultrasound (EAUS) and endorectal ultrasound (ERUS) have been introduced to clinical use since the 1980s. The techniques have been used to assess various anorectal disorders and conditions, including anorectal abscess and fistula, fecal incontinence, anorectal tumor, anorectal pain and occasionally evaluation of adjacent pelvic pathology. Information acquired includes anatomical location of disease, extent of disease, involvement of anal sphincter by disease and the status of anal sphincter. This information is valuable for treatment planning, prevention of disease recurrence, prevention and/or correction of sphincter defect and follow-up evaluation. The technique is cheap, simple, well tolerated, and repeatable with acceptable accuracy. Although the interpretation is operator-dependent, technology has developed to improved image quality such as 3D-reconstruction, peroxide-enhanced technique and volume render mode. This chapter reviews the current application of anorectal ultrasound in the common anorectal disorders.",signatures:"Kasaya Tantiphlachiva",downloadPdfUrl:"/chapter/pdf-download/61779",previewPdfUrl:"/chapter/pdf-preview/61779",authors:[{id:"200234",title:"Associate Prof.",name:"Kasaya",surname:"Tantiphlachiva",slug:"kasaya-tantiphlachiva",fullName:"Kasaya Tantiphlachiva"}],corrections:null},{id:"61031",title:"The Role of Three-Dimensional Endoanal Ultrasound in Preoperative Evaluation of Anorectal Diseases",doi:"10.5772/intechopen.76620",slug:"the-role-of-three-dimensional-endoanal-ultrasound-in-preoperative-evaluation-of-anorectal-diseases",totalDownloads:909,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Three-dimensional endoanal ultrasound (3D EAUS) has increased its application in coloproctology, both in pre- or in post-operative settings, since it provides more detailed information about anorectal anatomy and function. Perianal fistula complex, internal opening location and fistula tract relation with anal canal muscles are easily viewed on 3D EAUS. Moreover, hemorrhoidectomy, sphincterotomy and transanal rectal excisions hold potential in damaging anal sphincters and should be taken into account by the surgeon. Likewise, 3D EAUS has also a significant role in staging locoregional anal and rectal tumors with comparable accuracy to pelvic magnetic resonance imaging (MRI), particularly in regard to T staging in early lesions and tumor response after neoadjuvant therapy. Finally, patients with pelvic floor dysfunction or pelvic organ prolapse (POP) may benefit from 3D EAUS dynamic evaluation in order to rule out an occult sphincter defect or to unveil unsuspected anatomical multi-compartment dysfunction. Therefore, this review will address the current role of 3D EAUS as a valuable tool in modern colorectal surgical practice, highlighting its application in evaluating benign anorectal diseases, anal canal and rectal tumors and evacuation disorders, namely echodefecography.",signatures:"Marcelo de Melo Andrade Coura",downloadPdfUrl:"/chapter/pdf-download/61031",previewPdfUrl:"/chapter/pdf-preview/61031",authors:[{id:"239783",title:"M.Sc.",name:"Marcelo",surname:"Coura",slug:"marcelo-coura",fullName:"Marcelo Coura"}],corrections:null},{id:"62112",title:"Challenges in the Surgical Treatment of Rectal Prolapse",doi:"10.5772/intechopen.78059",slug:"challenges-in-the-surgical-treatment-of-rectal-prolapse",totalDownloads:1190,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The approach to a patient with overt rectal prolapse remains controversial since the choice of the most appropriate technical option may be a difficult task. The different approaches are based upon patients’ age, comorbidities, sex, size of prolapse, associated incontinence, constipation, and urinary and genital disturbances. However, analysis of the literature failed to detect a significant evidence favoring one among the large number of those different surgical techniques proposed for the treatment of rectal prolapse. In fact, many randomized prospective controlled trials, comparing perineal and abdominal operations, rectopexy alone, resection alone and/or resection plus rectopexy could not find significant differences in terms of morbidity, mortality, improvement of incontinence or constipation, quality of life and recurrence. Therefore, without a clear-cut support by the literature, a pragmatic approach is necessary, applying common sense, experience and considering the availability of resources as well. Nevertheless, we may expect that definitive answers to many open questions about surgery of rectal prolapse may come from larger studies and longer follow-up.",signatures:"Renato Pietroletti",downloadPdfUrl:"/chapter/pdf-download/62112",previewPdfUrl:"/chapter/pdf-preview/62112",authors:[{id:"239943",title:"Prof.",name:"Renato",surname:"Pietroletti",slug:"renato-pietroletti",fullName:"Renato Pietroletti"}],corrections:null},{id:"61753",title:"Fissure-In-ANO",doi:"10.5772/intechopen.76887",slug:"fissure-in-ano",totalDownloads:1534,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"This chapter provides a summary of the aetiology, diagnosis, investigation and management of anal fissure. It gives an overview of clinical anatomy and pathophysiology related to anal fissure. Focusing on anal sphincter hypertonia as the key factor for anal fissure progression, the chapter draws attention to perpetuating factors that contribute to a vicious cycle of fissure non-healing and addresses management options for these factors. This chapter also looks at the way how different treatment options for anal fissure emerged over time and uses evidence-based medicine to compare these options. “Fissure-in-ANO” concludes with summarising the treatment options and suggesting an algorithm for management of acute and chronic anal fissures.",signatures:"Muhammad Fahadullah and Colin Peirce",downloadPdfUrl:"/chapter/pdf-download/61753",previewPdfUrl:"/chapter/pdf-preview/61753",authors:[{id:"242625",title:"Mr.",name:"Colin",surname:"Peirce",slug:"colin-peirce",fullName:"Colin Peirce"},{id:"242627",title:"Mr.",name:"Muhammad",surname:"Fahad Ullah",slug:"muhammad-fahad-ullah",fullName:"Muhammad Fahad Ullah"}],corrections:null},{id:"62503",title:"Radiation