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.
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We 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!
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.
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Throughout 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\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\n
We 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:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{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"}]},book:{item:{type:"book",id:"9393",leadTitle:null,fullTitle:"Engineering Steels and High Entropy-Alloys",title:"Engineering Steels and High Entropy-Alloys",subtitle:null,reviewType:"peer-reviewed",abstract:'"This book entitled “Engineering Steels and High Entropy-Alloys” presents an overview of various types of advanced steels and high entropy alloys. It also discusses the current research trends, problems, and applications of engineering steels and high entropy materials. The book also gives a brief overview of advances in surface protection strategies of steels and laser processing of materials (additive manufacturing). \nThe various key features of this book include: 1. A comprehensive overview of various types of engineering steels, phase transformation, and applications in engineering. 2. A complete detailed understanding and mechanism of high entropy materials, including high entropy alloys and ceramics. 3. Descriptions of structure-property relationships in high entropy materials and their application in various fields such as biomedical implants. 4. A brief review of various laser processing (additive manufacturing) and surface protection of advanced materials."',isbn:"978-1-78985-948-5",printIsbn:"978-1-78985-947-8",pdfIsbn:"978-1-83880-556-2",doi:"10.5772/intechopen.84991",price:119,priceEur:129,priceUsd:155,slug:"engineering-steels-and-high-entropy-alloys",numberOfPages:286,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"d33466a3272f97353a6bf6d76d7512a5",bookSignature:"Ashutosh Sharma, Zoia Duriagina, Sanjeev Kumar",publishedDate:"June 24th 2020",coverURL:"https://cdn.intechopen.com/books/images_new/9393.jpg",numberOfDownloads:13431,numberOfWosCitations:17,numberOfCrossrefCitations:22,numberOfCrossrefCitationsByBook:3,numberOfDimensionsCitations:49,numberOfDimensionsCitationsByBook:3,hasAltmetrics:1,numberOfTotalCitations:88,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 18th 2019",dateEndSecondStepPublish:"September 19th 2019",dateEndThirdStepPublish:"November 18th 2019",dateEndFourthStepPublish:"February 6th 2020",dateEndFifthStepPublish:"April 6th 2020",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"145236",title:"Dr.",name:"Ashutosh",middleName:null,surname:"Sharma",slug:"ashutosh-sharma",fullName:"Ashutosh Sharma",profilePictureURL:"https://mts.intechopen.com/storage/users/145236/images/system/145236.jpeg",biography:"Ashutosh Sharma is currently working in the Department of Materials Science and Engineering, Ajou University, Suwon, South Korea. He earned his Ph.D. degree in Metallurgical and Materials Engineering from the Indian Institute of Technology (IIT) Kharagpur, India. His research interests include electrochemical deposition, lead-free soldering and brazing, additive manufacturing, high entropy alloys, gas sensors, and composites. Dr. Sharma is a life member of various scientific and professional bodies. In a very short time, he has contributed more than 100 international journals, 17 patents, 8 book chapters, and 1 authored book, and 1 edited book so far. Recently, he was awarded the Extraction and Processing Division (EPD) Award by The Minerals, Metals and Materials (TMS, USA) in 2016 in recognition of his outstanding research in the area of nonferrous materials processing.",institutionString:null,position:null,outsideEditionCount:null,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Ajou University",institutionURL:null,country:{name:"Korea, South"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"296040",title:"Dr.",name:"Sanjeev",middleName:null,surname:"Kumar",slug:"sanjeev-kumar",fullName:"Sanjeev Kumar",profilePictureURL:"https://mts.intechopen.com/storage/users/296040/images/system/296040.jpg",biography:"Dr. Sanjeev Kumar has been working as an assistant professor in the Department of Mechanical Engineering at the National Institute of Technology, Raipur, India, since August 2021. Prior to this position, he served as Senior Researcher at CDL-IPE, Technical University of Vienna, Austria, from June 2018 to July 2021. Dr, Kumar also served as a Postdoc Researcher on the FWF project at IMAT, TU Graz, Austria, from May 2017–April 2018. He obtained his Ph.D. and MTech degrees in Welding Metallurgy from IIT Roorkee, India, while also obtaining a BTech in Mechanical Engineering from AKGEC-GZB UPTU, Lucknow, India. His primary research interest is welding, thermomechanical processing, and material design. He has published one book and more than thirty-eight research papers in recognized international journals, conferences, and books.",institutionString:"National Institute of Technology Raipur",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"TU Wien",institutionURL:null,country:{name:"Austria"}}},coeditorTwo:{id:"205149",title:"Prof.",name:"Zoia",middleName:null,surname:"Duriagina",slug:"zoia-duriagina",fullName:"Zoia Duriagina",profilePictureURL:"https://mts.intechopen.com/storage/users/205149/images/system/205149.jfif",biography:"Zoia Duriagina , Sc.D., Prof., Head of the Department of Applied Materials Science and Materials Engineering, NULP, Ukraine. She is a professor, dr.hab. of the Lublin Catholic University, Poland. Her scientific and research interests include: stainless steels and functional alloys, surface engineering: application of functional coatings, creating new thermoelectric materials, and investigation the properties of Ti-powders alloys. She has authored and co-authored 268 scientific publications, including 52 articles in journals indexed in Scopus and Web of Science (Author ID: 6507291021, http://orcid.org/0000-0002-2585-3849, h-index:6), 8 scientific monographs, 4 textbooks, and 16 patents. Awards received included the Golden Medal of Scientific Society of Materials Science and Diploma of International expert in the field of materials science, China. Sh is a member of the Academy of Higher Education of Ukraine and a member of the World Academy of Materials and Manufacturing Engineering.",institutionString:"Lviv Polytechnic National University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Lviv Polytechnic National University",institutionURL:null,country:{name:"Ukraine"}}},coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"14",title:"Materials Science",slug:"materials-science"}],chapters:[{id:"69791",title:"Integrated Manufacturing of Fine-Grained Stainless Steels for Industries and Medicals",doi:"10.5772/intechopen.89754",slug:"integrated-manufacturing-of-fine-grained-stainless-steels-for-industries-and-medicals",totalDownloads:839,totalCrossrefCites:2,totalDimensionsCites:6,hasAltmetrics:0,abstract:"Austenitic stainless steels have been widely utilized in industries, infrastructures, housing structures, kitchen components, and medical tools. Higher hardness and strength as well as more improvement of wear and corrosion toughness are often required in the industrial and medical applications. Fine-grained stainless steel (FGSS) provides a solution to increase the strength without loss of ductility and toughness. Deeper research and development in manufacturing of FGSS is required to make full use of its properties toward its applications in industries and medicals. First, its mechanical properties and microstructure is introduced as a basic knowledge of FGSS with comparison to the normal stainless steels. Mechanical and laser machinability of FGSS is stated and discussed to finish the products in seconds. Its performance in metal forming and diffusion bonding is explained to explore its applications in third. Its surface treatment and tooling is discussed to describe the grain-size effect on the low temperature plasma nitriding and to demonstrate its effectiveness in die-making in forth. Finally, every aspect in manufacturing of FGSS sheets and solids is summarized as a conclusion.",signatures:"Tatsuhiko Aizawa, Tomomi Shiratori and Takafumi Komatsu",downloadPdfUrl:"/chapter/pdf-download/69791",previewPdfUrl:"/chapter/pdf-preview/69791",authors:[{id:"251217",title:"Prof.",name:"Tatsuhiko",surname:"Aizawa",slug:"tatsuhiko-aizawa",fullName:"Tatsuhiko Aizawa"},{id:"307066",title:"Dr.",name:"Tomomi",surname:"Shiratori",slug:"tomomi-shiratori",fullName:"Tomomi Shiratori"},{id:"312068",title:"Dr.",name:"Takafumi",surname:"Komatsu",slug:"takafumi-komatsu",fullName:"Takafumi Komatsu"}],corrections:null},{id:"67009",title:"Isothermal Transformation Behavior and Microstructural Evolution of Micro-Alloyed Steel",doi:"10.5772/intechopen.85900",slug:"isothermal-transformation-behavior-and-microstructural-evolution-of-micro-alloyed-steel",totalDownloads:807,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"In this present study, the transformation products in micro-alloyed steel have been examined as well as isothermal decomposition of austenite into various phase formation. The rapid cooling from austenitizing temperature 1200°C to 14 different isothermal temperatures between 750 and 100°C with 50°C intervals were carried out by using dilatometric strain dilatometer on thermo-mechanical simulator. The heat treatments were delayed at different times to examine the microstructure evolution at all isothermal temperatures. The transformation kinetics was recorded during isothermal treatments and designed an isothermal transformation diagram, which is verified by microstructural changes. The results show that the initial microstructure which consists of proeutectoid ferrite and pearlite transforms into a combination of proeutectoid ferrite, pearlite, widmanstätten ferrite, upper or lower bainite, or martensite phases. The austenite grain size has been found to be decreased with a decrease in the isothermal holding temperature. The nose temperature was achieved at isothermal temperature 500°C which have been taking the least time for start and end of transformation of phases. It is also worth noticing that the start and end transformation times were observed decreasing with a decrease in the isothermal holding temperatures and after the nose transformation again gradually increased.",signatures:"Sanjeev Kumar",downloadPdfUrl:"/chapter/pdf-download/67009",previewPdfUrl:"/chapter/pdf-preview/67009",authors:[{id:"296040",title:"Dr.",name:"Sanjeev",surname:"Kumar",slug:"sanjeev-kumar",fullName:"Sanjeev Kumar"}],corrections:null},{id:"72244",title:"Phase Transformation in Micro-Alloyed Steels",doi:"10.5772/intechopen.91468",slug:"phase-transformation-in-micro-alloyed-steels",totalDownloads:849,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Phase transformation in crystalline solid is an important factor that designs the microstructure and plays a great role in alloy development. Iron has an allotropic form, and this unique metallurgical property leads to phase transformation. Addition of micro-alloying elements enhances the phase transformation scenarios in steels. Phase transformation due to the addition of micro-alloying elements, together with exceptional precipitation hardening capabilities, substantially improves mechanical properties of steels of different grades. Ferrite transforming to other phases reduces the hardenability of steels. Micro-addition of elements forms precipitation in ferrite and austenite, which controls the microstructure and hence the mechanical properties of steels. Besides, interactions between different deformation sequences used in the production of steel and addition of elements as solute or precipitates regulate the microstructure. Ferrite grain refinement depends on the refinement of austenite grain size in one case, and austenite grain size growth can be varied by addition of various elements. Thus, a variety of elements influences phase transformation that leads to significantly modified properties.",signatures:"Fahim Khan and Hossain M. M. A. Rashed",downloadPdfUrl:"/chapter/pdf-download/72244",previewPdfUrl:"/chapter/pdf-preview/72244",authors:[{id:"305818",title:"Mr.",name:"Fahim",surname:"Khan",slug:"fahim-khan",fullName:"Fahim