World Federation of Neurological Surgeons Grading System for Subarachnoid Hemorrhage - (WFNS) scale.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"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:"7072",leadTitle:null,fullTitle:"Cerebral Palsy - Clinical and Therapeutic Aspects",title:"Cerebral Palsy",subtitle:"Clinical and Therapeutic Aspects",reviewType:"peer-reviewed",abstract:"Cerebral palsy is a common pediatric problem and is the leading cause of childhood disability. It occurs at a rate of 3.6 cases per 1000 children, and represents a major social and psychological impact on both family and society. It is a group of disorders with movement difficulties being common for all affected patients. Its severity and extent are variable from one patient to another. Additionally, the impacts of cerebral palsy on daily activities, communications, and requirements are also variable. Recent advances in clinical research increase our knowledge and understanding of causal pathways, possible preventive measures, specific intervention strategies, and the value of new treatment modalities such as botulinum toxin and intrathecal baclofen in the management of cerebral palsy.",isbn:"978-1-78984-831-1",printIsbn:"978-1-78984-830-4",pdfIsbn:"978-1-83881-757-2",doi:"10.5772/intechopen.73842",price:119,priceEur:129,priceUsd:155,slug:"cerebral-palsy-clinical-and-therapeutic-aspects",numberOfPages:164,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"eebd6581cd862f95edfacb284191e1c5",bookSignature:"Isam Jaber Al-Zwaini",publishedDate:"December 19th 2018",coverURL:"https://cdn.intechopen.com/books/images_new/7072.jpg",numberOfDownloads:12546,numberOfWosCitations:1,numberOfCrossrefCitations:5,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:7,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:13,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 14th 2018",dateEndSecondStepPublish:"April 4th 2018",dateEndThirdStepPublish:"June 3rd 2018",dateEndFourthStepPublish:"August 22nd 2018",dateEndFifthStepPublish:"October 21st 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"30993",title:"Prof.",name:"Isam Jaber",middleName:null,surname:"Al-Zwaini",slug:"isam-jaber-al-zwaini",fullName:"Isam Jaber Al-Zwaini",profilePictureURL:"https://mts.intechopen.com/storage/users/30993/images/system/30993.png",biography:"Prof. Isam Jaber AL-Zwaini graduated from AL-Mustansiryia College of Medicine, Iraq, in 1987, after which he worked as a house officer in different hospitals in Baghdad for fifteen months followed by military service for three years. He began his pediatrics study in 1991 and obtained a fellowship from the Iraqi Commission for Medical Specializations in 1996. He was a lecturer in the Department of Pediatrics, AL-Anbar College of Medicine, Iraq, from 1996 to 2001, after which he was promoted to assistant professor. In 2005, he began working in the Department of Pediatrics, Al-Kindy College of Medicine, University of Baghdad, Iraq. He became a professor there in 2008. Prof. AL-Zwaini was head of the Department of Pediatrics at both AL-Anbar and AL-Kindy Medical Colleges for many years. He is a member of the Royal College of Pediatrics and Child Health, UK. He has published more than thirty scientific papers in different pediatric fields and has a special interest in pediatric hematology, neurology, and nutrition.",institutionString:"University of Baghdad",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"6",totalChapterViews:"0",totalEditedBooks:"7",institution:{name:"University of Baghdad",institutionURL:null,country:{name:"Iraq"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1124",title:"Pediatric Rehabilitation Medicine",slug:"pediatric-rehabilitation-medicine"}],chapters:[{id:"62532",title:"Early Markers for Cerebral Palsy",doi:"10.5772/intechopen.79466",slug:"early-markers-for-cerebral-palsy",totalDownloads:1376,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Cerebral palsy (CP) is a term referring to a nonprogressive disease of the brain originating during the antenatal, neonatal, or early postnatal period when brain neuronal connections are still evolving. Secondary effects of spasticity on growth may, however, be progressive. There may be additional disturbances of sensation, perception, cognition, communication, and behavior. Babies who are neurologically abnormal as newborns are at increased risk of neurologic abnormality in later months and years. Being born preterm (born <37 weeks of gestation) or with a very low birth weight (weighing <1500 g/<32 weeks of gestation) or extreme low birth weight (<1000 g/<28 weeks of gestation) is associated with significant motor impairment. Which specific signs in the neonate are of greatest predictive power, what long-term disability these signs predict, and how well they predict it remain unclear? Physician’s major concern is to identify specific risk factors for severe impairment in early infancy so as to predict the developmental outcome of those children that may manifest later on with neurological deficit especially if they have perinatal insult. Parents on the other hand are also concerned about their growing infants, their development, and neurological outcome. Since cerebral palsy is a permanent disorder, early detection of signs of motor impairment is crucial to assist physicians to give close follow-up of those infants and to reassure parents whose children are normal. It has been shown that intervention may be most efficient when the plasticity of the brain is high, and an early detection of brain impairment is therefore crucial. An earlier follow-up and training program can have a positive effect of the motor development of the child with CP, in particular through prevention of limb contractions, and might make a difference in the child’s ability to handle everyday challenges. In addition, an early detection of CP gives the parents more time for adjustment and preparation. Since clinical manifestations of cerebral palsy do not emerge before a child is at least 6 months, the general movement (GM) is considered the most reliable early markers for monitoring of fetal and infant movement. Abnormal General movements and absence of the so-called fidgety movements at 3-5 months post-term carries a high risk of developing cerebral palsy. Beside a high specificity (82–99%) and sensitivity (95–100%), the assessment of the general movements (GMs) is quick, nonintrusive, and easy to acquire.",signatures:"Ali A. Al-Mayahi",downloadPdfUrl:"/chapter/pdf-download/62532",previewPdfUrl:"/chapter/pdf-preview/62532",authors:[{id:"252661",title:"Associate Prof.",name:"Ali",surname:"Al-Mayahi",slug:"ali-al-mayahi",fullName:"Ali Al-Mayahi"}],corrections:null},{id:"63463",title:"Clinical Classification of Cerebral Palsy",doi:"10.5772/intechopen.79246",slug:"clinical-classification-of-cerebral-palsy",totalDownloads:2650,totalCrossrefCites:3,totalDimensionsCites:4,hasAltmetrics:0,abstract:"The classification of cerebral palsy (CP) remains a challenge; hence the presence of so many classifications and a lack of consensus. Each classification used alone is incomplete. Therefore, a multiaxial classification gives a more comprehensive description of a child with CP. The recent WHO International Classification of Functioning, Disability and Health (ICF) emphasizes the importance of focusing on the functional consequences of various states of health and has stimulated the development of newer functional scales in CP. It is widely accepted that the functional classification is the best classification for the patient because it guides management. The objectives of this chapter are to review the various classifications of CP, to highlight the clinical features used in the various classifications, to outline the recent functional classifications of CP and to highlight how these recent classifications guide current management. It is expected that at the end of this chapter, the reader should be able to understand the difficulties in classifying CP, enumerate and discuss the various classifications of CP, understand the merits and shortcomings of each classification scheme, clinically evaluate and classify a child with CP multiaxially and understand how functional scales predict current and future needs of children with CP.",signatures:"Christian Chukwukere Ogoke",downloadPdfUrl:"/chapter/pdf-download/63463",previewPdfUrl:"/chapter/pdf-preview/63463",authors:[{id:"250398",title:"Dr.",name:"Christian",surname:"Ogoke",slug:"christian-ogoke",fullName:"Christian Ogoke"}],corrections:null},{id:"63097",title:"Survival, Mortality, and Life Expectancy",doi:"10.5772/intechopen.80293",slug:"survival-mortality-and-life-expectancy",totalDownloads:1393,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Cerebral palsy (CP) is a heterogenous condition, with level of disability ranging from immaterial to profound. In concert with the continuum of level of severity of disability/independent functioning, health care needs, therapies, medications, surgical interventions, costs of care, daily demands on parents and other family members, and expectations for the future in terms of education, employment, and other milestones of life all vary widely. Similarly, life expectancy in CP follows a continuum, from far lower than to potentially as high as general population life expectancy, that parallels the continuum of levels of disability. Here we review the literature documenting this, and examine the specific factors that are known to be strongly associated with mortality and longevity in CP. We also examine the evidence regarding causes of death in CP, and present some new findings related to this. Finally, we outline important methodological considerations for future research in this area.",signatures:"Steven M. Day and Robert J. Reynolds",downloadPdfUrl:"/chapter/pdf-download/63097",previewPdfUrl:"/chapter/pdf-preview/63097",authors:[{id:"220737",title:"Dr.",name:"Robert",surname:"J. Reynolds",slug:"robert-j.-reynolds",fullName:"Robert J. Reynolds"},{id:"220748",title:"Dr.",name:"Steven",surname:"M. Day",slug:"steven-m.-day",fullName:"Steven M. Day"}],corrections:null},{id:"62494",title:"Cerebral Palsy and Epilepsy",doi:"10.5772/intechopen.79565",slug:"cerebral-palsy-and-epilepsy",totalDownloads:1365,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The frequency of epilepsy in children with cerebral palsy is 40 times higher than the common population rate. The presence of epilepsy aggravates the clinical course of cerebral palsy, complicates the rehabilitation, affects the prognosis of motor and intellectual functions, and could be life-threatening. Another problem is the possibility of aggravation of epileptic seizures and their appearance de novo due to application of some neurorehabilitation methods (electrophoresis, acupuncture, nootropic drugs, brain stimulators, etc.). Children with cerebral palsy have a broad spectrum of epilepsies—varying from favorable combinations with benign idiopathic forms to extremely severe epileptic encephalopathies. Frequent combination of epileptic and non-epileptic paroxysms causes difficulty in their interpretation and differential diagnosis. Video-EEG monitoring is the “golden standard” for differential diagnostic of epileptic and non-epileptic events, and it is very useful for investigation of patients with cerebral palsy. Treatment of epilepsy in combination with cerebral palsy strictly requires an individual approach due to the form of epilepsy, seizure types, age of the patient, comorbidity, and somatic and mental condition of the patient.",signatures:"Alexey Kholin",downloadPdfUrl:"/chapter/pdf-download/62494",previewPdfUrl:"/chapter/pdf-preview/62494",authors:[{id:"253091",title:"Dr.",name:"Alexey",surname:"Kholin",slug:"alexey-kholin",fullName:"Alexey Kholin"}],corrections:null},{id:"63410",title:"Oral Health in Children with Cerebral Palsy",doi:"10.5772/intechopen.79452",slug:"oral-health-in-children-with-cerebral-palsy",totalDownloads:1301,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Cerebral palsy (CP) is a neurodevelopmental condition comprising a group of permanent disorders of movement and posture that are attributed to nonprogressive disturbances of the developing brain. The neuromuscular problems inherent in CP can affect oral health significantly in several ways. These can include changes in structure of the orofacial region, feeding problems, difficulties with maintaining oral hygiene; additionally, people with CP can encounter barriers in accessing oral health care. Several studies have examined caries rates in individuals who have CP. However, to date, no population-based studies have been published defining the risk factors for dental caries experience among children with CP. There is a high prevalence of orofacial motor dysfunction among people with CP, which can hinder oral hygiene and hence increase dental biofilm formation and retention. Factors such as food consistency, snacking between meals, and associated oromotor dysfunction have also been reported to contribute to the high incidence of caries found in those with CP. Therefore, this chapter will aim to describe the oral health status and factors affecting dental caries experience of children with CP, while also providing preventative and restorative recommendations to combat the prevalence of this disease.",signatures:"Rahena Akhter, Nur Mohmmad Monsur Hassan, Mangala Nadkarni,\nElizabeth F. Martin and Gulam Khandaker",downloadPdfUrl:"/chapter/pdf-download/63410",previewPdfUrl:"/chapter/pdf-preview/63410",authors:[{id:"231469",title:"Dr.",name:"Rahena",surname:"Akhter",slug:"rahena-akhter",fullName:"Rahena Akhter"},{id:"254193",title:"Dr.",name:"Nur Mohammad Monsur",surname:"Hassan",slug:"nur-mohammad-monsur-hassan",fullName:"Nur Mohammad Monsur Hassan"},{id:"254194",title:"Prof.",name:"Elizabeth",surname:"F. Martin",slug:"elizabeth-f.-martin",fullName:"Elizabeth F. Martin"},{id:"261319",title:"Dr.",name:"Mangala",surname:"Nadkarni",slug:"mangala-nadkarni",fullName:"Mangala Nadkarni"},{id:"261320",title:"Dr.",name:"Gulam",surname:"Khandaker",slug:"gulam-khandaker",fullName:"Gulam Khandaker"}],corrections:null},{id:"62885",title:"Use of Botulinum Toxin A in Cerebral Palsy",doi:"10.5772/intechopen.79551",slug:"use-of-botulinum-toxin-a-in-cerebral-palsy",totalDownloads:1382,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Botulinum toxin A (BTX-A) is widely used worldwide to overcome the significant problem in spastic cerebral palsy (CP). In the past three decades, botulinum toxin serotype A (BTX-A) has been introduced as a selective treatment option for spasticity in children with cerebral palsy. BTX-A is an acetylcholine-blocking agent that causes presynaptic neuromuscular blocking when injected into the muscle. Its action of decreasing or normalization of tone prevent the development of contractures and deformities and avoid or postponed surgical intervention particularly when combined with other treatment modalities such as physiotherapy, casting, orthosis, etc. Equinus deformity, scissoring and crouch gait in the lower limbs, and different spastic deformities like pronation of forearm, elbow flexion, wrist flexion, fisting, or abnormal dystonic posture of upper limb deformities were the main indications wherein botulinum toxin injection is needed in spastic cerebral palsy; moreover, its benefit of relieving pain that are associated with muscular hypertonia and palpation of the muscle, particularly the large one, remains the cornerstone for injection of BTX in CP patient for most experts worldwide, but it needs a well of knowledge in anatomy and its landmark. Invasive procedure like electromyography (EMG) is more difficult to be applied successfully in children than in adults. Spasticity is considered a positive phase of muscle function. Therefore, when relaxing the muscle, the patient’s condition might get worse functionally in some instance. So, the first question clinician put in his account before injecting BTX is whether hypertonia is impeding or improving function; therefore, injection is tailored individually by an expert physician. Generally, the adverse side effects of BTX-A are seldom to occur providing that the physician strictly adheres to the dose ranges and reinjection period. The inter-injection period must be at least 12 weeks to avoid antibodies ands. So far, BTX-A is considered to be safe to some extent if used professionally; however, long-term adverse effect particularly with multilevel therapy are still not clear.",signatures:"Adel A. Kareem",downloadPdfUrl:"/chapter/pdf-download/62885",previewPdfUrl:"/chapter/pdf-preview/62885",authors:[{id:"254143",title:"Dr.",name:"Adel",surname:"A. Kareem",slug:"adel-a.-kareem",fullName:"Adel A. Kareem"}],corrections:null},{id:"62805",title:"Baclofen Pump Implantation for Cerebral Palsy",doi:"10.5772/intechopen.79619",slug:"baclofen-pump-implantation-for-cerebral-palsy",totalDownloads:849,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Programmable baclofen pump implantation is used to provide the patient with minimal intrathecal dose of baclofen to provide relaxation when the oral permitted doses are no longer withstand able by the patient. We discussed the efficiency of programmable baclofen pump implantation in treating spasticity by reviewing several international papers. Satisfactory relaxation was noticed in most of the patients. The complications following intrathecal baclofen (ITB) surgeries are not uncommon. ITB is an advised method for treating spasticity whether due to cerebral or spinal causes. It has significant improvements with minor complications. It needs special trained multidisciplinary team to manage it.",signatures:"Moneer K. Faraj",downloadPdfUrl:"/chapter/pdf-download/62805",previewPdfUrl:"/chapter/pdf-preview/62805",authors:[{id:"255968",title:"Dr.",name:"Moneer",surname:"K. Faraj",slug:"moneer-k.