IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\n
By listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
All three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n
"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n
"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\n
In conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n
“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\n
We invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\n
Feel free to share this news on social media and help us mark this memorable moment!
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\n
By listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
All three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n
"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n
"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\n
In conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n
“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\n
We invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\n
Feel free to share this news on social media and help us mark this memorable moment!
\n\n
\n'}],latestNews:[{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"},{slug:"intechopen-identified-as-one-of-the-most-significant-contributor-to-oa-book-growth-in-doab-20210809",title:"IntechOpen Identified as One of the Most Significant Contributors to OA Book Growth in DOAB"}]},book:{item:{type:"book",id:"4552",leadTitle:null,fullTitle:"Soilless Culture - Use of Substrates for the Production of Quality Horticultural Crops",title:"Soilless Culture",subtitle:"Use of Substrates for the Production of Quality Horticultural Crops",reviewType:"peer-reviewed",abstract:"Soilless Culture - Use of Substrates for the Production of Quality Horticultural Crops provides useful information on the techniques of growing horticultural crops using either inert organic or inorganic substrates and also on use of substrates consisting locally available and inexpensive materials with adequate physical and chemical properties. 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\r\n\tOrganic electronics can impact healthcare, sports, and national security through inventions such as real-time biosensing and drug-delivery, stretchable and flexible sport track gear, and the electronic- nose and tongue. Organic semiconductors, based on carbon and hydrogen, two of the most abundant and low cost materials, can transduce ionic and electronic carriers into quantifiable data paving the way for multi-functional applications that are not easy to create with other material systems and often go beyond the working principle of the conventional field-effect transistor. We will begin our review with a general overview of the current state of OFETs focusing on complex architectures, materials and fabrication processes. We will discuss the device physics and explain the doping mechanisms that can exist in organic semiconducting channel materials. Then we will focus on exciting applications that include the electronic- nose and tongue, myriad biosensing applications for preventive, point-of-care testing and real-time drug delivery, emerging physico-chemical low cost sensing applications, and the well known flexible, stretchable electronics.
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1. Introduction
Although acute appendicitis is one of the most common causes for acute surgical abdomen accounting for 250,000 appendectomies in the United States every year, a large number of other clinical conditions can mimic the presentation of this acute surgical emergency [1]. Those conditions include a variety of gastrointestinal, vascular, genitourinary and gynaecological diseases. It is very important to consider those mimics when assessing patients presenting to the emergency department (ED) with acute right-sided abdominal pain.
The use of imaging modalities such as abdominal and pelvic ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) can be crucial in assessing those equivocal cases with vague nonspecific symptoms. The use of imaging in those circumstances not only aids in ruling in the diagnosis of acute appendicitis but also helps in differentiating other forms of pathology contributing to patient’s symptoms.
The most common imaging modality used in patients with right-sided abdominal pain is abdominal and pelvic CT, which has a sensitivity of 97% and a specificity of 98% [2, 3].
Classical features suggestive of appendicitis on CT include concentric and thickened appendiceal wall, the presence of an appendicolith, fat stranding, mesenteric lymphadenopathy and the presence of surrounding fluid. The presence of other features such as appendiceal wall defect, extraluminal air or localised abscess is more suggestive of a perforated appendix.
Ultrasound abdomen and pelvis is the second most common imaging modality used in patients presenting with acute abdominal pain in whom there is a degree of clinical uncertainty. Ultrasound has a sensitivity of 78% and a specificity of 83% [4]. It is the most preferred imaging modality in pregnancy and paediatric age group due to the inherent risk of radiation associated with computed tomography. Features suggestive of appendicitis on ultrasound include dilated (>6 mm outer diameter) non-compressible appendiceal wall, hyperechoic appendicolith with posterior acoustic shadowing, peri appendiceal fluid collection and mural hyperaemia on colour flow Doppler mode. Although it is the preferred imaging modality in pregnancy, it can be extremely challenging to interpret the images given the distorted abdominal and pelvic viscera especially in the third trimester of pregnancy.
When it comes to the elderly population presenting with acute abdominal pain, choosing the best Imaging modality can be extremely challenging due to the high mortality risk associated with false-negative imaging. The incidence of acute appendicitis in patients older than 50 years of age is only 15% when compared to younger patients where the incidence doubles to 30% [5]. Despite the declining incidence of acute appendicitis with advancing age, there is an increase in mortality rate from 1% in young patients to almost 8% in patients over 65 years of age [5]. This high mortality rate in the elderly age group can be explained by the increased incidences of appendicitis complications such as the development of appendicular abscess and perforation. There is also a considerable decline in the imaging diagnostic accuracy with advancing age as studies have shown that the percentage of patients with positive histological evidence of appendicitis drops from 78% to 64% in patients older than 65 years of age [6]. The use of enhanced CT scan for imaging in the elderly population is superior to ultrasound imaging. The low sensitivity, and negative predictive value along with the increased number of false-negative imaging in patients with complicated appendicitis make the ultrasound modality less preferable when it comes to choosing the best imaging modality. Due to the aforementioned reasons, the Jerusalem guidelines recommend the use of CT with IV contrast in patients older than 60 years old with an Alvarado score ≥ 5 and a negative ultrasound study [7]. This recommendation taking into account the risk of radiation where the number of performed CT scans after a negative ultrasound is reduced by 50% [7, 8]. It is also worth mentioning that the use of ultrasound is very important in screening elderly patients presenting to the Emergency Department with abdominal pain for an aortic abdominal aneurysm which a vascular emergency that can mimic appendicitis. The current recommendation by the UK Royal College of Emergency Medicine (RCEM) is for the Emergency Physician to perform an ultrasound scan on any patient older than 50 years presenting with abdominal pain [9].
The use of magnetic resonance imaging (MRI) depends on accessibility as it differs from one hospital to another. The presence of other more readily accessible imaging modalities such as computed tomography and ultrasound makes the use of magnetic resonance less popular. Features suggestive of appendicitis on MRI include the presence of dilated appendix (>7 mm outer diameter), fat stranding and restricted diffusion.
2. Conditions that mimic appendicitis
2.1 Gastrointestinal diseases
2.1.1 Inflammatory bowel disease (IBD)
Terminal ileitis caused by Crohn’s disease and Backwash ileitis associated with Ulcerative colitis both can present with right lower abdominal pain mimicking acute appendicitis. Typical age group is from 15 to 30 years and clinical presentation usually include symptoms of diarrhoea and bloody stool. IBD cannot be diagnosed via a blood test, however routine blood tests checking for pro-inflammatory markers such as raised white cell count (WCC), C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR) may aid in supporting the diagnosis and monitoring the disease activity later on.
Although colonoscopy remains the investigation of choice for confirming the diagnosis, the use of radiological imaging is warranted when colonoscopy is not accessible.
As per imaging choice, IBD is best evaluated with either CT or MRI enterography and classical findings include bowel wall thickening of more than 3 mm, mucosal hyperenhancement, fat stranding and engorged vasa recta known as “Comb” sign. Management of IBD includes both surgical and non-surgical treatment depending on the severity, the extent of the disease and the presence of complications.
2.1.2 Infectious enterocolitis
This refers to bowel inflammation caused by bacteria, viruses or parasites. Patients commonly present with abdominal pain, tenesmus and diarrhoea. Stools are often purulent and mixed with mucous and blood. Commonly implicated organisms include Campylobacter jujni, Salmonella, Shigella, Escherichia coli, Yersinia enterocolittica, cryptosporidium, Norovirus, Rotavirus and Entamoeba histolytica. Some infections such as tuberculosis and cryptosporidiosis are very important to consider in immunocompromised patients such as those with HIV infection. Routine blood tests looking for raised inflammatory markers along with stool microscopy and culture may help to support the diagnosis and monitor response to antimicrobial therapy. CT features include bowel long-segment circumferential wall thickening with homogenous enhancement and typically with no adjacent fat stranding. Treatment for infectious enterocolitis depends on the causative organisms.
2.1.3 Radiation enteritis
This is an inflammation of the bowel that occurs after radiotherapy. Symptoms include diarrhoea, nausea, vomiting and abdominal pain. Most cases of radiation enteritis resolve spontaneously a few weeks after treatment ends however for some it can extend for months and years after the termination of treatment. CT and MRI findings include bowel wall thickening with luminal narrowing, small bowel obstruction and sometimes the presence of a fistula between the bowel and the bladder or the vagina.