Khan"},{id:"316380",title:"Dr.",name:"Hossain M.M.A",surname:"Rashed",slug:"hossain-m.m.a-rashed",fullName:"Hossain M.M.A Rashed"}],corrections:null},{id:"71147",title:"Technologies of High-Temperature Insulating Coatings on Stainless Steels",doi:"10.5772/intechopen.91334",slug:"technologies-of-high-temperature-insulating-coatings-on-stainless-steels",totalDownloads:836,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"For the use of chromium steels in instrumentation, microelectronics, and electrical engineering, their surfaces are additionally protected by coatings based on glass ceramics and other insulating materials. Such materials can operate at high temperatures for a long time under the influence of the electric current or magnetic field. This chapter describes the research results on synthesized coatings based on oxide glass ceramics and oxide materials obtained by plasma chemical vapor deposition (CVD) on the surfaces of stainless steels.",signatures:"Zoia Duriagina, Taras Kovbasyuk, Volodymyr Kulyk, Andriy Trostianchyn and Tetiana Tepla",downloadPdfUrl:"/chapter/pdf-download/71147",previewPdfUrl:"/chapter/pdf-preview/71147",authors:[{id:"205149",title:"Prof.",name:"Zoia",surname:"Duriagina",slug:"zoia-duriagina",fullName:"Zoia Duriagina"},{id:"411573",title:"Dr.",name:"Zoia",surname:"Duriagina",slug:"zoia-duriagina",fullName:"Zoia Duriagina"},{id:"411574",title:"Dr.",name:"Taras",surname:"Kovbasyuk",slug:"taras-kovbasyuk",fullName:"Taras Kovbasyuk"},{id:"411575",title:"Dr.",name:"Volodymyr",surname:"Kulyk",slug:"volodymyr-kulyk",fullName:"Volodymyr Kulyk"},{id:"411576",title:"Dr.",name:"Andriy",surname:"Trostianchyn",slug:"andriy-trostianchyn",fullName:"Andriy Trostianchyn"},{id:"411577",title:"Dr.",name:"Tetiana",surname:"Tepla",slug:"tetiana-tepla",fullName:"Tetiana Tepla"}],corrections:null},{id:"69053",title:"Morphology Evolution of DF2 (AISI-O1) Surface Micromachined by Pulsed Nd:YAG Laser",doi:"10.5772/intechopen.89189",slug:"morphology-evolution-of-df2-aisi-o1-surface-micromachined-by-pulsed-nd-yag-laser",totalDownloads:461,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Pulsed Nd:YAG laser was taken to premicromachine DF2 (AISI-O1) cold work steel. The effect of laser-irradiated parameters on the morphology evolution of the processed surface was investigated by 3D profilometer, atomic force microscope (AFM), scanning electron microscopy (SEM), and optical microscopy (OM). Results show that when DF2 (AISI-O1) specimens were irradiated with various parameters, the morphology of DF2 (AISI-O1) cold work steel was changed correspondingly. Moreover, it demonstrates that for a given laser, various kinds of morphology of a laser-machined surface could be established successfully to satisfy with the desired finish surface for the practical applications later.",signatures:"Kelvii Wei Guo",downloadPdfUrl:"/chapter/pdf-download/69053",previewPdfUrl:"/chapter/pdf-preview/69053",authors:[{id:"279895",title:"Prof.",name:"Yeeli Kelvii",surname:"Kwok",slug:"yeeli-kelvii-kwok",fullName:"Yeeli Kelvii Kwok"}],corrections:null},{id:"70940",title:"Development of Lightweight Steels for Automotive Applications",doi:"10.5772/intechopen.91024",slug:"development-of-lightweight-steels-for-automotive-applications",totalDownloads:1122,totalCrossrefCites:7,totalDimensionsCites:9,hasAltmetrics:0,abstract:"The automotive industry plays a determinant role in the economy of developed countries. Sheet metal forming is one of the most important processes in car manufacturing. Recent trends in car production may be characterized by the application of lightweight principles. Its main priority is to fulfill both the customers’ demands and the increased legal requirements. The application of high strength steels may be regarded as one of the potential possibilities. Applying high strength steels has a positive response for many of the requirements: increasing the strength may lead to the application of thinner sheets resulting in significant mass reduction. Mass reduction is leading to lower consumption with increased environment protection. However, increasing the strength can often lead to the decrease of formability, which is very unfavorable for the forming processes. In this chapter, an overview of recent material developments in the automotive industry concerning the use of new-generation high strength steels will be given. In this paper, the material developments are emphasized from the point of view sheet metal forming; therefore, our focus is on the body-in-white manufacturing in the automotive industry.",signatures:"Miklós Tisza",downloadPdfUrl:"/chapter/pdf-download/70940",previewPdfUrl:"/chapter/pdf-preview/70940",authors:[{id:"313030",title:"Prof.",name:"Miklós",surname:"Tisza",slug:"miklos-tisza",fullName:"Miklós Tisza"},{id:"411196",title:"Dr.",name:"Miklós",surname:"Tisza",slug:"miklos-tisza",fullName:"Miklós Tisza"}],corrections:null},{id:"68441",title:"Light-Weight and Flexible High-Entropy Alloys",doi:"10.5772/intechopen.88332",slug:"light-weight-and-flexible-high-entropy-alloys",totalDownloads:1379,totalCrossrefCites:1,totalDimensionsCites:4,hasAltmetrics:0,abstract:"The lightweight and flexible materials can improve people’s quality of daily life; in addition, the materials can be widely used in aerospace, automotive, consumer electronics, etc. Recently, high-entropy alloys had become hot issues in materials science with many excellent properties; therefore, we can combine the design ideas of high-entropy alloys with lightweight materials and flexible materials, taking into account the advantages of two types of materials, and promoting the development and progress of new materials. In the chapter, we will elaborate on the relationship between the microstructure and properties of lightweight high-entropy alloys and the design ideas of high-entropy alloys with flexible materials that were investigated in recent years. Furthermore, as the microstructure and mechanical properties of the alloys exhibit the nonlinear behaviors with entropy on high-entropy alloys, we would like to define the lightweight high-entropy alloy as the density is lower than 6 g/cm3, the mix-entropy of these alloys is higher than 1R (here, R is gas constant), and the number of components is four or more. Finally, it is expected to broaden the research field of high-entropy alloys and provide some new directions for the development of new materials.",signatures:"Yasong Li and Yong Zhang",downloadPdfUrl:"/chapter/pdf-download/68441",previewPdfUrl:"/chapter/pdf-preview/68441",authors:[{id:"203937",title:"Prof.",name:"Yong",surname:"Zhang",slug:"yong-zhang",fullName:"Yong Zhang"},{id:"300786",title:"Dr.",name:"Ya Song",surname:"Li",slug:"ya-song-li",fullName:"Ya Song Li"}],corrections:null},{id:"68982",title:"Characterization and Testing of High-Entropy Alloys from AlCrFeCoNi System for Military Applications",doi:"10.5772/intechopen.88622",slug:"characterization-and-testing-of-high-entropy-alloys-from-alcrfeconi-system-for-military-applications",totalDownloads:903,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:1,abstract:"High-entropy alloys (HEAs) can be obtained using various metallurgical processes such as vacuum arc remelting (VAR), induction melting, powder metallurgy, additive manufacturing, plasma sintering of powders, etc. Among these methods, the obtaining process in the VAR plant provides superior homogeneity characteristics for metal matrices, simultaneously with advanced purity, due to the high level of protection of the melts. The chapter presents a series of results on alloys with high entropy from the AlCrFeCoNi system, which can be used for various applications, including in the military field, for the realization of high-speed penetration protection panels. Experimental alloys were obtained by melting in electric arc under an argon atmosphere, using high-purity raw materials (greater than 99.5 wt%), and homogenization is ensured by successive five-times remelting of mini-ingots. The obtained alloys were subjected to microstructural analyses, mechanical tests, and also dynamic impact tests using incendiary perforation projectiles. At the same time, some tests were carried out on ballistic packages made of different materials, including high-entropy alloys. The results obtained in mechanical tests revealed high values of microhardness (over 600 HV0.1) as well as compressive strengths above 2000 MPa. The mechanical characteristics of these alloys can undergo substantial changes by applying several heat treatments.",signatures:"Victor Geanta and Ionelia Voiculescu",downloadPdfUrl:"/chapter/pdf-download/68982",previewPdfUrl:"/chapter/pdf-preview/68982",authors:[{id:"201642",title:"Prof.",name:"Ionelia",surname:"Voiculescu",slug:"ionelia-voiculescu",fullName:"Ionelia Voiculescu"},{id:"301396",title:"Dr.",name:"Victor",surname:"Geanta",slug:"victor-geanta",fullName:"Victor Geanta"}],corrections:null},{id:"69432",title:"High-Entropy Ceramics",doi:"10.5772/intechopen.89527",slug:"high-entropy-ceramics",totalDownloads:1308,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:0,abstract:"High-entropy ceramics is an emerging class of high-entropy materials with properties superior to conventional ceramics. Recent research has been focused on the development of new high-entropy ceramic compositions. High-entropy oxides, carbides, borides, silicides, and boron carbides had been reported with superior mechanical, oxidation, corrosion, and wear properties. The research work on the processing and characterization of bulk high-entropy ceramics and coating systems has been summarized in this chapter. The composition design, structure, chemistry, composite processing of bulk high-entropy ceramics, and evolution of microstructure and properties are reported. The literature on the deposition of high-entropy ceramic coating and the influence of coating parameters have been discussed to produce high-entropy ceramic coatings with superior mechanical, oxidation, and wear properties.",signatures:"Sajid Ali Alvi, Hanzhu Zhang and Farid Akhtar",downloadPdfUrl:"/chapter/pdf-download/69432",previewPdfUrl:"/chapter/pdf-preview/69432",authors:[{id:"192206",title:"Associate Prof.",name:"Farid",surname:"Akhtar",slug:"farid-akhtar",fullName:"Farid Akhtar"},{id:"310486",title:"M.Sc.",name:"Sajid Ali",surname:"Alvi",slug:"sajid-ali-alvi",fullName:"Sajid Ali Alvi"},{id:"310487",title:"Ms.",name:"Hanzhu",surname:"Zhang",slug:"hanzhu-zhang",fullName:"Hanzhu Zhang"}],corrections:null},{id:"69176",title:"High Entropy Alloys for Medical Applications",doi:"10.5772/intechopen.89318",slug:"high-entropy-alloys-for-medical-applications",totalDownloads:1329,totalCrossrefCites:2,totalDimensionsCites:8,hasAltmetrics:1,abstract:"A wide variety of metallic biomaterials have been developed so far, including various types of alloys. However, there is a strong need in the medical field for new solutions in what concerns metallic biomaterials with superior biocompatibility and mechanical properties in order to meet future requirements, including the recently developed high entropy alloys (HEAs). This chapter presents some characteristics of high entropy biocompatible metallic alloys produced in an electric-arc remelting furnace in argon inert atmosphere. The effects of the chemical elements used, the microstructural features, and some mechanical characteristics, both in the cast state or after some heat treatments, are highlighted.",signatures:"Victor Geanta, Ionelia Voiculescu, Petrica Vizureanu and Andrei Victor Sandu",downloadPdfUrl:"/chapter/pdf-download/69176",previewPdfUrl:"/chapter/pdf-preview/69176",authors:[{id:"201642",title:"Prof.",name:"Ionelia",surname:"Voiculescu",slug:"ionelia-voiculescu",fullName:"Ionelia Voiculescu"},{id:"301396",title:"Dr.",name:"Victor",surname:"Geanta",slug:"victor-geanta",fullName:"Victor Geanta"},{id:"12354",title:"Prof.",name:"Petrică",surname:"Vizureanu",slug:"petrica-vizureanu",fullName:"Petrică Vizureanu"},{id:"310000",title:"Dr.",name:"Andrei Victor",surname:"Sandu",slug:"andrei-victor-sandu",fullName:"Andrei Victor Sandu"}],corrections:null},{id:"68252",title:"Multicomponent Alloys for Biomedical Applications",doi:"10.5772/intechopen.88250",slug:"multicomponent-alloys-for-biomedical-applications",totalDownloads:1223,totalCrossrefCites:1,totalDimensionsCites:4,hasAltmetrics:0,abstract:"Titanium alloys are considered to be