Proctitis",doi:"10.5772/intechopen.76200",slug:"radiation-proctitis",totalDownloads:962,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Pelvic radiotherapy (RT) has become a vital component of curative treatment for various pelvic malignancies. The fixed anatomical position of the rectum in the pelvis and the close proximity to the prostate, cervix, and uterus, makes the rectum especially vulnerable to secondary radiation injury resulting in chronic radiation proctitis (CRP). Clinical symptoms associated with CRP are commonly classified by the EORTC/RTOG late radiation morbidity scoring system. Rectal bleeding is the most frequent symptom of CRP occurring in 29–89.6% of patients. Endoscopy is essential to determine the extent and severity of CRP as well as to exclude other possible causes of inflammation or malignant disease. Typical endoscopic findings of rectal mucosal damage in the course of radiation-induced proctitis include friable mucosa, rectal mucosal hypervascularity, and telangiectases. There is no consensus available for the treatment of CRP, and different modalities present a recurrence rate varying from 10 to 30%. CRP can be managed conservatively, and also includes ablation (formalin enemas, radiofrequency ablation, YAG laser or argon plasma coagulation) as well as some patients require surgery. Although modifications of radiation techniques and doses are continually being studied to decrease the incidence of CRP, trials investigating preventive methods have been disappointing to date.",signatures:"Radzislaw Trzcinski, Michal Mik, Lukasz Dziki and Adam Dziki",downloadPdfUrl:"/chapter/pdf-download/62503",previewPdfUrl:"/chapter/pdf-preview/62503",authors:[{id:"242403",title:"Prof.",name:"Adam",surname:"Dziki",slug:"adam-dziki",fullName:"Adam Dziki"},{id:"243198",title:"Dr.",name:"Radzislaw",surname:"Trzcinski",slug:"radzislaw-trzcinski",fullName:"Radzislaw Trzcinski"}],corrections:null},{id:"61729",title:"Faecal Incontinence",doi:"10.5772/intechopen.77393",slug:"faecal-incontinence",totalDownloads:862,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Fecal incontinence (FI) is an extremely common condition, whose true prevalence is difficult to assess. It was defined as the uncontrolled passage of fecal material recurring for >3 months. Fecal incontinence is related to many etiologic factors, but one of the most frequent causes is secondary to pelvic and/or anal and rectal surgery, childbirth-related damage, or other pelvic trauma. Fecal incontinence after surgery may be elicited by many pelvic, rectal, and anal surgical/obstetric procedures, which contribute through different mechanisms to incontinence. After accurate evaluation, the first line approach with medical and behavioral treatments often fails in treating FI. Rehabilitative therapy and less invasive procedures are preferred before performing standard surgical intervention, while invasive procedures are to be discouraged.",signatures:"Filippo La Torre and Diego Coletta",downloadPdfUrl:"/chapter/pdf-download/61729",previewPdfUrl:"/chapter/pdf-preview/61729",authors:[{id:"230542",title:"Prof.",name:"Filippo",surname:"La Torre",slug:"filippo-la-torre",fullName:"Filippo La Torre"},{id:"249161",title:"Dr.",name:"Diego",surname:"Coletta",slug:"diego-coletta",fullName:"Diego Coletta"}],corrections:null},{id:"62209",title:"Clinical Pathway Evaluation for Left and Sigmoid Colectomy in Abdominal Surgery",doi:"10.5772/intechopen.78588",slug:"clinical-pathway-evaluation-for-left-and-sigmoid-colectomy-in-abdominal-surgery",totalDownloads:845,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"At the end of 2008, a new left colon clinical pathway was implemented in our hospital and set up by a multidisciplinary team, monitored by a clinical pathway coordinator. Our aim was to evaluate the quality of left and sigmoid colectomy management, to simplify the clinical pathway and to assess its impact on the patient, the medical and nursing staffs. A sample of 290 patients with benign or malignant disease requiring a laparoscopic of laparotomy left colon resection (mainly sigmoid) was included in this clinical pathway during the years 2009–2017. Our analysis focused particularly on the compliance with the protocol, the pain felt, the suture leak rate, the hospital stay, the re-hospitalization rate and redo surgery within 30 days. Our work leads to the conclusion that the introduction of a clinical pathway, when it is well prepared and brings together all the implicated persons with the same goal, is feasible with convincing results. 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Donnelly, JeanMarie Houghton and Yana Zavros",authors:[{id:"49368",title:"Dr.",name:"Yana",middleName:null,surname:"Zavros",fullName:"Yana Zavros",slug:"yana-zavros"}]},{id:"17338",title:"Differentiation of Cancer Stem Cells",slug:"differentiation-of-cancer-stem-cells",signatures:"Taro Yamashita, Masao Honda and Shuichi Kaneko",authors:[{id:"27817",title:"Dr.",name:"Taro",middleName:null,surname:"Yamashita",fullName:"Taro Yamashita",slug:"taro-yamashita"},{id:"43187",title:"Dr.",name:"Masao",middleName:null,surname:"Honda",fullName:"Masao Honda",slug:"masao-honda"},{id:"43188",title:"Dr.",name:"Shuichi",middleName:null,surname:"Kaneko",fullName:"Shuichi Kaneko",slug:"shuichi-kaneko"}]},{id:"17339",title:"Carbohydrate Antigens as Cancer-Initiating Cell Markers",slug:"carbohydrate-antigens-as-cancer-initiating-cell-markers",signatures:"Wei-Ming Lin, Uwe Karsten, Steffen Goletz and Yi Cao",authors:[{id:"51917",title:"Prof.",name:"Yi",middleName:null,surname:"Cao",fullName:"Yi Cao",slug:"yi-cao"},{id:"52594",title:"Dr.",name:"Wei-Ming",middleName:null,surname:"Lin",fullName:"Wei-Ming Lin",slug:"wei-ming-lin"},{id:"52595",title:"Dr.",name:"Uwe",middleName:null,surname:"Karsten",fullName:"Uwe Karsten",slug:"uwe-karsten"},{id:"52596",title:"Dr.",name:"Steffen",middleName:null,surname:"Goletz",fullName:"Steffen Goletz",slug:"steffen-goletz"}]},{id:"17340",title:"Influence of Culture Environment and Mollicutes Contaminations on CD133 Modulation in Cancer Stem Cells",slug:"influence-of-culture-environment-and-mollicutes-contaminations-on-cd133-modulation-in-cancer-stem-ce",signatures:"Elisabetta Mariotti, Peppino