-faraj",fullName:"Moneer K. Faraj"}],corrections:null},{id:"63452",title:"Plasma Growth Factors in Cerebral Palsy",doi:"10.5772/intechopen.80369",slug:"plasma-growth-factors-in-cerebral-palsy",totalDownloads:961,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The use of plasma growth factors is opening a new field of clinical application in medicine, developing a new discipline called regenerative medicine. In many fields such as traumatology, dental implantology or anesthesia, the use of this biotechnology is improving the quality of life of patients, through techniques that are not invasive but with extraordinary functional results. A discipline where this type of procedure opens an interesting field of application is undoubtedly neurology, especially those processes of ischemic or hypo-anoxic origin such as cerebral palsy, where recent studies point to an improvement of cognitive abilities in patients, together with specific neurorehabilitation therapies.",signatures:"Jesús Alcaraz Rubio and Juana María Sánchez López",downloadPdfUrl:"/chapter/pdf-download/63452",previewPdfUrl:"/chapter/pdf-preview/63452",authors:[{id:"216524",title:"Dr.",name:"Jesus",surname:"Alcaraz",slug:"jesus-alcaraz",fullName:"Jesus Alcaraz"},{id:"250790",title:"Mrs.",name:"Juana Maria",surname:"Sanchez Lopez",slug:"juana-maria-sanchez-lopez",fullName:"Juana Maria Sanchez Lopez"}],corrections:null},{id:"64318",title:"Hip Surgery in Cerebral Palsy",doi:"10.5772/intechopen.80442",slug:"hip-surgery-in-cerebral-palsy",totalDownloads:1269,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Hip pathology is one of the main orthopedic concerns in cerebral palsy (CP) patients. It has been demonstrated that correctly applied hip screening programs could significantly diminish the incidence of hip pathology. Unfortunately, in several countries, hip dislocation is significantly prevalent and is still a major concern in these patients. Depending on the age, the disability grade, the rehabilitation support, and the surgical strategies, results of hip treatment are variable. The ideal outcome of a stable, reduced, and long-lasting pain-free hip are not always achieved. In this chapter, we discuss theoretical and practical strategies used to treat specific CP hip dislocation. In younger children, simple femoral reorientation procedures (tenotomies with or without femoral osteotomies) promote correct acetabular remodeling. Later, surgical hip reduction can be an option even in late adolescents, and the use of capsuloplasty can lead to greater hip stability, in spite of eventual pelvis obliquity caused by associated spine pathology. Several technical tips for hip surgery are presented. It is essential that patients with CP hip problems receive proper follow-up, including rehabilitation medicine, physiotherapy, anti-spastic medication, on-time orthosis availability, and real teamwork concerned with this kind of pathology.",signatures:"João Lameiras-Campagnolo",downloadPdfUrl:"/chapter/pdf-download/64318",previewPdfUrl:"/chapter/pdf-preview/64318",authors:[{id:"251869",title:"Mr.",name:"João",surname:"Lameiras-Campagnolo",slug:"joao-lameiras-campagnolo",fullName:"João Lameiras-Campagnolo"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"7860",title:"Epilepsy",subtitle:"Advances in Diagnosis and Therapy",isOpenForSubmission:!1,hash:"17e914e07088c3e9c4d085a609be1f42",slug:"epilepsy-advances-in-diagnosis-and-therapy",bookSignature:"Isam Jaber Al-Zwaini and Ban Adbul-Hameed Majeed Albadri",coverURL:"https://cdn.intechopen.com/books/images_new/7860.jpg",editedByType:"Edited by",editors:[{id:"30993",title:"Prof.",name:"Isam Jaber",surname:"Al-Zwaini",slug:"isam-jaber-al-zwaini",fullName:"Isam Jaber Al-Zwaini"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6210",title:"Thalassemia and Other Hemolytic Anemias",subtitle:null,isOpenForSubmission:!1,hash:"857e8a4bff6f78189f15a00423bde1a6",slug:"thalassemia-and-other-hemolytic-anemias",bookSignature:"Isam AL-Zwaini",coverURL:"https://cdn.intechopen.com/books/images_new/6210.jpg",editedByType:"Edited by",editors:[{id:"30993",title:"Prof.",name:"Isam Jaber",surname:"Al-Zwaini",slug:"isam-jaber-al-zwaini",fullName:"Isam Jaber Al-Zwaini"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9805",title:"Infant Feeding",subtitle:"Breast versus Formula",isOpenForSubmission:!1,hash:"7d1570fa9b5653287eaa25fe171b404a",slug:"infant-feeding-breast-versus-formula",bookSignature:"Isam Jaber Al-Zwaini, Zaid Rasheed Al-Ani and Walter Hurley",coverURL:"https://cdn.intechopen.com/books/images_new/9805.jpg",editedByType:"Edited by",editors:[{id:"30993",title:"Prof.",name:"Isam Jaber",surname:"Al-Zwaini",slug:"isam-jaber-al-zwaini",fullName:"Isam Jaber Al-Zwaini"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7131",title:"Selected Topics in Facial Nerve Disorders",subtitle:null,isOpenForSubmission:!1,hash:"0c16c1a947ded4fae51c047243593fbf",slug:"selected-topics-in-facial-nerve-disorders",bookSignature:"Isam Al-Zwaini and Mohammed Jalal Hussein",coverURL:"https://cdn.intechopen.com/books/images_new/7131.jpg",editedByType:"Edited by",editors:[{id:"30993",title:"Prof.",name:"Isam Jaber",surname:"Al-Zwaini",slug:"isam-jaber-al-zwaini",fullName:"Isam Jaber Al-Zwaini"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7160",title:"Selected Topics in Myasthenia Gravis",subtitle:null,isOpenForSubmission:!1,hash:"eeda0ab67d079aaaef6c71f9d7f1bb26",slug:"selected-topics-in-myasthenia-gravis",bookSignature:"Isam Jaber Al-Zwaini and Ali AL-Mayahi",coverURL:"https://cdn.intechopen.com/books/images_new/7160.jpg",editedByType:"Edited by",editors:[{id:"30993",title:"Prof.",name:"Isam Jaber",surname:"Al-Zwaini",slug:"isam-jaber-al-zwaini",fullName:"Isam Jaber Al-Zwaini"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5203",title:"Recovery of Motor Function Following Spinal Cord Injury",subtitle:null,isOpenForSubmission:!1,hash:"8c1d0a0fb7465d107de2089e21227ad8",slug:"recovery-of-motor-function-following-spinal-cord-injury",bookSignature:"Heidi Fuller and Monte Gates",coverURL:"https://cdn.intechopen.com/books/images_new/5203.jpg",editedByType:"Edited by",editors:[{id:"87307",title:"Dr.",name:"Heidi",surname:"Fuller",slug:"heidi-fuller",fullName:"Heidi Fuller"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],ofsBooks:[]},correction:{item:{id:"79356",slug:"corrigendum-to-surgical-digitally-guided-planning-for-the-mini-screw-assisted-rapid-palatal-expansio",title:"Corrigendum to: Surgical Digitally Guided Planning for the Mini-Screw Assisted Rapid Palatal Expansion (MARPE) and Suture Perforation: MARPE Guide",doi:null,correctionPDFUrl:"https://cdn.intechopen.com/pdfs/79422.pdf",downloadPdfUrl:"/chapter/pdf-download/79422",previewPdfUrl:"/chapter/pdf-preview/79422",totalDownloads:null,totalCrossrefCites:null,bibtexUrl:"/chapter/bibtex/79422",risUrl:"/chapter/ris/79422",chapter:{id:"78828",slug:"surgical-digitally-guided-planning-for-the-mini-screw-assisted-rapid-palatal-expansion-marpe-and-sut",signatures:"Cristiane Barros André, Bruno de Paula Machado Pasqua, José Rino Neto and Fábio Dupart Nascimento",dateSubmitted:"August 27th 2021",dateReviewed:"August 31st 2021",datePrePublished:"October 2nd 2021",datePublished:null,book:{id:"10780",title:"Current Trends in Orthodontics",subtitle:null,fullTitle:"Current Trends in Orthodontics",slug:"current-trends-in-orthodontics",publishedDate:"August 17th 2022",bookSignature:"Farid Bourzgui",coverURL:"https://cdn.intechopen.com/books/images_new/10780.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"52177",title:"Prof.",name:"Farid",middleName:null,surname:"Bourzgui",slug:"farid-bourzgui",fullName:"Farid Bourzgui"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null}},chapter:{id:"78828",slug:"surgical-digitally-guided-planning-for-the-mini-screw-assisted-rapid-palatal-expansion-marpe-and-sut",signatures:"Cristiane Barros André, Bruno de Paula Machado Pasqua, José Rino Neto and Fábio Dupart Nascimento",dateSubmitted:"August 27th 2021",dateReviewed:"August 31st 2021",datePrePublished:"October 2nd 2021",datePublished:null,book:{id:"10780",title:"Current Trends in Orthodontics",subtitle:null,fullTitle:"Current Trends in Orthodontics",slug:"current-trends-in-orthodontics",publishedDate:"August 17th 2022",bookSignature:"Farid Bourzgui",coverURL:"https://cdn.intechopen.com/books/images_new/10780.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"52177",title:"Prof.",name:"Farid",middleName:null,surname:"Bourzgui",slug:"farid-bourzgui",fullName:"Farid Bourzgui"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null},book:{id:"10780",title:"Current Trends in Orthodontics",subtitle:null,fullTitle:"Current Trends in Orthodontics",slug:"current-trends-in-orthodontics",publishedDate:"August 17th 2022",bookSignature:"Farid Bourzgui",coverURL:"https://cdn.intechopen.com/books/images_new/10780.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"52177",title:"Prof.",name:"Farid",middleName:null,surname:"Bourzgui",slug:"farid-bourzgui",fullName:"Farid Bourzgui"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"11902",leadTitle:null,title:"Lignin - Chemistry, Structure, and Application",subtitle:null,reviewType:"peer-reviewed",abstract:"\r\n\tThe book aims to present the chemistry of lignin molecules, their composition, and structure, strategies for chemical modification, recent progress, and studies of biopolymer lignin. Lignin is composed of alkyl-aryl ether polymers and is found in the cell walls of trees and plants. It is known as the second most naturally abundant biopolymer. The book will focus on the application of lignin in various materials, its synthesis and characterizations, and its development prospects followed by degradation methodologies. In addition to that, it will also emphasize the strategies to prepare nano- and microparticles of lignin by various means, as well as their chemical modification to obtain desired properties. It will also include the industrial aspects of lignin, lignin derivatives, their configuration, and their significant role in thermosetting, thermoplastic materials. In addition, the book welcomes contributions on the technical and economical potential of lignin in generating green bio-fuel and fine chemicals which will or can be used as an energy source for various industrial plants.
",isbn:"978-1-83968-546-0",printIsbn:"978-1-83968-545-3",pdfIsbn:"978-1-83968-861-4",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"4c3ccf3ce961d9c60aeb9774034eeb87",bookSignature:"Associate Prof. Arpit Sand and Dr. Jaya Tuteja",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11902.jpg",keywords:"Biofuel, Esters, Ethers, Adhesives, Lignin, Structural Features, Physicochemical Properties, Degradation Techniques, Biosynthesis, Biodegradation, Kraft Lignin, Qualitative Analysis",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 14th 2022",dateEndSecondStepPublish:"June 23rd 2022",dateEndThirdStepPublish:"August 22nd 2022",dateEndFourthStepPublish:"November 10th 2022",dateEndFifthStepPublish:"January 9th 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"2 months",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Dr. Sand, associate professor of Chemistry, was a postdoctoral fellow at Gwangju Institute of Science & Technology, Korea, and at Karolinska Institutet, Sweden. With a keen interest in polymer synthesis, Dr. Sand is an editorial board member for Polymer Synthesis Journal by Cambridge Scholars Publishing UK and Journal of Polymer Science.",coeditorOneBiosketch:'An enthusiastic, disciplined, well-organized Assistant Professor in Chemistry, Dr. Tuteja earned her Ph.D. degree in Materials Science from the Japan Advanced Institute of Science and Technology (JAIST) in 2015 for which she was awarded an “Excellent Doctorate Student". Her research includes the development and application of heterogeneous catalysts for the effective conversion of biomass to value-added products.',coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"287032",title:"Associate Prof.",name:"Arpit",middleName:null,surname:"Sand",slug:"arpit-sand",fullName:"Arpit Sand",profilePictureURL:"https://mts.intechopen.com/storage/users/287032/images/system/287032.jpg",biography:"Dr. Arpit Sand is currently an associate professor in the Department of Chemistry, Manav Rachna University, Faridabad, India. He received his BSc in Science and MSc in Chemistry from the University of Allahabad, India, in 2004 and 2006, respectively. He received his Ph.D. in Chemistry from the same university in 2010. Dr. Sand is an editorial board member for Polymer Synthesis Journal by Cambridge Scholars Publishing UK and Journal of Polymer Science. He is an academic book editor and a reviewer for international journals including Carbohydrate Polymers, International Journal of Biological Macromolecules, and Fibers and Polymers, among others.\r\nDr. Sand’s previous roles include assistant professor (guest faculty) in the Department of Chemistry, University of Allahabad; research associate at the National Physical Laboratory (NPL) New Delhi; postdoctoral fellow at Gwangju Institute of Science & Technology (GIST), Korea; postdoctoral fellow at Karolinska Institutet, Sweden; junior researcher at the Brno University of Technology, Czech Republic; and researcher at Soongsil University, South Korea.\r\nHe has more than ten years of teaching and research experience. He is also a life member of the Indian Science Congress and Green Chemistry Network center. He has made significant contributions in the modification and characterization of graft copolymers and films decorated with chalcogenide quantum dots to tune the energy bandgap for solar energy harvesting applications. His research interests include polymer synthesis using different polymerization techniques. He has authored more than twenty-four international research articles and review articles in reputed SCI journals.",institutionString:"Manav Rachna University Faridabad",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"1",institution:null}],coeditorOne:{id:"453331",title:"Dr.",name:"Jaya",middleName:null,surname:"Tuteja",slug:"jaya-tuteja",fullName:"Jaya Tuteja",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003NAhktQAD/Profile_Picture_1643970806232",biography:"Dr. Jaya Tuteja is currently working as Assistant Professor, Department of Chemistry, Faculty of Applied Science, Manav Rachna University since January 2018. She earned her Ph.D. degree in Materials Science from Japan Advanced Institute of Science and Technology (JAIST), Japan in 2015 and was awarded as “Excellent Doctorate Student” by JAIST. \r\nShe has published 5 research papers in reputed international journals with a sum of impact factor of >25. She also has 2 patents filed on her name from her Ph.D. research work. One of the articles in ChemSusChem 7 (1), 96-100 has reached a citation of more than 100 and was selected among 25 Most Accessed Articles from ChemSusChem. Her first research article was awarded a BCSJ award article. She also has 1 book chapter in her account.\r\nBefore joining Manav Rachna University, she was working in a chromatography Industry YMC India Ltd. as a Technical and Application Manager. Her research area includes the development, characterization, and application of heterogeneous catalysts for effective conversion of biomass to value-added products, nanoparticles synthesis and nanoparticle-based heterogeneous catalysts, bimetallic nanoparticles, carbohydrate chemistry, and analytical techniques for compound identification.",institutionString:"Manav Rachna University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"8",title:"Chemistry",slug:"chemistry"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"444315",firstName:"Karla",lastName:"Skuliber",middleName:null,title:"Mrs.",imageUrl:"https://mts.intechopen.com/storage/users/444315/images/20013_n.jpg",email:"karla@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"10776",title:"Cellulose Science and Derivatives",subtitle:null,isOpenForSubmission:!1,hash:"947660259ce1915c3cac58bf7d990424",slug:"cellulose-science-and-derivatives",bookSignature:"Arpit Sand and Sangita Banga",coverURL:"https://cdn.intechopen.com/books/images_new/10776.jpg",editedByType:"Edited by",editors:[{id:"287032",title:"Associate Prof.",name:"Arpit",surname:"Sand",slug:"arpit-sand",fullName:"Arpit Sand"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"117",title:"Artificial Neural Networks",subtitle:"Methodological Advances and Biomedical Applications",isOpenForSubmission:!1,hash:null,slug:"artificial-neural-networks-methodological-advances-and-biomedical-applications",bookSignature:"Kenji Suzuki",coverURL:"https://cdn.intechopen.com/books/images_new/117.jpg",editedByType:"Edited by",editors:[{id:"3095",title:"Prof.",name:"Kenji",surname:"Suzuki",slug:"kenji-suzuki",fullName:"Kenji Suzuki"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3828",title:"Application of Nanotechnology in Drug Delivery",subtitle:null,isOpenForSubmission:!1,hash:"51a27e7adbfafcfedb6e9683f209cba4",slug:"application-of-nanotechnology-in-drug-delivery",bookSignature:"Ali Demir Sezer",coverURL:"https://cdn.intechopen.com/books/images_new/3828.jpg",editedByType:"Edited by",editors:[{id:"62389",title:"PhD.",name:"Ali Demir",surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"872",title:"Organic Pollutants Ten Years After the Stockholm Convention",subtitle:"Environmental and Analytical Update",isOpenForSubmission:!1,hash:"f01dc7077e1d23f3d8f5454985cafa0a",slug:"organic-pollutants-ten-years-after-the-stockholm-convention-environmental-and-analytical-update",bookSignature:"Tomasz Puzyn and Aleksandra Mostrag-Szlichtyng",coverURL:"https://cdn.intechopen.com/books/images_new/872.jpg",editedByType:"Edited by",editors:[{id:"84887",title:"Dr.",name:"Tomasz",surname:"Puzyn",slug:"tomasz-puzyn",fullName:"Tomasz Puzyn"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"70054",title:"Endovascular Treatment of Brain Aneurysms",doi:"10.5772/intechopen.88964",slug:"endovascular-treatment-of-brain-aneurysms",body:'\nA cerebral aneurysm is defined as a local outpouching of an intracranial artery and can either be saccular or fusiform. The formation of aneurysms is an incompletely understood gradual process [1] involving genetics, epidemiology and pathobiology, in conjugation with the study of biophysics provides a more complete picture on how these factors interact [2]. The natural history of saccular intracranial aneurysms consists of three phases: initiation, growth, and either stabilization or rupture, and the application of scientific principles to biological processes has made it easier to understand the behavior of aneurysm formation and rupture.
\nVarious genome studies and subsequent replication case control studies suggest genetic components in the formation of intracranial aneurysms (IA), no specific genes strongly associated with formation have yet been identified. A meta-analysis [3], identified three single nucleotide polymorphisms (SNPs) located on chromosome 9 within the
Cerebral arteries are prone to aneurysm formation due to presence of cerebrospinal fluid, sparse tunica adventitia, lower proportion of elastic fibers and disruption of internal lamina at bifurcation [7, 8, 9]. Blood is an active participant in the formation of aneurysms, its flow provides the mechanical triggers for reactions in the vessels at the level of the endothelium, while it is also a biological participant in the inflammatory cascade [10, 11]. This dual function of blood contributes significantly to the degradation of the arterial wall in the formation of aneurysms [2].
\nCohort studies on people with a familial preponderance to saccular aneurysm have shown that the geometry of bifurcations around the circle of Willis adds additional stress to the vessel walls, given the significant shifts in flow velocity, dynamic forces, and shear stress. Thus, high flow across a wall that is not “designed” for the exposed pressures results in tissue injury and remodeling. The biological result may be plaque or may be an aneurysm, depending on the presence (or absence) of an intact media [2]. Fluid-dynamic models calculate and visualize wall shear stress or wall shear gradients, intra-aneurysmal flow, impingement zones, and flow patterns or velocities. Wall shear stress constitutes the degree of friction in the intracranial aneurysm wall that results from blood inflow and impingement into the aneurysm. High and low wall shear stress can both be present during aneurysm formation but the relevance of these flow conditions to the pathogenesis, growth and rupture of an aneurysm remain unclear [12]. The role of shear stress is very controversial, responsible for damage at specific phases of aneurysmal development and rupture. Some studies suggest the direct effect of shear stress on the vessel wall resulting in injury and degeneration of the wall’s media, leading to aneurysm formation. Others suggest that low shear stress in the aneurysm and the vessel wall may result in small thrombus formation, endothelial reactivity, and inflammation at the site, thus weakening the vessel.
\nData generated from fluid-dynamic models could help improve our understanding of aneurysm formation patterns and potential structural deficiencies in aneurysms. The relevance of existing data derived from computational fluid modeling is limited, however, because the majority of studies compared ruptured with unruptured aneurysms. An ideal approach would be to compare the same aneurysm before and after rupture [13, 14, 15, 16].