the most advanced materials for orthopedic implants due to the favorable combination of mechanical properties, low density, tissue tolerance, high strength-to-weight ratio, good resistance to corrosion by body fluids, biocompatibility, low density, nonmagnetic properties, and the ability to join with the bone. This is the reason why we decided to assess the resistance of two titanium alloys currently used for orthopedic implants, namely, Ti6Al7Nb and Ti6Al4V, as reference, to cyclic fatigue by dynamic tests with crevice corrosion stimulation. According to the results obtained, the examined electrochemical quantities, the visual and SEM observations, and EDX analysis reveal better corrosion behavior of the prostheses made of Ti6Al4V—anodized series compared to prostheses made of Ti6Al7Nb. The further comparison of two explanted proximal modules, made of Ti6Al7Nb and Ti6Al4V, to the same type of prostheses evaluated by cyclic fatigue dynamic tests with crevice corrosion stimulation reveals that there are significant similarities, in particular with regard to the electrolyte diffusion, deposition of products and corrosion. Cation extraction tests which were carried out for Ti6Al7Nb prostheses that have undergone particular surface treatments show significant differences depending on the surface treatment and demonstrate that orthopedic implant materials are not “inert.”",signatures:"Lucien Reclaru, Lavinia Cosmina Ardelean, Alexandru Florian Grecu and Catalin Adrian Miu",downloadPdfUrl:"/chapter/pdf-download/68252",previewPdfUrl:"/chapter/pdf-preview/68252",authors:[{id:"180569",title:"Dr.",name:"Lavinia",surname:"Ardelean",slug:"lavinia-ardelean",fullName:"Lavinia Ardelean"},{id:"214317",title:"Prof.",name:"Lucien",surname:"Reclaru",slug:"lucien-reclaru",fullName:"Lucien Reclaru"},{id:"300275",title:"Dr.",name:"Alexandru Florian",surname:"Grecu",slug:"alexandru-florian-grecu",fullName:"Alexandru Florian Grecu"},{id:"300446",title:"Dr.",name:"Catalin Adrian",surname:"Miu",slug:"catalin-adrian-miu",fullName:"Catalin Adrian Miu"}],corrections:null},{id:"71171",title:"High-Entropy Alloys for Micro- and Nanojoining Applications",doi:"10.5772/intechopen.91166",slug:"high-entropy-alloys-for-micro-and-nanojoining-applications",totalDownloads:896,totalCrossrefCites:2,totalDimensionsCites:7,hasAltmetrics:1,abstract:"The aim of this chapter is to provide a basic understanding of the metal-ceramic joints and high-entropy alloy (HEA) research in microjoining applications. We will first overview the issues in metal-ceramic brazing and solutions to overcome those issues using various fillers. Various approaches are available for joining ceramic to metallic materials. One approach will be to look for brazing alloys with the so-called high-entropy characteristics which exhibit a solid solution phase. The conventional alloy design and arc melting, Bridgman solidification, and advanced powder metallurgy techniques will be studied, including high-energy ball milling (HEBM) for the mechanical alloying process, and hot-press and spark plasma sintering (SPS) techniques are utilized for improved densification and phase transformation. 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A strength model is proposed depending on the surface roughness of the coating. The influence of the scale factor on the change in the strength of coatings is established. To assess the long-term strength of the coatings, we studied the temperature-time dependence of strength. The values of the activation energy of the destruction process of some coatings are experimentally determined. The dependence of the long-term strength of the coatings on tensions is given. The kinetics of changes in the short-term strength of coatings during aging is considered from the perspective of the kinetic concept of the strength of solids. The condition for coating cracking is obtained. 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\r\n\tThe goal of this book is to give the reader an overview of a field related to various applications in chemistry, chemical engineering, and nanotechnology. This book aims to provide information about the design of ion exchangers, their application in environmental technologies, and in biotechnology and pharmaceutical applications. This book will be written by authors in the field of experimental methods and critical reviews from multi-disciplines such as chemistry, membranes, and materials science. Among others, some of the topics covered will be Structure of ion exchangers, Synthesis of ion exchangers, Synthesis of inorganic ion exchangers, Properties of ion exchangers, Ion exchange voltammetry, Ion exchange as a separations method, Ion exchange in analytical chemistry, Ion exchange and extraction, Ion exchange membranes, Preparation of organic-inorganic hybrid ion exchangers, Application in environmental technologies, Application in biotechnology and pharmaceutical applications.
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1. Introduction
Clinical benign prostate hyperplasia is an aging disease, with a high prevalence after 40 years of age, from 8 to 60% at 90 years. The interventional treatments include open adenoma removal, transurethral resection of the prostate, HOLMIUM, and THULIUMenucleation, laser vaporization, steam ablation, microwavethermotherapy, etcetera. Prostate cancer has a high incidence in men over 60 years and is considered the second cause of death. Early detection assisted by PSA (prostate-specific antigen), MR imaging, and in some centers PSMA PET SCAN, and targeted biopsies, let us offer less invasive techniques, compared with radical prostatectomy or external beam radiation, with a decrease of morbidity, achieving what has been called “TRIFECTA”: disease control, urinary continence and erectile function.
High intensity focused ultrasound, a relatively new technique, uses a sound beam directed to a specific spot inside the prostate parenchyma, causing thermal ablation with customized planning, including whole gland, the benign enlargement of localized lesions, defined as focal therapies. More than 50,000 treatments have been performed worldwide, with growing improvement in the outcomes, mainly caused by a good selection of cases and technical improvements of imaging and emission of sound beams. By 2010, Sonablate and Ablatherm devices were used widely in some countries of Latin America (Mexico, Brazil, Ecuador, and Argentina), Europe and Japan, in 2015 FDA cleared the usage of HIFU with both machines. Some countries still consider HIFU as experimental therapy [1, 2].
2. Bases of HIFU
2.1 Physics of HIFU
Sound has been for several centuries a subject of interest for the different branches of science, been the development of its understanding as a physical phenomenon and its use in the different fields of science and technology the main topics. The medical sciences have not been the exception in this search. Ultrasound, a technology derived from sound, has had a significant boom in medicine due to its implementation as a diagnostic or therapeutic instrument. It has been widely disseminated as a diagnostic instrument due to its various advantages ranging from cost–benefit to high sensitivity and specificity for diagnosing pathologies [3]. As a therapeutic option, ultrasound has been used for the development of technologies such as extracorporeal lithotripsy, HIFU, sonophoresis, sonodynamic therapy, sonothrombolysis or histotripsy, among others, which base their efficacy on the induction of sonic bio-effects, both thermal and non-thermal (cavitation, radiation, etcetera) to induce tissue changes [4, 5].
The difference between ultrasound as a diagnostic or therapeutic technology is based on inducing a certain amount of bioeffect at the tissue level [4]. Ultrasound as a diagnostic tool seeks to induce the least possible bioeffect [4, 6]. In contrast, ultrasound as a therapy seeks certain technologies to achieve tissue ablation through inducing thermal or non-thermal bioeffects, such as the HIFU [4, 5, 6].
HIFU had its first antecedents in 1942 when the first destruction of tissue was recorded through an extracorporeal ultrasound energy source [5]; later, in the 1990s, its technology was refined by integrating real-time imaging methods for monitoring the procedure [5]. The use of real-time imaging has improved the efficacy of this treatment, reducing morbidity and mortality at making the treatment more accurate [5, 7]. Its clinical implementation increased significantly after the clinical case report of a patient treating a malignant bone neoplasm in Chongqing, China, in 1997 [5]. During the following 15 years, the use of HIFU clinically reported more than 30,000 cases of kidney, pancreas, bone, liver, or uterine fibroids, showing its great utility as a minimally invasive technology [5, 8]. Currently, HIFU technology can be divided according to the radiological technique used to guide the procedure (Magnetic Resonance or Diagnostic Ultrasound) or according to the system used to deliver the energetic (transrectal for the treatment of prostate pathologies, interstitial for the treatment of biliary or esophageal tumors, extracorporeal for the treatment of organs accessible to sound through the skin) [5, 7, 9].
For this chapter, and to delve into HIFU therapy and its biophysical effects, it is necessary to understand some basic concepts of the physics of sound.
Sound can be defined as a wave, classified as a transverse or longitudinal wave [5, 7]. For the chapter, and because it is the most used form in medicine, the longitudinal wave classification will be used [7].
Once a pulse is generated, the energy will oscillate the particles closest to the origin of the pulse, and these particles will, in turn, oscillate with those immediately adjacent so that this energy will be transmitted from proximal to distal. Each pulse generates positive pressure and negative pressure in one wave, together are wave cycles [5, 7].
Frequency, the number of wave cycles (one positive part and negative part of a wave) that occur in one second is measured in Hertz (one wave cycle per second = 1 Hert) [5, 7].
Amplitude is the distance that the most positive or negative part of each wave cycle has about the basal pressure of the medium [5, 7].
Intensity-Power; Power is defined as the amount of ultrasound energy that a device generates; the tissue receives this energy, this is where the intensity comes in; Intensity can be defined as the amount of energy that passes through a point in 90°, so it is expressed as the amount of power divided by the unit of area, Watts/cm2 [5, 7].
The HIFU as a therapeutic ultrasound system generates an intensity of approximately 1000–20,000 W/cm2, generating an elevation of between 60 and 100° C in 1 second in that unit area while using a frequency around 0.8−5 MegaHertz (each MegaHertz = 106 Hertz) (Figure 1) [4, 6, 8].
Figure 1.
Sound properties. Schematic representation of sound properties. Created with BioRender.com.
2.2 Biologic effects of HIFU
Multiple bio-effects have been described (thermal and non-thermal) related to the exposure of a sound field by a tissue. Different authors have classified these as thermal and non-thermal bio-effects [4, 5]. For its part, the HIFU system predominantly generates thermal bio-effects; however, these are not pure, since the presence of other non-thermal bio-effects such as cavitation has been described in the same tissue [4].
The main bio-effect caused by HIFU has been compared to the use of a magnifying glass to focus the sun’s rays on a point [6] because it generates a frequency of 0.8−5 MegaHertz with a wavelength of 2−0.3 mm, this is translated into a small area subjected to great ultrasonic power [6, 7]. As we previously mentioned, when this power crosses a specific point can be translated into intensity, being in the case of HIFU between 1000−20,000 watts/cm2 [5, 6]. It is considered that it is necessary to raise the temperature of the tissue to 56–60° C or more for about a second to produce an irreversible cytotoxic lesion with protein denaturation and heat-induced coagulative necrosis; using this concept of the irreversible lesion induced by heat, the result can be inferred from raising the temperature to around 60–100° C at a focal point as occurs with HIFU therapy (Figure 2) [4, 5, 6].
Figure 2.
Temperature changes are produced at the focal point, and near the transducer. (Courtesy of HIFUMx).