Mirabelli, Francesca D’Alessio, Marica Gemei, Rosa Di Noto, Giuliana Fortunato and Luigi Del Vecchio",authors:[{id:"28066",title:"Dr.",name:"Rosa",middleName:null,surname:"Di Noto",fullName:"Rosa Di Noto",slug:"rosa-di-noto"},{id:"44267",title:"Dr.",name:"Elisabetta",middleName:null,surname:"Mariotti",fullName:"Elisabetta Mariotti",slug:"elisabetta-mariotti"},{id:"44268",title:"Dr.",name:"Peppino",middleName:null,surname:"Mirabelli",fullName:"Peppino Mirabelli",slug:"peppino-mirabelli"},{id:"44269",title:"Dr.",name:"Francesca",middleName:null,surname:"D'Alessio",fullName:"Francesca D'Alessio",slug:"francesca-d'alessio"},{id:"44270",title:"Dr.",name:"Marica",middleName:null,surname:"Gemei",fullName:"Marica Gemei",slug:"marica-gemei"},{id:"44271",title:"Prof.",name:"Giuliana",middleName:null,surname:"Fortunato",fullName:"Giuliana Fortunato",slug:"giuliana-fortunato"},{id:"44272",title:"Prof.",name:"Luigi",middleName:null,surname:"Del Vecchio",fullName:"Luigi Del Vecchio",slug:"luigi-del-vecchio"}]},{id:"17341",title:"Therapeutic Strategies Targeting Cancer Stem Cells",slug:"therapeutic-strategies-targeting-cancer-stem-cells",signatures:"Atique U. Ahmed, Bart Thaci, Derek A. Wainwright, Mahua Dey and Maciej S. Lesniak",authors:[{id:"33310",title:"Dr.",name:"Maciej",middleName:null,surname:"Lesniak",fullName:"Maciej Lesniak",slug:"maciej-lesniak"},{id:"83065",title:"Dr.",name:"Atique",middleName:null,surname:"Ahmed",fullName:"Atique Ahmed",slug:"atique-ahmed"},{id:"83066",title:"Dr.",name:"Bart",middleName:null,surname:"Thaci",fullName:"Bart Thaci",slug:"bart-thaci"},{id:"83067",title:"Dr.",name:"Derek",middleName:null,surname:"Wainwright",fullName:"Derek Wainwright",slug:"derek-wainwright"},{id:"83068",title:"Dr.",name:"Mahua",middleName:null,surname:"Dey",fullName:"Mahua Dey",slug:"mahua-dey"}]},{id:"17342",title:"Latest Therapeutic Approaches Based on Cancer Stem Cells",slug:"latest-therapeutic-approaches-based-on-cancer-stem-cells",signatures:"Dou Jun, Wang Jing and Gu Ning",authors:[{id:"27777",title:"Prof.",name:"Jun",middleName:null,surname:"Dou",fullName:"Jun Dou",slug:"jun-dou"}]},{id:"17343",title:"Potential Application of Natural Dietary Components to Target Cancer Stem Cells",slug:"potential-application-of-natural-dietary-components-to-target-cancer-stem-cells",signatures:"Yanyan Li, Steven J. Schwartz and Duxin Sun",authors:[{id:"31751",title:"Dr",name:"Yanyan",middleName:null,surname:"Li",fullName:"Yanyan Li",slug:"yanyan-li"},{id:"32401",title:"Dr.",name:"Steven",middleName:null,surname:"Schwartz",fullName:"Steven Schwartz",slug:"steven-schwartz"},{id:"37219",title:"Dr.",name:"Duxin",middleName:null,surname:"Sun",fullName:"Duxin Sun",slug:"duxin-sun"}]},{id:"17344",title:"Towards New Anticancer Strategies by Targeting Cancer Stem Cells with Phytochemical Compounds",slug:"towards-new-anticancer-strategies-by-targeting-cancer-stem-cells-with-phytochemical-compounds",signatures:"Sharif Tanveer, Emhemmed Fathi and Fuhrmann Guy",authors:[{id:"32270",title:"Dr.",name:"Guy",middleName:null,surname:"Fuhrmann",fullName:"Guy Fuhrmann",slug:"guy-fuhrmann"},{id:"95078",title:"Mr.",name:"Fathi",middleName:null,surname:"Emhemmed",fullName:"Fathi Emhemmed",slug:"fathi-emhemmed"},{id:"95082",title:"Mr.",name:"Tanveer",middleName:null,surname:"Sharif",fullName:"Tanveer Sharif",slug:"tanveer-sharif"}]},{id:"17345",title:"Isolation of Liver Cancer Stem-Like Cells by Hoe33342 or Rhodamine123 Efflux",slug:"isolation-of-liver-cancer-stem-like-cells-by-hoe33342-or-rhodamine123-efflux",signatures:"Weihui Liu, Nan You and Kefeng Dou",authors:[{id:"29825",title:"Prof.",name:"Weihui",middleName:null,surname:"Liu",fullName:"Weihui Liu",slug:"weihui-liu"},{id:"38333",title:"Prof.",name:"Kefeng",middleName:null,surname:"Dou",fullName:"Kefeng Dou",slug:"kefeng-dou"},{id:"83386",title:"Dr.",name:"Nan",middleName:null,surname:"You",fullName:"Nan You",slug:"nan-you"}]},{id:"17346",title:"Large-Scale Production of Human Glioblastoma-Derived Cancer Stem Cell Tissue in Suspension Bioreactors to Facilitate the Development of Novel Oncolytic Therapeutics",slug:"large-scale-production-of-human-glioblastoma-derived-cancer-stem-cell-tissue-in-suspension-bioreacto",signatures:"Krishna Panchalingam, Wendy Paramchuk, Parvinder Hothi, Nameeta Shah, Leroy Hood, Greg Foltz and Leo A. Behie",authors:[{id:"32955",title:"Prof.",name:"Leo",middleName:"Augustus",surname:"Behie",fullName:"Leo Behie",slug:"leo-behie"}]},{id:"17347",title:"Cancer Stem Cells: The Role of the Environment and Methods to Identify Them",slug:"cancer-stem-cells-the-role-of-the-environment-and-methods-to-identify-them",signatures:"Giuseppe Pirozzi",authors:[{id:"34509",title:"Dr.",name:"Giuseppe",middleName:null,surname:"Pirozzi",fullName:"Giuseppe Pirozzi",slug:"giuseppe-pirozzi"}]},{id:"17348",title:"Modulation of Multidrug Resistance on the Same Single Cancer Cell in a Microfluidic Chip: Intended for Cancer Stem Cell Research",slug:"modulation-of-multidrug-resistance-on-the-same-single-cancer-cell-in-a-microfluidic-chip-intended-fo",signatures:"XiuJun Li, Yuchun Chen and Paul C.H. Li",authors:[{id:"29972",title:"Prof.",name:"Paul",middleName:null,surname:"Li",fullName:"Paul Li",slug:"paul-li"},{id:"40073",title:"Prof.",name:"XiuJun",middleName:null,surname:"Li",fullName:"XiuJun Li",slug:"xiujun-li"},{id:"40074",title:"Ms.",name:"Yuchun",middleName:null,surname:"Chen",fullName:"Yuchun Chen",slug:"yuchun-chen"}]},{id:"17349",title:"Evolution of Cancer Stem Cells",slug:"evolution-of-cancer-stem-cells",signatures:"Stanley Shostak",authors:[{id:"28104",title:"Prof.",name:"Stanley",middleName:null,surname:"Shostak",fullName:"Stanley Shostak",slug:"stanley-shostak"}]}]}],publishedBooks:[{type:"book",id:"318",title:"Acute Leukemia",subtitle:"The Scientist's Perspective and Challenge",isOpenForSubmission:!1,hash:"7e697a80aa41aec2dd86a911ddcd7be9",slug:"acute-leukemia-the-scientist-s-perspective-and-challenge",bookSignature:"Mariastefania Antica",coverURL:"https://cdn.intechopen.com/books/images_new/318.jpg",editedByType:"Edited by",editors:[{id:"36211",title:"Prof.",name:"Mariastefania",surname:"Antica",slug:"mariastefania-antica",fullName:"Mariastefania Antica"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"377",title:"T-Cell