\nIn response to internal elastic lamina disruption and the subsequent mechanical overload and shift in tensile forces, vascular smooth muscle cells and fibroblasts synthesize collagen types I and V, which are the main molecular constituents of intracranial aneurysms [17].
\nOnce the molecular mechanisms fail to compensate for the mechanical overload of the vessel wall and myo-intimal injury, cellular and humoral inflammatory responses become the main drivers of aneurysm formation [17, 18, 19, 20]. These responses are mediated by inflammatory cytokines such as tumor necrosis factor (TNF), IL-1β and matrix metalloproteinases (MMPs), promote influx of macrophages and continuous degradation of collagen and elastin fibers. Wall shear stress might also contribute to cellular inflammatory responses during aneurysm formation.
\nAneurysm rupture has been suggested to occur as aneurysm expansion approaches and exceeds the physical limits of the tissue. It has also been suggested that the vibrations induced by pulsatile flow and the subsequent resonant frequency may promote aneurysmal rupture [21, 22]. Although not directly resulting in aneurysmal rupture, vibrational irregularities secondary to the presence of the aneurysm may accelerate the degeneration of the aneurysmal wall and subsequently lead to rupture. A shift to quantitative and not just qualitative analysis, and a focus on flow and flow dynamics as a force of influence in rupture have changed the landscape of research for cerebral aneurysms [2].
\nAlthough Unruptured Intracranial Aneurysms (UIA) are common [23, 24]. Their prevalence is subject to changes due to the improvements in invasive and non-invasive imaging techniques, the increasing knowledge about the related factors that determines screening in asymptomatic populations and the increase in the life expectancy. Historically, the methods used to address prevalence were retrospective or prospective autopsy studies in the decades from 1950’s to the earliest 2000’s [25] but non-invasive imaging studies have demonstrated higher prevalence and prevalence ratios compared to autopsy studies (PR 3•5, 95% CI 2•1–6•1)3. To study UIA, the Magnetic Resonance Angiography (MRA) is the most common method for detection in asymptomatic patients [26] and compared to Intra-Arterial Digital Subtraction Angiography (IA-DSA), systematic reviews have found no significant differences in the prevalence reported between these two imaging techniques (more details will be elucidated in the next section of this chapter). However, it’s important to highlight that prevalence reported in non-invasive imaging studies can present limitations due to the interobserver agreement, training, experience, quality of equipment and expert’s judgment [27].
\nThe IA characteristics are also a major concern in prevalence studies; technical limitations in regard to location, size and morphology can decrease the sensitivity and specificity of the diagnostic methods. Both, large and relatively small [28] cohort’s studies had shown that saccular morphology is the most common form of presentation and that among patients without history of subarachnoid hemorrhage (SAH) the distribution of IA in the internal carotid artery (ICA) and middle cerebral artery (MCA) are 24.8 and 22.7% [29] respectively, however in patients with previous history of SAH, the prevalence is higher in the MCA. In regard to the size, modern imaging techniques can easily detect aneurysms from 2 mm, which is extremely important to determine the risks of possible treatments or natural history, so far, the current evidence is that UIA > 5 mm, location in basilar artery apex and decrease in BMI over the follow-up period are related to speed up the 2.9% of aneurysm growth per year. However, irrespective of aneurysm size, the irregular shape and daughter sac are more likely to rupture [30, 31]. Although we know these are contributing factors, there is still a need to understand better the contribution of aneurysm related factors.
\nThe prevalence of UIA among the general population is 3–5% [32] but there are several differences between populations that increase the risk for having a IA or a SAH. The risk factors commonly associated to IA development and rupture whether there’s a previous history of SAH or not, are age > 30, female sex, African-American race, smoking, alcoholism, hypercholesterolemia, high blood pressure, first and second-degree relatives with SAH history, and other comorbidities as polycystic kidney disease, connective tissue disorders and brain tumors [33, 34, 35, 36]. However, lifelong follow-up studies of UIA suggested that only female sex and smoking status were significant risk factors for aSAH [37]. Across countries, compared to USA prevalence, China, Japan, European countries including (UK, Netherlands, Finland, Germany and Italy) had no significant differences in the prevalence ratios adjusted to age, sex and comorbidities [38, 39, 40, 41]. Other studies in Iranian population [42] have shown a prevalence of 3.2% but more studies in non-Caucasian populations are still required to further understand the impact of genetics and cultural practices.
\nThe incidence of aneurysmal SAH (aSAH) reports are questionable, first, in average 20% of the aSAH deaths occur suddenly, away from hospital or in emergency rooms [43]. Therefore, incidence can vary between countries with different autopsy rates and medical study protocols. In the case of Finland, the PHASES study showed a 3–6 times increased risk of aneurysm rupture in compared to other European nations and USA [44]. However, these findings can be a proof of how epidemiological studies need to improve their parameters more than a proof that Finnish people have more risk of aSAH. Finland has high rates of autopsy studies in sudden deaths [45] and all nonhospital deaths and moreover, longer life expectancy and pyramid shrinking due to the increasing of elderly population [46]. So, there’s no currently strong evidence to conclude that aSAH in Finland cohorts is truly higher than the other countries included in the PHASES study.
\nIn spite of this evidence, careful consideration must be taken when we think about the pros and cons to treat a patient based on their personal risk factors. Most of the large cohort’s publications and meta-analysis have been done in populations where ethnicity diversity was limited, the impact of social stratus had not been assessed and criteria for collecting data and analysis was not standardized. Therefore, perfect epidemiological studies do not exist so, great efforts will be necessary to determine inclusion and exclusion criteria in future prospective cohorts.
\nDiagnosis of unruptured intracranial aneurysms (UIA) in most of the cases is incidentally during evaluations of other conditions [44] because the vast majority are asymptomatic or have subtle manifestations. Only, 10 to 15.5% of patients have symptoms related to UIA [45]. These symptoms generally are associated to mass effect due to the aneurysm size and growth, rarely cranial neuropathy or even more rare with sentinel hemorrhage, due to minimal blood leaking with the consequent meningeal irritation [45]. Symptomatic UIA often present with neurological deficits as visual dysfunction, ocular nerve palsy, bilateral temporal hemianopsia and other neurological symptoms as headaches, embolic cerebral ischemia, poorly defined spells, and seizures [46, 47]. Patients with symptomatic UIA need more attention because this can be a manifestation about riskier distribution and morphological [45] characteristics of the aneurysm, and a warning sign of an impending rupture [48]. The diagnoses modality after incidental discovery of an UIA, is based on which imaging modality is more sensitive depending on aneurysms characteristics, patients related factors, medical history and moreover, methods available in each center. Therefore, there is no specific diagnoses algorithm for UIA. The decision of screening or further imaging after finding an incidental aneurysm is still on the specialist judgment. These considerations are discussed below:
\nIt has been mentioned that most of the UIA are diagnosed incidentally, and some of the non-invasive imaging methods have also been mentioned in the “prevalence” section of this chapter. However, there are still different evidences about the rates of diagnosis and prevalence reported through these non-invasive imaging methods as the MRA or CTA and IA-DSA, the current gold standard [22, 49]. Many authors had suggested that the MRA and CTA to be the best methods for preliminary screening of IA [50, 51], the sensitivity and specificity of both methods are 87 and 95% for MRA and 90 and 86% for CTA [47]. But the effectiveness of the diagnoses can decrease depending on the IA characteristics; in UIA < 3 mm, MRA and CTA sensitivity plummet to 38 and 61%, respectively [52]. Moreover, the high rates of comorbidities in people with UIA product of common pathophysiology (like hypertension with the consequent kidney failure) or to the old age of patients can limit the use of the contrast dye in CTA for screening. Therefore, MRA is the most frequent tool for screening nowadays. Other non-invasive techniques like transcranial Doppler (TCD) have been explored, but whether power Doppler is done with or without contrast enhancement, it’s sensitivity and specificity together are not superior to MRA and CTA [51]. Nevertheless, TCD can be a screening tool in countries were the expensive costs of MRA or CTA makes them inaccessible.
\nSensitivity and specificity of imaging methods for diagnostic are important, but more considerations should be taken to study UIA characteristics. IADSA, provides the better spatial resolution than other techniques [44], but this method may not provide a good sense of aneurysm volume and can present difficulties when vessels are overlapped, and therefore 3D reconstructions are often needed to fully evaluated for intracranial aneurysms. Moreover, IADSA as an invasive method, can carry risks; 2.3% of patients can present transient neurological complications, 0.4% permanent neurological complications and 14.7% of non-neurological complications [52]. Novel imaging methods as the Optical coherence tomography (OCT) can be useful to assess key factors in aneurysm structure due to the power to increase 10 times image resolution compared to other current techniques [44] and furthermore, OCT has a nearly-biopsy resolution [53] and enhance resolution of birefringent tissues as artery laminas [54] which is major concern in pathophysiology, as mentioned before in this chapter.
\nFurthermore, considerations need to be taken as to imaging modality if the patient has had previously treated aneurysms. MRA is not sensitive for patients with previously treated clipped aneurysms. For these patients CTA is preferred. MRA is still sensitive for previously coiled aneurysms. For patients treated with flow diverter stents either MRA with contrast or CTA can be used. If the patient had coils with any kind of stent, then MRA with contrast is the preferred modality.
\nTaken together the results of imaging for UIA, the neuro-interventional team consider the possible treatments for each patient based on the risks and benefits between prevent treatment and natural history, however due to lack of evidence of the natural history in some categories of UIA is not uncommon to balance the pros and cos between prevent treatment and aSAH outcomes. Some of the current available treatments will be discussed below.
\nFirst of all, having an aneurysm does not imply always the need to undergo surgical or endovascular treatment. Most of the UIA will never cause symptoms neither rupture or at least the probability of this events will not be over 1% per year. Therefore, many patients decide to take the risk of conservative management over the risks of preventive treatments. However, conservative management is not equal to doing nothing, this management bear intervention from the physician to educate well the patient about the risk factors that will increase the probabilities of rupture and an active participation of the patients to modify their risky habits. There is strong evidence that supports the conservative management when lifetime risk of morbidity and mortality is low [42] as represented in Figure 1.
\nGiant right vertebral aneurysm before and after coiling.
Nevertheless, in patients under conservative management, imaging follow-ups at 1 year intervals have been recommended with CTA or MRA [25] to assess aneurysm growth, although it is unclear whether this frequency of time-interval is truly necessary. However, is not uncommon to have mixed factors in UIA patients, to make it clear, a systematic review showed that if hypertension and history of SAH are present (considering this both as major risk factors) in a patient under 70 years, with an <10 mm UIA in the anterior circulation, we will still be talking about a probability of risk of ~1% per year [24]. So, a standardized timing for imaging follow-ups according to each patients and aneurysm related factors does not exist, in part because aneurysm growing is discontinuous but the ELAPSS score (mentioned in Figure 1) can be helpful to determine the need of follow-up at 3 or 5 years based on the risk of aneurysm growth [55]. These patients who choose conservative management live with a small very definite risk of rupture. Recently, a study showed that patients with untreated UIA, may decrease their quality of life (QoL) and moreover, trigger mental disorder as anxiety and depression [56, 57] possibly due to the uncertainty of whether their aneurysm is going to burst and when.
\nSuccessful surgery is achieved in most of the cases by excluding aneurysms from circulation but currently, there is a lack of prospective, multicenter and randomized trials that report outcomes in a uniform way. Moreover, most of the studies were done in patients with previous aSAH like the ISAT trial [58], which makes difficult to extrapolate those results to patients with UIA and no history of aSAH. The ISUIA-2 study did evaluate the surgical outcomes of nearly 1500 patients. They reported a mortality rate of 2.7% at 1 year and poor outcome (mRS 3–5) of 1.4% at 1 year. In this study, age > 70, posterior circulation and giant aneurysms were all associated with higher surgical morbidity and mortality. A meta-analysis done in the US with patients without previous history of aSAH that underwent to elective surgical clipping (SC) 14,411 and to endovascular treatment (EVT) 16,659 reported that iatrogenic stroke, intracranial hemorrhage, pulmonary complications, sepsis and status epilepticus were significantly higher after SC [59]. Moreover, the reduced recovery time and shorter stays in hospital [60] play a major role in the final decision of patient to avoid surgery. Nowadays, SC is usually reserved to younger patients that will benefit more from an immediate occlusion of the aneurysm, less need to have follow-up imaging, less probability of retreatment and the ones with large and giant aneurysms or locations in the MCA.
\nSince its conception, endovascular treatment has rapidly taken over as the major treatment for most intracranial aneurysms. While there is supporting data for ruptured intracranial aneurysms from the ISAT trial, there is no randomized controlled trial comparing surgery and endovascular treatment to surgical clipping for unruptured aneurysms. Relative indications for endovascular treatment are poor surgical candidate, favorable aneurysm and vascular anatomy, high risk for anesthesia complications and posterior circulation aneurysms. In 2012, a systematic review and meta-analysis reported different outcomes between endovascular treatments; >52 years, >10 mm and posterior circulation location were main risk factors to poor outcomes [61]. Coiling alone was safer compared to the percent of complications reported with balloon-assisted coiling 7.1% (99% CI 3.9–12.7), 9.3% (99% CI 4.9–16.9) with stent-assisted coiling and 11.5% (99% CI 4.9–24.6) with flow-diverting stents. However, the increase of the complications reported with additional devices can be due to the more-complex aneurysm cases or due to the number and type of devices placed. Furthermore, in the last decade the neuro-interventional procedures have improved their outcomes with increased understanding of the various treatments and technological innovation improving safety and efficacy.
\nEVT emerged in the 1990’s with coiling [62]. Since then, technological advances in coil properties made neuro-interventional procedures safer with improved outcomes. Recently, a single center study reported 0% of poor outcomes when coiling was used [25], however >20% of poor outcomes have been reported after coiling in aneurysms >10 mm size, with wide necks, unfavorable dome-to-neck ratio < 2 and fusiform configuration [63]. So, using coiling alone must be used just in aneurysms with specific characteristics, otherwise new devices must be considered.
\nThis method represents a solution for aneurysms in which coiling alone will not be the best option (mentioned in Figure 1), as coiling this endovascular technique has the same concerns about patient selection, recovery and risks. However, when leaving a stent placed in the artery it is important to manage the tolerance and adherence of the patient to dual anti-platelet therapy (DAPT) (Figure 2)[64].
\nPipeline placement in a wide neck aneurysm in the left vertebral artery.
This method was developed in the 2000s. The concept of Flow Diversion is that a high-mesh density stent placed in the parent artery will disrupts blood flow into the aneurysm with the subsequent thrombosis of the aneurysm, this process takes 6 weeks to 6 months in average in radiographic follow-ups. Moreover, the stent in parent artery provides a scaffold for which endothelium can grow [62]. In 2011, the FDA approved the Pipeline Embolization Device (PED) for large or giant (≥10 mm) wide-necked intracranial aneurysms from the petrous to the superior hypophyseal segments of the ICA [65]. Since then, a second flow diverter stent (Surpass) has come to market. Flow diverter stents now have expanded indications, including smaller aneurysms, and aneurysm up to the internal carotid artery bifurcation. Recently, a multicenter group published a retrospective study of follow-ups after PED placement [66], in this report overall complications were 3.4% and in multivariate analysis older age > 70, larger diameter > 15 mm and fusiform were identified as independent variables with higher rates of incomplete occlusion in 6-month follow-up. However, currently there is not a standardized scale to report radiographic outcomes that can be useful to meta-analysis studies or to new prospective randomized cohorts. Flow diverter stents are currently also limited usually to unruptured aneurysms, given the need for DAPT, however their use has found a niche in the treatment of ruptured blister aneurysms. Consequently, the next generation of this technology is looking into the possibility of special coating to mitigate the need for DAPT. Further investigation is still needed before this advancement will come to market.
\nAlthough flow diversion devices can work out for many types of aneurysms as off-label uses; aneurysms located in bifurcations with wide neck and dome-to-neck ratio > 1 and < 2 remains a challenge for this technology. Therefore, the WEB device was created in regard of these concerns in flow diversion and has proven promising to overcome those limitations. The WEB device is placed intra-aneurysm with a subsequent change in the blood flow at the aneurysm neck [67]. In European multicenter prospective studies, the WEB device placed in basilar, MCA, Acomm and ICA bifurcation showed 2.7% of morbidity and at 1 year of follow-up, 56% of aneurysm complete occlusion [68]. Owing this method does not require to put the patient under DAPT unlike the PED, it can be used also in aSAH cases. Further investigation is needed as to the long-term outcomes for this device (Figures 3 and 4).
\nWeb Endoluminal bridge placement in left ICA bifurcation.
Flowchart of management after incidental UIA diagnosis.
All the patients that can be good candidates for PED placement based on their UIA characteristics needs also to be eligible for prolonged DAPT. Acetylsalicylic acid (ASA) plus clopidogrel is the DAPT of reference used for preventing thrombosis in such procedures [69]. The laboratory tests pre and post-procedure are yet to be standardized; due to the risk of clopidogrel resistant (28–68%) [70], is has been considered necessary to assess platelet reactivity. High platelet reactivity (HPR) is related with thromboembolic evens after stenting arteries [71]. Depending on institutional protocols, some neuro-interventional teams use the VerifyNow P2Y12 assay which has been widely studied however, the results of this tests may not be completely reliable [72] due to the fact that P2Y12 response units (PRU) cannot differentiate aspirin-induced platelet inhibition in patients administered clopidogrel. Other studies recommend the use of the Thromboelastography (TEG), which is dynamic and real time tool to measure clot formation. The advantages of VerifyNow assay is that can be done very fast with instant results, however in patients with programed procedures for UIA stenting this concerning may not be transcendental.
\nVerifyNow can overestimate the rate of clopidogrel resistance when compared to TEG. However, there is currently no randomized trials that have assessed the utility of this tests. Moreover, there’s no strong evidence to support that the assessment of platelet reactivity improves clinical and imaging outcomes after stent placement. Nevertheless, the neuro-interventional teams at these days usually starts the DAPT with 325 mg of ASA and 75 mg of clopidogrel 7 days prior and maintain for 3–6 months after PED placement.