2.2.1 Coagulative necrosis
In different in vivo studies, it has been observed that the main effect caused by HIFU as a thermal injury is the induction of coagulative necrosis through protein denaturation and induction of apoptosis via nuclear lysis by endonucleases [5]. Specific characteristics have been described that differentiate this coagulative necrosis derived from thermal injury from coagulative necrosis of ischemic origin. The difference is mainly due to the predominance in the interaction of giant cells with chronic inflammation, unlike the tissue regeneration process via granulation tissue seen in coagulative necrosis due to ischemia [5].
Associated with coagulative necrosis, the ability of HIFU to injure small-caliber vessels (<2 mm) has been described as an endothelial lesion, and thrombosis of these vessels with these characteristics has been found in various studies. However, the ability of larger vessels to dissipate temperature has been described, thus suffering minor injury (heat sink) (Figure 3) [5].
Figure 3.
Thermal ablation. Schematic representation of thermal ablation mechanism and specificity.
2.2.2 Cavitation
The second most crucial mechanism described during the HIFU treatment is the non-thermal bio-effect of a mechanical type induced through cavitation [5, 9]. Cavitation can be defined as gas or vapor cavities forming within a liquid medium and their subsequent dynamics in this medium [5]. Cavitation formation can occur under different conditions (hydrodynamic, thermal, or acoustic energy changes); its importance lies in the possibility of generating a lesion adjacent to the formation of these cavities through micro-boiling, increased temperature, and shear stress [4, 5]. Cavitation, unlike temperature-induced injury, is more unstable in nature and less predictable (Figure 4) [5].
Figure 4.
Mechanical destruction. Schematic representation of mechanical destruction mechanism and specificity.
Two types of cavitation have been described by their nature, stable (non-inertial) cavitation and transient (inertial) cavitation [4]. Transient cavitation involves a significant change in bubble size in a period of few acoustic cycles [4], resulting in a more aggressive collapse [4, 5]. In contrast, stable cavitation maintains a more stable range in terms of growth of its diameter without significant growth and remains stable during many acoustic cycles [4, 5].
The appearance of these cavities depends on the different properties of both the source of acoustic energy and the medium where this energy will be exerted. Generally, it is known that to a greater extent, the temperature and pressure exerted on the medium are essential determinants for the formation of cavities. The temperature is inversely proportional to the cavitation threshold (the possibility of a said event happening) [4, 5].
Its importance lies in the possibility of causing more significant tissue damage, currently a field of study for the development of therapies such as histotripsy, which base their efficacy on this principle (Figure 5).
Figure 5.
Massive controlled cavitation formed in the posterior aspect of the prostate adenoma (Urovallarta Urology Center).
3. HIFU systems
3.1 EDAP - Ablatherm
The first HIFU technology used for the treatment of prostate cancer to become available was Ablatherm® (Edap-Technomed, Lyon, France), with initial clinical results published in 1996 [10].
The Ablatherm system uses separate crystals to produce an image (7.5 MHz) and to deliver treatment (3 MHz), and since 2005, the two types of transducers have been integrated into the same probe, which has a focal point of 45 mm from the crystal. The 3 MHz treatment crystal creates an ablation zone with a volume that can range from 29 mm3 to 36 mm3. The Ablatherm has 3 different types of treatment algorithms, each designed for a specific application: HIFU as primary treatment, HIFU as secondary treatment after failed Radiation Therapy, and HIFU re-treatment [11].
The Ablatherm has a mechanism to detect patient movement based on an internal automatic A-mode ultrasound detection system, which together with the external ultrasound used during the treatment planning phase, measures the distance from the rectal wall, and ensures that the patient has not moved [12].
Treatment with the Ablatherm is performed with the patient in a lateral decubitus position, on their right side. This is done as a precautionary measure, since if there were any bubbles in the liquid around the transducer used for the treatment, these would rise out of the treatment field, with the patient on their side, and the bubbles would not remain between the transducer crystal and the prostate [13].
3.2 Focal one
Focal One® (Edap-Technomed, Lyon, France) is the first HIFU device, specifically designed to perform focal therapy and was introduced for the focal treatment of prostate cancer. With this device, the procedure is performed on a conventional surgical table with the patient in a lateral position to avoid air bubbles in between the crystal and the rectal wall.
The transducer that uses focal one is a dynamic focus transducer, made with 16 isocentric rings, each ring is moved by a dedicated electronic system, composed of 16 lines, this allows the user to move the focal point of the transducer to a maximum of 8 different points that are between 32 and 67 mm from the transducer. The dynamic approach treatment involves unitary HIFU lesions, stacked in the prostate, within the axis of the ultrasound. Each lesion measures approximately 5 mm and by stacking 2 to 8 lesions it is possible to extend the necrotic area by 5 to 40 mm [14].
3.3 Sonablate
Focus Surgery (Indianapolis, IN, USA) introduced the Sonablate500® system and preliminary results of its use for the treatment of prostate cancer were published in 2002 [15]. The Sonablate uses a single crystal to obtain the images and to deliver HIFU treatment, to achieve this, the Sonablate uses a transducer that has two crystals placed back-to-back.
At frequencies of 6/4 MHz, it can provide good image quality and effective treatment, respectively. The 6 MHz frequency probe provides good resolution of the anterior prostate but has a lower resolution of the posterior prostate margin and rectal wall, compared to higher frequency transducers. Originally, the operator could choose between different crystals depending on the size of the prostate, with a focal length of between 30 and 40 mm.
The Sonablate does not have a real-time imaging system while the treatment is given, but instead alternates between the treatment mode and image acquisition to create an image overlay that is used to detect patient movement; this is achieved by placing images of treatment planning along with images taken during treatment, if both images are aligned, it is indicative that there has been no movement of the patient (Figure 6) [16].
Figure 6.
Schematics of the HIFU transducer used in the Sonablate system and the focal point within the tissue.
Insightec, a company located at Tirat Carmel, Israel, developed a system called EXABLATE 2100, which produces high-intensity focused ultrasound real-time guided by MRI. The focused ultrasound is delivered through an endorectal probe, with a 990-element phased-array transducer.
Once the probe is placed inside the rectum, it is filled with degassed water, producing an interface between the prostate and rectal wall. The MRI imaging includes T1-weighted dynamic contrast-enhanced, T2-weighted, and diffusion-weighted sequences, to accurately localize the lesion to be treated; with these images the EXABLATE software lets the user plan, manually contouring the area, including 5 mm tumor-free margins. The system then produces a specific treatment protocol, calculating the energy required and the number of shots to be delivered, avoiding damage to peripheral tissue. A pretreatment low energy targeting is delivered, checked with MRI thermometry. This information is overlapped on the anatomic images. Once confirmed, full power sonications are produced, monitorization is done with real-time MRI thermometry. A successful therapy is considered when the temperature in sonicated tissue achieves a threshold of 65°. A complete treatment is considered when non-perfused areas on MRI are found [17]. During the 2021 AUA meeting, the FDA 510 k clearance was informed.
4.2 Profound-TULSA-pro
The prostate therapy system is called TULSA, which stands for Transurethral Ultrasound Ablation. The device is designed to perform prostate tissue ablation in a transurethral approach. The probe is placed through the urethra, once in place, MRI guidance in real-time is used, so the treatment must be done in MRI suites.
In the main module, using high-definition MRI images, the prostate is contoured, during the planning step, the area to be treated is defined, preserving the urethra, and a 3 mm margin of apical prostate immediately above the sphincter [18, 19]. As described by the company [18], it is possible to treat bigger prostates compared with the ultrasound-guided devices.
The TULSA system uses a robotically-driven directional thermal ultrasound; the probe has 10 independent transducers, each of them delivering therapeutic ultrasound, so it is totally customizable, the user can select the number of elements to be used, depending on the length of the prostate. The probe includes a water pump cooling system, and an endorectal cooling device keeps 1 to 2 mm periurethral and rectal protected from thermal damage.
The therapy is done using an intraurethral rotational movement of the probe, creating a “sweeping heating pattern,” directional energy, with in-and-out sonication into the prostate parenchyma. The probe is fixed by an MRI robotic system, controlling the linear and rotational movements. The real-time MRI guidance, shows the thermal changes inside the treated volumes, every 6 seconds, allowing the users to modify the treatment parameters if needed. At the end of the ablation, a complete MRI revision is done, showing with the thermometric measures, all the missing areas that did not receive adequate energy, reassuring a safe and complete treatment [20].
5. HIFU applications
5.1 Benign prostate hyperplasia (BPH)
The use of HIFU for the treatment of BPH has been described since 1992. The physical principle for treating an adenoma is not different from whole gland treatment. Tissue temperatures in the range of 80–90° C can produce thermoablation of the treated tissue, and it is possible to induce intra-prostatic cavities comparable to post-TURP effects.
In a series of 50 cases of prostatectomies after treatment with HIFU, it was possible to study the extent of coagulative necrosis caused by HIFU. Madersbacher reports that the prostate volume that can be destroyed during BPH treatment, with a probe with a focal length of 3−5 cm, is 8 cm3, and 14 cm3 with a focal length of 4 cm, so he calculates that approximately 25−30% of the total prostate could be destroyed during the procedure in these patients while keeping the tissue damage on the adjacent tissues minimal [21].
These results encouraged the search for new, less invasive treatment techniques to alleviate lower tract symptoms while reducing possible adverse effects. The main difference in the treatment of BPH against the whole gland lies in the possibility of delimiting the treatment area only to the prostatic adenoma, leaving the rest of the prostate intact.
In order to decrease the rate of complications due to TURP, Ebert et al. reported the use of HIFU for the treatment of prostate enlargement in 50 patients using a Focus Surgery HIFU generator. The short-term results were interesting, with a mean increase in Qmax from 5.7 to 11.6 ml/s at 6 weeks post-treatment, while the incidence of complications seems to be in favor of HIFU versus TURP [22].
In another report by Madersbacher et al., where 98 patients underwent HIFU for BPH, the author obtained similar results of improvement in urodynamic parameters at 12 months post-treatment, however, in the long-term follow-up, they observed that 43.8% of the treated patients had to undergo re-treatment with TURP due to unsatisfactory clinical results [23].
Both authors concluded that this method is promising, and although the long-term results were not satisfactory, they noted that there was a lot of variability in the results due to the heterogeneity of patients with inclusion criteria (prostate size, detrusor activity, middle lobe, etc.) So more protocols are needed to identify the ideal patient for this technique.
Currently, the authors of this chapter are working on the development of a novel technique for the treatment of BPH using a Sonablate HIFU device, with an up-to-date HIFU system and improved protocols: using higher energies, looking to modify the cavitation threshold, to achieve more cavitation than thermal lesions, with promising results in the time of treatment, catheterization and reduction volume of adenoma.
5.2 Prostate cancer
5.2.1 Whole gland treatment
In the last 20 years, the indications for HIFU have expanded, from its original indication for prostate ablation in localized prostate cancer in patients who were not the candidates for radical prostatectomy to hemi ablation or focal therapy for localized disease or as salvage therapy after failed radiation therapy [24].
5.2.1.1 Patient selection
Whole gland prostate ablation with HIFU as primary treatment is indicated in patients with localized prostate cancer (T1 - T2, Nx, M0) without high-risk factors. They must not have any anorectal pathology that prevents the correct placement of the endorectal transducer.