2.1.4 Neutropenic colitis
Also known as Typhlitis is an acute life-threatening condition that affects immunocompromised patients such as patients with HIV disease or those who are on immunosuppressive therapy. The aetiology involves mucosal damage secondary to ischemia and secondary bacterial infection with a predilection for the caecum and ascending colon. Patients may present with abdominal pain, diarrhoea, vomiting and fever. Typhlitis is commonly associated with Neutropenia. Early diagnosis and management are crucial to prevent complications such as perforation and sepsis. Classical CT findings include dilated caecum with circumferential wall thickening, peri-colic fluid collection and pneumatosis. Management includes bowel rest and antibiotic therapy.
2.1.5 Diverticular disease and diverticulitis
This is commonly seen in patients over the age of 40, where small bulging pouches also known as diverticula, form at the weakest portion of the bowel. Diverticulitis is the term used when there is associated inflammation of the diverticula. Symptoms include abdominal pain, vomiting and fever. Risk factors include aging, smoking, low fibre diet, obesity and sedentary life. Laboratory blood tests checking for raised inflammatory markers are useful in making the diagnosis of diverticulitis. Classical features of diverticulitis on CT include bowel wall thickening with infiltration of adjacent mesenteric fat. Managing patients with uncomplicated diverticular disease involves the introduction of low-fibre diet and antibiotics. Surgery is reserved for patients with complications such as perforation, diverticular abscess or fistula formation.
2.1.6 Meckel’s diverticulitis
This is caused by congenital anomaly characterised by the presence of the vitelline duct which normally connects the yolk sac to the midgut during the fetal development. It occurs in 2–3% of the general population [10]. Inflammation of Meckel’s diverticulum usually caused by enterolith and symptoms include abdominal pain, rectal bleeding and vomiting.
CT findings include the identification of a blind-end tubular structure protruding from the antimesenteric side of the distal ileum, wall thickening, hyperenhancement and fat stranding. Management is surgical resection of the diverticulum.
2.2 Vascular diseases
2.2.1 Abdominal aortic aneurysm (AAA)
This is a life-threatening emergency where there is an abnormal dilatation of the abdominal aorta due to vascular wall weakness. This abnormal dilation (1.5 times its normal diameter or greater than 3 cm) of the aorta is commonly seen involving the infrarenal part of the abdominal aorta. AAA is a fatal condition where mortality is about 80% with leaking aneurysm and only half of the patients survive 30 days post emergency repair [11]. AAA is more common in men and the risk factors implicated in the aetiology are the same factors contributing to atherosclerosis such advancing age, diabetes, hypertension, hypercholesterolemia and smoking history. Clinical presentation of AAA includes a variety of symptoms such as abdominal pain, back pain, groin pain, and a pulsating abdominal mass. Ultrasound aorta remains the gold standard for screening patients for AAA in the emergency setting and the UK Royal College of Emergency Medicine (RCEM) recommends that all emergency physicians are to perform ultrasound aorta in all patients who are over the age of 50 presenting with abdominal pain. Disadvantages for ultrasound include difficult studies due to the patient’s body habitus, or the presence of overlying bowel obscuring the visualisation of the aorta. Another downside to the use of ultrasound is its operator dependability and the inability to exclude any aneurysmal leak. CT aortogram is a highly acute study that can confirm the presence and the size of an aneurysm which aids in planning surgery. Management of AAA involves either open repair or endovascular aneurysm repair (EVAR) depending on the fitness of patients for surgery and the morphology of the aneurysm.
2.2.2 Mesenteric ischemia
This refers to small bowel injury secondary to insufficient blood supply which can be acute or chronic. Patients with mesenteric ischemia can present with diarrhoea, rectal bleeding, abdominal pain, especially after eating, and unintentional weight loss due to the fear of eating and vomiting. Risk factors include atrial fibrillation, heart failure and chronic kidney disease. Early CT findings include mesenteric oedema, bowel dilation and wall thickening, mesenteric stranding and the presence of an adjacent solid organ infarction. Treatment depends on the cause of ischemia and as such can be medical or surgical however if it is a late presentation the only treatment is surgical since there is a risk of necrotic bowel.
2.3 Urological diseases
2.3.1 Urolithiasis
Urolithiasis or kidney stone disease can present with a right lower abdominal pain mimicking acute appendicitis. Careful consideration for the presence of obstructive uropathy is very important to prevent kidney injury. CT Urinary system is the gold standard imaging when assessing patients with suspected urolithiasis. CT findings include the identification of a high attenuation calculus within the urinary system with or without hydroureter and hydronephrosis, ureteral wall thickening and adjacent fat stranding.
Ultrasound can be used in patients with ureteric colic to identify any features of hydronephrosis. The only disadvantage of ultrasound imaging is its operator dependability. Conservative treatment is indicated for patients with stones measuring less than 4 mm.
2.3.2 Pyelonephritis
Pyelonephritis or kidney infection is commonly caused by ascending urinary tract infection with the most commonly implicated organism being Escherichia coli. It is a clinical diagnosis where history and clinical examination play a major role. Although imaging such as Computed tomography and Ultrasound can be normal in pyelonephritis, both can be particularly useful in assessment for complications such as abscess formation and identifying emphysematous pyelonephritis, which typically occurs in immunosuppressed patients. Typical features of pyelonephritis on Computed tomography include nephromegaly, delayed nephrogram, perinephric fat stranding and enhancement of the collecting system. Ultrasound features of pyelonephritis include nephromegaly and hydronephrosis with the loss of corticomedullary junction. Treatment includes supportive measures and antibiotics.
2.4 Gynaecological and obstetric diseases
2.4.1 Ectopic pregnancy
This medical emergency occurs when pregnancy happens outside the uterus and needs to be excluded in all women of reproductive age who present with abdominal pain. Blood and urine beta-HCG measurement is crucial in making the diagnosis. The absence of an intrauterine gestational sac on transvaginal ultrasound along with a high beta-HCG, intrapelvic fluid and a delayed period should raise the possibility of an ectopic pregnancy. Ultrasound features include the detection of a yolk sac or a live embryo outside the uterus makes the diagnosis. Other features include the detection of a hyperechoic ring around the adnexal gestation sac also known as the “tubal ring” sign. If detected early, methotrexate can be administered to terminate the ectopic pregnancy. Surgical intervention is indicated in the case of methotrexate contraindication, ruptured ectopic or in patients with hemodynamical instability.
2.4.2 Ovarian torsion
Another medical emergency that should be considered in all women of reproductive age presenting with severe abdominal pain. It is caused by twisting of the ovary around its supporting ligaments cutting the blood supply to the ovary and fallopian tube. Ovarian torsion commonly occurs in patients with ongoing gynaecological pathology such as ovarian cysts, tumours, enlarged corpus luteum or in patients who are undergoing ovarian stimulation for assisted fertilisation. Ultrasound is the first line of imaging and features suggestive of torsion include increased ovarian size more than 4 cm in diameter, heterogeneous appearance due to oedema and haemorrhage, and the detection of a cyst or an ovarian mass. Doppler Arterial and venous flow can be helpful when compared to the other non-affected side. Management includes surgical de-torsion of the ovary and debridement of any necrotic tissue.
2.4.3 Haemorrhagic ovarian cyst
This condition occurs when there is a sudden haemorrhage into an ovarian cyst. Ultrasound findings usually depend on how old the haemorrhage is. Most classical feature on ultrasound is a finely septated fishnet pattern caused by the fibrin bands. Management is usually conservative.
2.4.4 Pelvic inflammatory disease (PID)
This refers to the infection of the female reproductive system caused most commonly as a result of untreated ascending sexually transmitted infections. Most commonly implicated organisms are Chlamydia trachomatis and Neisseria gonorrhoea. Symptoms can be very subtle such as mild abdominal pain with per vaginal discharge. Rarely infection can spread to the liver and other tissues around the liver what is known as Fitz-Hugh-Curtis syndrome or gonococcal perihepatitis. Transvaginal ultrasound features include enlarged heterogenous ovaries, dilated fallopian tubes and adnexal thickening and pelvic fluid collection. CT features of Pelvic inflammatory disease include enlarged ovaries with abnormal enhancement, fluid-filled dilated fallopian tube, pelvic fat stranding, enhancement of the adjacent peritoneum and the presence of a pelvic abscess in severe cases. Treatment is conservative with antibiotics.
2.4.5 Mittelschmerz
This refers to one-sided abdominal pain that is associated with mid-cycle ovulation. Mittelschmerz means “middle pain” in German. If the pain occurs on the right side of the abdomen, it can mimic acute appendicitis. In most cases, mittelschmerz does not warrant any medical treatment.