\nA 50-year-old female was preparing her children for school when she experienced a headache severe enough to make her lie down on the sofa. She managed to get the children off to school, but the headache did not abate. She was used to headaches, as she had migraines periodically that were controlled with over-the-counter medications, but this one was different and much more intense. She took a couple of acetaminophen, and when the pain was not relieved, she brought herself to the emergency department (ED) [73].
\nHeadache is seen in up to 2% of patients, presenting to the emergency department (ED). Most are benign, but it is imperative to understand and discern the life-threatening causes of headache when they present. Headache caused by a subarachnoid hematoma (SAH) from a ruptured aneurysm is one of the deadliest, but fortunately, also rare, comprising only 1% of all headaches presenting to the ED [74].
\nRupture is the most serious consequence of intracranial aneurysms. Subarachnoid hemorrhage (SAH) from a leaking aneurysm is a neurological emergency. While SAH is typical of aneurysmal rupture, it is also associated with intraventricular hemorrhage, intracerebral hemorrhage, and subdural hematoma. The force of rupture and location of an aneurysm determine the presence of the other types of hemorrhage. Although the prevalence of aneurysms is high, the global annual incidence of subarachnoid hemorrhage is 10/100,000person years, so the best possible treatment plan would be to determine exactly those aneurysms that will rupture and the ones that never will.
\nThe presenting symptom of SAH is acute headache, generally described as “the worst headache of my life.”
\nSome cohort studies mention it as “thunderclap” headache that peaks at headache onset or reaches severity within minutes to an hour of onset [75].
Signs of meningeal irritation-meningismus, photophobia
Signs of intracranial hypertension-nausea, vomiting, diminished level of consciousness
Epileptic seizures
Focal neurological deficits
Several scoring systems have been developed to predict patient outcomes for those with aneurysm related sub-arachnoid hemorrhage (a-SAH). The Hunt and Hess score and World Federation of Neurological Surgeons grading system are both used to predict patient outcome, and the Fisher grade helps to predict vasospasm [80, 81].
\nThe severity of neurologic impairment and the amount of subarachnoid bleeding on admission are the strongest predictors of neurologic complications and outcome [82]. Therefore, it is essential that patients with SAH be scored promptly after arrival and stabilization. The World Federation of Neurological Surgeons Scale (WFNSS) and the modified Fisher Scale are the most reliable and simple to perform [74, 75]. Higher WFNSS and modified Fisher Scale scores are associated with worse clinical outcome and a higher proportion of neurologic complications. The modified Fisher scale is designed to predict the development of delayed cerebral ischemia (DCI) which is the most common cause of disability secondary to rupture next the actual rupture itself (Tables 1–3).
\nGrade | \nGlasgow coma scale (GCS) | \nNeurological exam | \n
---|---|---|
1 | \n15 | \nNo motor deficit | \n
2 | \n13–14 | \nNo motor deficit | \n
3 | \n13–14 | \nMotor deficit | \n
4 | \n7–12 | \nWith/without motor deficit | \n
5 | \n5–6 | \nWith/without motor deficit | \n
World Federation of Neurological Surgeons Grading System for Subarachnoid Hemorrhage - (WFNS) scale.
Grade | \nCriteria | \nSurvival | \n
---|---|---|
I | \nAsymptomatic, mild headache, slight nuchal rigidity | \n70% | \n
II | \nModerate to severe headache, nuchal rigidity, no neurological deficit other than cranial nerve palsy | \n60% | \n
III | \nDrowsiness/confusion and mild focal neurological deficit | \n50% | \n
IV | \nStupor, moderate to severe hemiparesis | \n20% | \n
V | \nComa, decerebrate positioning | \n10% | \n
Hunt and Hess scale.
Grade | \nAppearance of blood on CT | \nRisk of cerebral hemorrhage | \n
---|---|---|
0 | \nNo sub arachnoid hemorrhage (SAH) or ventricular hemorrhage (VH) | \n0% | \n
1 | \nMinimal SAH, No VH in 2 lateral ventricles | \n6% | \n
2 | \nMinimal SAH, VH in 2 lateral ventricles | \n14% | \n
3 | \nLarge SAH, No VH in 2 lateral ventricles | \n12% | \n
4 | \nLarge SAH, VH in 2 lateral ventricles | \n28% | \n
Modified fisher grading system [82].
With such a large number of patients presenting to the ED with a chief complaint of headache [79, 80, 81, 82, 83, 84], the description of headache can help differentiating those with a benign cause from those with an emergent etiology such as SAH. The diagnosis of SAH should be considered in any patient with a severe and sudden onset or rapidly escalating headache (Figure 5).
\nFlowchart of management aSAH [
Once the patient has been diagnosed with an SAH, treatment should focus on limiting secondary neurologic injuries to improve the patient’s functional outcome.
Resuscitation of a patient with SAH should follow all established protocols with immediate attention to airway and circulatory support.
After stabilization of the airway and circulation, treatments specific to SAH can begin.
In patients with a suspected ruptured aneurysm, seizures can lead to aneurysmal rebleeding and result in intracranial hypertension and herniation, the risk of being highest in patients with poor Hunt and Hess grade and those with thick subarachnoid blood [85]. Routine prophylactic antiepileptic drug use in patients with SAH is a common practice despite limited evidence The American Stroke Association (ASA) guideline recommends consideration of short-term prophylactic antiepileptic drug use in the immediate post hemorrhage period [86]. No randomized controlled trials have investigated the safety and effectiveness of antiepileptic drugs in SAH [87].
\nDelayed cerebral ischemia (DCI) is one of the most serious complications associated with SAH, occurring in one-third of patients surviving the initial hemorrhage and results in poor outcome in half of the patients with this complication [86]. Nimodipine is a calcium antagonist that is thought to reduce the rate of cerebral vasospasm by reducing the influx of calcium into the vascular smooth muscle cells. The administration of nimodipine to reduce the risk of poor outcome and DCI is the only level IA evidence recommended by the ASA [86].
\nThere is general consensus that hypertension should be controlled after SAH and until the ruptured aneurysm is secured. However, specific parameters for blood pressure have not been defined and data are sparse. Early retrospective studies suggest a higher rate of rebleeding with SBP greater than 160 mm Hg and severity of initial hemorrhage [88]. Therefore, the ASA and Neurocritical Care Society recommend maintaining SBP less than 160 mm Hg and mean arterial pressure less than 110 mm Hg before the ruptured aneurysm is secured to reduce the risk of rebleeding [86, 87, 89, 90]. The ideal antihypertensive to use in SAH would be a parenteral agent that produces a rapid and reproducible dose response while concurrently minimizing adverse cerebral effects. Labetalol, nicardipine, and clevidipine are agents recommended by the ASA [86].
\nWhen early definitive treatment of the ruptured aneurysm is not possible, antifibrinolytic therapies such as amino epsilon caproic acid or tranexamic acid can be considered to reduce the risk of early aneurysmal rebleeding. Early studies showed a reduction in rebleeding but an increase in cerebral ischemia with prolonged use of antifibrinolytics [88]. Neither aminocaproic acid or tranexamic acid is approved by the US Food and Drug Administration for prevention of aneurysmal rebleeding, thus the use of antifibrinolytic therapies should be discussed on a case-by-case basis.
\nRebleeding can occur before the ruptured aneurysm is secured, and is associated with significant mortality and poor prognosis for functional recovery, most common within the first 24 hours, with some studies reporting peak time of rebleeding within 2 hours [88]. Factors associated with rebleeding include longer time to aneurysm treatment, worse neurologic status on presentation, initial loss of consciousness, previous sentinel headaches, larger aneurysm size, and possibly SBP greater than 160 mm Hg [91]. Although early definitive treatment of ruptured aneurysms can reduce the risk of rebleeding, approximately 12–15% of patients die before reaching the hospital [90].
\nAcute hydrocephalus is common in patients with SAH and is a common cause of early neurologic decline. Treatment of symptomatic hydrocephalus often requires placement of an external ventricular drain, which allows ICP monitoring as well as CSF drainage. Untreated hydrocephalus can lead to intracranial hypertension and cerebral ischemia with potential cerebral herniation. Identification of the presence of hydrocephalus on CT and communication of this finding with neurosurgical consultants are key steps in the management of SAH.
\nDefinitive treatment of SAH is early microsurgical clipping or endovascular coiling of the ruptured aneurysm to prevent rebleeding and its associated complications. Choice of treatment modality depends on aneurysm size, characteristics, and location, as well as the patient’s clinical grade and comorbidities [92]. The International Subarachnoid Aneurysm Trial (ISAT) [93] is a multicenter, randomized clinical trial, which compares a policy of neurosurgical clipping with a policy of endovascular treatment with detachable platinum coils in patients with ruptured intracranial aneurysms considered suitable for either treatment. The results show that endovascular intervention with detachable platinum coils in patients with ruptured intracranial aneurysms can improve the chances of independent survival compared with neurosurgical intervention to clip the neck of the aneurysm.
\nThe PED has mostly been used to treat unruptured aneurysms, whereas its use for acutely ruptured aneurysms has been limited and is theoretically contraindicated, given the need for dual antiplatelet therapy as it increases the risk of re-hemorrhage [94].
\nHowever, in certain cases of complex ruptured aneurysms, the PED may still serve as a good alternative (and sometimes may be the only available option) because these aneurysms are anatomically and technically more difficult to treat using standard techniques [93]. Furthermore, certain anticoagulation protocols can be put into place to prevent the feared consequences associated with PED placement in ruptured aneurysms due to dual antiplatelet therapy. The standard management for the prevention of thromboembolic events when using flow diverters is pretreatment with aspirin and clopidogrel for 7–10 days prior to the procedure. When treating ruptured aneurysms with the PED in conjunction with this dual antiplatelet therapy, there is a concern for hemorrhagic complications. Chalouhi and colleagues [95] described a new regimen for anticoagulation that was recently implemented in the hope of minimizing the risk of thromboembolic and hemorrhagic complications. In summary, the PED may be particularly helpful in acutely ruptured aneurysms that are not amenable to coiling or clipping. It can also be used in a staged fashion 1 or 2 weeks after partial coiling of the aneurysm dome. It is generally preferable to place an external ventricular drain if treatment with the PED is contemplated [96].
\nThe future of neuroendovascular surgery is bright. The technology platforms for access, delivery and treatment continue to improve at exponential rates. As it is there has been a rapid change in the number of brain aneurysm patients treated with endovascular treatment versus open surgical clipping. With this change comes a great void in experience and skill in the open surgical management of brain aneurysms. It remains to be seen whether this skill will be needed in the future [97].
\nCurrently there is only one flow disruptor available in the US market; the WEB device. Currently, its limitations lie in the fact that it is only available in sizes to treat aneurysms 3–10 mm in size. The second limitation exists in its delivery system which, at larger sizes requires a 33-microcatheter, and at smallest sizes requires a 21-microcatheter. As newer generations come to market over the next 5 years, we expect there to be improved deliverability, different shapes available, and smaller designs for smaller ruptured aneurysms [98].
\nCurrently there are two flow diverter stents available in the US Market, the Pipeline Flex (2nd generation), and the Surpass. Currently the bulk of innovation required with this technology is in finding a coating for the stent that might mitigate the need for dual anti-platelet therapy. The second area of innovation is in the deliverability of the stents, currently needing 27-microcatheter for delivery, there is an expectation that these stents can be delivered through a 21-microcatheter in the near future, with also smaller diameter stent sizes available to treat more distal aneurysms. We fully expect the indications on which type of aneurysms can be treated in the near future.
\nCoiling has likely reached its technological pinnacle. There has been little advancement in this technology over the last 5 years. One area of interest is in endosaccular flow disruptor type coils such as the Medina system. This is not as of yet FDA approved and remains to be seen whether this is efficacious or safe. Also the adjunctive tools for coiling continue to improve such as the Atlas stent, Pulserider stent and barrel stent which all are improvements for the treatment of bifurcation aneurysms and make difficult to coil aneurysms easier. We expect further improvements in these designs, and with improvements in deliverability. In addition to stents, the balloons available for balloon assisted coiling continue to improve in shape, design and deliverability which are particularly helpful in the setting of a ruptured small or wide necked aneurysm [99].
\nCurrently other than aneurysm size, and certain bio-social risk factors, there is no way to accurately predict which aneurysms are at risk for rupture. Over the next 5 years we expect to see, further advancement in the arena of MR vessel wall imaging, and flow-modeling. We hope that this will help improve our predictive models.
\nSexually transmitted diseases (STDs), often known as “venereal diseases,” are among the most contagious diseases and are caused by a variety of microorganisms that differ in symptomology, size, life cycle, and treatment susceptibility. Bacteria, viruses, fungi, and protozoa are indeed the pathogens of STDs [1, 2].
These germs can spread from one person to another through blood, sperm, vaginal, and other physiological fluids. As a result, sexually transmitted infections (STIs) are passed from one person to the next by close physical contact, primarily but not solely through sexual intercourse. Ejaculation does not have to occur for STIs to be transmitted from person to person [1, 3].
Nonsexual transmission of these infections happens often from mother to newborn during pregnancy and childbirth, through blood transfusions, and through the sharing of unsterilized needles. Any sexually active individual should discuss his or her risk factors for STIs with health professionals and ask to get a test because anyone may have an STI even without showing any symptoms [1].
Although some infections, including meningitis, can be transmitted through sexual contact, they are not considered STDs because the germs that cause meningitis can already be found in the body or in the environment, and people can get the disease for a variety of reasons [1, 2].
The prevalence of STDs remains high in poor nations, with emerging countries bearing a disproportionate share of the burden. The World Health Organization (WHO) estimates that 374 million new infections with one of four STIs will occur in 2020, which indicates that there are almost 1 million STIs acquired every day. The most prevalent STI is Chlamydia, which accounts for 129 million new infections each year. Gonorrhea has 82 million new infections per year, and syphilis has 42 million new infections annually [3].
Common bacterial STIs may affect the anorectum and perianal skin. Some of these infections are a result of the contiguous spread of sexual intercourse. Worldwide, the incidence of bacterial STIs has shown a gradual increase in recent years. The fast spread of these infections may be due to their varied clinical presentation, which includes pharyngeal, rectal, and urogenital involvement, as well as a significant number of asymptomatic cases [4, 5].
The symptoms of STIs differ between individuals depending on the causative pathogens, and commonly, many people may not experience any symptoms at all. Immediate initiation of STIs treatment is important to minimize the long-term complications of STIs and also prevent the transmission of infections to other people. Common bacterial sexually transmitted diseases are Chlamydia, gonorrhea, and syphilis [1].
The infection is more likely transmitted during unprotected sexual intercourse through vaginal, anal, or oral sex with someone with the infection, even though semen does not have STI pathogens to transmit the infection from person to person. Women can get Chlamydia in the cervix, rectum, and throat. Men can get Chlamydia in the urethra, rectum, and throat [6, 7, 8]. During childbirth, chlamydial infection is also passed from mother to baby [9, 10].
For behavioral, biological, and cultural reasons, sexually active young individuals are at high risk of getting chlamydial infection. Multiple abnormalities can result from C. trachomatis infection in women including pelvic inflammatory diseases (PIDs), ectopic pregnancy, and infertility. Sometimes women receiving a diagnosis of uncomplicated cervical infection may have asymptomatic upper genital tract infection [6].
Chlamydial infection is commonly asymptomatic both in women and men. Health sector institutions frequently rely on screening tests for all sexually active women aged <25 years, and recommended annual screening for high risky individuals (women aged ≥25 years who have more than one sex partner, a new sex partner, or a sex partner who has an STIs) to detect chlamydial infection [2].
Chlamydia is a global public health problem that is the leading bacterial sexually transmitted infection in developed and undeveloped countries.
Even though evidences are insufficient to recommend routine screening for C. trachomatis among sexually active young men because of different factors (i.e., efficacy, feasibility, and cost-effectiveness), where there are clinical settings with a high prevalence of Chlamydia sexually active young men should be screened. The primary focus of women diagnosed with Chlamydia infection should be to detect and treat the infection, prevent complications, and to treat their partners, whereas men should be screened for Chlamydia only when resources permit and prevalence is high [2].
No genital symptoms are specifically correlated with chlamydial cervical infection. But over 70% of men experience symptoms, such as urethral discharge, penile discomfort, and dysuria, which may cause serious complications that result in irreversible damage, including infertility [13].
Chlamydial infection may cause induced endocervical bleeding and mucopurulent endocervical discharge. The observation of purulent yellow or greenish cervical discharge on a cervical swab is associated with the presence of chlamydial infection [14]. When a woman does not receive treatment; Chlamydia can spread into the uterus or fallopian tubes, causing PIDs, which occur in about 10–15% of women [6, 15, 16]. In young, sexually active men, about 70% of acute epididymitis appears to be attributable to chlamydial infection [17].
Since chlamydial infections may not have specific symptoms and are often indistinguishable, laboratory diagnosis is necessary to identify the correct etiology; the cell culture, and nucleic acid amplification tests (NAATs) were the gold standard tests for detection for years. Cell culture is the most sensitive test to use on easy-to-obtain specimens [10, 13].
The other most widely used diagnostic methods are the direct fluorescent antibody (DFA) and enzyme immunoassay (EIA) tests. Polymerase chain reaction (PCR) in the diagnosis of chlamydial infection has also been a gold standard [18]. Chlamydial trachomatis infection can be diagnosed by cervical or vaginal swabs or first-void urine for women, and for men can be diagnosed by testing a urethral swab or first-void urine similar to women [2].
Chlamydia can be cured easily with antibiotic medications. Although medical treatment will cure the infection, the disease will not repair any long-term damage alone. To prevent spreading the infection to sex partners, patients starting single-dose antibiotic therapy should not have sex until the treatment is completed [6]. In some cases, chlamydial infection recurs 3–6 weeks after treatment [19].
Adolescent and adult chlamydial infection treatment regimen: doxycycline 100 mg orally two times/day for 7 days; alternatively; azithromycin 1 g orally in a single-dose or levofloxacin 500 mg orally once daily for 7 days are recommended.
Azithromycin 1 g orally in a single dose is recommended for chlamydial infection during pregnancy or amoxicillin 500 mg orally three times per day for 7 days.