The physician must be mindful of the anteroposterior diameter of the prostate and the focal point of the HIFU device he or she is using, since the prostatic tissue that is beyond the focal point will remain outside the ablation zone. If the dimensions of the prostate exceed the capabilities of the transducer in the longitudinal or transverse planes, it is possible to reposition the probe and perform the ablation in two or more phases, but it is not possible to reach tissue beyond the focal point.
It is also important to ensure that there are no significant prostatic calcifications, especially if they project posterior acoustic shadow, since the ultrasound beam could bounce off these calcifications, potentially compromising the oncological outcome of the procedure or the integrity of the rectal wall. It is a common practice to perform a TURP prior to HIFU treatment to remove large calcifications or reduce prostate size, and the procedure can be safely performed 6 weeks after TURP.
5.2.1.2 The HIFU procedure
The HIFU procedure in the prostate is performed using a HIFU generator connected to an endorectal transducer, which contains piezoelectric crystals capable of generating ultrasound waves; this can alternate between high energy for ablation and low energy for image visualization [25].
The endorectal tube is usually connected to a cooling system that maintains the rectal wall at a temperature between 14 and 16°C. The procedure begins with the introduction of the probe and the visualization of the field to be treated. While Ablatherm requires a special surgical table, and the patient is placed in the lateral position, with Sonablate the patient is in a dorsal position and is performed on a standard surgical table.
Treatment planning is a bit different between devices, with the Ablatherm, the prostate is divided into 4 to 6 volumes, and is treated apex to base, slice by slice in an automated process. With Sonablate, the treatment is carried out in 2 to 3 coronal layers, starting with the anterior area and moving towards the posterior zone, in contact with the rectal wall [26].
The prostate normally must be divided into regions or lines of ablation, which correspond to the focal length of the transducer. The transducer can be moved longitudinally and rotated 180° around the axis of the transducer so that the system can plan an ablation line in the longitudinal or transverse plane as long as it is at the same focal length. Although the focal length is fixed, it is possible to move the transducer, which is attached to a mechanical arm, in an antero-posterior direction to achieve the stacking of several treatment planes, making ablation of the entire gland possible.
Once the treatment is finished, the prostate tissue does not undergo immediate necrosis, but rather through a process of progressive ischemia that ends with coagulation necrosis several days after treatment. The thermal damage suffered by the tissue leads to edema and inflammation of the prostate, with an increase in the volume of up to 30% of its base value, this causes an incidence of acute urine retention between 1 and 20% of patients [27].
During this post-surgical period, it is necessary to perform a urinary diversion through a suprapubic or transurethral Foley catheter to ensure urinary drainage, during this time, it takes the prostate tissue to complete the sloughing phase, which is the elimination of necrotic tissue through the urethra, which happens between the first and fourth weeks after surgery; during this time the patient may complain of dysuria and urgency, in addition to obstructive symptoms.
5.2.1.3 Outcomes and follow-up
In 2012, Blana et al., analyzed data from 9 European centers, where 1975 patients received whole gland ablation with HIFU (Ablatherm device): clinical stages T1/T2, 356 (18%) were classified as “complete HIFU patients”; 160 (44.9%) had low-risk cancer, 141 patients (39.6%) intermediate, 52 (14.6%) high risk and 3 (0.8%) were unclassified. 205 had a preHIFU TURP. The median PSA Nadir was 0.11 ng/mL (0.78–3.6 ng/mL), obtained at a mean of 14.4 weeks (3.2 months PO-HIFU). Negative biopsies were reported in 182 patients (80.5%): low risk group 86 (86%), intermediate risk 73 (78.5%), and high risk 23 (78.2%). The biochemical disease-free survival rates (DFSR) at 5 years were: low risk 49 cases (88%), intermediate 82 (40%), and high risk 11 (78%). At 7 years: low-risk group 22 (80%), intermediated 14 (82%), and high-risk 3 (64%) [28].
Crouzet reported in 2013: in 1002 patients treated in a single center the following: a median follow-up of 6.4 years. 392 patients received androgen deprivation therapy prior to HIFU, during a median duration of 4.3 months, to shrink the prostate, and it was stopped after HIFU in all cases.
PO-HIFU biopsies were done in 774 patients (77%), being negative in 485 (63%) and positive in 289 (37%). PSA Nadir was at ≤6 months PO-HIFU in all patients, with a median nadir of 0.14 ng/mL.
Biochemical recurrence (Phoenix definition) in 205 cases (21.2%). The biochemical free-survival rates at 5 and 8 years was: low risk 86−76%, intermediate risk 78−63%, and high-risk group 68–57%, respectively (p < 0.001). The overall BFSR at 10 years was 60%.
The adverse effects reported in this series were: urinary incontinence grade 2/3 from 6.4 to 3.1%, mostly managed conservatively and with physiotherapy (94.5%), requiring artificial sphincter in 3.4%, and suburethral sling in 2.1%. Bladder neck or urethral strictures, from 34.9 to 5.9%, resolved with cold knife incision or TURP. 3 patients required a urethral stent. Erections were preserved in 42.3% of patients with a baseline IIEF score ≥ 17 (<70 years: 55.6%; ≥ 70 years: 25.6% (p < 0.001). Rectourethral fistulas presented in 4 patients (0.4%) were related to repeated HIFU ablation [29].
Dickinson et al. reported medium-term results of 569 patients, in a multicenter study, where they received total gland ablation with HIFU as a treatment for localized prostate cancer, using the Sonablate 500 system.
They found that prostate ablation with HIFU is a treatment effective in cancer control in the medium term, with a 5-year relapse-free rate of 70%, with 87%, 63%, and 58% for low, intermediate, and high-risk groups, respectively. 29% required re-treatment with HIFU.
The adverse events reported were unique urinary tract infection in 58 of 754 (7.7%); repeated infection with epididymo-orchitis 22/754 (2.9%); rectourethral fistula 1/754 (0.13%); 183/754 (88%) continent; and form 236 patients with good erection prior to HIFU, 91 (39%) remained with good erections after HIFU. In the study, they concluded that HIFU is a repeatable outpatient treatment with good oncological control in localized cancer, with a low complication rate [30].
5.2.2 Focal therapy
“Focal therapy” and “partial gland ablation” are therapeutic options more frequently considered as good alternatives to treat localized prostate cancer, decreasing morbidity, seen more frequently after radical prostatectomy and external beam radiation.
According to an International Multidisciplinary Consensus on standardized nomenclature and surveillance methodologies, the definition of “focal therapy” describes “a guided ablation of an image-defined, biopsy-confirmed, cancerous lesion with a safety margin surrounding the targeted lesion” [31]. The therapeutic guided term “partial gland ablation” as stated by the consensus, is regional image-guided ablation based on biopsy location. This alternative therapy does not use the identification of lesions by imaging, but anatomical limits, trying to preserve functionality, with a complete tumor treatment. Included in the partial ablations are quadrant therapy, hemiablation, hockey stick, and subtotal ablation.
The main goal of focal therapies is to ablate the prostate cancer focus, with an adequate margin, considered 8 to 10 mm, to have a good oncological control, with preservation of the surrounding tissue, in order to decrease secondary morbidity common in more extensive treatments, maintaining a good quality of life, continence and erectile function.
The frequency of detection of localized prostate cancer has increased importantly with the routinary usage of PSA; since the refinement of the mpMRI of the prostate, and the updated PI RADS, the possibility of defining suspicious lesions is more reliable. Using this high definition T2-weighted MRI images in the fusion systems (Koelis, Artemis, etc.), have improved the precision in targeting smaller and localized cancers.
The description of the “index lesion”, is defined as the tumor lesion responsible for the biological behavior of prostate cancer. The panelist in the consensus, to standardize nomenclature, considered that all MRI-visible lesions with clinically significant cancer should be used as a target for Focal therapies [31, 32, 33]. All these parameters are suggested to be considered as decision-making guides to select patients for focal therapies or partial gland ablation.
5.2.2.1 Focal therapy bases
It must be remarked, that focal therapy and partial gland ablation are not included in the AUA or EAU guidelines for the prostate cancer treatment, as a consequence we will base on the recommendations suggested in the expert consensus [31] to indicate them.
The clinically significant prostate cancer (CsPC) has been defined as prostate cancers with a volume more than 0.5 cc, or a T3 stage or major in a whole-mount specimen, and at least one core with Gleason score of 3 + 4 or 6, with core length more than 4 mm [34].
The detection of clinically significant prostate cancer (CsPC) has been facilitated with MRI-TRUS, in-bore MRI-targeted biopsy, and cognitive biopsy techniques. In systematic reviews, MRI-targeted biopsies demonstrated that CsPC detection was significatively more frequent than TRUS-guided biopsy, with the relative sensitivity of 1.16 (95% CI 1.02–1.32) compared with TRUS-guided biopsy [34, 35].
In a meta-analysis that included 16 studies with an accumulated number of 1926 patients, the rate of general detection of prostate cancer was similar between MRI-targeted biopsy (sensitivity, 0.85; 95% CI 0.80−0.89) and TRUS-guided biopsy (sensitivity, 0.81; 95% CI 0.70−0.88); in contrast to detection of CsPC by MRI-targeted biopsy, greater than TRUS-target biopsy (sensitivity 0.91; 95% CI 0.87−0.94 vs. 0.76; 95% CI 0.64−0.84), and a lower detection rate of insignificant cancer (sensitivity 0.44; 95% CI 0.26−0.64 vs. 0.83; 95% confidence interval 0.77−0.87, respectively) [36].
5.2.2.2 Selection of patients
Patient selection is a mandatory step to indicate a focal therapy or a partial gland ablation. As mentioned before, a precise image location of a lesion (PI RADS/LIKERT systems) and a pathology report of an index lesion; the agreement about index lesion (that of greater volume and pathology grade) capable of inducing the risk of prostate cancer progression.
The goal to treat the index lesion is to produce an acceptable oncologic control, decreasing morbidity preserving surrounding structures [32, 33]. The proposed selection criteria included: prostate-specific antigen (PSA) level < 10 ng/mL, no Gleason 4 or 5, the maximum length of cancer in each core of 7 mm, and less than 33% of positive cores [37]. In a multicenter study, reporting safety outcomes and complications, the selection criteria included: Gleason score ≤ 4 + 3 = 7b, if unilaterality, clinical stage T1 or T2, PSA levels - < 15 ng/mL, and life expectancy ≥10 years [38].
5.2.2.3 Planning
The definition to perform focal therapy or partial gland ablation depends on a good visualization of tumoral lesion, corroborated by pathology test, within limits of tumor volume that allows safe oncologic margins; in those cases, with multiple cancer lesions in the same parenchymal topography, the recommended treatment is a templated organ-preserving partial gland ablation, which in general uses urethra as anatomic landmark. Figure 7 defines focal and partial ablations [31].
Figure 7.
Differences between focal therapy and templated partial gland ablation. Focal therapy: Focused ablation of image-visible, biopsy-confirmed lesion(s) plus a safety margin. Quadrant ablation: Inclusion of all tissue within a quadrant of the prostate. Hemiablation: Inclusion of all tissue within a lateralized hemisphere of the prostate or the anterior half of the prostate. Hockey stick: Destruction of tissue within a lateralized hemisphere and anterior contralateral zone. Subtotal ablation: Inclusion of most of the parenchyma preserving the posterior lateral zone(s). The intention is to preserve at least one neurovascular bundle.