3. Conclusion
Although the diagnosis of acute appendicitis is essentially clinical, familiarisation with other causes of acute abdominal pain that can mimic appendicitis is equally important especially in females and those with the extremes of age. Here we present a plethora of gastrointestinal, urological, vascular, infectious, and gynaecological conditions that can be similar in presentation to acute appendicitis. The supplementary use of appropriate laboratory tests and radiological imaging can be pivotal where there is clinical uncertainty, not only aiding in confirming the diagnosis of appendicitis or its associated complications but also in identifying other alternative pathology. Routine blood tests that include a full blood count (FBC) and c-reactive protein (CRP) can aid in the diagnosis of acute appendicitis as evidenced by the presence of raised white cell count and CRP. Although raised inflammatory markers can raise the likelihood for clinically suspected acute appendicitis, it is non-specific and less helpful where the clinical presentation is inconclusive and other differential diagnoses are equivocal. A urinalysis also should be considered in all patients with suspected acute appendicitis as part of their workup since it is an important bedside test when assessing for potential renal or urology pathologies such as the presence of blood in urolithiasis or nitrites and leukocytes in urinary tract infection (UTI).
Special consideration is warranted for female patients presenting with abdominal pain as the presence of an underlying gynaecological pathology can potentially complicate the clinical picture and affect the diagnostic accuracy. In this special category of patients, it is particularly important to check the blood or urine samples for beta Human chorionic gonadotrophin hormone (Beta-hCG) in all female patients of childbearing age presenting to the Emergency Department with acute abdominal pain to exclude ectopic pregnancy. Ultrasound remains the first line of imaging in investigating gynaecological pathology (transvaginal ultrasound) and in the paediatric age group due to the inherent risk of radiation associated with CT imaging.
Another special consideration is given to the elderly population where the incidence of acute appendicitis is less common. In assessing elderly patients, it is of a high priority to exclude time-critical conditions such as ruptured abdominal aortic aneurysm and bowel ischemia. The current recommendation by the Royal College of Emergency Medicine in the UK is for the emergency physician to perform an ultrasound aorta in all patients who are older than 50 years presenting with acute abdominal pain to rule out abdominal aortic aneurysm (AAA). A follow up dedicated CT aortogram may be required if the patient is hemodynamically stable to confirm the diagnosis of abdominal aortic aneurysm and to evaluate for any potential leak. Bowel ischemia is another time-critical emergency where there is a compromise to the bowels blood supply. Risk factors for bowel ischemia include diabetes, hypertension, smoking, hypercholesterolemia and atrial fibrillation (AF). It is important to consider the diagnosis of bowel ischemia in all patients who are older than 50 years presenting with a sudden onset of severe abdominal pain along with a raised serum lactate level reflecting organ hypoperfusion. CT abdomen and pelvis with IV contrast or a dedicated CT angiography remains the best imaging technique for all hemodynamically stable patients in whom bowel ischemia is suspected.
As discussed above a variety of clinical conditions can mimic acute appendicitis and familiarisation with those alternative conditions is crucial when deciding what imaging modality will best suit the patient assessment thus increasing the diagnostic accuracy and ensuring optimal care to all patients.
Funding
I have received no financial funding or grants for this paper.
Disclaimer
I declare no conflict of interest.
Dedication
I dedicate this work to my beloved wife and parents who have both supported me throughout my career in emergency medicine. I will always appreciate their love, affection, patience and encouragement.
Abbreviations
AA
Acute appendicitis
AAA
Abdominal aortic aneurysm
US
Ultrasound
CT
Computed tomography
MRI
Magnetic resonance imaging
WCC
White cell count
CRP
C-reactive protein
ESR
Erythrocyte sedimentation rate
\n',keywords:"acute appendicitis, appendicitis mimics, emergency department, Alvarado score, aortic abdominal aneurysm, inflammatory bowel disease, infectious enterocolitis, diverticulitis, radiation enteritis, neutropenic colitis, Meckel’s diverticulitis, mesenteric ischemia, urolithiasis, pyelonephritis, ectopic pregnancy, ovarian torsion, haemorrhagic ovarian cyst, pelvic inflammatory disease, Mittelschmerz",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/75380.pdf",chapterXML:"https://mts.intechopen.com/source/xml/75380.xml",downloadPdfUrl:"/chapter/pdf-download/75380",previewPdfUrl:"/chapter/pdf-preview/75380",totalDownloads:281,totalViews:0,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:0,impactScore:0,impactScorePercentile:40,impactScoreQuartile:2,hasAltmetrics:0,dateSubmitted:"December 13th 2020",dateReviewed:"February 2nd 2021",datePrePublished:"April 26th 2021",datePublished:"January 12th 2022",dateFinished:"February 24th 2021",readingETA:"0",abstract:"Acute appendicitis (AA) is a common surgical diagnosis in patients presenting to the Emergency Department with acute abdominal pain. A wide variety of other clinical conditions can present with a very similar presentation to acute appendicitis and therefore it can be occasionally challenging to make the correct diagnosis. In this review paper, the focus is to shed some light on the differential diagnosis of acute appendicitis which includes a variety of gastrointestinal, vascular, urological, and gynaecological conditions. In the emergency setting there are three main imaging modalities to evaluate patients presenting with abdominal pain, this includes computed tomography (CT), ultrasound (US) and magnetic resonance imaging (MRI). The choice of imaging modality for each clinical condition is variable and as such being familiar with those differential diagnoses is vital in deciding what is the best imaging modality for every patient presenting with abdominal pain.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/75380",risUrl:"/chapter/ris/75380",book:{id:"10316",slug:"doubts-problems-and-certainties-about-acute-appendicitis"},signatures:"Esam Amer",authors:[{id:"332649",title:"Dr.",name:"Esam",middleName:null,surname:"Amer",fullName:"Esam Amer",slug:"esam-amer",email:"dr_esamamer@yahoo.com",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332649/images/15763_n.jpg",institution:{name:"Royal College of Physicians of Edinburgh",institutionURL:null,country:{name:"United Kingdom"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Conditions that mimic appendicitis",level:"1"},{id:"sec_2_2",title:"2.1 Gastrointestinal diseases",level:"2"},{id:"sec_2_3",title:"2.1.1 Inflammatory bowel disease (IBD)",level:"3"},{id:"sec_3_3",title:"2.1.2 Infectious enterocolitis",level:"3"},{id:"sec_4_3",title:"2.1.3 Radiation enteritis",level:"3"},{id:"sec_5_3",title:"2.1.4 Neutropenic colitis",level:"3"},{id:"sec_6_3",title:"2.1.5 Diverticular disease and diverticulitis",level:"3"},{id:"sec_7_3",title:"2.1.6 Meckel’s diverticulitis",level:"3"},{id:"sec_9_2",title:"2.2 Vascular diseases",level:"2"},{id:"sec_9_3",title:"2.2.1 Abdominal aortic aneurysm (AAA)",level:"3"},{id:"sec_10_3",title:"2.2.2 Mesenteric ischemia",level:"3"},{id:"sec_12_2",title:"2.3 Urological diseases",level:"2"},{id:"sec_12_3",title:"2.3.1 Urolithiasis",level:"3"},{id:"sec_13_3",title:"2.3.2 Pyelonephritis",level:"3"},{id:"sec_15_2",title:"2.4 Gynaecological and obstetric diseases",level:"2"},{id:"sec_15_3",title:"2.4.1 Ectopic pregnancy",level:"3"},{id:"sec_16_3",title:"2.4.2 Ovarian torsion",level:"3"},{id:"sec_17_3",title:"2.4.3 Haemorrhagic ovarian cyst",level:"3"},{id:"sec_18_3",title:"2.4.4 Pelvic inflammatory disease (PID)",level:"3"},{id:"sec_19_3",title:"2.4.5 Mittelschmerz",level:"3"},{id:"sec_22",title:"3. Conclusion",level:"1"},{id:"sec_23",title:"Funding",level:"1"},{id:"sec_24",title:"Disclaimer",level:"1"},{id:"sec_25",title:"Dedication",level:"1"},{id:"sec_28",title:"Abbreviations",level:"1"}],chapterReferences:[{id:"B1",body:'Addiss D, Shaffer N, Fowler B, Tauxe R. The epidemiology of appendicitis and appendectomy in the united states. American Journal of Epidemiology. 1990;132(5):910-925'},{id:"B2",body:'Raman SS, Lu DS, Kadell BM, Vodopich DJ, Sayre J, Cryer H. Accuracy of non-focused helical CT for the diagnosis of acute appendicitis: a 5-year review. AJR American journal of roentgenology 2002; 178:1319-1325'},{id:"B3",body:'Rao PM, Rhea JT, Novelline RA, et al. Helical CT technique for the diagnosis of appendicitis: a prospective evaluation of a focused appendix CT examination. Radiology 1997; 202:139-144'},{id:"B4",body:'Rosen MP, Ding A, Blake MA, et al. ACR Appropriateness Criteria(R) right lower quadrant pain--suspected appendicitis. 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World J Emerg Surg. 2016 Jul 18; 11:34. doi: https://doi.org/10.1186/s13017-016-0090-5'},{id:"B8",body:'Poortman P, Oostvogel HJ, Bosma E, Lohle PN, Cuesta MA, de Lange-de Klerk ES, Hamming JF. Improving diagnosis of acute appendicitis: results of a diagnostic pathway with standard use of ultrasonography followed by selective use of CT. J Am Coll Surg. 2009 Mar;208(3):434-441. doi: https://doi.org/10.1016/j.jamcollsurg.2008.12.003'},{id:"B9",body:'Management and Transfer of Patients with a Diagnosis of Ruptured Abdominal Aortic Aneurysm to a Specialist Vascular Centre [Internet]. Rcem.ac.uk. 2019 [cited 7 January 2021]. Available from: https://www.rcem.ac.uk/docs/RCEM%20Guidance/RCEM_BPC_rAAA_220119%20FINAL.pdf'},{id:"B10",body:'Sagar J, Kumar V, Shah DK. Meckel’s diverticulum: a systematic review. J R Soc Med. 2006 Oct;99(10):501-505'},{id:"B11",body:'Aortic Aneurysms | BSIR [Internet]. Bsir.org. 2018 [cited 7 January 2021]. Available from: https://www.bsir.org/patients/aortic-aneurysms/'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Esam Amer",address:"dr_esamamer@yahoo.com",affiliation:'