The following is the recommended treatment regimen for neonatal chlamydial infection: Erythromycin base or ethyl succinate 50 mg/kg body weight per day, divided into four doses per day for 14 days
For pregnant women with chlamydial infection, a single dose of azithromycin 1 g orally is recommended, and alternatively amoxicillin 500 mg orally three times a day for 7 days [2].
An individual treated for Chlamydia infection should be instructed to abstain from sexual intercourse for 7 days after single-dose therapy to minimize disease transmission to their sexual partners. To minimize the risk of reinfection, an infected person should abstain from sexual intercourse until all of their sex partners have been treated.
Multiple coinfections may happen when a person receives a diagnosis of Chlamydia infection and should be tested for human immunodeficiency virus
Gonorrhea is an STD that is caused by the bacterium
It can cause infections in the genitals, rectum, and throat, which affect young people ages 15–24 years. Men who experience symptomatic urethral infections may seek curative therapy, whereas women frequently experience asymptomatic infections caused by
Gonorrhea can spread by having sexual contact with an infected person, and from mother to child during childbirth. Gonorrhea is the second commonly reported bacterial sexually transmitted diseases, and the incidence of new cases of gonorrhea is especially high in developing countries, which can produce symptoms in men that cause them to seek curative treatment to prevent complications [22, 23].
Annual screening for
Gonorrhea may have no symptoms, but some men may have a burning sensation when urinating; white, yellow, or green discharge from the penis; painful or swollen testicles, and some women may often have a painful or burning sensation when urinating; increased vaginal discharge/vaginal bleeding, which may have a risk of developing serious complications [24].
If gonorrhea is not appropriately treated, it can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy. Pregnant women can pass the gonorrheal infection to their babies during childbirth, and the newborn can become blind or have life-threatening infections as a result [21].
Anorectal gonococcal infection shows a thick purulent discharge that is expressed from the anal crypts in response to external anal pressure. Nonspecific findings of mucosal erythema, edema, friability, and pus are noted in infected individuals with proctitis from rectal infection [4].
Specific microbiologic diagnosis of
The standard diagnostic procedure for men with symptomatic urethritis is the gram stain, because of its high specificity and sensitivity. However, in asymptomatic men or women with genital infections, the Gram stain is less useful because of its lower sensitivity. Gram stain of endocervical specimens, pharyngeal specimens, or rectal specimens is not sufficient to detect infection and therefore is not recommended [25].
The result of cultural diagnosis may be reduced if lubricants with antibacterial agents are used during anoscopy, which makes water a recommended lubricant in this setting. There are no approved nucleic acid amplification tests for rectal infection, while nonculture techniques are gaining acceptance in genital gonococcal infections [26].
Certain NAATs that have been demonstrated to detect Neisseria species might have low specificity when diagnosing oropharyngeal specimens for
Gonorrhea treatment is complicated by the ability of
Many of the previously recommended therapies are no longer effective, which makes treatment opportunities for
Recommendation regimen for gonorrheal infection of the pharynx, cervix, urethra, or rectum that is not complicated. If chlamydial infection has not been ruled out, treat for 7 days with doxycycline 100 mg orally twice a day.
Alternative regimens if ceftriaxone is not available; gentamicin 240 mg IM in a single-dose, plus azithromycin 2 g orally in a single dose, or cefixime 800 mg orally in a single-dose [2].
Gonorrhea treatment may be complicated by the ability of
Syphilis is one of the most prevalent bacterial STDs caused by the
It is a contagious disease that can cause serious health problems, such as arthritis, brain damage, dementia, and blindness, and may lead to death if left untreated. Syphilis is often difficult to diagnose, and the patient may not have any symptoms for years [1].
Syphilis infection is divided into four stages with different symptoms that appear in the patient. The symptoms and signs associated with each stage may overlap each other, and symptoms may not appear in order. Some patients have not had any symptoms for years. After the initial infection, the bacterium
The infection is highly contagious during this stage. The symptoms at this stage will go away when the treatment is initiated. Without the right treatment, the infection will move to the latent and tertiary stages of syphilis [1, 5, 29]. The majority of untreated symptoms of syphilis spontaneously resolve after 12 weeks. One-fourth of these untreated patients will experience early latent syphilis [4].
Dark field microscopic examinations and molecular tests for detecting
A nontreponemal test (i.e., venereal disease research laboratory [VDRL] or rapid plasma reagin [RPR] test) and a treponemal test (
For adults and adolescents with primary, secondary, or early latent syphilis; benzathine penicillin (G 2.4 million units) is administered intramuscularly in a single dose.
For adults and adolescents with late latent syphilis or latent syphilis of unknown duration; benzathine penicillin G 7.2 million units total, administered as three doses of 2.4 million units each administered intramuscularly at weekly intervals.
For neurosyphilis, ocular syphilis, or otosyphilis; aqueous crystalline penicillin G 18–24 million units per day, administered as 3–4 million units intravenously every 4 hours or continuous infusion for 10–14 days [2, 32].
All individuals who have primary and secondary syphilis are encouraged to take an HIV test at the time of diagnosis and treatment and recommended to offered HIV PrEP for negative HIV test results. Persons who have symptomatic neurologic syphilis disease should have an evaluation that includes cerebral spinal fluid analysis and individuals with syphilis who have symptoms of ocular syphilis should have cranial nerve and ophthalmologic examinations [2].
Clinical and serologic investigations should be needed within 12 months of treatment; if conditions for follow-up are uncertain more frequent evaluation might be prudent. Assessing serologic response to treatment can be difficult, and definitive criteria for evaluating treatment outcomes by serologic criteria have not been well established [33].
In addition, nontreponemal test titers might decrease more slowly for persons previously treated for syphilis. Among individuals with neurologic findings without any reported sexual exposure during the previous 3–6 months indicating that treatment failure might be possible, a cerebral spinal fluid examination is recommended, and should also be reevaluated for HIV infection [34].
The authors declare no conflict of interest.
CNS | Central Nervous System |
CIAs | Chemiluminescence Immunoassays |
DFA | Direct Fluorescent Antibody |
EIA | Enzyme Immunoassay |
LGV | Nonlymphogranuloma Venereum |
NAATs | Nucleic acid amplification tests |
RPR | Rapid Plasma Regain |
STDs | Sexually Transmitted Diseases |
STIs | Sexually Transmitted Infections |
TP-PA | Treponema Pallidum Passive Particle Agglutination |
VDRL | Venereal Disease Research Laboratory |
WHO | World Health Organization |
Ove Odredbe i uvjeti ističu pravila i regulacije u svezi korištenja IntechOpenove stranice www.intechopen.com i svih poddomena u vlasništvu IntechOpena, tvrtke sa sjedištem u 5 Princes Gate Court, London, SW7 2QJ, Ujedinjeno Kraljevstvo.
',metaTitle:"Odredbe i uvjeti",metaDescription:"Ove Odredbe i uvjeti ističu pravila i regulacije u svezi korištenja IntechOpenove stranice www.intechopen.com i svih poddomena u vlasništvu IntechOpena, tvrtke sa sjedištem u 5 Princes Gate Court, London, SW7 2QJ, Ujedinjeno Kraljevstvo.",metaKeywords:null,canonicalURL:"/page/cro-terms-and-conditions",contentRaw:'[{"type":"htmlEditorComponent","content":"Pristupom na stranicu www.intechopen.com slažete se s ovim odredbama, sa svim primjenjivim zakonskim odredbama, te se slažete s poštovanjem svih lokalnih zakona. Korištenje i/ili pristup ovoj stranici temelji se na potpunom prihvaćanju ovih odredbi. Svi materijali na ovoj stranici zaštićeni su primjenjivim zakonima o autorskim pravima i žigu.
\\n\\nSljedeća terminologija odnosi se na Odredbe i uvjete, te na sve naše ugovore:
\\n\\nKlijent, stranka, vi, vaš odnosi se na vas, osobu koja pristupa ovoj stranici i prihvaća IntechOpenove Odredbe i uvjete;
\\n\\nKompanija, tvrtka, mi, naše odnosi se na tvrtku IntechOpen;
\\n\\nStranke, strane odnosi se na klijenta i na nas, ili samo na klijenta ili nas.
\\n\\nSve odredbe koje se odnose na ponudu, prihvat ili razmatranje plaćanja, a za koja mi pružamo asistenciju klijentu, bilo na ugovoreni ili fiksni način, a s ciljem da se ostvare potrebe i želje klijenta u svezi s našim uslugama, su podložne zakonskim odredbama Ujedinjenog Kraljevstva.
\\n\\nOsim ako nije suprotno navedeno, IntechOpen i/ili svi davatelji licence vlasnici su intelektualnog vlasništva nad svim materijalima na www.intechopen.com. Sva prava intelektualnog vlasništva su pridržana. Stranice sa www.intechopen.com možete gledati, preuzimati, dijeliti, dijeliti poveznice i printati za osobnu uporabu, a temeljem pravila sadržanih u ovim Odredbama i uvjetima.
\\n\\nMi koristimo kolačiće. Korištenjem IntechOpenove stranice slažete se s korištenjem kolačića u skladu s IntechOpenovom Politikom privatnosti. Većina modernih, interaktivnih stranica koristi kolačiće kako bi omogućila ponovno pronalaženje korisničkih detalja kod svakog posjeta. Na našoj stranici kolačići se uglavnom koriste kako bi omogućili funkcionalnost i olakšali posjetiteljima korištenje stranice.
\\n\\nIntechOpen ili njegovi suradnici niti u jednom slučaju neće biti odgovorni za štete (štete uključuju gubitak podataka ili profita, druge poslovne prekide, te sve ostale štete) koje nastanu zbog korištenja materijala na IntechOpenovoj stranici ili nemogućnosti da se iste koriste, čak i ako je IntechOpen ili njegov predstavnik o takvoj šteti obaviješten pismenim ili usmenim putem. Neke jurisdikcije ne dozvoljavaju ograničenja garancija ili ograničenja obveza za posljedične ili slučajne štete pa se u tom slučaju ova ograničenja možda ne odnose na vas.
\\n\\nMaterijali koji se pojavljuju na IntechOpenovoj stranici mogu sadržavati manje greške, tipfelere ili fotografske greške. IntechOpen može napraviti promjene na bilo kojem materijalu koji se nalazi na stranici u bilo koje vrijeme.
\\n\\nIntechOpen nije formalno povezan niti s jednom vanjskom stranicom čije poveznice vode na www.intechopen.com, osim ako to nije izravno navedeno. Iz tog razloga IntechOpen nije odgovoran za sadržaj koji se pojavljuje na takvim stranicama. Poveznica na IntechOpenovu stranicu ne implicira povezanost sa IntechOpenom. Korištenje takvih poveznica isključiva je odgovornost korisnika.
\\n\\nZadržavamo pravo vlasništva nad cjelokupnom stranicom www.intechopen.com i nad svim materijalom na toj stranici. Koristeći se našim uslugama, slažete se da maknete sve poveznice na našu stranicu odmah nakon što to od vas zatražimo. Također, zadržavamo pravo da ove Odredbe i uvjete, i politiku o poveznicama izmjenimo u bilo koje vrijeme. Koristeći se poveznicama na naše stranice slažete se s ovim Odredbama i uvjetima.
\\n\\nAko smatrate da je bilo koja poveznica na našoj stranici sumnjiva iz bilo kojeg razloga, molimo vas da nas kontaktirate. U tom slučaju razmotrit ćemo micanje poveznice s naše stranice, iako nismo obvezni to napraviti.
\\n\\nBez prethodne privole i izričite pisane dozvole, ne možete stvarati okvire oko naših stranica ili koristiti druge tehnike koje na bilo koji način mogu promijeniti prezentaciju ili izgled naše stranice.
\\n\\nIntechOpen može ove Odredbe izmijeniti u bilo koje vrijeme i bez prethodne obavijesti. Koristeći ovu stranicu vi se slažete s trenutnim Odredbama i uvjetima koje su na snazi.
\\n\\nOve Odredbe i uvjeti su sastavljeni u skladu s odredbama prava Ujedinjenog Kraljevstva, a za sve sporove nadležan je sud u Londonu, Ujedinjeno Kraljevstvo.
\\n"}]'},components:[{type:"htmlEditorComponent",content:"Pristupom na stranicu www.intechopen.com slažete se s ovim odredbama, sa svim primjenjivim zakonskim odredbama, te se slažete s poštovanjem svih lokalnih zakona. Korištenje i/ili pristup ovoj stranici temelji se na potpunom prihvaćanju ovih odredbi. Svi materijali na ovoj stranici zaštićeni su primjenjivim zakonima o autorskim pravima i žigu.
\n\nSljedeća terminologija odnosi se na Odredbe i uvjete, te na sve naše ugovore:
\n\nKlijent, stranka, vi, vaš odnosi se na vas, osobu koja pristupa ovoj stranici i prihvaća IntechOpenove Odredbe i uvjete;
\n\nKompanija, tvrtka, mi, naše odnosi se na tvrtku IntechOpen;
\n\nStranke, strane odnosi se na klijenta i na nas, ili samo na klijenta ili nas.
\n\nSve odredbe koje se odnose na ponudu, prihvat ili razmatranje plaćanja, a za koja mi pružamo asistenciju klijentu, bilo na ugovoreni ili fiksni način, a s ciljem da se ostvare potrebe i želje klijenta u svezi s našim uslugama, su podložne zakonskim odredbama Ujedinjenog Kraljevstva.
\n\nOsim ako nije suprotno navedeno, IntechOpen i/ili svi davatelji licence vlasnici su intelektualnog vlasništva nad svim materijalima na www.intechopen.com. Sva prava intelektualnog vlasništva su pridržana. Stranice sa www.intechopen.com možete gledati, preuzimati, dijeliti, dijeliti poveznice i printati za osobnu uporabu, a temeljem pravila sadržanih u ovim Odredbama i uvjetima.
\n\nMi koristimo kolačiće. Korištenjem IntechOpenove stranice slažete se s korištenjem kolačića u skladu s IntechOpenovom Politikom privatnosti. Većina modernih, interaktivnih stranica koristi kolačiće kako bi omogućila ponovno pronalaženje korisničkih detalja kod svakog posjeta. Na našoj stranici kolačići se uglavnom koriste kako bi omogućili funkcionalnost i olakšali posjetiteljima korištenje stranice.
\n\nIntechOpen ili njegovi suradnici niti u jednom slučaju neće biti odgovorni za štete (štete uključuju gubitak podataka ili profita, druge poslovne prekide, te sve ostale štete) koje nastanu zbog korištenja materijala na IntechOpenovoj stranici ili nemogućnosti da se iste koriste, čak i ako je IntechOpen ili njegov predstavnik o takvoj šteti obaviješten pismenim ili usmenim putem. Neke jurisdikcije ne dozvoljavaju ograničenja garancija ili ograničenja obveza za posljedične ili slučajne štete pa se u tom slučaju ova ograničenja možda ne odnose na vas.
\n\nMaterijali koji se pojavljuju na IntechOpenovoj stranici mogu sadržavati manje greške, tipfelere ili fotografske greške. IntechOpen može napraviti promjene na bilo kojem materijalu koji se nalazi na stranici u bilo koje vrijeme.
\n\nIntechOpen nije formalno povezan niti s jednom vanjskom stranicom čije poveznice vode na www.intechopen.com, osim ako to nije izravno navedeno. Iz tog razloga IntechOpen nije odgovoran za sadržaj koji se pojavljuje na takvim stranicama. Poveznica na IntechOpenovu stranicu ne implicira povezanost sa IntechOpenom. Korištenje takvih poveznica isključiva je odgovornost korisnika.
\n\nZadržavamo pravo vlasništva nad cjelokupnom stranicom www.intechopen.com i nad svim materijalom na toj stranici. Koristeći se našim uslugama, slažete se da maknete sve poveznice na našu stranicu odmah nakon što to od vas zatražimo. Također, zadržavamo pravo da ove Odredbe i uvjete, i politiku o poveznicama izmjenimo u bilo koje vrijeme. Koristeći se poveznicama na naše stranice slažete se s ovim Odredbama i uvjetima.
\n\nAko smatrate da je bilo koja poveznica na našoj stranici sumnjiva iz bilo kojeg razloga, molimo vas da nas kontaktirate. U tom slučaju razmotrit ćemo micanje poveznice s naše stranice, iako nismo obvezni to napraviti.
\n\nBez prethodne privole i izričite pisane dozvole, ne možete stvarati okvire oko naših stranica ili koristiti druge tehnike koje na bilo koji način mogu promijeniti prezentaciju ili izgled naše stranice.
\n\nIntechOpen može ove Odredbe izmijeniti u bilo koje vrijeme i bez prethodne obavijesti. Koristeći ovu stranicu vi se slažete s trenutnim Odredbama i uvjetima koje su na snazi.
\n\nOve Odredbe i uvjeti su sastavljeni u skladu s odredbama prava Ujedinjenog Kraljevstva, a za sve sporove nadležan je sud u Londonu, Ujedinjeno Kraljevstvo.