5.2.2.4 Therapy
Treatment is accomplished using any of the two available commercial softwares: Focal-one or Sonablate, both systems can import standard DICOM MRI, to fuse and define the treatment zone, or as cognitive guidance.
Using high definition T2-weighted images as a guide, the prostate contour is done and the ROI section is marked, to be used in the HIFU system, the software allows through elastic fusion to match both MR and ultrasound images, to localize the suspicious lesion, and proceed with the therapy, customizing the number of zones, margins, and power to be used; limits and number of shots are defined automatically by the equipment, starting the treatment [15].
The validation of the treatment is done, in the FOCAL ONE system, once the therapy is finished, doing a CEUS volume, injecting microbubbles. The acquired volume shows very clearly the devascularized area. All sectors treated not showing enhancement after microbubbles injection are considered as entirely destroyed; when prostate sectors show enhancement, this tissue can be considered as living tissue (benign and malignant). The images obtained after CEUS can be fused in the initial planning sequence, showing the treated areas, and if needed new areas can be added to complete the ablation [15].
In the Sonablate system, two seconds immediately after sonication, the equipment scans, updating the prostate images in sagittal and axial, and a proprietary system measures the quality of RF caused in the treated tissue, giving a colorimetric scale: orange adequate energy delivered, yellow energy enough to destroy the tissue, green suboptimal energy delivered, and gray not measured.
This TCM system lets the physician replan those suboptimal or not measured spots and retreat, adjusting the energy to achieve the correct lesion. The second and more reliable procedure to validate the effectiveness of each shot, is the presence of cavitation, called “pop corn”, because the change of echogenicity, same as with TCM, 2 seconds after the sonication, the updated scan, shows in real-time the presence of a hyperechoic lesion, that must be evaluated, to control the power delivered, keeping it inside of the treatment box, as mentioned previously, the main goal is to cause extensive controlled cavitation in the treated tissue [39].
5.2.2.5 Post-HIFU evaluation
The suggested way to evaluate the treated zone, and the peripheral tissues, is Gadolinium-enhanced (non-dynamic) MRI. The immediate images reveal a central zone without enhancement that explains devascularization secondary to the coagulative necrosis, surrounded by an enhanced rim. After six months post-HIFU, a shrinkage of prostate volume is noticed (61% of median volume reduction), with a decrease of the signal intensity on T2-weighted images [15, 40].
5.2.2.6 Outcomes after focal HIFU
In 2018, Guillaumier S. et al., reported a 5-year outcomes study after focal therapy with HIFU. It was a prospective study including 625 patients with localized clinically significant prostate cancer. The study took place from January 1, 2006, to December 31, 2015, the inclusion criteria were: Gleason score 6−9, clinical-stage T1c-3bN0M0, prostate-specific antigen of ≤30 ng/mL.
All patients were followed for 3−6 months PSA, with mpMRI done at 1 year and 1−2 years the following years. All rises in PSA after nadir were evaluated with prostate biopsy or mpMRI, when suspicious with MRI-targeted biopsy. When clinically significant prostate cancer was found on biopsies, in field or out field, a repeat HIFU was offered. 599 patients completed at least 6 months follow-up, and 505 (84%) presented as intermediate of high-risk prostate cancer (D’Amico classification).
The Failure-free survival was: 1 year 99% (95% CI 98−100%), at 2 years 92% (95% CI 90−95%), and at 5 years88% (95% CI 85−91%). Kaplan–Meier estimated at 5 years for low risk 96% (95% CI 91−100%), intermediate risk 88% (95% CI 84–93%), and high risk group 84% (95% CI 78−90%). 8 patients opted for salvage radical prostatectomy, 36 salvage radiotherapy, and 1 androgen deprivation therapy. 10 patients progressed with metastases: Kaplan–Meier estimated for metastases-free survival: 1 year 99.7% (95% CI 99−100%), 3 years 99% (95% CI 98−100%), and 5 years 99% (95% CI 97−100%). Repeat focal HIFU: one done in 112, and two repeat HIFU in 9.56 patients out of 222, required biopsy after HIFU, secondary to PSA rise or mp MRI suspicion; 29 had in-field recurrence, 16 histological evidence of out-field cancer; and 11 patients both in and out-field cancer [41].
As described by Schmid, Schindele et al., in his multicenter study, included 98 men with localized low to intermediate risk prostate cancer, the parameters were median-PSA before HIFU of 6.5 ng/mL (1.03−14.9 ng/mL); clinical T stage ≥2 with cT1 in 76.5% (n = 75), cT2 in 23.5% (n = 23); Gleason score 3 + 3 = 6 in 17.3% (n = 17), 3 + 4 = 7a in 65.4% (n = 64), and 4 + 3 = 7b in 17.3% (n = 17); median prostate volume of 39.6 cc (21.6−135.2 cc); the treated index lesion volume of 10.5 cc (3.9−28.2 cc).
Their evaluation showed the following complications after HIFU therapy: 35 patients (35.7%) had adverse effects during the following 30 days after HIFU treatment with Clavien-Dindo grade ≥ II: 15 points (15.3%) with urinary tract infection and 26 patients (26.5%) with urinary retention. 4 patients (4.1%) needed another procedure (Clavien-Dindo grade IIIa/b). Late post HIFU complications, happening during days 30 to 90 was 2.0%. Considering the cancer location, the most common complications were those located at the anterior base in 50% of cases. When the urethra was ablated, the complications were present in 48.8% of cases (20 of 41), considered as a significant risk factor during the 30 days post-HIFU (odd ratio = 2.53; 95% confidence interval: 1.08−5.96; P = 0.033) [38].
5.2.3 Post external beam radiotherapy recurrences
Recurrence of prostate cancer after EBRT is a common condition, reported in up to 46% of patients treated with radiation. The therapeutic options used to control the progression are salvage prostatectomy, usually indicated in selected cases, because of technical difficulties, and higher morbidity; salvage cryotherapy, hormone blockage, and salvage HIFU. Biochemical recurrence (using PSA levels) in relation to the ASTRO-AUA-EAU guidelines, is a safe parameter to detect local recurrences, between 10−30% of cases. Extension studies must be included in the staging process, mpMRI and PET SCAN PSMA have shown excellent options to discard metastatic involvement.
Ideal patients considered as candidates for salvage HIFU must have PSA levels up to 2 ng/mL according to the ASTRO-Phoenix guidelines, correlated with extension studies as mpMRI or PET SCAN PSMA that will show suspicious tumors in the prostate, biopsy should be used as a confirmatory method; patients with metastatic involvement should be offered another type of procedure but HIFU. Additionally, candidates should have a Gleason score ≤ 8, and clinical-stage ≤T1-T3aNoMo.
Fulfillment of the guidelines can assure a better prognosis among prostate cancer patients treated with HIFU, since case selection is a determinant factor for a successful result, as described in a 2011 evaluation that was performed on a group of 84 men with biochemical failure after EBRT and a whole-gland salvage HIFU. Results have demonstrated that 93% of them were discharged within 23 hours following treatment, and only 20% (17 of 84 patients) needed an intervention for bladder obstruction. Within a follow-up of 19.8 months, 25% (21 of 84 patients) of the cohort presented a residual cancer detected on biopsy after salvage HIFU [42]. It is noteworthy that repeated HIFU procedures are a high-risk factor for rectal fistula development.
In a 2017 prospective study at University College London Hospitals and NHS Basingstoke Trust, in 150 men who received salvage HIFU between 2006 and 2015, the Kaplan–Meier overall survival at 60 months was 92% and among complications, UTI was 11.3% (17 of 150 patients) and bladder neck strictures of 8%. In addition, 87.5% remained pad-free at 2 years among those pad-free at baseline [43].
6. Conclusions
High-Intensity Focused Ultrasound or Focused Ultrasound Surgery is an emerging image-guided therapy for obstructive benign prostatic hyperplasia and prostate cancer.
With the advent of new methodologies in MRI, specifically multiparametric MRI; the possibility of fusioning the MR images in real-time ultrasound scans, changed the accuracy of targeting biopsies, and recently the therapy targeting to improve control of focalized lesions.
Recently, the usage of MRI guidance with EXABLATE and TULSA-PRO, taking advantage of thermometric scanning, allowed more accurate treatments, limited by the need for MRI facilities. In the case of whole gland ablation, it is compared in outcomes with radical prostatectomy and EBRT, with less adverse effects.
The most common consideration of less aggressive treatments for clinically significant prostate cancer made the focal therapy a growing alternative, only limited at this time for the availability of good technical mpMR images, necessary to assess accurately the parenchymal lesions. The general results in different centers make HIFU a highly promising therapeutic option.
Acknowledgments
Our deepest thanks to:
Prof. Narendra Sanghvi, Focus-Surgery and Sonablate Corp.
Alex Gonzalez, Sonablate Corp.
Rodrigo Chaluisan, Sonablate Corp. In memoriam.
Conflict of interest
The authors declare to use a Sonablate device for BPH and prostate cancer treatments, since 2005, participate in the proctoring teaching system of Sonablate Company and participate in a BPH protocol with Sonablate Company.
Video materials
All video materials referenced in this chapter are available to download here: https://bit.ly/33T5UxZ.
Acronyms and Abbreviations
PSA
prostate-specific antigen
HIFU
high intensity focused ultrasound
TURP
transurethral resection of prostate
BPH
benign prostate hyperplasia
mpMRI
multiparametric magnetic resonance image
EBRT
external beam radiotherapy
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Magnetic resonance imaging-transrectal ultrasound fusion image-guided prostate biopsy: current status of the cancer detection and the prospects of tailor-made medicine of the prostate cancer. Investigative and Clinical Urology. 2019;60(1):4-13. DOI: 10.4111/icu.2019.60.1.4'},{id:"B36",body:'Schoots IG, Roobol MJ, Nieboer D, Bangma CH, Steyerberg EW, Hunink MG. Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: A systematic review and meta-analysis. European Urology. 2015;68(3):438-450. DOI: 10.1016/j.eururo.2014.11.037'},{id:"B37",body:'Barret E, Durand M. Technical Aspects of Focal Therapy in Localized Prostate Cancer. France: Springer-Verlag; 2015. DOI: 10.1007/978-2-8178-0484-2'},{id:"B38",body:'Schmid FA, Schindele D, Mortezavi A, et al. Prospective multicentre study using high intensity focused ultrasound (HIFU) for the focal treatment of prostate cancer: Safety outcomes and complications. Urologic Oncology. 2020;38(4):225-230. DOI: 10.1016/j.urolonc.2019.09.001'},{id:"B39",body:'Sanghvi NT, Chen WH, Carlson R, et al. Clinical validation of real-time tissue change monitoring during prostate tissue ablation with high intensity focused ultrasound. Journal of Therapeutic Ultrasound. 2017;5:24. DOI: 10.1186/s40349-017-0102-2'},{id:"B40",body:'Kirkham AP, Emberton M, Hoh IM, Illing RO, Freeman AA, Allen C. MR imaging of prostate after treatment with high-intensity focused ultrasound. Radiology. 2008;246(3):833-844. DOI: 10.1148/radiol.2463062080'},{id:"B41",body:'Guillaumier S et al. A Multicenter study of 5-year outcomes following focal therapy in treating clinically significant Nonmetastasic Prostae Cancer. European Urology. 2018;74(4):422-429. 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Open Access Funding
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For Authors who are still unable to obtain funding from their institutions or research funding bodies for individual projects, IntechOpen does offer the possibility of applying for a Waiver to offset some or all processing feed. Details regarding our Waiver Policy can be found here.