Leukemia",subtitle:null,isOpenForSubmission:!1,hash:"3467e106fca6aaa2fabd2468461a0c70",slug:"t-cell-leukemia",bookSignature:"Olga Babusikova, Sinisa Dovat and Kimberly J. Payne",coverURL:"https://cdn.intechopen.com/books/images_new/377.jpg",editedByType:"Edited by",editors:[{id:"41671",title:"Dr.",name:"Olga",surname:"Babusikova",slug:"olga-babusikova",fullName:"Olga Babusikova"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"539",title:"Novel Aspects in Acute Lymphoblastic Leukemia",subtitle:null,isOpenForSubmission:!1,hash:"dfef11575616931bbc329551f943115f",slug:"novel-aspects-in-acute-lymphoblastic-leukemia",bookSignature:"Stefan Faderl",coverURL:"https://cdn.intechopen.com/books/images_new/539.jpg",editedByType:"Edited by",editors:[{id:"64603",title:"Dr.",name:"Stefan",surname:"Faderl",slug:"stefan-faderl",fullName:"Stefan Faderl"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"826",title:"Tumor Angiogenesis",subtitle:null,isOpenForSubmission:!1,hash:"b7623895df0aba62ffdeed2e9588df06",slug:"tumor-angiogenesis",bookSignature:"Sophia Ran",coverURL:"https://cdn.intechopen.com/books/images_new/826.jpg",editedByType:"Edited by",editors:[{id:"79980",title:"Dr.",name:"Sophia",surname:"Ran",slug:"sophia-ran",fullName:"Sophia Ran"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"946",title:"Advancements in Tumor Immunotherapy and Cancer Vaccines",subtitle:null,isOpenForSubmission:!1,hash:"aa9eb0c98931a6c6e516ecf1962f99a4",slug:"advancements-in-tumor-immunotherapy-and-cancer-vaccines",bookSignature:"Hilal Arnouk",coverURL:"https://cdn.intechopen.com/books/images_new/946.jpg",editedByType:"Edited by",editors:[{id:"76431",title:"Dr.",name:"Hilal",surname:"Arnouk",slug:"hilal-arnouk",fullName:"Hilal Arnouk"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],publishedBooksByAuthor:[]},onlineFirst:{chapter:{type:"chapter",id:"80317",title:"Durable Ventricular Assist Device for Bridge to Transplantation",doi:"10.5772/intechopen.102467",slug:"durable-ventricular-assist-device-for-bridge-to-transplantation",body:'The first bridge to transplantation strategy was started in the 1980s, but a patient needed to stay in hospital due to a huge driving console, even if the device was implantable. First-generation of implantable ventricular assist device (VAD) was not widely implanted due to its huge size and a limited reliable support period. Development and introduction to the clinical arena of a rotary blood pump in the early 2000 completely changed the landscape. The smaller pump size enabled easier implantation in smaller body size patients and an operation of the device by portable batteries paved a way to outpatient management. A so-called second-generation device is driven in the presence of contact bearings, which were found to lead to several tough complications, such as pump thrombosis and gastrointestinal bleeding. Advent of the third-generation device, in which an impeller is rotated without contact to an inner housing by magnetic and/or hydrodynamic levitation systems. Most updated devices are manufactured by incorporating a magnetic levitation system. Thanks to these technological refinements and improvements of continuous-flow VAD (cf-VAD) support patients, the survival of patients on a VAD has been steadily prolonging. In this chapter, the current status and survival of cf-VAD patients for bridge to transplantation (BTT) in Japan and the United States (US) are reviewed.
Two Japan-made cf-LVAD (EVAHEART, Sun Medical Research Corp., Nagano, Japan and DuraHeart, Terumo Heart Inc., Ann Arbor, MI) were approved for health insurance coverage as a BTT in April 2010. Subsequently, HeartMate II (Abbott, Chicago, IL) in April 2013, Jarvik 2000 (Jarvik Heart Inc., New York, NY) in January 2014, HVAD (Medtronic, Minneapolis, MN) in February 2019 and HeartMate 3 (Abbott, Chicago, IL) in July 2019 were approved for a BTT. Similar to Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) in the US, we have the Japanese Registry for Mechanically Assisted Circulatory Support (J-MACS) as a mandatory registry system of cf-LVAD. J-MACS was established in 2009 with an intention of harmonization by doing with Food and Drug Administration (FDA) in the US [1].
Registry summary report is published every year, and the most recent one was published online in March 2021 [2]. HeartMate 3 was approved as the first DT device in May 2021, so the most recent J-MACS registry report included solely data regarding a BTT strategy. This report analyzed data of cf-LVADs which were implanted by October 31, 2020. The total number of implantation was 1353, among which primary implantation was in 956 (70.7%), bridge to bridge (BTB, conversion from paracorporeal device to cf-LVAD) in 218 (16.1%) and device exchange from cf-LVAD in 179 (13.2%). The total number of patients was 1174 (primary VAD + BTB). There were 871 male patients (74.2%) with an average age of 43.5 years. The distribution of the age in decade is shown in Table 1. The height, weight, body mass index (BMI) and body surface area (BSA) were 167.0 +/− 8.7 cm, 57.6 +/− 11.8 kg, 20.5 +/− 3.3 kg/m2 and 1.64 +/− 0.19 m2, respectively (Table 2). The majority of the patients were implanted for non-ischemic dilated cardiomyopathy (DCM; 64.8%), followed by ischemic heart disease (12.2%) and dilated-phase of hypertrophic cardiomyopathy (10.6%) (Table 3). The severity INTERMACS/J-MACS profile of the patients before cf-LVAD implantation was shown in Table 4. Almost half of the patients were implanted at profile 3 (46.7%), and only 9.1% belonged to profile 1. Kaplan–Meier survival curve showed that 1- and 2-year survival rates were 92% and 89% (Figure 1). The longest support exceeded 5 years. Figure 2 shows Kaplan–Meier survival stratified by the age group by decade. Patients with age in 50s and over 60 years had significantly worse survival (p < 0.0001). Figure 3 shows the survivals divided by preoperative J-MACS profiles, demonstrating a significantly worse survival in profile 1 (p = 0.032). Figure 4 shows the competing outcomes. Waiting time for heart transplantation is more than 4 years recently, so the curve of survival on the device crosses that of transplantation around 1500 days.