\n"}]},successStories:{items:[]},authorsAndEditors:{filterParams:{},profiles:[{id:"396",title:"Dr.",name:"Vedran",middleName:null,surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/396/images/7281_n.png",biography:"After obtaining his Master's degree in Mechanical Engineering he continued his education at the Vienna University of Technology where he obtained his PhD degree in 2004. He worked as a researcher at the Automation and Control Institute, Faculty of Electrical Engineering, Vienna University of Technology until 2008. His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. He has contributed in stochastic estimation of control area especially, in the Multiple Target Tracking and Interactive Multiple Model (IMM) research, Ball & Beam Control Problem, Robotics, Levitation Control. He has contributed in developing Algorithms for Fingerprint Matching, Computer Vision and Face Recognition. He has been supervising Pattern Recognition, Formal Languages and Distributed Processing projects for several years. He has reviewed many books on Management, Computer Science. Currently, he is an active and permanent reviewer for many international conferences and symposia and the program committee member for many international conferences.\nIn teaching he has taught the core computer science subjects like, Digital Design, Real Time Embedded System Programming, Operating Systems, Software Engineering, Data Structures, Databases, Compiler Construction. In the Engineering side, Digital Signal Processing, Computer Architecture, Electronics Devices, Digital Filtering and Engineering Management.\nApart from his Academic Interest and activities he loves sport especially, Cricket, Football, Snooker and Squash. He plays cricket for Esbjerg city in the second division team as an opener wicket keeper batsman. He is a very good player of squash but has not played squash since his arrival in Denmark.",institutionString:null,institution:null},{id:"611",title:"Prof.",name:"T",middleName:null,surname:"Nagarajan",slug:"t-nagarajan",fullName:"T Nagarajan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universiti Teknologi Petronas",country:{name:"Malaysia"}}}],filtersByRegion:[{group:"region",caption:"North America",value:1,count:13389},{group:"region",caption:"Middle and South America",value:2,count:11662},{group:"region",caption:"Africa",value:3,count:4168},{group:"region",caption:"Asia",value:4,count:22333},{group:"region",caption:"Australia and Oceania",value:5,count:2019},{group:"region",caption:"Europe",value:6,count:33644}],offset:12,limit:12,total:135278},chapterEmbeded:{data:{}},editorApplication:{success:null,errors:{}},ofsBooks:{filterParams:{hasNoEditors:"0",sort:"dateEndThirdStepPublish",topicId:"161925"},books:[],filtersByTopic:[{group:"topic",caption:"Agricultural and Biological Sciences",value:5,count:22},{group:"topic",caption:"Biochemistry, Genetics and Molecular Biology",value:6,count:6},{group:"topic",caption:"Business, Management and Economics",value:7,count:4},{group:"topic",caption:"Chemistry",value:8,count:15},{group:"topic",caption:"Computer and Information Science",value:9,count:18},{group:"topic",caption:"Earth and Planetary Sciences",value:10,count:8},{group:"topic",caption:"Engineering",value:11,count:37},{group:"topic",caption:"Environmental Sciences",value:12,count:5},{group:"topic",caption:"Immunology and Microbiology",value:13,count:8},{group:"topic",caption:"Materials Science",value:14,count:15},{group:"topic",caption:"Mathematics",value:15,count:8},{group:"topic",caption:"Medicine",value:16,count:61},{group:"topic",caption:"Nanotechnology and Nanomaterials",value:17,count:2},{group:"topic",caption:"Neuroscience",value:18,count:2},{group:"topic",caption:"Pharmacology, Toxicology and Pharmaceutical Science",value:19,count:7},{group:"topic",caption:"Physics",value:20,count:5},{group:"topic",caption:"Psychology",value:21,count:5},{group:"topic",caption:"Robotics",value:22,count:2},{group:"topic",caption:"Social Sciences",value:23,count:8},{group:"topic",caption:"Veterinary Medicine and Science",value:25,count:2}],offset:12,limit:12,total:0},popularBooks:{featuredBooks:[{type:"book",id:"7827",title:"Interpersonal Relationships",subtitle:null,isOpenForSubmission:!1,hash:"ebf41f4d17c75010eb3294cc8cac3d47",slug:"interpersonal-relationships",bookSignature:"Martha Peaslee Levine",coverURL:"https://cdn.intechopen.com/books/images_new/7827.jpg",editors:[{id:"186919",title:"Dr.",name:"Martha",middleName:null,surname:"Peaslee Levine",slug:"martha-peaslee-levine",fullName:"Martha Peaslee Levine"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10808",title:"Current Concepts in Dental Implantology",subtitle:"From Science to Clinical Research",isOpenForSubmission:!1,hash:"4af8830e463f89c57515c2da2b9777b0",slug:"current-concepts-in-dental-implantology-from-science-to-clinical-research",bookSignature:"Dragana Gabrić and Marko Vuletić",coverURL:"https://cdn.intechopen.com/books/images_new/10808.jpg",editors:[{id:"26946",title:"Prof.",name:"Dragana",middleName:null,surname:"Gabrić",slug:"dragana-gabric",fullName:"Dragana Gabrić"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10796",title:"Extracellular Vesicles",subtitle:"Role in Diseases, Pathogenesis and Therapy",isOpenForSubmission:!1,hash:"eb5407fcf93baff7bca3fae5640153a2",slug:"extracellular-vesicles-role-in-diseases-pathogenesis-and-therapy",bookSignature:"Manash K. Paul",coverURL:"https://cdn.intechopen.com/books/images_new/10796.jpg",editors:[{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10908",title:"Advances in Decision Making",subtitle:null,isOpenForSubmission:!1,hash:"126486f7f91e18e2e3539a32c38be7b1",slug:"advances-in-decision-making",bookSignature:"Fausto Pedro García Márquez",coverURL:"https://cdn.intechopen.com/books/images_new/10908.jpg",editors:[{id:"22844",title:"Prof.",name:"Fausto Pedro",middleName:null,surname:"García Márquez",slug:"fausto-pedro-garcia-marquez",fullName:"Fausto Pedro García Márquez"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"95",title:"Applications and Experiences of Quality Control",subtitle:null,isOpenForSubmission:!1,hash:"4bcb22b1eee68210a977a97d5a0f363a",slug:"applications-and-experiences-of-quality-control",bookSignature:"Ognyan Ivanov",coverURL:"https://cdn.intechopen.com/books/images_new/95.jpg",editors:[{id:"22230",title:"Prof.",name:"Ognyan",middleName:null,surname:"Ivanov",slug:"ognyan-ivanov",fullName:"Ognyan Ivanov"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"2160",title:"MATLAB",subtitle:"A Fundamental Tool for Scientific Computing and Engineering Applications - Volume 1",isOpenForSubmission:!1,hash:"dd9c658341fbd264ed4f8d9e6aa8ca29",slug:"matlab-a-fundamental-tool-for-scientific-computing-and-engineering-applications-volume-1",bookSignature:"Vasilios N. Katsikis",coverURL:"https://cdn.intechopen.com/books/images_new/2160.jpg",editors:[{id:"12289",title:"Prof.",name:"Vasilios",middleName:"N.",surname:"Katsikis",slug:"vasilios-katsikis",fullName:"Vasilios Katsikis"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"3560",title:"Advances in Landscape Architecture",subtitle:null,isOpenForSubmission:!1,hash:"a20614517ec5f7e91188fe8e42832138",slug:"advances-in-landscape-architecture",bookSignature:"Murat Özyavuz",coverURL:"https://cdn.intechopen.com/books/images_new/3560.jpg",editors:[{id:"93073",title:"Dr.",name:"Murat",middleName:null,surname:"Ozyavuz",slug:"murat-ozyavuz",fullName:"Murat Ozyavuz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10739",title:"Global Decline of Insects",subtitle:null,isOpenForSubmission:!1,hash:"543783652b9092962a8fa4bed38eeb17",slug:"global-decline-of-insects",bookSignature:"Hamadttu Abdel Farag El-Shafie",coverURL:"https://cdn.intechopen.com/books/images_new/10739.jpg",editors:[{id:"192142",title:"Dr.",name:"Hamadttu",middleName:null,surname:"Abdel Farag El-Shafie",slug:"hamadttu-abdel-farag-el-shafie",fullName:"Hamadttu Abdel Farag El-Shafie"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10911",title:"Higher Education",subtitle:"New Approaches to Accreditation, Digitalization, and Globalization in the Age of Covid",isOpenForSubmission:!1,hash:"223a02337498e535e967174c1f648fbc",slug:"higher-education-new-approaches-to-accreditation-digitalization-and-globalization-in-the-age-of-covid",bookSignature:"Lee Waller and Sharon Waller",coverURL:"https://cdn.intechopen.com/books/images_new/10911.jpg",editors:[{id:"263301",title:"Dr.",name:"Lee",middleName:null,surname:"Waller",slug:"lee-waller",fullName:"Lee Waller"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"3568",title:"Recent Advances in Plant in vitro Culture",subtitle:null,isOpenForSubmission:!1,hash:"830bbb601742c85a3fb0eeafe1454c43",slug:"recent-advances-in-plant-in-vitro-culture",bookSignature:"Annarita Leva and Laura M. R. Rinaldi",coverURL:"https://cdn.intechopen.com/books/images_new/3568.jpg",editors:[{id:"142145",title:"Dr.",name:"Annarita",middleName:null,surname:"Leva",slug:"annarita-leva",fullName:"Annarita Leva"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"3737",title:"MATLAB",subtitle:"Modelling, Programming and Simulations",isOpenForSubmission:!1,hash:null,slug:"matlab-modelling-programming-and-simulations",bookSignature:"Emilson Pereira Leite",coverURL:"https://cdn.intechopen.com/books/images_new/3737.jpg",editors:[{id:"12051",title:"Prof.",name:"Emilson",middleName:null,surname:"Pereira Leite",slug:"emilson-pereira-leite",fullName:"Emilson Pereira Leite"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"1770",title:"Gel Electrophoresis",subtitle:"Principles and Basics",isOpenForSubmission:!1,hash:"279701f6c802cf02deef45103e0611ff",slug:"gel-electrophoresis-principles-and-basics",bookSignature:"Sameh Magdeldin",coverURL:"https://cdn.intechopen.com/books/images_new/1770.jpg",editors:[{id:"123648",title:"Dr.",name:"Sameh",middleName:null,surname:"Magdeldin",slug:"sameh-magdeldin",fullName:"Sameh Magdeldin"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],offset:12,limit:12,total:4797},hotBookTopics:{hotBooks:[],offset:0,limit:12,total:null},publish:{},publishingProposal:{success:null,errors:{}},books:{featuredBooks:[{type:"book",id:"7827",title:"Interpersonal Relationships",subtitle:null,isOpenForSubmission:!1,hash:"ebf41f4d17c75010eb3294cc8cac3d47",slug:"interpersonal-relationships",bookSignature:"Martha Peaslee Levine",coverURL:"https://cdn.intechopen.com/books/images_new/7827.jpg",publishedDate:"July 27th 2022",numberOfDownloads:7175,editors:[{id:"186919",title:"Dr.",name:"Martha",middleName:null,surname:"Peaslee Levine",slug:"martha-peaslee-levine",fullName:"Martha Peaslee Levine"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10808",title:"Current Concepts in Dental Implantology",subtitle:"From Science to Clinical Research",isOpenForSubmission:!1,hash:"4af8830e463f89c57515c2da2b9777b0",slug:"current-concepts-in-dental-implantology-from-science-to-clinical-research",bookSignature:"Dragana Gabrić and Marko Vuletić",coverURL:"https://cdn.intechopen.com/books/images_new/10808.jpg",publishedDate:"July 27th 2022",numberOfDownloads:1981,editors:[{id:"26946",title:"Prof.",name:"Dragana",middleName:null,surname:"Gabrić",slug:"dragana-gabric",fullName:"Dragana Gabrić"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10796",title:"Extracellular Vesicles",subtitle:"Role in Diseases, Pathogenesis and Therapy",isOpenForSubmission:!1,hash:"eb5407fcf93baff7bca3fae5640153a2",slug:"extracellular-vesicles-role-in-diseases-pathogenesis-and-therapy",bookSignature:"Manash K. Paul",coverURL:"https://cdn.intechopen.com/books/images_new/10796.jpg",publishedDate:"July 20th 2022",numberOfDownloads:2308,editors:[{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10908",title:"Advances in Decision Making",subtitle:null,isOpenForSubmission:!1,hash:"126486f7f91e18e2e3539a32c38be7b1",slug:"advances-in-decision-making",bookSignature:"Fausto Pedro García Márquez",coverURL:"https://cdn.intechopen.com/books/images_new/10908.jpg",publishedDate:"July 27th 2022",numberOfDownloads:1473,editors:[{id:"22844",title:"Prof.",name:"Fausto Pedro",middleName:null,surname:"García Márquez",slug:"fausto-pedro-garcia-marquez",fullName:"Fausto Pedro García Márquez"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"95",title:"Applications and Experiences of Quality Control",subtitle:null,isOpenForSubmission:!1,hash:"4bcb22b1eee68210a977a97d5a0f363a",slug:"applications-and-experiences-of-quality-control",bookSignature:"Ognyan Ivanov",coverURL:"https://cdn.intechopen.com/books/images_new/95.jpg",publishedDate:"April 26th 2011",numberOfDownloads:318571,editors:[{id:"22230",title:"Prof.",name:"Ognyan",middleName:null,surname:"Ivanov",slug:"ognyan-ivanov",fullName:"Ognyan Ivanov"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"2160",title:"MATLAB",subtitle:"A Fundamental Tool for Scientific Computing and Engineering Applications - Volume 1",isOpenForSubmission:!1,hash:"dd9c658341fbd264ed4f8d9e6aa8ca29",slug:"matlab-a-fundamental-tool-for-scientific-computing-and-engineering-applications-volume-1",bookSignature:"Vasilios N. Katsikis",coverURL:"https://cdn.intechopen.com/books/images_new/2160.jpg",publishedDate:"September 26th 2012",numberOfDownloads:271836,editors:[{id:"12289",title:"Prof.",name:"Vasilios",middleName:"N.",surname:"Katsikis",slug:"vasilios-katsikis",fullName:"Vasilios Katsikis"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"3560",title:"Advances in Landscape Architecture",subtitle:null,isOpenForSubmission:!1,hash:"a20614517ec5f7e91188fe8e42832138",slug:"advances-in-landscape-architecture",bookSignature:"Murat Özyavuz",coverURL:"https://cdn.intechopen.com/books/images_new/3560.jpg",publishedDate:"July 1st 2013",numberOfDownloads:243450,editors:[{id:"93073",title:"Dr.",name:"Murat",middleName:null,surname:"Ozyavuz",slug:"murat-ozyavuz",fullName:"Murat Ozyavuz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10739",title:"Global Decline of Insects",subtitle:null,isOpenForSubmission:!1,hash:"543783652b9092962a8fa4bed38eeb17",slug:"global-decline-of-insects",bookSignature:"Hamadttu Abdel Farag El-Shafie",coverURL:"https://cdn.intechopen.com/books/images_new/10739.jpg",publishedDate:"July 20th 2022",numberOfDownloads:1582,editors:[{id:"192142",title:"Dr.",name:"Hamadttu",middleName:null,surname:"Abdel Farag El-Shafie",slug:"hamadttu-abdel-farag-el-shafie",fullName:"Hamadttu Abdel Farag El-Shafie"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10911",title:"Higher Education",subtitle:"New Approaches to Accreditation, Digitalization, and Globalization in the Age of Covid",isOpenForSubmission:!1,hash:"223a02337498e535e967174c1f648fbc",slug:"higher-education-new-approaches-to-accreditation-digitalization-and-globalization-in-the-age-of-covid",bookSignature:"Lee Waller and Sharon Waller",coverURL:"https://cdn.intechopen.com/books/images_new/10911.jpg",publishedDate:"July 13th 2022",numberOfDownloads:2082,editors:[{id:"263301",title:"Dr.",name:"Lee",middleName:null,surname:"Waller",slug:"lee-waller",fullName:"Lee Waller"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"3568",title:"Recent Advances in Plant in vitro Culture",subtitle:null,isOpenForSubmission:!1,hash:"830bbb601742c85a3fb0eeafe1454c43",slug:"recent-advances-in-plant-in-vitro-culture",bookSignature:"Annarita Leva and Laura M. R. Rinaldi",coverURL:"https://cdn.intechopen.com/books/images_new/3568.jpg",publishedDate:"October 17th 2012",numberOfDownloads:256294,editors:[{id:"142145",title:"Dr.",name:"Annarita",middleName:null,surname:"Leva",slug:"annarita-leva",fullName:"Annarita Leva"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],latestBooks:[{type:"book",id:"8452",title:"Organizational Conflict",subtitle:"New Insights",isOpenForSubmission:!1,hash:"96bdaaba38a7850a7e7379aa5a505748",slug:"organizational-conflict-new-insights",bookSignature:"Josiane Fahed-Sreih",coverURL:"https://cdn.intechopen.com/books/images_new/8452.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"103784",title:"Dr.",name:"Josiane",middleName:null,surname:"Fahed-Sreih",slug:"josiane-fahed-sreih",fullName:"Josiane Fahed-Sreih"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10778",title:"Model-Based Control Engineering",subtitle:"Recent Design and Implementations for Varied Applications",isOpenForSubmission:!1,hash:"e39a567d9b6d2a45d0a1d927362c9005",slug:"model-based-control-engineering-recent-design-and-implementations-for-varied-applications",bookSignature:"Umar Zakir Abdul Hamid and Ahmad `Athif Mohd Faudzi",coverURL:"https://cdn.intechopen.com/books/images_new/10778.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"268173",title:"Dr.",name:"Umar Zakir Abdul",middleName:null,surname:"Hamid",slug:"umar-zakir-abdul-hamid",fullName:"Umar Zakir Abdul Hamid"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10780",title:"Current Trends in Orthodontics",subtitle:null,isOpenForSubmission:!1,hash:"badce0e23eb5176fd653b049d5295c0a",slug:"current-trends-in-orthodontics",bookSignature:"Farid Bourzgui",coverURL:"https://cdn.intechopen.com/books/images_new/10780.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"52177",title:"Prof.",name:"Farid",middleName:null,surname:"Bourzgui",slug:"farid-bourzgui",fullName:"Farid Bourzgui"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10793",title:"Molecular Mechanisms in Cancer",subtitle:null,isOpenForSubmission:!1,hash:"3ed2817275edb3de6f5683602314706e",slug:"molecular-mechanisms-in-cancer",bookSignature:"Metin Budak and Rajamanickam Rajkumar",coverURL:"https://cdn.intechopen.com/books/images_new/10793.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"226275",title:"Ph.D.",name:"Metin",middleName:null,surname:"Budak",slug:"metin-budak",fullName:"Metin Budak"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11308",title:"Selected Topics on Infant Feeding",subtitle:null,isOpenForSubmission:!1,hash:"213c3e403327a2919eca1dc5e82a0ec3",slug:"selected-topics-on-infant-feeding",bookSignature:"Isam Jaber AL-Zwaini and Haider Hadi AL-Musawi",coverURL:"https://cdn.intechopen.com/books/images_new/11308.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"30993",title:"Prof.",name:"Isam Jaber",middleName:null,surname:"Al-Zwaini",slug:"isam-jaber-al-zwaini",fullName:"Isam Jaber Al-Zwaini"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10808",title:"Current Concepts in Dental Implantology",subtitle:"From Science to Clinical Research",isOpenForSubmission:!1,hash:"4af8830e463f89c57515c2da2b9777b0",slug:"current-concepts-in-dental-implantology-from-science-to-clinical-research",bookSignature:"Dragana Gabrić and Marko Vuletić",coverURL:"https://cdn.intechopen.com/books/images_new/10808.