Department of Accident and Emergency, Ipswich General Hospital, East Suffolk and North Essex NHS Foundation Trust, Ipswich, United Kingdom
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1. Introduction
Analog Astronaut Training Center (AATC) is a private company, which main mission is to develop activities for safe human spaceflight available for all in spirit of the New Space era. Sending humans to Moon and Mars is definitely one of the largest challenges for humanity of the twenty-first century. It will bring smart solutions to climate change problems. Failure is not an option since it’s not only a matter of money but a matter of life. Human spaceflight studies rapidly increase the price and quality of human spaceflight studies. But such work gives the largest return of investment: new science, new technologies and new lifestyles for everyone including not only humans but all living creatures. Among several variants of testing platforms for human spaceflight R&Ds, analog simulations seem to be more and more efficient in releasing advanced TLR projects, where TLR means Technology Readiness Level – a standard parameter used by space sector community. We organise and coordinate scientific studies, introduce new technologies, incubate new start-ups and facilitate carriers for space passionates. The initial motivation to create AATC was a project titled “Time Architecture” developed in 2016 at Advanced Concepts Team in European Space and Technology Centre (ESTEC), Netherlands [1]. The main idea of the time architecture concept is to modulate time perception in human brains in a way to decrease ageing processes and to optimise the circadian clock performance to keep the optimal health of people working and living in isolated spaces. In order to prove the concept, there was a need to perform appropriate investigations on humans in special laboratory conditions. Available in Europe, chronobiological chambers (laboratories to study biological clocks on humans) were very expensive to use and restricted to perform experiments only for two people at the time, limiting the statistical power of generated results. Therefore, the cheapest and the most efficient solution was to create a new, specially customised laboratory to test humans in isolation from sunlight and time. Because experiments on time perception require a minimum 1–2 weeks of stay in isolation, it was reasonable to combine biological clock experiments with trainings simulating the space mission. In order to make trainings attractive for people, a unique program of training was elaborated, and the foundation for analog astronaut mission scenarios was developed for lunar, Martian and orbital simulations.
Origins of analog missions in Poland were hard, what is presented on the Figure 1. We had laboratory equipment, mission scenarios, mission protocols, passionated collaborators and analog astronauts, but we struggled with inadequacies in infrastructure. Despite all obstacles, every year we moved forward: in 2016, we built Modular Analog Research Station (M.A.R.S.) in Turza and organised the first lunar analog simulation at Queen Jadwiga Astronomical Observatory in Rzepiennik. In the beginning of 2017, M.A.R.S. base was moved 700 km north to a different location—a military airport in Piła. The new base was expanded by merging six M.A.R.S.’s containers and dome with a hangar dedicated for EVA trainings.
Figure 1.
The history of analog missions in Poland. The first analog mission was organised in 2016 under the M.A.R.S. affiliations. The first simulation was 6 days long and was crucial to gain the know-how and the initial experience to adjust mission scenarios for future activities. All people involved at this stage of the project were Polish with various specialisations and levels of professionalism. In the same year, a Space Garden company was established to act as an incubator for start-ups related with development of space technologies (that is why we named it garden). In 2017, the base (6 containers and dome) was transported through the whole country to military airport in Piła. The base was expanded with a large isolated from sunlight EVA training terrain. The base was renamed from M.A.R.S. to LunAres. New environments and possibilities followed modernisation of the mission scenarios and opening up of new training opportunities for educational purposes. Another 8 missions were organised gaining critical experience. LunAres became independent unit belonging to Space Garden, operated by Space is More company, which until now organised 8 additional analog missions not depicted on this graphics. In 2019, in the south of Poland an additional base—independent and fully private Analog Astronaut Training Center—was created; it is now located in a confined 57 m2 smart space fully controlled by multiple sensors and completely isolated from sunlight and time. AATC is focused on organisation of scientific and educational analog simulations. Until now, we have organised 30 analog missions in this location.
The base was renamed as Lunares. In 2017, after organising eight scientific and educational missions, we moved back to Rzepiennik, establishing the Analog Astronaut Training Center to be completely an independent private organisation. In this paper, we present results from lunar and Martian analog missions organised in Poland. A series of technological, operational, medical, biological, geological, ecological and human factors projects towards the goals of the future manned space missions were initiated and successfully developed. The results from these missions provide recommendations for future manned expeditions to increase the quality of simulation. Additionally, we focussed on optimisation of procedures and scheduling methods as well as science return based on improved resource allocation and crew habitation.
2. Educational analog missions
By educational analog mission, we mean hands-on experience of multidisciplinary experiments and tasks mounted in the space mission scenario. Objectives of this type of training are clearly defined and easy to evaluate, even in the form of self-evaluation. AATC elaborated three types of trainings adjusted to three basic levels of education: primary school kids, high school pupils and students. For each group, we prepared different types of trainings based on the participants’ background.
In the case of primary school kids, we organised Junior Space Camps [2]. The main aim of these types of trainings is practical application of STEAM subjects and learning of effective teamwork. Attention is given to the development of exploration skills and skills related to decision making, asking questions, being sceptical, hardworking, precise and patient. Multiple puzzles mixed with the development of manual skills are implemented in the training process and this makes such analog missions continuously exciting, engaging multiple senses and skills at the time. We developed short and long time duration trainings. Short trainings are designed in a way, that each participant receives a working card with 20 assignments to be realized under specific responsibilities and roles. Such work is presented on Figure 2. Each assignment is evaluated considering the quality of performance and time of realisation. The document (a working card) contains elements of a real astronaut training such as solving mathematical, linguistic, technological problems as well as cognitive tasks. Each working card is different for each participant depending on selected role and responsibilities. For example, commander receives a dedicated working card containing planning and management tasks, astrobiologist receives tasks related with space biology experiments, data officer will work on collecting environmental and physiological data, etc. All working cards are complementary and require performing dedicated tasks in the right order what requires good communication and management skills within the crew. Working cards are designed according to the time of the educational mission. Some of them can be performed at school for 3 h; other training programmes are made to run in the habitat. This type of training can be longer, even until 7 days in the form of Green School or Junior Space Camp.
Figure 2.
Lunar educational mission “ Youth for Moon” consisted on 25 pupils divided into two groups: analog astronauts and mission control center. All analog astronauts and mission control center participants were working point by point according to their printed versions of working cards (visible in the hand of one of individuals).