N | % | ||
---|---|---|---|
Total number | 1174 | ||
Gender | Male | 871 | 74.2 |
Female | 303 | 25.8 | |
Age distribution | < 10 | 1 | 0.1 |
10–19 | 66 | 5.6 | |
20–29 | 129 | 11.0 | |
30–39 | 227 | 19.3 | |
40–49 | 307 | 26.1 | |
50–59 | 304 | 25.9 | |
60–69 | 139 | 11.8 | |
> 70 | 1 | 0.1 |
Gender and age distribution.
Mean ± SD | |
---|---|
Age (years) | 43.5 ± 13.4 |
Height (cm) | 167.0 ± 8.7 |
Weight (kg) | 57.6 ± 11.8 |
BMI (kg/m2) | 20.5 ± 3.3 |
BSA (m2) | 1.64 ± 0.19 |
Patient demographics. BMI: Body mass index, BSA: Body surface area.
N | % | |
---|---|---|
CHD | 22 | 1.9 |
IHD | 143 | 12.2 |
HCM (dilated phase) | 125 | 10.6 |
HCM (no dilated phase) | 5 | 0.4 |
VHD | 10 | 0.9 |
DCM | 761 | 64.8 |
RCM | 5 | 0.4 |
Others | 102 | 8.7 |
Unknown | 1 | 0.1 |
Total | 1174 |
Causative diseases.
CHD: congenital heart disease, IHD: ischemic heart disease, HCM: hypertrophic cardiomyopathy, VHD: valvular heart disease, DCM: idiopathic dilated cardiomyopathy, RCM: restrictive cardiomyopathy.
INTERMACS/J-MACS profile | N | % |
---|---|---|
Profile 1 | 107 | 9.1 |
Profile 2 | 453 | 38.6 |
Profile 3 | 548 | 46.7 |
Profile 4 | 52 | 4.4 |
Profile 5–7 | 14 | 1.2 |
Total | 1174 |
Preimplant INTERMACS/J-MACS profile.
Actuarial survival after BTT cf-LVAD implantation.
Actuarial survival after BTT cf-LVAD implantation stratified by age group.
Actuarial survival after BTT cf-LVAD implantation stratified by preimplant profiles.
Competing outcomes.
Pump thrombosis-free curve is shown in Figure 5 with 1- and 2-year event-free rates of 97% and 97% for the primary implant, which is much less compared to an INTERMACS report. Driveline infection-free curve is shown in Figure 6, demonstrating that 1- and 2-year event-free rates are 78% and 67% for a primary implant. Figure 7 shows stroke-free curve including all stroke events of any grade. The gastrointestinal bleeding-free curve is shown in Figure 8, demonstrating 1- and 2-year event-free rate of 95% and 93% for primary implantation, which is much more infrequent compared to the US. Figure 9 shows the readmission-free rate. Almost two-thirds of the patients were readmitted within 1 year and three-quarters in 2 years, which is still an important issue to be solved. Figure 10 shows a pump exchange free rate with a 1- and 2-year event-free rate of 96% and 92% for primary implantation.
Pump thrombosis-free rate divided by primary VAD and BTB.
Driveline infection-free rate divided by primary VAD and BTB.
Stroke (any grade)-free rate divided by primary VAD and BTB.
Gastrointestinal bleeding-free rate divided by primary VAD and BTB.
Readmission-free rate divided by primary VAD and BTB.
Pump exchange-free rate divided by primary VAD and BTB.
Five hundred sixty-six heart transplantations (512 adult and 54 pediatric HTx) were performed by December 2020 in Japan since the Organ Transplantation Act came into force in October 1997 [3]. Figure 11 shows the number and the type of circulatory support device on which the recipient was placed at the time of HTx [4]. There were only three recipients who were not on any circulatory support including inotropes. All these three were pediatric patients. Thirty-two recipients (5.7%) were on continuous inotropic support. Thus, the majority of the recipients (93.8%) were on any type of mechanical circulatory support. Paracorporeal air-driven LVAD was used in 126 patients (22.3%), including 110 Nipro VAD (Nipro, Osaka, Japan) and 16 Berlin Heart Excor pediatric VADs (Berlin Heart GmbH, Berlin, Germany). Implantable LVAD was used in 393 recipients (69.4%) and 12 patients (2.1%) were on biventricular VAD (BIVAD) support. Most frequently implanted cf-LVAD device was HeartMate II in 166, followed by EVAHEART in 86, Jarvik 2000 in 61, DuraHeart in 56 and so on. A small number of first-generation implantable pulsatile devices were used in the early years (n = 11).
The number and the type of circulatory support at HTx(n = 566). Cf-VAD: continuous-flow left ventricular assist device, PI VAD: pulsatile implantable left ventricular assist device, P-LVAD: paracorporeal left ventricular assist device.
Figure 12 shows a yearly trend of the type of circulatory support [4]. Paracorporeal VADs were mainly used for a BTT before the year 2011 when two Japan-made cf-LVAD were approved for health insurance coverage. Berlin Heart Excor pediatric was started to be covered by health insurance in 2015. Figure 13 shows a yearly trend of waiting time for HTx divided by adult and pediatric recipients [4]. Since a shortage of brain-dead donations is extreme in Japan, a waiting time has continuously prolonged and reached 1625 days in adult recipients in 2020. A waiting time was variable year by year in pediatric recipients, but in general longer than that of Western countries.
The number and the type of circulatory support at HTxin each year. Cf-VAD: continuous-flow left ventricular assist device, PI VAD: pulsatile implantable left ventricular assist device, P-LVAD: paracorporeal left ventricular assist device.