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"26946",title:"Prof.",name:"Dragana",middleName:null,surname:"Gabrić",slug:"dragana-gabric",fullName:"Dragana Gabrić"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11331",title:"Secondary Metabolites",subtitle:"Trends and Reviews",isOpenForSubmission:!1,hash:"7d6274f42d5441e537c5fa744bc84523",slug:"secondary-metabolites-trends-and-reviews",bookSignature:"Ramasamy Vijayakumar and Suresh Selvapuram Sudalaimuthu Raja",coverURL:"https://cdn.intechopen.com/books/images_new/11331.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"176044",title:"Dr.",name:"Ramasamy",middleName:null,surname:"Vijayakumar",slug:"ramasamy-vijayakumar",fullName:"Ramasamy Vijayakumar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10820",title:"Data Clustering",subtitle:null,isOpenForSubmission:!1,hash:"086d299ffd05aacd2311c3ca4ebf0d3a",slug:"data-clustering",bookSignature:"Niansheng Tang",coverURL:"https://cdn.intechopen.com/books/images_new/10820.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"221831",title:"Prof.",name:"Niansheng",middleName:null,surname:"Tang",slug:"niansheng-tang",fullName:"Niansheng Tang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10827",title:"Oral Health Care",subtitle:"An Important Issue of the Modern Society",isOpenForSubmission:!1,hash:"9a0ceb9ced4598aea3f3723f6dc4ea04",slug:"oral-health-care-an-important-issue-of-the-modern-society",bookSignature:"Lavinia Cosmina Ardelean and Laura Cristina Rusu",coverURL:"https://cdn.intechopen.com/books/images_new/10827.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"180569",title:"Dr.",name:"Lavinia",middleName:null,surname:"Ardelean",slug:"lavinia-ardelean",fullName:"Lavinia Ardelean"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11139",title:"Geochemistry and Mineral Resources",subtitle:null,isOpenForSubmission:!1,hash:"928cebbdce21d9b3f081267b24f12dfb",slug:"geochemistry-and-mineral-resources",bookSignature:"Hosam M. Saleh and Amal I. Hassan",coverURL:"https://cdn.intechopen.com/books/images_new/11139.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"144691",title:"Prof.",name:"Hosam M.",middleName:null,surname:"Saleh",slug:"hosam-m.-saleh",fullName:"Hosam M. Saleh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"993",title:"Pre-Hospital Emergency Medicine",slug:"critical-care-medicine-pre-hospital-emergency-medicine",parent:{id:"173",title:"Critical Care Medicine",slug:"critical-care-medicine"},numberOfBooks:3,numberOfSeries:0,numberOfAuthorsAndEditors:69,numberOfWosCitations:18,numberOfCrossrefCitations:13,numberOfDimensionsCitations:22,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicId:"993",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"5970",title:"Bedside Procedures",subtitle:null,isOpenForSubmission:!1,hash:"ba56d3036ac823a7155f40e4a02c030d",slug:"bedside-procedures",bookSignature:"Gabriel Cismaru",coverURL:"https://cdn.intechopen.com/books/images_new/5970.jpg",editedByType:"Edited by",editors:[{id:"191888",title:"Dr.",name:"Gabriel",middleName:null,surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5756",title:"Intensive Care",subtitle:null,isOpenForSubmission:!1,hash:"c15f872f6c0158a19bf64f081fe1e854",slug:"intensive-care",bookSignature:"Nissar Shaikh",coverURL:"https://cdn.intechopen.com/books/images_new/5756.jpg",editedByType:"Edited by",editors:[{id:"107703",title:"Dr.",name:"Nissar",middleName:null,surname:"Shaikh",slug:"nissar-shaikh",fullName:"Nissar Shaikh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5220",title:"Oncology Critical Care",subtitle:null,isOpenForSubmission:!1,hash:"6ca48669ac7afaf59398a958335eff65",slug:"oncology-critical-care",bookSignature:"Jeffrey B. Hoag",coverURL:"https://cdn.intechopen.com/books/images_new/5220.jpg",editedByType:"Edited by",editors:[{id:"91738",title:"Dr.",name:"Jeffrey",middleName:null,surname:"Hoag",slug:"jeffrey-hoag",fullName:"Jeffrey Hoag"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:3,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"52089",doi:"10.5772/64372",title:"Infections in Cancer Patients",slug:"infections-in-cancer-patients",totalDownloads:2569,totalCrossrefCites:4,totalDimensionsCites:5,abstract:"Cancer therapy is a dynamically evolving field. Chemotherapy and biologic agents impact the magnitude and duration of immunosuppression in the already-immunocompromised cancer hosts who are then susceptible to a broad spectrum of infectious complications ranging from mild opportunistic infections to severe, fatal neutropenic sepsis. Numerous bacterial, fungal, and viral organisms have been implicated dictating varied preventative approaches. Rapid assessment and risk stratification of febrile patients identify individuals requiring hospital admission. Timely delivery of antimicrobials reduces the risk of complications and death. Herein, we summarize the current “state of art” in the management of infection in the cancer patient. We detail the advances in antibacterial and antifungal therapy.",book:{id:"5220",slug:"oncology-critical-care",title:"Oncology Critical Care",fullTitle:"Oncology Critical Care"},signatures:"Deepjot Singh and Robert A. Bonomo",authors:[{id:"181936",title:"Dr.",name:"Deepjot",middleName:null,surname:"Singh",slug:"deepjot-singh",fullName:"Deepjot Singh"},{id:"187145",title:"Dr.",name:"Robert",middleName:null,surname:"Bonomo",slug:"robert-bonomo",fullName:"Robert Bonomo"}]},{id:"55443",doi:"10.5772/intechopen.68630",title:"Aneurysmal Subarachnoid Hemorrhage",slug:"aneurysmal-subarachnoid-hemorrhage",totalDownloads:2940,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Aneurysmal subarachnoid hemorrhage (SAH) is a devastating neurological syndrome, which occurs at a rate of 3–25 per 100,000 population. Smoking and hypertension are the most important risk factors of subarachnoid hemorrhage. Rupture of cerebral aneurysm leads to rapid spread of blood into cerebrospinal fluid and subsequently leads to sudden increase of intracranial pressure and severe headache. Subarachnoid hemorrhage is associated with neurological (such as re‐bleeding and vasospasm) and systemic (such as myocardial injury and hyponatremia) complications that are causes of high mortality and morbidity. Although patients with poor‐grade subarachnoid hemorrhage are at higher risk of neurological and systemic complications, the early and aggressive management of this group of patient has decreased overall mortality by 17% in last 40 years. Early aneurysm repair, close monitoring in dedicated neurological intensive care unit, prevention, and aggressive management of medical and neurological complications are the most important strategies to improve outcome.",book:{id:"5756",slug:"intensive-care",title:"Intensive Care",fullTitle:"Intensive Care"},signatures:"Adel E. Ahmed Ganaw, Abdulgafoor M. Tharayil, Ali O. Mohamed\nBel Khair, Saher Tahseen, Jazib Hassan, Mohammad Faisal Abdullah\nMalmstrom and Sohel Mohamed Gamal Ahmed",authors:[{id:"198979",title:"Dr.",name:"Saher",middleName:null,surname:"Tahseen",slug:"saher-tahseen",fullName:"Saher Tahseen"},{id:"199923",title:"Dr.",name:"Adel. E. Ahmad",middleName:null,surname:"Ganaw",slug:"adel.-e.-ahmad-ganaw",fullName:"Adel. E. Ahmad Ganaw"},{id:"200584",title:"Dr.",name:"Abdulgafoor",middleName:null,surname:"Tharayil",slug:"abdulgafoor-tharayil",fullName:"Abdulgafoor Tharayil"},{id:"205193",title:"Dr.",name:"Ali",middleName:"O Mohamed",surname:"Bel Khair",slug:"ali-bel-khair",fullName:"Ali Bel Khair"},{id:"205194",title:"Dr.",name:"Jazib",middleName:null,surname:"Hassan",slug:"jazib-hassan",fullName:"Jazib Hassan"},{id:"205195",title:"Dr.",name:"M. Faisal",middleName:null,surname:"Malmstrom",slug:"m.-faisal-malmstrom",fullName:"M. Faisal Malmstrom"},{id:"205787",title:"Dr.",name:"Sohel Mohamed Gamal",middleName:null,surname:"Ahmed",slug:"sohel-mohamed-gamal-ahmed",fullName:"Sohel Mohamed Gamal Ahmed"}]},{id:"56878",doi:"10.5772/intechopen.70498",title:"Lumbar Puncture of the Newborn",slug:"lumbar-puncture-of-the-newborn",totalDownloads:1462,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Heinrich Irenäus Quincke was the first person in medical history to perform lumbar puncture (LP). Indications of lumbar puncture include suspected meningitis, suspected subarachnoid hemorrhage, administration of chemotherapeutic agents, instillation of contrast media for imaging of the spinal cord, and the evaluation of various neurologic conditions including normal pressure hydrocephalus and Guillain-Barré syndrome, and the treatment of idiopathic intracranial hypertension. Contraindications of lumbar puncture include findings of increased intracranial pressure, bleeding diathesis, cardiopulmonary instability, soft tissue infection at the puncture site, shock, respiratory insufficiency, and suspected meningococcal septicemia with extensive or spreading purpura. Altered mental status, focal neurologic signs, papilledema, focal seizure, and risk for brain abscess are indications for cranial imaging before performing LP. Lack of local anesthetic use and advancement of the spinal needle with the stylet in place were most prominent risk factors for a traumatic LP. Ultrasound may minimize the number of LP attempts and decrease patient and parent anxiety by easily identifying an insertion site. Infection, spinal hematoma, epidermoid tumor, and cerebral herniation are the main complications of LP. When LP is traumatic, the wisest approach is to assume the patient is having meningitis and start empirical therapy.",book:{id:"5970",slug:"bedside-procedures",title:"Bedside Procedures",fullTitle:"Bedside Procedures"},signatures:"Selim Öncel",authors:[{id:"200133",title:"Associate Prof.",name:"Selim",middleName:null,surname:"Öncel",slug:"selim-oncel",fullName:"Selim Öncel"}]},{id:"54793",doi:"10.5772/intechopen.68308",title:"Intensive Care Unit Workforce: Occupational Health and Safety",slug:"intensive-care-unit-workforce-occupational-health-and-safety",totalDownloads:2221,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"There are many different work tasks and workplace hazards related to the ICU setting. The workplace hazards include the physical environment of the ICU, working conditions, psychosocial factors, ergonomic factors, biological factors and chemical factors that cause ICU workers to have health problems. The occurrence of occupational health problems in ICU workers not only leads to decreased job satisfaction and productivity but also increases absenteeism and burnout. Moreover, this situation adversely affects patient care and increases the cost of treatment. Recognising occupational hazards and risks arising from the work environment will assist in planning strategies to protect and promote health programmes for ICU workers. Understanding the importance of occupational health and safety practices by all institutions is a key factor to improve quality of life, work efficiency and work satisfaction of ICU workers.",book:{id:"5756",slug:"intensive-care",title:"Intensive Care",fullTitle:"Intensive Care"},signatures:"Melek Nihal Esin and Duygu Sezgin",authors:[{id:"183522",title:"Prof.",name:"Melek Nihal",middleName:null,surname:"Esin",slug:"melek-nihal-esin",fullName:"Melek Nihal Esin"},{id:"197030",title:"Dr.",name:"Duygu",middleName:null,surname:"Sezgin",slug:"duygu-sezgin",fullName:"Duygu Sezgin"}]},{id:"54955",doi:"10.5772/intechopen.68348",title:"Acute Kidney Injury in the Intensive Care Unit",slug:"acute-kidney-injury-in-the-intensive-care-unit",totalDownloads:2452,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Acute kidney injury (AKI) is defined as an abrupt decrease in glomerular filtration rate (GFR). Incidence varies from 20% to as high as 70% in critically ill patients. Classically, AKI has been divided into three broad pathophysiologic categories: prerenal AKI, intrinsic AKI, and postrenal (obstructive) AKI. The clinical manifestations of AKI vary among a wide range of symptoms and metabolic abnormalities. A sudden decrease in GFR will result in rising concentrations of solutes in the blood, which are normally excreted by the kidneys. Recently, new urinary and serum biomarkers have gained a place in the diagnosis, classification, and prognosis prediction of AKI. The best treatment for AKI is prevention. Patients with prerenal azotemia should have intravascular volume deficits corrected and cardiac function optimized. Obstructive (postrenal) kidney disease is treated by mechanical relief of the block. The primary management of acute interstitial nephritis is discontinuation of the inciting agent. Renal replacement therapy (RRT) has emerged as a supportive mechanism rather than just as a lifesaving measure. Continuous techniques are preferable in treating critically ill patients, although every modality has its benefits, indications, and contraindications.",book:{id:"5756",slug:"intensive-care",title:"Intensive Care",fullTitle:"Intensive Care"},signatures:"Jose J. Zaragoza and Faustino J. Renteria",authors:[{id:"181646",title:"Dr.",name:"Jose",middleName:"Jesus",surname:"Zaragoza",slug:"jose-zaragoza",fullName:"Jose Zaragoza"},{id:"200843",title:"Dr.",name:"Faustino",middleName:null,surname:"Renteria",slug:"faustino-renteria",fullName:"Faustino Renteria"}]}],mostDownloadedChaptersLast30Days:[{id:"55736",title:"Haemodynamic Monitoring in the Intensive Care Unit",slug:"haemodynamic-monitoring-in-the-intensive-care-unit",totalDownloads:3370,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Monitoring is a cognitive aid that allows clinicians to detect the nature and extent of pathology and helps assessment of response to therapy. The cardiovascular system is the most commonly monitored organ system in the critical care setting. It helps identify the presence and nature of shock and guides response to resuscitation by detection of cardiac rate and rhythm, evaluation of volume state, cardiac contractility and systemic vascular resistance. Newer technologies allow greater assessment of oxygen delivery to vulnerable tissues. We discuss the nature, history, modalities and interpretation of the most commonly available haemodynamic monitoring methods in clinical use currently.",book:{id:"5756",slug:"intensive-care",title:"Intensive Care",fullTitle:"Intensive Care"},signatures:"Mainak Majumdar",authors:[{id:"86678",title:"Dr.",name:"Mainak",middleName:null,surname:"Majumdar",slug:"mainak-majumdar",fullName:"Mainak Majumdar"}]},{id:"56744",title:"Endotracheal Intubation in Children: Practice Recommendations, Insights, and Future Directions",slug:"endotracheal-intubation-in-children-practice-recommendations-insights-and-future-directions",totalDownloads:2450,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Management of airway is mandatory in a critically ill child with severe trauma or any other situation that threatens his or her life. It is important, that clinicians who attend critically ill pediatric patients requiring airway management know the rapid sequence intubation (RSI) procedure, identify a patient with difficult airway, know the devices and techniques for the management of difficult airway, and look for receiving a formal training in endotracheal intubation (ETI). Future strategies for teaching and/or training clinicians in pediatric and neonatal ETI should be evaluated through conducting controlled clinical trials to identify which type will be the most effective by considering the less number of attempts and complications.",book:{id:"5970",slug:"bedside-procedures",title:"Bedside Procedures",fullTitle:"Bedside Procedures"},signatures:"Maribel Ibarra-Sarlat, Eduardo Terrones-Vargas, Lizett Romero-\nEspinoza, Graciela Castañeda-Muciño, Alejandro Herrera-Landero\nand Juan Carlos Núñez-Enríquez",authors:[{id:"166303",title:"Dr.",name:"Juan",middleName:"Carlos",surname:"Nuñez-Enriquez",slug:"juan-nunez-enriquez",fullName:"Juan Nuñez-Enriquez"},{id:"206296",title:"Dr.",name:"Eduardo",middleName:null,surname:"Terrones-Vargas",slug:"eduardo-terrones-vargas",fullName:"Eduardo Terrones-Vargas"},{id:"206297",title:"Dr.",name:"Maribel",middleName:null,surname:"Ibarra-Sarlat",slug:"maribel-ibarra-sarlat",fullName:"Maribel Ibarra-Sarlat"},{id:"206298",title:"Dr.",name:"Lizett",middleName:null,surname:"Romero-Espinoza",slug:"lizett-romero-espinoza",fullName:"Lizett Romero-Espinoza"},{id:"206299",title:"Dr.",name:"Alejandro",middleName:null,surname:"Herrera-Landero",slug:"alejandro-herrera-landero",fullName:"Alejandro Herrera-Landero"},{id:"213723",title:"Dr.",name:"Graciela",middleName:null,surname:"Castañeda-Muciño",slug:"graciela-castaneda-mucino",fullName:"Graciela Castañeda-Muciño"}]},{id:"55848",title:"Airway Management in ICU Settings",slug:"airway-management-in-icu-settings",totalDownloads:2864,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Maintenance of patent airway, adequate ventilation, and pulmonary gas exchange is very important in critically ill patients. Airway management in intensive care patients differs significantly from routine surgical procedures in the operating room. The airway competence in intensive care unit (ICU) should be coping with the rapidly evolving advances in airway management. Therefore, efforts should be focused on the three pillars of airway master: airway providers as intensivists or critical care physicians, equipment, and operational plans. Not all institutions can afford all airway equipment in the market; however, they should make sure that critical care providers have a full access to the available tools and they are comfortable using it. Educational sessions and refresher courses should be tailored to meet the competence level of the ICU providers and equipment availability. Operational plan includes developing institutional airway protocols and implementing difficult airway guidelines. The protocols should consider different staffing models of ICU and make sure all the time at least one member of the team with the highest experience in airway should be always available. The aim of writing this chapter is to enable the intensivist to optimize their use of airway equipment and managing high‐risk patients in ICU.",book:{id:"5756",slug:"intensive-care",title:"Intensive Care",fullTitle:"Intensive Care"},signatures:"Nabil Abdelhamid Shallik, Mamdouh Almustafa, Ahmed Zaghw\nand Abbas Moustafa",authors:[{id:"202782",title:"Dr.",name:"Nabil A.",middleName:null,surname:"Shallik",slug:"nabil-a.