For secondary school pupils, we also focussed on STEAM subjects, but this time, orienting the training towards efficient support in the selection of future careers. Most of the secondary pupils are interested in testing themselves in different roles such as mission commander, scientist, engineer, communication officer, data officer, journalist, medical surgeon, astronomer, planetary scientist, geophysicist, mathematician, computer scientist and so on. In order to obtain the best results, participants are able to try all interested roles, potentially their future jobs (even 3 role shifts at the time of training, if necessary), and then decide, which role suits them the best. All pupils whom we trained like this, approved that this type of training was unique and very helpful for them to decide what to do in the future. The training itself was based on the pre-training phase, familiarising with the mission manual and habitat procedures. After pre-training, participants are requested to select their roles for the analog mission. Each role with its responsibilities is described in the mission manual. Each role is assigned to separate scenarios and dedicated tasks incorporated in the mission schedule. Each scenario is designed in a way that it is interlocked with scenarios of other roles; so a single scenario cannot be realised without the support of interlocked components. Each participant receives an individual training manual (mission scenario), with specified tasks to be done in a specific order. Pupils are requested to write reports and solve all tasks in the way it is described in the training manual. The mission success is determined by the realisation of all required tasks, timing, motivation of the crew, quality of performed tasks and independence (parameter computed based on number of contacts with remote mission control centre). At the end of the analog mission, participants present their results on the summary meeting. Everyone elaborates the lessons learned.
The largest group we educate are students who want to develop their career in space sector. Analog simulations are attractive, short term and efficient internships to gain unique experience and condensed knowledge in practice. Analog simulations help to win international internships at ESA, NASA and scholar grants. One of our analog astronauts participating in the mission Spectra—Dr. Sian Proctor flown to space in the first civilian mission “Inspiration 4” organised by Space X in September 2021. Increased number of engineer, master and doctoral theses realized at AATC approve, that analog missions are no longer game or exclusive holidays but can be useful in shaping future careers. This new approach oriented on personal development increases the credibility of such type of trainings. Analog astronauts are no longer funny people wearing blue suits. Global situation and increased interest in commercialisation of human spaceflight catalyse the transition of analog simulations into platform for scientific studies and development of technologies.
Students are selected based on the mission call, where they are asked to send CV and cover letter. Using this information we adjust training system relevant to the background of the mission candidate. The main part of this training is to perform experiment inside the analog environment. This task requires multiple decisions to be made, considering the limitations of time and distance, restricted communication, simple tools and workspace. Work is performed in a noisy environment similar to that in a space station. Artificial lighting and crew mates mounted in the mission schedule create demanding conditions which induce stressful environment and need to explore new ways of solving completely new problems. Effects of training during educational missions are cooperation, creative problem solving, building a common strategy, systematic work, professional commands/language, organisation of work time, delegating tasks, providing information transfer and fast decision making.
Analog mission is based on established simulations.
We simulate:
language specific for astronauts and mission control centres,
experiments in simulated microgravity on Random Positioning Machines
experiments on lunar and Martian regolith simulants
flight suits, EVA suits and airlock mock-ups
emergency situations
Remote analog missions are based on training manuals and realisation of mission tasks that do not require the habitat environment. These tasks are based on processing satellite data, monitoring space weather, making astronomical observations, solving astropuzzles (Figure 3) and folding space origami (Figure 4). Because of huge interest in space origami, we published a small booklet with models, which can be freely downloaded from our website [3].
Figure 3.
Example of astropuzzles. A: find coordinates of yellow star. B: solution of this puzzle presented in the training manual of one of our pupils. Participants are requested not only to find numbers but also to describe the method which they used. C and D: astropuzzle: find a star labelled in the red circle on the D image. This kind of astropuzzles is used to find constellations of points. When all points are correctly defined, they create a specific shape which is the final answer for the task.
Figure 4.
Space origami is a manual training and practical demonstration bringing lots of joy in learning of space topics. Folded structures are made using space technologies such as hydrogel materials, NRC foil and other composites. Hexagons, flexagons, cubesats, antennas, radar reflectors, solar panels, space shuttles and rockets are some of examples used in the training.
At the end of each successful analog simulation, we generate certificates. What is important to note is that we organise analog missions not only inside the habitat, but remotely and at schools around the world, for example in New Delhi (Figure 5).
Figure 5.
The final day of the educational training at the Modern School in New Delhi. Happy analog astronauts with their certificates after 1 week of training. Visible on the table awarded projects of lunar and Martian bases, designed mission patches and astronaut helmets.
3. Scientific analog missions
Scientific experiments in space are limited by strict policy rules as well as size and mass limits. Most of the scientists cannot afford to send their experiments to space because of high costs. Creating analogous environment on the Earth enables alternative and much cheaper opportunities. The Analog Astronaut Training Center develops multidisciplinary scientific projects in collaboration with research centres, universities, space agencies and private space companies. These projects are often the development of master, engineer, and PhD theses, investigating high-risk hypotheses.
The following are the scientific projects with AATC:
VIS/NIR reflectance and fluorescence spectrometric studies of minerals, water, organics and biomarkers in MoonMars analogue samples [4]
Bacterial cellulose for clothes production in space using kombucha microbial consortium [5]
Hydrogel bacterial cellulose: a patch to improved materials for new eco-friendly textiles [6]
Cardiorespiratory profiling during simulated lunar mission using impedance pneumography [7]—doctoral thesis
Circadian clock and subjective time perception: a simple open-source application for the Analysis of Induced Time Perception in Humans [8]
Human Nature: The Subject and the Headache of IoT-Based Sociometric Studies [9]
Remote research in lunar and Martian analog international missions to rise knowledge about life in isolation [11]
The influence of diet on behaviour in simulated space mission conditions [12]—doctoral thesis
Effects of sunlight simulator lighting system on serotonin, melatonin and physiological parameters related with circadian clock of the analog astronaut crews performing simulation of space mission in the AATC habitat in Poland [13]
Non-circulative hydroponics to preserve plant health during a long-time power failure in a space colony [14]
HabitatOS—operating system with IoT sensors and machine learning/data analysis—master’s thesis
HabitatOS sensor data analysis for analog simulations at AATC habitat from 2016 to 2020 [16]
Reliability in Extreme Isolation: A natural language processing tool for stress self-assessment [17]
Design and shielding for a future Moon habitat—master’s thesis [18]
Design of the first colony on Mars—master thesis [19]
Experiments which cannot be done on Earth—Alldream institute [20]
Using a state-of-the art human centrifuge to simulate space flight with Soyuz MS-10 rocket and re-entry into the atmosphere
Comparative analysis of mass loss, digestion and aggression in cockroaches exposed to sunlight simulator lighting system in an analog habitat environment [21]
Analog missions for students require preparations before the mission launch. The optimal time of mission preparations is 2 months. After the recruitment phase, students are asked to fill in a spreadsheet with basic information concerning communication, interests, affiliations and proposed experiments. AATC encourages students to bring their own experiments to the habitat. Each experiment must be described in a special research collaboration form. After approval, students transfer their experiment title, description and procedures to the main mission document, which is called the Mission Manual. The Mission Manual is an internal document describing the whole mission scenario including mission objectives, mission procedures, operations and the main expected results. Based on this information there is a possibility to evaluate the quality of the mission and analog astronauts’ performance.
Analog Astronaut Training Center serves as unique laboratory platform for multidisciplinary projects covering geology, robotics, telecommunication, space architecture, biology, nutrition, medicine, ecology, life support systems and agriculture. For each mission we prepare customised laboratory equipment, chemical reagents and tools dedicated for specific projects. We collaborate with several laboratories, research centres and engineering teams to get algae, plant or animal species, specific yeast and bacteria lines, liquid nitrogen, dry ice, regolith simulants, centrifuges, microscopes, rovers, landers, lidars and spectrometers.
AATC aims to expand activities in the following areas:
work optimization in interdisciplinary environments;
multiculturalism;
smart biohacking;
ecology and in situ resource utilization;
smart telerobotic technologies based on artificial intelligence
technologies related to health and safety in areas isolated from the natural environment
life support systems and sustainability
space tourism
applying and realisation of grants
start-up incubation
4. Technology development
Scientific approaches and researching to solve fundamental problems for safe colonisation of Moon and Mars lead to the development of new technologies. AATC realises technology grants based on concepts and prototypes implemented and tested inside the habitat. The first technology developed in AATC is the sunlight simulator lighting system to synchronise biological clocks (Figure 6). Several prototypes have been made and tested in isolated conditions on plants, animals and humans (under bioethical committee approvals).
Figure 6.
Sunlight simulator system to generate various cocktails of light with unique functionalities such as raising serotonin and vitamin D levels.
Figure 7.
Analog astronauts working with us as M.A.R.S., LunAres, or AATC. Each of this person invested private money and time in development of human spaceflight commercial programs. Thank you for sharing your passions and giving us a wonderful feedback and motivation to be better in what we love to do. Ad Astra!