Waiting time for heart transplantation in both adult and pediatric recipients.
A cf-VAD has been widely used for a BTT in these two decades due to improvement of long-term safe support, less complications and size miniaturization. Figure 14 is from ISHLT (International Society for Heart and Lung Transplantation) 2019 Annual Report Slides [5], showing an annual trend of a ratio of adult patients who were bridged to HTx with mechanical circulatory support devices. Including LVAD, BIVAD, VAD + ECMO and isolated RVAD, 52.5% and 49.6% of the recipients were bridged to HTx in 2016 and 2017, respectively. An isolated LVAD support was the majority like 49.6% and 47.0% in 2016 and 2017, respectively. Figure 15 from ISHLT 2019 Report demonstrates that survival (89.9% and 77.6% at 1 and 5 years) in patients with cf-LVAD support is identical with that of no LVAD/no inotrope group (90.0% and 79.0%) or no LVAD/Inotrope group (91.9% and 78.7%) [5]. Cox-hazard analysis of risk factors for 1-year mortality among adult heart transplants between 2012 and June 2017 showed that VAD support was a significant risk factor (p < 0.01; HR 1.241, 95% CI 1.082–1.424). However, VAD bridge was not a significant risk factor for cardiac allograft vasculopathy (CAV) or severe renal dysfunction within 5 years by Cox-hazard analysis of adult heart transplants conditional on survival to discharge between 2008 and June 2013 [5].
Adult heart transplants. The ratio of patients bridged with mechanical circulatory support by year and device type.
Adult heart transplants. Kaplan–Meier survival by pre-transplant mechanical circulatory support use (transplants: Jan 2010 –June 2017).
Figure 16 from ISHLT Pediatric HTx 2019 Annual Report shows an annual trend of a ratio of patients who were bridged with mechanical circulatory support [6]. Different from adult recipients, an increasing trend of the MCS bridge ratio was not steady, but there was a trend for increase with 31.8% in VAD or TAH and 1.5% in VAD + ECMO. Figure 17 demonstrates that about a quarter of pediatric recipients were bridged with LVAD (20.2%) or BIVAD (5.4%) between 2010 and June 2018 [6]. Notably, almost a half of the recipients were bridged with LVAD (39.8%) or BIVAD (8.7%) in DCM among transplants between 2010 and June 2018 [6]. Figure 18 shows a ratio of patients who were bridged with MCS divided by age group [6]. A total of 30% patients with age of 1 to 17 years were bridged with VAD or TAH, or VAD + ECMO [6]. Figure 19 is a Kaplan–Meier survival curve stratified by device strategies, demonstrating that survivals of the VAD or TAH group (93.7% and 85.2% at 1 and 5 years) are not different from those of no support group (93.1% and 84.8%) [6]. The VAD support was a risk factor for 1-year mortality by Cox-hazard analysis (p = 0.02; HR 1.396, 95% CI 1.047–1.860). However, as in adult HTx, pretransplant VAD use was not associated with CAV progression or renal dysfunction within 5 years conditional on survival to discharge.
Pediatric heart transplants. Ratio of patients bridged with mechanical circulatory support by year (transplants: Jan 2005 –Dec 2017).
Pediatric heart transplants. The ratio of patients bridged with mechanical circulatory support by the device (transplants: Jan 2010 –June 2018).
Pediatric heart transplants. The ratio of patients bridged with mechanical circulatory support by age group (transplants: Jan 2010 –June 2018).
Pediatric heart transplants. Kaplan–Meier survival by mechanical circulatory support usage (transplants: Jan 2010 –June 2017).
In addition to BTT, a cf-VAD has been implanted for bridge to candidacy or destination therapy. A recent trend of survival after cf-VAD implantation for each strategy was reported in The Society of Thoracic Surgeons (STS) INTERMACS 2020 annual Report [7]. Survival of cf-LVAD patients by a device strategy is shown in Figure 20. Patients with a BTT strategy enjoyed better survival than those with other strategies. The absolute difference of survival at each year between BTT and DT strategies ranged from 6.7% to 10.3%. Steady improvement of survival after HTx with cf-VAD support was clearly demonstrated in the ISHLT adult heart transplantation 2021 report [8]. As shown in Figure 21, a significant improvement in survival is achieved as years elapsed. A similar finding was also confirmed in pediatric recipients with a BTT strategy [9].
Kaplan–Meier survival curves for primary cf-LVAD for 2015–2019 by implant strategy. BTC: Bridge to candidacy, BTT: Bridge to transplant, Cf-LVAD, continuous-flow left ventricular assist device, DT: Destination therapy.
Adult heart transplants with cf-VAD BTT. Kaplan–Meier survival within 12 months by recipient era (transplants: Jan 2000 -Jun 2017).
A new heart allocation policy was introduced in October 2018 with an intention to: 1. decrease a wait-list death, and 2. equalize a chance to be transplanted for a severely ill recipient. This policy change made the new donor heart allocation system to prioritize candidates supported by temporary devices. However, waitlist and post-transplant outcomes in candidates with durable LVAD remain to be elucidated. Mullan et al. analyzed the United Network for Organ Sharing (UNOS) database of adults with cf-LVAD at listing or implanted while listed between April 2017 and April 2020, and elucidated that the number of patients listed with LVAD decreased nationally over time from 102 in April 2017 to 12 in April 2020 (p < 0.001). The proportion of patients with LVAD at the time of transplant decreased from 47% to 14% (Figure 22) [10]. They also showed that transplantation rates were not different before and after the allocation policy change (85.4% vs. 83.6%; p = 0.225), but waitlist time decreased in the post-period (82 vs. 65 days; p = 0.004). Waitlist survival did not change, but post-transplantation survival was worse in patients with BTT post-change (p < 0.001) [10]. Abrupt decrease of a BTT strategy among cf-LVAD implantation was endorsed by the STS INTERMACS 2020 annual Report (Figure 23) [7].
Trends in LVAD utilization in patients listed for heart transplantation.
Implant strategy by implant year for primary continuous-flow LVADs.