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Added Value of Publishing with IntechOpen
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Indexing and listing across major repositories, see details ...
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Visibility on the world's strongest OA platform
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Live Performance Metrics to track readership and the impact of your chapter
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Dissemination and Promotion
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Benefits of Publishing with IntechOpen
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Proven world leader in Open Access book publishing with over 10 years experience
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The aim of the chapter is to give details on advance computational modelling and analytical methodologies, which can be used in order to design shallow and deep tunnels and to present real case studies from around the world, from very shallow tunnels in India with only 4.5 m overburden to a deep tunnel in Venezuela with extreme squeezing conditions under 1300 m overburden.",book:{id:"7690",slug:"tunnel-engineering-selected-topics",title:"Tunnel Engineering",fullTitle:"Tunnel Engineering - Selected Topics"},signatures:"Spiros Massinas",authors:[{id:"295762",title:"Dr.",name:"Spiros",middleName:null,surname:"Massinas",slug:"spiros-massinas",fullName:"Spiros Massinas"}]},{id:"68157",title:"Introductory Chapter: Textile Manufacturing Processes",slug:"introductory-chapter-textile-manufacturing-processes",totalDownloads:4484,totalCrossrefCites:16,totalDimensionsCites:26,abstract:null,book:{id:"8892",slug:"textile-manufacturing-processes",title:"Textile Manufacturing Processes",fullTitle:"Textile Manufacturing Processes"},signatures:"Faheem Uddin",authors:[{id:"228107",title:"Prof.",name:"Faheem",middleName:null,surname:"Uddin",slug:"faheem-uddin",fullName:"Faheem Uddin"}]},{id:"66828",title:"Breathing Monitoring and Pattern Recognition with Wearable Sensors",slug:"breathing-monitoring-and-pattern-recognition-with-wearable-sensors",totalDownloads:3113,totalCrossrefCites:12,totalDimensionsCites:16,abstract:"This chapter introduces the anatomy and physiology of the respiratory system, and the reasons for measuring breathing events, particularly, using wearable sensors. 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New technologies open the door to future methods of noninvasive breathing analysis using wearable sensors associated with machine learning techniques for pattern detection.",book:{id:"7654",slug:"wearable-devices-the-big-wave-of-innovation",title:"Wearable Devices",fullTitle:"Wearable Devices - the Big Wave of Innovation"},signatures:"Taisa Daiana da Costa, Maria de Fatima Fernandes Vara, Camila Santos Cristino, Tyene Zoraski Zanella, Guilherme Nunes Nogueira Neto and Percy Nohama",authors:[{id:"192464",title:"Ph.D.",name:"Percy",middleName:null,surname:"Nohama",slug:"percy-nohama",fullName:"Percy Nohama"},{id:"285706",title:"MSc.",name:"Taísa Daiana",middleName:null,surname:"Da Costa",slug:"taisa-daiana-da-costa",fullName:"Taísa Daiana Da Costa"},{id:"285707",title:"MSc.",name:"Maria de Fatima Fernandes",middleName:null,surname:"Vara",slug:"maria-de-fatima-fernandes-vara",fullName:"Maria de Fatima Fernandes Vara"},{id:"285708",title:"BSc.",name:"Camila Santos",middleName:null,surname:"Cristino",slug:"camila-santos-cristino",fullName:"Camila Santos Cristino"},{id:"285709",title:"Prof.",name:"Guilherme Nunes",middleName:null,surname:"Nogueira Neto",slug:"guilherme-nunes-nogueira-neto",fullName:"Guilherme Nunes Nogueira Neto"},{id:"293109",title:"BSc.",name:"Tyene",middleName:null,surname:"Zoraski Zanella",slug:"tyene-zoraski-zanella",fullName:"Tyene Zoraski Zanella"}]},{id:"41411",title:"Textile Dyes: Dyeing Process and Environmental Impact",slug:"textile-dyes-dyeing-process-and-environmental-impact",totalDownloads:20676,totalCrossrefCites:101,totalDimensionsCites:320,abstract:null,book:{id:"3137",slug:"eco-friendly-textile-dyeing-and-finishing",title:"Eco-Friendly Textile Dyeing and Finishing",fullTitle:"Eco-Friendly Textile Dyeing and Finishing"},signatures:"Farah Maria Drumond Chequer, Gisele Augusto Rodrigues de Oliveira, Elisa Raquel Anastácio Ferraz, Juliano Carvalho Cardoso, Maria Valnice Boldrin Zanoni and Danielle Palma de Oliveira",authors:[{id:"49040",title:"Prof.",name:"Danielle",middleName:null,surname:"Palma De Oliveira",slug:"danielle-palma-de-oliveira",fullName:"Danielle Palma De Oliveira"},{id:"149074",title:"Prof.",name:"Maria Valnice",middleName:null,surname:"Zanoni",slug:"maria-valnice-zanoni",fullName:"Maria Valnice Zanoni"},{id:"153502",title:"Ph.D.",name:"Farah",middleName:null,surname:"Chequer",slug:"farah-chequer",fullName:"Farah Chequer"},{id:"153504",title:"MSc.",name:"Gisele",middleName:null,surname:"Oliveira",slug:"gisele-oliveira",fullName:"Gisele Oliveira"},{id:"163377",title:"Dr.",name:"Juliano",middleName:null,surname:"Cardoso",slug:"juliano-cardoso",fullName:"Juliano Cardoso"},{id:"163393",title:"Dr.",name:"Elisa",middleName:null,surname:"Ferraz",slug:"elisa-ferraz",fullName:"Elisa Ferraz"}]},{id:"70242",title:"Advancements in the Fenton Process for Wastewater Treatment",slug:"advancements-in-the-fenton-process-for-wastewater-treatment",totalDownloads:1985,totalCrossrefCites:13,totalDimensionsCites:26,abstract:"Fenton is considered to be one of the most effective advanced treatment processes in the removal of many hazardous organic pollutants from refractory/toxic wastewater. It has many advantages, but drawbacks are significant such as a strong acid environment, the cost of reagents consumption, and the large production of ferric sludge, which limits Fenton’s further application. The development of Fenton applications is mainly achieved by improving oxidation efficiency and reducing sludge production. This chapter presents a review on fundamentals and applications of conventional Fenton, leading advanced technologies in the Fenton process, and reuse methods of iron containing sludge to synthetic and real wastewaters are discussed. Finally, future trends and some guidelines for Fenton processes are given.",book:{id:"9415",slug:"advanced-oxidation-processes-applications-trends-and-prospects",title:"Advanced Oxidation Processes",fullTitle:"Advanced Oxidation Processes - Applications, Trends, and Prospects"},signatures:"Min Xu, Changyong Wu and Yuexi Zhou",authors:[{id:"307479",title:"Dr.",name:"Changyong",middleName:null,surname:"Wu",slug:"changyong-wu",fullName:"Changyong Wu"},{id:"307546",title:"Prof.",name:"Yuexi",middleName:null,surname:"Zhou",slug:"yuexi-zhou",fullName:"Yuexi Zhou"},{id:"311139",title:"Dr.",name:"Min",middleName:null,surname:"Xu",slug:"min-xu",fullName:"Min Xu"}]}],onlineFirstChaptersFilter:{topicId:"24",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82676",title:"Electrospinning of Fiber Matrices from Polyhydroxybutyrate for the Controlled Release Drug Delivery Systems",slug:"electrospinning-of-fiber-matrices-from-polyhydroxybutyrate-for-the-controlled-release-drug-delivery-",totalDownloads:13,totalDimensionsCites:0,doi:"10.5772/intechopen.105786",abstract:"The submission provides an overview of current state of the problem and authors’ experimental data on manufacturing nonwoven fibrous matrices for the controlled release drug delivery systems (CRDDS). The choice of ultrathin fibers as effective carriers is determined by their characteristics and functional behavior, for example, such as a high specific surface area, anisotropy of some physicochemical characteristics, spatial limitations of segmental mobility that are inherent in nanosized objects, controlled biodegradation, and controlled diffusion transport. The structural-dynamic approach to the study of the morphology and diffusion properties of biopolymer fibers based on polyhydroxybutyrate (PHB) is considered from several angles. In the submission, the electrospinning (ES) application to reach specific characteristics of materials for controlled release drug delivery is discussed.",book:{id:"11127",title:"Electrospinning - Material Technology of the Future",coverURL:"https://cdn.intechopen.com/books/images_new/11127.jpg"},signatures:"Anatoly A. Olkhov, Svetlana G. Karpova, Anna V. Bychkova, Alexandre A. Vetcher and Alexey L. Iordanskii"},{id:"82600",title:"Impact of the Spreading of Sludge from Wastewater Treatment Plants on the Transfer and Bio-Availability of Trace Metal Elements in the Soil-Plant System",slug:"impact-of-the-spreading-of-sludge-from-wastewater-treatment-plants-on-the-transfer-and-bio-availabil",totalDownloads:12,totalDimensionsCites:0,doi:"10.5772/intechopen.103745",abstract:"The spreading of sludge from sewage treatment plants increased the production of durum wheat and rapeseed. Their richness in nitrogen, phosphorus, and potassium gives them a beneficial effect on crops. However, the application of the sludge can induce increases in the concentration of metals in plant tissues. This increase can generate disturbances at the level of the cell and organelles, such as mitochondria and chloroplasts, which can be altered. Repeated applications of the sludge on the same site tend to increase the accumulation of heavy metals in the soil, so that an cause toxicities for soil microorganisms, animals, and humans, via the food chain. However, it is important to specify that these nuisances mainly concerned industrial sludge, but the use of this sludge is strictly prohibited. In addition, the high doses used in our field experiments are significantly higher than those authorized in agricultural practice. Finally, the risk assessment by calculating both the level of consumer exposure and the number of years for soil saturation shows that the use of urban sludge is safe, especially in the short and medium-term. Nevertheless, the quality of the sludge to be spread must be constantly monitored.",book:{id:"11173",title:"Wastewater Treatment",coverURL:"https://cdn.intechopen.com/books/images_new/11173.jpg"},signatures:"Najla Lassoued and Bilal Essaid"},{id:"81249",title:"Electrospun Polymeric Substrates for Tissue Engineering: Viewpoints on Fabrication, Application, and Challenges",slug:"electrospun-polymeric-substrates-for-tissue-engineering-viewpoints-on-fabrication-application-and-ch",totalDownloads:8,totalDimensionsCites:0,doi:"10.5772/intechopen.102596",abstract:"Electrospinning is the technique for producing nonwoven fibrous structures, to mimic the fabrication and function of the native extracellular matrix (ECM) in tissue. Prepared fibrous with this method can act as potential polymeric substrates for proliferation and differentiation of stem cells (with the cellular growth pattern similar to damaged tissue cells) and facilitation of artificial tissue remodeling. Moreover, such substrates can improve biological functions, and lead to a decrease in organ transplantation. In this chapter, we focus on the fundamental parameters and principles of the electrospinning technique to generate natural ECM-like substrates, in terms of structural and functional complexity. In the following, the application of these substrates in regenerating various tissues and the role of polymers (synthetic/natural) in the formation of such substrates is evaluated. Finally, challenges of this technique (such as cellular infiltration and inadequate mechanical strength) and solutions to overcome these limitations are studied.",book:{id:"11127",title:"Electrospinning - Material Technology of the Future",coverURL:"https://cdn.intechopen.com/books/images_new/11127.jpg"},signatures:"Azadeh Izadyari Aghmiuni, Arezoo Ghadi, Elmira Azmoun, Niloufar Kalantari, Iman Mohammadi and Hossein Hemati Kordmahaleh"},{id:"82145",title:"Slope Casting Process: A Review",slug:"slope-casting-process-a-review",totalDownloads:9,totalDimensionsCites:0,doi:"10.5772/intechopen.102742",abstract:"Semi solid processing is a near net shape casting process and one of the promising techniques to obtain dendritic free structure of metals. Semi solid casting gives numerous advantages than solid processing and liquid processing. Semi solid casting process gives, Laminar flow filling of die without turbulence, Lower metal temperature, Less shrinkage, Less porosity, Higher mechanical properties. Semi solid casting process is industrially successful, producing a variety of products with good quality. Slope Casting process is a simple technique to produce semi solid feed-stoke with globular microstructure and dendrite free structure castings. Slope casting process depends on different