Other technologies that are being developed in AATC in collaboration with scientific partners are as follows:
hydroponic systems
aquaponic systems
air purification systems
hypergravity simulators
clothes in space
3d printed materials from bacterial nanocellulose
telemedical devices
gravity machines for scientific purposes
habitat operational system based on machine learning integrated with multiple sensors,
advanced crew medical restraint system—platform for advanced cardiovascular life support (ACLS) procedures for microgravity CPR, IV/IO access and advanced airway management on incapacitated astronaut for commercial human spaceflight applications
5. Habitat
Technology development in AATC is a natural process triggered by needs to create the optimal space for performing analog simulations at the highest quality. Actually we develop microgravity simulations for humans in pressurised spacesuits. Every year we develop new instruments, mock-ups and attractions for analog astronauts. All this is possible because of having independent and expandable habitat. By name “habitat” we mean fully equipped (including dedicated software), human spaceflight research facility for long-term isolated crewed projects. AATC Habitat (TRL level 5) is a bioastronautics research laboratory proving ground for future Moon and Mars missions (Table 1). The habitat is adjusted to mission requirements, which are isolation from sunlight, remotely controlled sunlight simulator lighting system, confined space, healthy mineral water access, healthy atmosphere, safe environment, social isolation (limit of people inside the base is 6), multiple communication channels including protected LoRaWAN network, two laboratories: clean lab and geolab to run critical experiments, smart sensors and monitoring systems implemented with the mission control, vertigo training equipment, gyroscopes, tele medical devices. The total living surface is 52.7 m2. In 2020, we started to expand the infrastructure due to increasing demands for high quality training, education and scientific research. The new infrastructure will be 300 m2 with more than 1 ha of specially formed EVA terrain. Perspectives for analog missions are promising. Actually we collaborate with more than 20 universities and educational centres in the world. Our next big step will be to implement educational analog missions in European Credit Transfer and Accumulation System (ECTS), so students can gain not only experience and publications but also valuable credits. Among collaborative partners we can distinguish: the International Lunar Exploration Working Group (ILEWG), EuroMoonMars, IPSA Toulouse, European Space Agency (ESA), Embry Riddle Aeronautical University (ERAU), SCK-CEN in Belgium, Military University of Technology in Poland, Polish Military Institute of Aviation Medicine, Space Research Center in Poland, Jagiellonian University, Space Technologies Center at AGH, University of Padva, Politecnico di Milano, University of Warwick, University of Glasgow, London Imperial College, KU Leuven and Italian research centers (IBFM, INFN-LNS and STEBICEF). We search for collaborations to develop unique space habitat equipment, which can be mobile and be used by universities, academic centres, companies and schools, even in the pandemic state. We also search for collaborations with artists [22, 23].
Table 1.
Analog missions organised in Poland.
Authors listed only organised or co-organised missions by themselves without considering 13 missions in 2021. Four more missions were organised in Lunares habitat.
6. Training activities
Analog missions are the most dominant form of activities of AATC. However, we provide much more types of practical trainings related with commercial astronautics and future space tourism, for example, stratospheric missions, rocket workshops (in collaboration with Polish Rocket Society), underwater EVAs in neutral buoyancy, diving, open sea survival and HUET training (in collaboration with Marine School), skydiving (in collaboration with Skydiving Association in Piła), survival (in collaboration with special forces), human centrifuge training and hyperbaric trainings in collaboration with Military University of Aviation Medicine. The main objective is to provide trainings similar or identical to the real astronaut trainings. While searching for such possibilities, surprisingly we found out, that training facilities and professional equipment are available in Poland. What is even more interesting is that the prices for these unique trainings are affordable by everyone. This means, that commercial astronautics have chances to grow quickly in the era of space commercialisation. Infrastructure and teachers already exist.
7. Conclusions
Educational and scientific missions are inspiring alternatives for conventional learning. They become more and more a professional platform to perform space studies, with a wide range of opportunities for development of new technologies. They act as an incubator for innovative science, where science fiction is transformed into reality. Participants can use their imagination and creativity without limits and use it as a trampoline to jump directly into professional space projects. This is what we observe in AATC. Analog missions motivate students to write publications in relevant scientific journals and popular science media. They bring valuable experience and training dedicated to work in space sector. They are unique for team-building, with independent access and international activity. Analog missions are the most attractive form of the training which we offer. Other types of trainings require good health and coping with various extreme situations.
Acknowledgments
This work cannot be described without our analog astronauts (Figure 7) and people, who believed in us and supported in organisation of analog missions. The list is long (more than 100 people) and will only be longer. Thank you all for this contribution into the NewSpace era. We wish you a safe and pleasant flight to space as soon as it is possible and in as cost effective way as possible. Think about it and just make it happen.
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Growing experience in educational aspect of the training as well as continuous development of the habitat and its professional space science laboratory equipment correspond to increased interest of educational organizations, universities, and individual students. We serve unique practical platform for space engineering, space master, and even space doctoral theses. In addition to a wide range of training courses offered for future astronauts, for example, diving, skydiving, rocket workshops, and stratospheric missions, AATC provides a private laboratory to simulate the space environment. It carries out scientific experiments focused on biology and space medicine, as well as addressing several multidisciplinary issues related to the Moon and Mars exploration, including space mining. The main goal of each our analog simulation is to get publishable results, what means that our analog astronauts obtain not only certification of completion of the training but also ability to continue studies and to perform it individually. This chapter summarizes methodology used by us, didactic tools, and obtained results for both educational and scientific analog simulations.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/80217",risUrl:"/chapter/ris/80217",signatures:"Agata Maria Kołodziejczyk and M. Harasymczuk",book:{id:"10955",type:"book",title:"Lunar Science - Habitat and Humans",subtitle:null,fullTitle:"Lunar Science - Habitat and Humans",slug:null,publishedDate:null,bookSignature:"Dr. Yann H. Chemin",coverURL:"https://cdn.intechopen.com/books/images_new/10955.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80355-079-4",printIsbn:"978-1-80355-078-7",pdfIsbn:"978-1-80355-080-0",isAvailableForWebshopOrdering:!0,editors:[{id:"270578",title:"Dr.",name:"Yann",middleName:"H.",surname:"Chemin",slug:"yann-chemin",fullName:"Yann Chemin"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Educational analog missions",level:"1"},{id:"sec_3",title:"3. Scientific analog missions",level:"1"},{id:"sec_4",title:"4. Technology development",level:"1"},{id:"sec_5",title:"5. Habitat",level:"1"},{id:"sec_6",title:"6. Training activities",level:"1"},{id:"sec_7",title:"7. Conclusions",level:"1"},{id:"sec_8",title:"Acknowledgments",level:"1"}],chapterReferences:[{id:"B1",body:'Kolodziejczyk A et al. Time architecture. Acta Futura. 2016;10:37-44'},{id:"B2",body:'Kołodziejczyk A et al. Educational analog missions in Lunares habitat in Poland. In: Proceedings of the 69th International Astronautical Congress (IAC); 1-5 October 2018; Bremen, Germany. IAC-18,A1,7,15,x45646. 2018'},{id:"B3",body:'Kołodziejczyk A et al. Kosmiczne Origami. 2020. ISBN: 978-83-956752-2-5'},{id:"B4",body:'Vos H et al. VIS/NIR reflectance and fluorescence spectrometric studies of minerals, water, organics and biomarkers in MoonMars analogue samples. EGU General Assembly 2017. European Geosciences Union; Vienna, Austria. 2017. Abstract. EGU2017-1537'},{id:"B5",body:'Kołodziejczyk A et al. Bacterial cellulose for clothes production in space using kombucha microbial consortium. In: 69th International Astronautical Congress (IAC); 1-5 October 2018; Bremen, Germany. IAC-18,A1,7,15,x45657. 2018'},{id:"B6",body:'Kamiński K, Jarosz M, Grudzień J, et al. Hydrogel bacterial cellulose: A path to improved materials for new eco-friendly textiles. Cellulose. 2020;27:5353-5365. DOI: 10.1007/s10570-020-03128-3'},{id:"B7",body:'Młyńczak M et al. Cardiorespiratory profiling during simulated lunar mission using impedance pneumography. Biomedical Signal Processing and Control. 