Edelson et al. conducted an ISHLT data analysis to seek the influence of mechanical circulatory support on post-transplant outcomes in pediatric patients [11]. Among 5095 patients between 2005 and 2017, 26% of patients received MCS prior to transplant: 240 (4.7%) on extracorporeal membrane oxygenation (ECMO), 1030 (20.2%) on VAD, and 54 both. They found that survival in congenital heart disease (CHD) and DCM was similar in patients with no MCS or those with VAD, while pretransplant ECMO use is strongly associated with death after transplant particularly in children with CHD. HTx in patients with Fontan operation has been challenging, and a durable LVAD has been used to bridge a post-Fontan patient anecdotally. The first collective study of durable VAD support in Fontan patients was reported in 2021. Cedars et al. conducted a retrospective analysis of data collected in the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry, a multicenter learning network of pediatric hospitals actively involved in the implantation and management of VADs in children and adults with CHD [12]. They identified 45 Fontan patients implanted with a VAD. The average age of patients was 10 years (interquartile range: 4.5–18). The majority of patients were INTERMACS Profile 2 (56%). The most commonly employed device was the Medtronic HVAD (56%). A total of 13 patients were discharged on device support, and 67% of patients experienced adverse events, the most common of which were neurologic (25%). At 1 year after device implantation, the rate of transplantation was 69.5%, 9.2% of patients continued to be VAD supported, and 21.3% of patients had died.
In this chapter, the author reviews durable VAD used for a BTT. BTT strategy both in adult HTx by cf-LVAD and in pediatric HTx by Berlin Heart Excor or cf-LVAD is mandatory in Japan because a waiting time is over 4 years in adults and over 2 years in children due to a severe donor shortage. A total of 95% of adult HTx and 80% of pediatric HTx were bridged with a durable LVAD as of December 2020. As shown by J-MACS registry data, the survival of cf-LVAD patients was favorable. In the majority of European countries and the US cf-VAD use for a BTT was steadily increasing. VAD support was employed successfully in about 50% in adult and about 30% in pediatric HTx recipients. Survival after HTx with durable VAD support has been improving, and no survival difference is observed compared to that of recipients without VAD support. Recent heart allocation policy change in the US had a great impact on a judgment to choose a durable LVAD for a BTT. A chance to choose BTT strategy by using cf-LVAD will be declining undoubtedly, but nobody still knows what will be a future outcome.
IntechOpen implements a robust policy to minimize and deal with instances of fraud or misconduct. As part of our general commitment to transparency and openness, and in order to maintain high scientific standards, we have a well-defined editorial policy regarding Retractions and Corrections.
",metaTitle:"Retraction and Correction Policy",metaDescription:"Retraction and Correction Policy",metaKeywords:null,canonicalURL:"/page/retraction-and-correction-policy",contentRaw:'[{"type":"htmlEditorComponent","content":"IntechOpen’s Retraction and Correction Policy has been developed in accordance with the Committee on Publication Ethics (COPE) publication guidelines relating to scientific misconduct and research ethics:
\\n\\n1. RETRACTIONS
\\n\\nA Retraction of a Chapter will be issued by the Academic Editor, either following an Author’s request to do so or when there is a 3rd party report of scientific misconduct. Upon receipt of a report by a 3rd party, the Academic Editor will investigate any allegations of scientific misconduct, working in cooperation with the Author(s) and their institution(s).
\\n\\nA formal Retraction will be issued when there is clear and conclusive evidence of any of the following:
\\n\\nPublishing of a Retraction Notice will adhere to the following guidelines:
\\n\\n1.2. REMOVALS AND CANCELLATIONS
\\n\\n2. STATEMENTS OF CONCERN
\\n\\nA Statement of Concern detailing alleged misconduct will be issued by the Academic Editor or publisher following a 3rd party report of scientific misconduct when:
\\n\\nIntechOpen believes that the number of occasions on which a Statement of Concern is issued will be very few in number. In all cases when such a decision has been taken by the Academic Editor the decision will be reviewed by another editor to whom the author can make representations.
\\n\\n3. CORRECTIONS
\\n\\nA Correction will be issued by the Academic Editor when:
\\n\\n3.1. ERRATUM
\\n\\nAn Erratum will be issued by the Academic Editor when it is determined that a mistake in a Chapter originates from the production process handled by the publisher.
\\n\\nA published Erratum will adhere to the Retraction Notice publishing guidelines outlined above.
\\n\\n3.2. CORRIGENDUM
\\n\\nA Corrigendum will be issued by the Academic Editor when it is determined that a mistake in a Chapter is a result of an Author’s miscalculation or oversight. A published Corrigendum will adhere to the Retraction Notice publishing guidelines outlined above.
\\n\\n4. FINAL REMARKS
\\n\\nIntechOpen wishes to emphasize that the final decision on whether a Retraction, Statement of Concern, or a Correction will be issued rests with the Academic Editor. The publisher is obliged to act upon any reports of scientific misconduct in its publications and to make a reasonable effort to facilitate any subsequent investigation of such claims.
\\n\\nIn the case of Retraction or removal of the Work, the publisher will be under no obligation to refund the APC.
\\n\\nThe general principles set out above apply to Retractions and Corrections issued in all IntechOpen publications.
\\n\\nAny suggestions or comments on this Policy are welcome and may be sent to permissions@intechopen.com.
\\n\\nPolicy last updated: 2017-09-11
\\n"}]'},components:[{type:"htmlEditorComponent",content:'IntechOpen’s Retraction and Correction Policy has been developed in accordance with the Committee on Publication Ethics (COPE) publication guidelines relating to scientific misconduct and research ethics:
\n\n1. RETRACTIONS
\n\nA Retraction of a Chapter will be issued by the Academic Editor, either following an Author’s request to do so or when there is a 3rd party report of scientific misconduct. Upon receipt of a report by a 3rd party, the Academic Editor will investigate any allegations of scientific misconduct, working in cooperation with the Author(s) and their institution(s).
\n\nA formal Retraction will be issued when there is clear and conclusive evidence of any of the following:
\n\nPublishing of a Retraction Notice will adhere to the following guidelines:
\n\n1.2. REMOVALS AND CANCELLATIONS
\n\n2. STATEMENTS OF CONCERN
\n\nA Statement of Concern detailing alleged misconduct will be issued by the Academic Editor or publisher following a 3rd party report of scientific misconduct when:
\n\nIntechOpen believes that the number of occasions on which a Statement of Concern is issued will be very few in number. In all cases when such a decision has been taken by the Academic Editor the decision will be reviewed by another editor to whom the author can make representations.
\n\n3. CORRECTIONS
\n\nA Correction will be issued by the Academic Editor when:
\n\n3.1. ERRATUM
\n\nAn Erratum will be issued by the Academic Editor when it is determined that a mistake in a Chapter originates from the production process handled by the publisher.
\n\nA published Erratum will adhere to the Retraction Notice publishing guidelines outlined above.