-shallik",fullName:"Nabil A. Shallik"},{id:"206965",title:"Dr.",name:"Mamdouh",middleName:null,surname:"Almustafa",slug:"mamdouh-almustafa",fullName:"Mamdouh Almustafa"},{id:"206966",title:"Dr.",name:"Ahmed",middleName:null,surname:"Zaghw",slug:"ahmed-zaghw",fullName:"Ahmed Zaghw"},{id:"206967",title:"Dr.",name:"Abbas",middleName:null,surname:"Moustafa",slug:"abbas-moustafa",fullName:"Abbas Moustafa"}]},{id:"56878",title:"Lumbar Puncture of the Newborn",slug:"lumbar-puncture-of-the-newborn",totalDownloads:1461,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Heinrich Irenäus Quincke was the first person in medical history to perform lumbar puncture (LP). Indications of lumbar puncture include suspected meningitis, suspected subarachnoid hemorrhage, administration of chemotherapeutic agents, instillation of contrast media for imaging of the spinal cord, and the evaluation of various neurologic conditions including normal pressure hydrocephalus and Guillain-Barré syndrome, and the treatment of idiopathic intracranial hypertension. Contraindications of lumbar puncture include findings of increased intracranial pressure, bleeding diathesis, cardiopulmonary instability, soft tissue infection at the puncture site, shock, respiratory insufficiency, and suspected meningococcal septicemia with extensive or spreading purpura. Altered mental status, focal neurologic signs, papilledema, focal seizure, and risk for brain abscess are indications for cranial imaging before performing LP. Lack of local anesthetic use and advancement of the spinal needle with the stylet in place were most prominent risk factors for a traumatic LP. Ultrasound may minimize the number of LP attempts and decrease patient and parent anxiety by easily identifying an insertion site. Infection, spinal hematoma, epidermoid tumor, and cerebral herniation are the main complications of LP. When LP is traumatic, the wisest approach is to assume the patient is having meningitis and start empirical therapy.",book:{id:"5970",slug:"bedside-procedures",title:"Bedside Procedures",fullTitle:"Bedside Procedures"},signatures:"Selim Öncel",authors:[{id:"200133",title:"Associate Prof.",name:"Selim",middleName:null,surname:"Öncel",slug:"selim-oncel",fullName:"Selim Öncel"}]},{id:"55443",title:"Aneurysmal Subarachnoid Hemorrhage",slug:"aneurysmal-subarachnoid-hemorrhage",totalDownloads:2938,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Aneurysmal subarachnoid hemorrhage (SAH) is a devastating neurological syndrome, which occurs at a rate of 3–25 per 100,000 population. Smoking and hypertension are the most important risk factors of subarachnoid hemorrhage. Rupture of cerebral aneurysm leads to rapid spread of blood into cerebrospinal fluid and subsequently leads to sudden increase of intracranial pressure and severe headache. Subarachnoid hemorrhage is associated with neurological (such as re‐bleeding and vasospasm) and systemic (such as myocardial injury and hyponatremia) complications that are causes of high mortality and morbidity. Although patients with poor‐grade subarachnoid hemorrhage are at higher risk of neurological and systemic complications, the early and aggressive management of this group of patient has decreased overall mortality by 17% in last 40 years. Early aneurysm repair, close monitoring in dedicated neurological intensive care unit, prevention, and aggressive management of medical and neurological complications are the most important strategies to improve outcome.",book:{id:"5756",slug:"intensive-care",title:"Intensive Care",fullTitle:"Intensive Care"},signatures:"Adel E. Ahmed Ganaw, Abdulgafoor M. Tharayil, Ali O. Mohamed\nBel Khair, Saher Tahseen, Jazib Hassan, Mohammad Faisal Abdullah\nMalmstrom and Sohel Mohamed Gamal Ahmed",authors:[{id:"198979",title:"Dr.",name:"Saher",middleName:null,surname:"Tahseen",slug:"saher-tahseen",fullName:"Saher Tahseen"},{id:"199923",title:"Dr.",name:"Adel. E. Ahmad",middleName:null,surname:"Ganaw",slug:"adel.-e.-ahmad-ganaw",fullName:"Adel. E. Ahmad Ganaw"},{id:"200584",title:"Dr.",name:"Abdulgafoor",middleName:null,surname:"Tharayil",slug:"abdulgafoor-tharayil",fullName:"Abdulgafoor Tharayil"},{id:"205193",title:"Dr.",name:"Ali",middleName:"O Mohamed",surname:"Bel Khair",slug:"ali-bel-khair",fullName:"Ali Bel Khair"},{id:"205194",title:"Dr.",name:"Jazib",middleName:null,surname:"Hassan",slug:"jazib-hassan",fullName:"Jazib Hassan"},{id:"205195",title:"Dr.",name:"M. Faisal",middleName:null,surname:"Malmstrom",slug:"m.-faisal-malmstrom",fullName:"M. Faisal Malmstrom"},{id:"205787",title:"Dr.",name:"Sohel Mohamed Gamal",middleName:null,surname:"Ahmed",slug:"sohel-mohamed-gamal-ahmed",fullName:"Sohel Mohamed Gamal Ahmed"}]}],onlineFirstChaptersFilter:{topicId:"993",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:11,numberOfPublishedChapters:91,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:332,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:11,numberOfPublishedChapters:143,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:124,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:23,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,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\tSustainable approaches to health and wellbeing in our COVID 19 recovery needs to focus on ecological approaches that prioritize our relationships with each other, and include engagement with nature, the arts and our heritage. This will ensure that we discover ways to live in our world that allows us and other beings to flourish. We can no longer rely on medicalized approaches to health that wait for people to become ill before attempting to treat them. We need to live in harmony with nature and rediscover the beauty and balance in our everyday lives and surroundings, which contribute to our well-being and that of all other creatures on the planet. This topic will provide insights and knowledge into how to achieve this change in health care that is based on ecologically sustainable practices.
",coverUrl:"https://cdn.intechopen.com/series_topics/covers/92.jpg",hasOnlineFirst:!1,hasPublishedBooks:!1,annualVolume:11976,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,series:{id:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:"2753-6580"},editorialBoard:[{id:"169536",title:"Dr.",name:"David",middleName:null,surname:"Claborn",slug:"david-claborn",fullName:"David Claborn",profilePictureURL:"https://mts.intechopen.com/storage/users/169536/images/system/169536.jpeg",institutionString:null,institution:{name:"Missouri State University",institutionURL:null,country:{name:"United States of America"}}},{id:"248594",title:"Ph.D.",name:"Jasneth",middleName:null,surname:"Mullings",slug:"jasneth-mullings",fullName:"Jasneth Mullings",profilePictureURL:"https://mts.intechopen.com/storage/users/248594/images/system/248594.jpeg",institutionString:"The University Of The West Indies - Mona Campus, Jamaica",institution:null},{id:"331299",title:"Prof.",name:"Pei-Shan",middleName:null,surname:"Liao",slug:"pei-shan-liao",fullName:"Pei-Shan Liao",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000032Fh2FQAS/Profile_Picture_2022-03-18T09:39:41.jpg",institutionString:"Research Center for Humanities and Social Sciences, Academia Sinica, Taiwan",institution:null}]},onlineFirstChapters:{paginationCount:7,paginationItems:[{id:"83087",title:"Role of Cellular Responses in Periodontal Tissue Destruction",doi:"10.5772/intechopen.106645",signatures:"Nam Cong-Nhat Huynh",slug:"role-of-cellular-responses-in-periodontal-tissue-destruction",totalDownloads:8,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Periodontology - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/11566.jpg",subseries:{id:"1",title:"Oral Health"}}},{id:"82654",title:"Atraumatic Restorative Treatment: More than a Minimally Invasive Approach?",doi:"10.5772/intechopen.105623",signatures:"Manal A. Ablal",slug:"atraumatic-restorative-treatment-more-than-a-minimally-invasive-approach",totalDownloads:4,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Dental Caries - The Selection of Restoration Methods and Restorative Materials",coverURL:"https://cdn.intechopen.com/books/images_new/11565.jpg",subseries:{id:"1",title:"Oral Health"}}},{id:"82735",title:"The Influence of Salivary pH on the Prevalence of Dental Caries",doi:"10.5772/intechopen.106154",signatures:"Laura-Cristina Rusu, Alexandra Roi, Ciprian-Ioan Roi, Codruta Victoria Tigmeanu and Lavinia Cosmina Ardelean",slug:"the-influence-of-salivary-ph-on-the-prevalence-of-dental-caries",totalDownloads:12,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Dental Caries - The Selection of Restoration Methods and Restorative Materials",coverURL:"https://cdn.intechopen.com/books/images_new/11565.jpg",subseries:{id:"1",title:"Oral Health"}}},{id:"82357",title:"Caries Management Aided by Fluorescence-Based Devices",doi:"10.5772/intechopen.105567",signatures:"Atena Galuscan, Daniela Jumanca and Aurora Doris Fratila",slug:"caries-management-aided-by-fluorescence-based-devices",totalDownloads:6,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Dental Caries - The Selection of Restoration Methods and Restorative Materials",coverURL:"https://cdn.intechopen.com/books/images_new/11565.jpg",subseries:{id:"1",title:"Oral Health"}}},{id:"81894",title:"Diet and Nutrition and Their Relationship with Early Childhood Dental Caries",doi:"10.5772/intechopen.105123",signatures:"Luanna Gonçalves Ferreira, Giuliana de Campos Chaves Lamarque and Francisco Wanderley Garcia Paula-Silva",slug:"diet-and-nutrition-and-their-relationship-with-early-childhood-dental-caries",totalDownloads:20,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Dental Caries - The Selection of Restoration Methods and Restorative Materials",coverURL:"https://cdn.intechopen.com/books/images_new/11565.jpg",subseries:{id:"1",title:"Oral Health"}}},{id:"78064",title:"The Salivary Secretome",doi:"10.5772/intechopen.98278",signatures:"Luís Perpétuo, Rita Ferreira, Sofia Guedes, Francisco Amado and Rui Vitorino",slug:"the-salivary-secretome",totalDownloads:108,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Periodontology - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/11566.jpg",subseries:{id:"1",title:"Oral Health"}}},{id:"65334",title:"Introductory Chapter: Some Important Aspects of Root Canal Treatment",doi:"10.5772/intechopen.83653",signatures:"Ana Luiza de Carvalho Felippini",slug:"introductory-chapter-some-important-aspects-of-root-canal-treatment",totalDownloads:850,totalCrossrefCites:0,totalDimensionsCites:0,authors:[{name:"Ana Luiza",surname:"De Carvalho Felippini"}],book:{title:"Root Canal",coverURL:"https://cdn.intechopen.com/books/images_new/7133.jpg",subseries:{id:"1",title:"Oral Health"}}}]},publishedBooks:{paginationCount:5,paginationItems:[{type:"book",id:"8737",title:"Rabies Virus at the Beginning of 21st Century",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/8737.jpg",slug:"rabies-virus-at-the-beginning-of-21st-century",publishedDate:"May 11th 2022",editedByType:"Edited by",bookSignature:"Sergey Tkachev",hash:"49cce3f548da548c718c865feb343509",volumeInSeries:9,fullTitle:"Rabies Virus at the Beginning of 21st Century",editors:[{id:"61139",title:"Dr.",name:"Sergey",middleName:null,surname:"Tkachev",slug:"sergey-tkachev",fullName:"Sergey Tkachev",profilePictureURL:"https://mts.intechopen.com/storage/users/61139/images/system/61139.png",institutionString:"Russian Academy of Sciences",institution:{name:"Russian Academy of Sciences",institutionURL:null,country:{name:"Russia"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"10497",title:"Canine Genetics, Health and Medicine",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/10497.jpg",slug:"canine-genetics-health-and-medicine",publishedDate:"June 2nd 2021",editedByType:"Edited by",bookSignature:"Catrin Rutland",hash:"b91512e31ce34032e560362e6cbccc1c",volumeInSeries:7,fullTitle:"Canine Genetics, Health and Medicine",editors:[{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",institutionString:null,institution:{name:"University of Nottingham",institutionURL:null,country:{name:"United Kingdom"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9081",title:"Equine Science",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/9081.jpg",slug:"equine-science",publishedDate:"September 23rd 2020",editedByType:"Edited by",bookSignature:"Catrin Rutland and Albert Rizvanov",hash:"ac415ef2f5450fa80fdb9cf6cf32cd2d",volumeInSeries:5,fullTitle:"Equine Science",editors:[{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",institutionString:null,institution:{name:"University of Nottingham",institutionURL:null,country:{name:"United Kingdom"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8524",title:"Lactation in Farm Animals",subtitle:"Biology, Physiological Basis, Nutritional Requirements, and Modelization",coverURL:"https://cdn.intechopen.com/books/images_new/8524.jpg",slug:"lactation-in-farm-animals-biology-physiological-basis-nutritional-requirements-and-modelization",publishedDate:"January 22nd 2020",editedByType:"Edited by",bookSignature:"Naceur M'Hamdi",hash:"2aa2a9a0ec13040bbf0455e34625504e",volumeInSeries:3,fullTitle:"Lactation in Farm Animals - Biology, Physiological Basis, Nutritional Requirements, and Modelization",editors:[{id:"73376",title:"Dr.",name:"Naceur",middleName:null,surname:"M'Hamdi",slug:"naceur-m'hamdi",fullName:"Naceur M'Hamdi",profilePictureURL:"https://mts.intechopen.com/storage/users/73376/images/system/73376.jpg",institutionString:null,institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7144",title:"Veterinary Anatomy and Physiology",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7144.jpg",slug:"veterinary-anatomy-and-physiology",publishedDate:"March 13th 2019",editedByType:"Edited by",bookSignature:"Catrin Sian Rutland and Valentina Kubale",hash:"75cdacb570e0e6d15a5f6e69640d87c9",volumeInSeries:2,fullTitle:"Veterinary Anatomy and Physiology",editors:[{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",institutionString:null,institution:{name:"University of Nottingham",institutionURL:null,country:{name:"United Kingdom"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},testimonialsList:[{id:"27",text:"The opportunity to work with a prestigious publisher allows for the possibility to collaborate with more research groups interested in animal nutrition, leading to the development of new feeding strategies and food valuation while being more sustainable with the environment, allowing more readers to learn about the subject.",author:{id:"175967",name:"Manuel",surname:"Gonzalez Ronquillo",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/175967/images/system/175967.png",slug:"manuel-gonzalez-ronquillo",institution:{id:"6221",name:"Universidad Autónoma del Estado de México",country:{id:null,name:"Mexico"}}}},{id:"18",text:"It was great publishing with IntechOpen, the process was straightforward and I had support all along.",author:{id:"71579",name:"Berend",surname:"Olivier",institutionString:"Utrecht University",profilePictureURL:"https://mts.intechopen.com/storage/users/71579/images/system/71579.png",slug:"berend-olivier",institution:{id:"253",name:"Utrecht University",country:{id:null,name:"Netherlands"}}}},{id:"8",text:"I work with IntechOpen for a number of reasons: their professionalism, their mission in support of Open Access publishing, and the quality of their peer-reviewed publications, but also because they believe in equality.",author:{id:"202192",name:"Catrin",surname:"Rutland",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",slug:"catrin-rutland",institution:{id:"134",name:"University of Nottingham",country:{id:null,name:"United Kingdom"}}}}]},submityourwork:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:11,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:10,numberOfPublishedChapters:141,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:124,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:12,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}],subseriesList:[],annualVolumeBook:{},thematicCollection:[],selectedSeries:null,selectedSubseries:null},seriesLanding:{item:{id:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343",scope:"Biomedical Engineering is one of the fastest-growing interdisciplinary branches of science and industry. The combination of electronics and computer science with biology and medicine has improved patient diagnosis, reduced rehabilitation time, and helped to facilitate a better quality of life. Nowadays, all medical imaging devices, medical instruments, or new laboratory techniques result from the cooperation of specialists in various fields. The series of Biomedical Engineering books covers such areas of knowledge as chemistry, physics, electronics, medicine, and biology. This series is intended for doctors, engineers, and scientists involved in biomedical engineering or those wanting to start working in this field.",coverUrl:"https://cdn.intechopen.com/series/covers/7.jpg",latestPublicationDate:"August 14th, 2022",hasOnlineFirst:!0,numberOfOpenTopics:3,numberOfPublishedChapters:108,numberOfPublishedBooks:12,editor:{id:"50150",title:"Prof.",name:"Robert",middleName:null,surname:"Koprowski",fullName:"Robert Koprowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTYNQA4/Profile_Picture_1630478535317",biography:"Robert Koprowski, MD (1997), PhD (2003), Habilitation (2015), is an employee of the University of Silesia, Poland, Institute of Computer Science, Department of Biomedical Computer Systems. For 20 years, he has studied the analysis and processing of biomedical images, emphasizing the full automation of measurement for a large inter-individual variability of patients. Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},subseries:[{id:"7",title:"Bioinformatics and Medical Informatics",keywords:"Biomedical Data, Drug Discovery, Clinical Diagnostics, Decoding Human Genome, AI in Personalized Medicine, Disease-prevention Strategies, Big Data Analysis in Medicine",scope:"Bioinformatics aims to help understand the functioning of the mechanisms of living organisms through the construction and use of quantitative tools. The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",fullName:"Reda R. Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. Osma",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDv7QAG/Profile_Picture_1626602531691",institutionString:null,institution:{name:"Universidad de Los Andes",institutionURL:null,country:{name:"Colombia"}}},{id:"69697",title:"Dr.",name:"Mani T.",middleName:null,surname:"Valarmathi",fullName:"Mani T. Valarmathi",profilePictureURL:"https://mts.intechopen.com/storage/users/69697/images/system/69697.jpg",institutionString:"Religen Inc. | A Life Science Company, United States of America",institution:null},{id:"205081",title:"Dr.",name:"Marco",middleName:"Vinícius",surname:"Chaud",fullName:"Marco Chaud",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDGeQAO/Profile_Picture_1622624307737",institutionString:null,institution:{name:"Universidade de Sorocaba",institutionURL:null,country:{name:"Brazil"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"profile.detail",path:"/profiles/65996",hash:"",query:{},params:{id:"65996"},fullPath:"/profiles/65996",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()