2019;51:216-221'},{id:"B8",body:'Kolodziejczyk et al. Circadian clock and subjective time perception: A simple open source application for the analysis of induced time perception in humans. International Journal of Medical, Health, Biomedical, Bioengineering and Pharmaceutical Engineering. International Journal of Cognitive and Language Sciences. 2017;11(3). DOI: 10.5281/zenodo.1129596'},{id:"B9",body:'Matraszek M et al. Human nature: The subject and the headache of IoT-based sociometric studies. In: EWSN ‘20: Proceedings of the 2020 International Conference on Embedded Wireless Systems and Networks on Proceedings of the 2020 International Conference on Embedded Wireless Systems and Networks. 2020. pp. 265-270'},{id:"B10",body:'Kołodziejczyk A et al. Sunlight simulator for isolated spaces. ICES2021. 2021'},{id:"B11",body:'Kołodziejczyk A et al. Remote research in lunar and martian analog international missions to rise knowledge about life in isolation. EGU21-8684. 2021'},{id:"B12",body:'Bubrowska N et al. The influence of diet on behavior in simulated space mission conditions. GLEX-2021,8,3,4,x62182. 2021'},{id:"B13",body:'Kołodziejczyk et al. Effects of sunlight simulator lighting system on serotonin, melatonin and physiological parameters related with circadian clock of the analog astronaut crews performing simulation of space mission in the AATC habitat in Poland. GLEX-2021,8,2,4,x62201. 2021'},{id:"B14",body:'Forgues-Mayet E et al. Non-circulative hydroponics to preserve plant health during a long-time power failure in a space colony. GLEX-2021,11,2,8,x62393. 2021'},{id:"B15",body:'Trzos et al. CPR and rescuer’s position in microgravity. GLEX-2021,8,2,8,x62457. 2021'},{id:"B16",body:'Harasymczuk M et al. HabitatOS sensor data analysis for analog simulations at AATC habitat from 2016-2020. GLEX-2021,11,2,6,x62477. 2021'},{id:"B17",body:'Alcibiade A et al. Reliability in extreme isolation: A natural language processing tool for stress self-assessment. Advances in Human Factors and Systems Interaction. 2020. ISBN: 978-3-030-51368-9'},{id:"B18",body:'Ptak M. The project of the modular, self-sustaining Mars base in the initial stage of colonisation process [master thesis]. Cracow University of Technology; 2019'},{id:"B19",body:'Nieuwborg A. Design and shielding for a future Moon habitat [master thesis]. 2019'},{id:"B20",body:'Pelc J et al. Alldream Lunar Institute, Home on the Moon Project. 2020. ISBN: 978-83-956752-1-8. Available from: www.astronaut.center website'},{id:"B21",body:'Kolodziejczyk A et al. Comparative analysis of mass loss, digestion and aggression in cockroaches exposed to sunlight simulator lighting system in analog habitat environment. Poster at COSPAR. 2021'},{id:"B22",body:'Pell S. Apollo and the Muses: A preliminary discussion of the cultural and technical inspirational knowledge embedded in the lunar space arts of an analogue mission. In: 70th International Astronautical Congress (IAC); 21-25 October 2019; Washington D.C, United States: 2019. IAC-19-E5,3.11'},{id:"B23",body:'Pell S et al. Human spaceflight performance: Bootstrapping the intersection of biometrics and artistic expression through planetary mission analogue EVAs. In: 70th International Astronautical Congress (IAC); 21-25 October 2019; Washington D.C, United States: 2019. 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\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
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\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
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\r\n\t
\r\n
\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
\r\n
\r\n\t
\r\n
\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
\r\n
\r\n\t
\r\n
\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
\r\n
\r\n\t
\r\n
\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
\r\n
\r\n\t
\r\n
\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
\r\n
\r\n\t
\r\n
\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
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His research interest focuses on computational chemistry and molecular modeling of diverse systems of pharmacological, food, and alternative energy interests by resorting to DFT and Conceptual DFT. He has authored a coauthored more than 255 peer-reviewed papers, 32 book chapters, and 2 edited books. He has delivered speeches at many international and domestic conferences. He serves as a reviewer for more than eighty international journals, books, and research proposals as well as an editor for special issues of renowned scientific journals.",institutionString:"Centro de Investigación en Materiales Avanzados",institution:{name:"Centro de Investigación en Materiales Avanzados",country:{name:"Mexico"}}},{id:"76477",title:"Prof.",name:"Mirza",middleName:null,surname:"Hasanuzzaman",slug:"mirza-hasanuzzaman",fullName:"Mirza Hasanuzzaman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/76477/images/system/76477.png",biography:"Dr. Mirza Hasanuzzaman is a Professor of Agronomy at Sher-e-Bangla Agricultural University, Bangladesh. He received his Ph.D. in Plant Stress Physiology and Antioxidant Metabolism from Ehime University, Japan, with a scholarship from the Japanese Government (MEXT). Later, he completed his postdoctoral research at the Center of Molecular Biosciences, University of the Ryukyus, Japan, as a recipient of the Japan Society for the Promotion of Science (JSPS) postdoctoral fellowship. He was also the recipient of the Australian Government Endeavour Research Fellowship for postdoctoral research as an adjunct senior researcher at the University of Tasmania, Australia. Dr. Hasanuzzaman’s current work is focused on the physiological and molecular mechanisms of environmental stress tolerance. Dr. Hasanuzzaman has published more than 150 articles in peer-reviewed journals. He has edited ten books and written more than forty book chapters on important aspects of plant physiology, plant stress tolerance, and crop production. According to Scopus, Dr. Hasanuzzaman’s publications have received more than 10,500 citations with an h-index of 53. He has been named a Highly Cited Researcher by Clarivate. He is an editor and reviewer for more than fifty peer-reviewed international journals and was a recipient of the “Publons Peer Review Award” in 2017, 2018, and 2019. He has been honored by different authorities for his outstanding performance in various fields like research and education, and he has received the World Academy of Science Young Scientist Award (2014) and the University Grants Commission (UGC) Award 2018. He is a fellow of the Bangladesh Academy of Sciences (BAS) and the Royal Society of Biology.",institutionString:"Sher-e-Bangla Agricultural University",institution:{name:"Sher-e-Bangla Agricultural University",country:{name:"Bangladesh"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",biography:"Kusal K. Das is a Distinguished Chair Professor of Physiology, Shri B. M. Patil Medical College and Director, Centre for Advanced Medical Research (CAMR), BLDE (Deemed to be University), Vijayapur, Karnataka, India. Dr. Das did his M.S. and Ph.D. in Human Physiology from the University of Calcutta, Kolkata. His area of research is focused on understanding of molecular mechanisms of heavy metal activated low oxygen sensing pathways in vascular pathophysiology. He has invented a new method of estimation of serum vitamin E. His expertise in critical experimental protocols on vascular functions in experimental animals was well documented by his quality of publications. He was a Visiting Professor of Medicine at University of Leeds, United Kingdom (2014-2016) and Tulane University, New Orleans, USA (2017). For his immense contribution in medical research Ministry of Science and Technology, Government of India conferred him 'G.P. Chatterjee Memorial Research Prize-2019” and he is also the recipient of 'Dr.Raja Ramanna State Scientist Award 2015” by Government of Karnataka. He is a Fellow of the Royal Society of Biology (FRSB), London and Honorary Fellow of Karnataka Science and Technology Academy, Department of Science and Technology, Government of Karnataka.",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"243660",title:"Dr.",name:"Mallanagouda Shivanagouda",middleName:null,surname:"Biradar",slug:"mallanagouda-shivanagouda-biradar",fullName:"Mallanagouda Shivanagouda Biradar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243660/images/system/243660.jpeg",biography:"M. S. Biradar is Vice Chancellor and Professor of Medicine of\nBLDE (Deemed to be University), Vijayapura, Karnataka, India.\nHe obtained his MD with a gold medal in General Medicine and\nhas devoted himself to medical teaching, research, and administrations. He has also immensely contributed to medical research\non vascular medicine, which is reflected by his numerous publications including books and book chapters. Professor Biradar was\nalso Visiting Professor at Tulane University School of Medicine, New Orleans, USA.",institutionString:"BLDE (Deemed to be University)",institution:{name:"BLDE University",country:{name:"India"}}},{id:"289796",title:"Dr.",name:"Swastika",middleName:null,surname:"Das",slug:"swastika-das",fullName:"Swastika Das",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/289796/images/system/289796.jpeg",biography:"Swastika N. Das is Professor of Chemistry at the V. P. Dr. P. G.