\n\n3.2. CORRIGENDUM
\n\nA Corrigendum will be issued by the Academic Editor when it is determined that a mistake in a Chapter is a result of an Author’s miscalculation or oversight. A published Corrigendum will adhere to the Retraction Notice publishing guidelines outlined above.
\n\n4. FINAL REMARKS
\n\nIntechOpen wishes to emphasize that the final decision on whether a Retraction, Statement of Concern, or a Correction will be issued rests with the Academic Editor. The publisher is obliged to act upon any reports of scientific misconduct in its publications and to make a reasonable effort to facilitate any subsequent investigation of such claims.
\n\nIn the case of Retraction or removal of the Work, the publisher will be under no obligation to refund the APC.
\n\nThe general principles set out above apply to Retractions and Corrections issued in all IntechOpen publications.
\n\nAny suggestions or comments on this Policy are welcome and may be sent to permissions@intechopen.com.
\n\nPolicy last updated: 2017-09-11
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His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. 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Among the several advanced functional materials used as TiO2 NP support, the hierarchical meso/macroporous SiO2 spheres not only show the advantages associated to its chemical nature but also the dendritic fibrous structure provides a porous network that offers many benefits to be exploited in optical and catalytic devices. In this chapter, different synthetic approaches to design hierarchical meso/macroporous silica and the strategies to support TiO2 NPs regarding the photocatalytic performance of these materials are shown.",book:{id:"7671",slug:"concepts-of-semiconductor-photocatalysis",title:"Concepts of Semiconductor Photocatalysis",fullTitle:"Concepts of Semiconductor Photocatalysis"},signatures:"Keyla M. Fuentes, Margarita Sánchez-Dominguez and Sara A. 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Many studies have shown their applications in various fields, specifically in photocatalysis. There are different methods to synthesis of rare-earth nanostructures. In this study, we discuss about modification of rare-earth-based materials. Also production methods and their advantages and disadvantages have been presented, briefly. Finally, photocatalytic applications of rare-earth nanostructures are highlighted.",book:{id:"7671",slug:"concepts-of-semiconductor-photocatalysis",title:"Concepts of Semiconductor Photocatalysis",fullTitle:"Concepts of Semiconductor Photocatalysis"},signatures:"Sahar Zinatloo-Ajabshir and Zahra Sayyar",authors:[{id:"292583",title:"Dr.",name:"Sahar",middleName:null,surname:"Zinatloo_Ajabshir",slug:"sahar-zinatloo_ajabshir",fullName:"Sahar Zinatloo_Ajabshir"},{id:"296400",title:"Dr.",name:"Zahra",middleName:null,surname:"Sayyar",slug:"zahra-sayyar",fullName:"Zahra Sayyar"}]},{id:"67697",title:"TiO2 Nanoparticles Supported on Hierarchical Meso/Macroporous SiO2 Spheres for Photocatalytic Applications",slug:"tio-sub-2-sub-nanoparticles-supported-on-hierarchical-meso-macroporous-sio-sub-2-sub-spheres-for-pho",totalDownloads:928,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Supporting a photocatalyst, such as titania nanoparticles (TiO2 NPs), is a good strategy to improve its performance since it can facilitate the photocatalyst recovery from the aqueous media and provides a high surface area for pollutant adsorption. Among the several advanced functional materials used as TiO2 NP support, the hierarchical meso/macroporous SiO2 spheres not only show the advantages associated to its chemical nature but also the dendritic fibrous structure provides a porous network that offers many benefits to be exploited in optical and catalytic devices. In this chapter, different synthetic approaches to design hierarchical meso/macroporous silica and the strategies to support TiO2 NPs regarding the photocatalytic performance of these materials are shown.",book:{id:"7671",slug:"concepts-of-semiconductor-photocatalysis",title:"Concepts of Semiconductor Photocatalysis",fullTitle:"Concepts of Semiconductor Photocatalysis"},signatures:"Keyla M. Fuentes, Margarita Sánchez-Dominguez and Sara A. Bilmes",authors:[{id:"93593",title:"Dr.",name:"Margarita",middleName:null,surname:"Sanchez-Dominguez",slug:"margarita-sanchez-dominguez",fullName:"Margarita Sanchez-Dominguez"},{id:"290978",title:"Ph.D.",name:"Keyla M.",middleName:null,surname:"Fuentes",slug:"keyla-m.-fuentes",fullName:"Keyla M. Fuentes"},{id:"300173",title:"Prof.",name:"Sara",middleName:null,surname:"Aldabe Bilmes",slug:"sara-aldabe-bilmes",fullName:"Sara Aldabe Bilmes"}]},{id:"64785",title:"Effect of Annealing on Metal-Oxide Nanocluster",slug:"effect-of-annealing-on-metal-oxide-nanocluster",totalDownloads:798,totalCrossrefCites:0,totalDimensionsCites:3,abstract:"Recently, the development of optoelectronic devices based on metal-oxide nanocluster has attracted intensive research interest. Nanoclusters are suitable for these because of their large surface-to-volume ratio and the presence of abundant oxygen vacancies or trap states. Metal–oxides such as ZnO, In2O3, and TiO2 synthesized using different technique produces high surface area films consisting of clusters and provides complete control over the film morphology. In this chapter, some of the metal oxides nanocluster film has investigated, and the effect of annealing on the structural, optical and electrical properties of the grown films when subjected to different annealing temperatures will be studied. Theoretically, these properties are presumed to improve after the heat treatment as the crystallinity, and the grain size of the film has increased due to the diminishing of oxygen vacancies. Thus, the greater surface-to-volume ratio, the better stoichiometry and higher level of crystallinity compared to bulk materials make nanocluster-based devices very promising for the mentioned application.",book:{id:"7671",slug:"concepts-of-semiconductor-photocatalysis",title:"Concepts of Semiconductor Photocatalysis",fullTitle:"Concepts of Semiconductor Photocatalysis"},signatures:"Naorem Khelchand Singh and Rajshree Rajkumari",authors:[{id:"263847",title:"Dr.",name:"Naorem Khelchand",middleName:null,surname:"Singh",slug:"naorem-khelchand-singh",fullName:"Naorem Khelchand Singh"},{id:"276260",title:"Ms.",name:"Rajshree",middleName:null,surname:"Rajkumari",slug:"rajshree-rajkumari",fullName:"Rajshree Rajkumari"}]}],onlineFirstChaptersFilter:{topicId:"958",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:317,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:105,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:15,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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