process parameters like slope length, slope angle, pouring temperature etc. The present study mainly focuses on review of various explorations made by researchers with different process parameters of the Slope casting process and explain the mechanisms that lead to microstructural changes which leads to good mechanical properties.",book:{id:"11119",title:"Casting Processes",coverURL:"https://cdn.intechopen.com/books/images_new/11119.jpg"},signatures:"Mukkollu Sambasiva Rao and Amitesh Kumar"},{id:"81861",title:"Emerging Human Coronaviruses (SARS-CoV-2) in the Environment Associated with Outbreaks Viral Pandemics",slug:"emerging-human-coronaviruses-sars-cov-2-in-the-environment-associated-with-outbreaks-viral-pandemics",totalDownloads:21,totalDimensionsCites:0,doi:"10.5772/intechopen.103886",abstract:"In December 2019, there was a cluster of pneumonia cases in Wuhan, a city of about 11 million people in Hubei Province. The World Health Organization (WHO), qualified CoVid-19 as an emerging infectious disease on March 11, 2020, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which spreads around the world. Coronaviruses are also included in the list of viruses likely to be found in raw sewage, as are other viruses belonging to the Picornaviridae family. SRAS-CoV-2 has been detected in wastewater worldwide such as the USA, France, Netherlands, Australia, and Italy according to the National Research Institute for Public Health and the Environment. In addition, the SARS-CoV-2 could infect many animals since it has been noticed in pigs, domestic and wild birds, bats, rodents, dogs, cats, tigers, cattle. Therefore, the SARS-CoV-2 molecular characterization in the environment, particularly in wastewater and animals, appeared to be a novel approach to monitor the outbreaks of viral pandemics. This review will be focused on the description of some virological characteristics of these emerging viruses, the different human and zoonotic coronaviruses, the sources of contamination of wastewater by coronaviruses and their potential procedures of disinfection from wastewater.",book:{id:"11173",title:"Wastewater Treatment",coverURL:"https://cdn.intechopen.com/books/images_new/11173.jpg"},signatures:"Chourouk Ibrahim, Salah Hammami, Eya Ghanmi and Abdennaceur Hassen"},{id:"81797",title:"Study of Change Surface Aerator to Submerged Nonporous Aerator in Biological Pond in an Industrial Wastewater Treatment in Daura Refinery",slug:"study-of-change-surface-aerator-to-submerged-nonporous-aerator-in-biological-pond-in-an-industrial-w",totalDownloads:11,totalDimensionsCites:0,doi:"10.5772/intechopen.104860",abstract:"Daura refinery, with a capacity of 140,000 barrel per stream day as a refining capacity, wastewater discharged from refining and treatment processing units, polluted water as foul water, drainages, oil spills, blowdown of boilers and cooling towers, and many other polluted water sources, aims to remove pollutants and reject clean water to the river; wastewater treatment system takes place in this treatment process. Wastewater treatment system suffers from many problems and specifically biological stage; at this stage, activated sludge with bacteria, should be supplied with oxygen, aeration system done by surface aerators with four surface fans; these fans suffer from high vibration, loss support, and in consequence, lack in oxygen supply to aerobic bacteria less than 4 ppm. The nonporous aerator is suggested as an oxygen source for the biological pool. The pilot plant builds the aim to study the ability to apply the new aeration system at the biological pool, pilot plant build with 1 cubic meter capacity tank and continuous overflow of wastewater of 10 liters.min−1, air injected with the pressure of (0.5–0.75) bar(g), and airflow of (7.6–9.7) liter.min−1 respectively. Oxygen concentration was recorded as (3.4–6.0) ppm; in terms of consumption power, changing the aeration system reduces it to less than 20%.",book:{id:"11173",title:"Wastewater Treatment",coverURL:"https://cdn.intechopen.com/books/images_new/11173.jpg"},signatures:"Omar M. Waheeb, Mohanad Mahmood Salman and Rand Qusay Kadhim"}],onlineFirstChaptersTotal:27},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:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:141,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:123,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,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:22,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{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"}}}}]},series:{item:{id:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:"2753-6580",scope:"
\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
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\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
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\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
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\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
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\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
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\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
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\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
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\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
",coverUrl:"https://cdn.intechopen.com/series/covers/24.jpg",latestPublicationDate:"August 2nd, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:1,editor:{id:"262440",title:"Prof.",name:"Usha",middleName:null,surname:"Iyer-Raniga",slug:"usha-iyer-raniga",fullName:"Usha Iyer-Raniga",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRYSXQA4/Profile_Picture_2022-02-28T13:55:36.jpeg",biography:"Usha Iyer-Raniga is a professor in the School of Property and Construction Management at RMIT University. Usha co-leads the One Planet Network’s Sustainable Buildings and Construction Programme (SBC), a United Nations 10 Year Framework of Programmes on Sustainable Consumption and Production (UN 10FYP SCP) aligned with Sustainable Development Goal 12. The work also directly impacts SDG 11 on Sustainable Cities and Communities. She completed her undergraduate degree as an architect before obtaining her Masters degree from Canada and her Doctorate in Australia. Usha has been a keynote speaker as well as an invited speaker at national and international conferences, seminars and workshops. Her teaching experience includes teaching in Asian countries. She has advised Austrade, APEC, national, state and local governments. She serves as a reviewer and a member of the scientific committee for national and international refereed journals and refereed conferences. She is on the editorial board for refereed journals and has worked on Special Issues. Usha has served and continues to serve on the Boards of several not-for-profit organisations and she has also served as panel judge for a number of awards including the Premiers Sustainability Award in Victoria and the International Green Gown Awards. Usha has published over 100 publications, including research and consulting reports. Her publications cover a wide range of scientific and technical research publications that include edited books, book chapters, refereed journals, refereed conference papers and reports for local, state and federal government clients. She has also produced podcasts for various organisations and participated in media interviews. She has received state, national and international funding worth over USD $25 million. Usha has been awarded the Quarterly Franklin Membership by London Journals Press (UK). Her biography has been included in the Marquis Who's Who in the World® 2018, 2016 (33rd Edition), along with approximately 55,000 of the most accomplished men and women from around the world, including luminaries as U.N. Secretary-General Ban Ki-moon. In 2017, Usha was awarded the Marquis Who’s Who Lifetime Achiever Award.",institutionString:null,institution:{name:"RMIT University",institutionURL:null,country:{name:"Australia"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:5,paginationItems:[{id:"91",title:"Sustainable Economy and Fair Society",coverUrl:"https://cdn.intechopen.com/series_topics/covers/91.jpg",isOpenForSubmission:!0,editor:{id:"181603",title:"Dr.",name:"Antonella",middleName:null,surname:"Petrillo",slug:"antonella-petrillo",fullName:"Antonella Petrillo",profilePictureURL:"https://mts.intechopen.com/storage/users/181603/images/system/181603.jpg",biography:"Antonella Petrillo, Ph.D., is a professor in the Department of Engineering, University of Naples “Parthenope,” Italy. She received her Ph.D. in Mechanical Engineering from the University of Cassino and Southern Lazio, Italy. Her research interests include multi-criteria decision analysis, industrial plants, logistics, manufacturing, and safety. She serves as an associate editor for the International Journal of the Analytic Hierarchy Process and is an editorial board member for several other journals. She is also a member of the Analytic Hierarchy Process (AHP) Academy.",institutionString:"Parthenope University of Naples",institution:{name:"Parthenope University of Naples",institutionURL:null,country:{name:"Italy"}}},editorTwo:null,editorThree:null},{id:"92",title:"Health and Wellbeing",coverUrl:"https://cdn.intechopen.com/series_topics/covers/92.jpg",isOpenForSubmission:!0,editor:{id:"348225",title:"Prof.",name:"Ann",middleName:null,surname:"Hemingway",slug:"ann-hemingway",fullName:"Ann Hemingway",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035LZFoQAO/Profile_Picture_2022-04-11T14:55:40.jpg",biography:"Professor Hemingway is a public health researcher, Bournemouth University, undertaking international and UK research focused on reducing inequalities in health outcomes for marginalised and excluded populations and more recently focused on equine assisted interventions.",institutionString:null,institution:{name:"Bournemouth University",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null},{id:"93",title:"Inclusivity and Social Equity",coverUrl:"https://cdn.intechopen.com/series_topics/covers/93.jpg",isOpenForSubmission:!0,editor:{id:"210060",title:"Prof. Dr.",name:"Ebba",middleName:null,surname:"Ossiannilsson",slug:"ebba-ossiannilsson",fullName:"Ebba Ossiannilsson",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6LkBQAU/Profile_Picture_2022-02-28T13:31:48.png",biography:"Professor Dr. Ebba Ossiannilsson is an independent researcher, expert, consultant, quality auditor and influencer in the fields of open, flexible online and distance learning (OFDL) and the 'new normal'. Her focus is on quality, innovation, leadership, and personalised learning. She works primarily at the strategic and policy levels, both nationally and internationally, and with key international organisations. She is committed to promoting and improving OFDL in the context of SDG4 and the future of education. Ossiannilsson has more than 20 years of experience in her current field, but more than 40 years in the education sector. She works as a reviewer and expert for the European Commission and collaborates with the Joint Research Centre for Quality in Open Education. Ossiannilsson also collaborates with ITCILO and ICoBC (International Council on Badges and Credentials). She is a member of the ICDE Board of Directors and has previously served on the boards of EDEN and EUCEN. Ossiannilsson is a quality expert and reviewer for ICDE, EDEN and the EADTU. She chairs the ICDE OER Advocacy Committee and is a member of the ICDE Quality Network. She is regularly invited as a keynote speaker at conferences. She is a guest editor for several special issues and a member of the editorial board of several scientific journals. She has published more than 200 articles and is currently working on book projects in the field of OFDL. Ossiannilsson is a visiting professor at several international universities and was recently appointed Professor and Research Fellow at Victoria University of Wellington, NZ. Ossiannilsson has been awarded the following fellowships: EDEN Fellows, EDEN Council of Fellows, and Open Education Europe. She is a ICDE OER Ambassador, Open Education Europe Ambassador, GIZ Ambassador for Quality in Digital Learning, and part of the Globe-Community of Digital Learning and Champion of SPARC Europe. On a national level, she is a quality developer at the Swedish Institute for Standards (SIS) and for ISO. 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