\nHalakatti College of Engineering and Technology, BLDE (Deemed\nto be University), Vijayapura, Karnataka, India. She obtained an\nMSc, MPhil, and PhD in Chemistry from Sambalpur University,\nOdisha, India. Her areas of research interest are medicinal chemistry, chemical kinetics, and free radical chemistry. She is a member\nof the investigators who invented a new modified method of estimation of serum vitamin E. She has authored numerous publications including book\nchapters and is a mentor of doctoral curriculum at her university.",institutionString:"BLDEA’s V.P.Dr.P.G.Halakatti College of Engineering & Technology",institution:{name:"BLDE University",country:{name:"India"}}},{id:"248459",title:"Dr.",name:"Akikazu",middleName:null,surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248459/images/system/248459.png",biography:"Akikazu Takada was born in Japan, 1935. After graduation from\nKeio University School of Medicine and finishing his post-graduate studies, he worked at Roswell Park Memorial Institute NY,\nUSA. He then took a professorship at Hamamatsu University\nSchool of Medicine. In thrombosis studies, he found the SK\npotentiator that enhances plasminogen activation by streptokinase. He is very much interested in simultaneous measurements\nof fatty acids, amino acids, and tryptophan degradation products. By using fatty\nacid analyses, he indicated that plasma levels of trans-fatty acids of old men were\nfar higher in the US than Japanese men. . He also showed that eicosapentaenoic acid\n(EPA) and docosahexaenoic acid (DHA) levels are higher, and arachidonic acid\nlevels are lower in Japanese than US people. By using simultaneous LC/MS analyses\nof plasma levels of tryptophan metabolites, he recently found that plasma levels of\nserotonin, kynurenine, or 5-HIAA were higher in patients of mono- and bipolar\ndepression, which are significantly different from observations reported before. In\nview of recent reports that plasma tryptophan metabolites are mainly produced by\nmicrobiota. He is now working on the relationships between microbiota and depression or autism.",institutionString:"Hamamatsu University School of Medicine",institution:{name:"Hamamatsu University School of Medicine",country:{name:"Japan"}}},{id:"137240",title:"Prof.",name:"Mohammed",middleName:null,surname:"Khalid",slug:"mohammed-khalid",fullName:"Mohammed Khalid",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/137240/images/system/137240.png",biography:"Mohammed Khalid received his B.S. degree in chemistry in 2000 and Ph.D. degree in physical chemistry in 2007 from the University of Khartoum, Sudan. He moved to School of Chemistry, Faculty of Science, University of Sydney, Australia in 2009 and joined Dr. Ron Clarke as a postdoctoral fellow where he worked on the interaction of ATP with the phosphoenzyme of the Na+/K+-ATPase and dual mechanisms of allosteric acceleration of the Na+/K+-ATPase by ATP; then he went back to Department of Chemistry, University of Khartoum as an assistant professor, and in 2014 he was promoted as an associate professor. In 2011, he joined the staff of Department of Chemistry at Taif University, Saudi Arabia, where he is currently an assistant professor. His research interests include the following: P-Type ATPase enzyme kinetics and mechanisms, kinetics and mechanisms of redox reactions, autocatalytic reactions, computational enzyme kinetics, allosteric acceleration of P-type ATPases by ATP, exploring of allosteric sites of ATPases, and interaction of ATP with ATPases located in cell membranes.",institutionString:"Taif University",institution:{name:"Taif University",country:{name:"Saudi Arabia"}}},{id:"63810",title:"Prof.",name:"Jorge",middleName:null,surname:"Morales-Montor",slug:"jorge-morales-montor",fullName:"Jorge Morales-Montor",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/63810/images/system/63810.png",biography:"Dr. Jorge Morales-Montor was recognized with the Lola and Igo Flisser PUIS Award for best graduate thesis at the national level in the field of parasitology. He received a fellowship from the Fogarty Foundation to perform postdoctoral research stay at the University of Georgia. He has 153 journal articles to his credit. He has also edited several books and published more than fifty-five book chapters. He is a member of the Mexican Academy of Sciences, Latin American Academy of Sciences, and the National Academy of Medicine. He has received more than thirty-five awards and has supervised numerous bachelor’s, master’s, and Ph.D. students. Dr. Morales-Montor is the past president of the Mexican Society of Parasitology.",institutionString:"National Autonomous University of Mexico",institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"217215",title:"Dr.",name:"Palash",middleName:null,surname:"Mandal",slug:"palash-mandal",fullName:"Palash Mandal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217215/images/system/217215.jpeg",biography:null,institutionString:"Charusat University",institution:null},{id:"49739",title:"Dr.",name:"Leszek",middleName:null,surname:"Szablewski",slug:"leszek-szablewski",fullName:"Leszek Szablewski",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49739/images/system/49739.jpg",biography:"Leszek Szablewski is a professor of medical sciences. He received his M.S. in the Faculty of Biology from the University of Warsaw and his PhD degree from the Institute of Experimental Biology Polish Academy of Sciences. He habilitated in the Medical University of Warsaw, and he obtained his degree of Professor from the President of Poland. Professor Szablewski is the Head of Chair and Department of General Biology and Parasitology, Medical University of Warsaw. Professor Szablewski has published over 80 peer-reviewed papers in journals such as Journal of Alzheimer’s Disease, Biochim. Biophys. Acta Reviews of Cancer, Biol. Chem., J. Biomed. Sci., and Diabetes/Metabol. Res. Rev, Endocrine. He is the author of two books and four book chapters. He has edited four books, written 15 scripts for students, is the ad hoc reviewer of over 30 peer-reviewed journals, and editorial member of peer-reviewed journals. Prof. Szablewski’s research focuses on cell physiology, genetics, and pathophysiology. He works on the damage caused by lack of glucose homeostasis and changes in the expression and/or function of glucose transporters due to various diseases. He has given lectures, seminars, and exercises for students at the Medical University.",institutionString:"Medical University of Warsaw",institution:{name:"Medical University of Warsaw",country:{name:"Poland"}}},{id:"173123",title:"Dr.",name:"Maitham",middleName:null,surname:"Khajah",slug:"maitham-khajah",fullName:"Maitham Khajah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/173123/images/system/173123.jpeg",biography:"Dr. Maitham A. Khajah received his degree in Pharmacy from Faculty of Pharmacy, Kuwait University, in 2003 and obtained his PhD degree in December 2009 from the University of Calgary, Canada (Gastrointestinal Science and Immunology). Since January 2010 he has been assistant professor in Kuwait University, Faculty of Pharmacy, Department of Pharmacology and Therapeutics. His research interest are molecular targets for the treatment of inflammatory bowel disease (IBD) and the mechanisms responsible for immune cell chemotaxis. He cosupervised many students for the MSc Molecular Biology Program, College of Graduate Studies, Kuwait University. Ever since joining Kuwait University in 2010, he got various grants as PI and Co-I. He was awarded the Best Young Researcher Award by Kuwait University, Research Sector, for the Year 2013–2014. He was a member in the organizing committee for three conferences organized by Kuwait University, Faculty of Pharmacy, as cochair and a member in the scientific committee (the 3rd, 4th, and 5th Kuwait International Pharmacy Conference).",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"195136",title:"Dr.",name:"Aya",middleName:null,surname:"Adel",slug:"aya-adel",fullName:"Aya Adel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/195136/images/system/195136.jpg",biography:"Dr. Adel works as an Assistant Lecturer in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. Dr. Adel is especially interested in joint attention and its impairment in autism spectrum disorder",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"94911",title:"Dr.",name:"Boulenouar",middleName:null,surname:"Mesraoua",slug:"boulenouar-mesraoua",fullName:"Boulenouar Mesraoua",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94911/images/system/94911.png",biography:"Dr Boulenouar Mesraoua is the Associate Professor of Clinical Neurology at Weill Cornell Medical College-Qatar and a Consultant Neurologist at Hamad Medical Corporation at the Neuroscience Department; He graduated as a Medical Doctor from the University of Oran, Algeria; he then moved to Belgium, the City of Liege, for a Residency in Internal Medicine and Neurology at Liege University; after getting the Belgian Board of Neurology (with high marks), he went to the National Hospital for Nervous Diseases, Queen Square, London, United Kingdom for a fellowship in Clinical Neurophysiology, under Pr Willison ; Dr Mesraoua had also further training in Epilepsy and Continuous EEG Monitoring for two years (from 2001-2003) in the Neurophysiology department of Zurich University, Switzerland, under late Pr Hans Gregor Wieser ,an internationally known epileptologist expert. \n\nDr B. Mesraoua is the Director of the Neurology Fellowship Program at the Neurology Section and an active member of the newly created Comprehensive Epilepsy Program at Hamad General Hospital, Doha, Qatar; he is also Assistant Director of the Residency Program at the Qatar Medical School. \nDr B. Mesraoua's main interests are Epilepsy, Multiple Sclerosis, and Clinical Neurology; He is the Chairman and the Organizer of the well known Qatar Epilepsy Symposium, he is running yearly for the past 14 years and which is considered a landmark in the Gulf region; He has also started last year , together with other epileptologists from Qatar, the region and elsewhere, a yearly International Epilepsy School Course, which was attended by many neurologists from the Area.\n\nInternationally, Dr Mesraoua is an active and elected member of the Commission on Eastern Mediterranean Region (EMR ) , a regional branch of the International League Against Epilepsy (ILAE), where he represents the Middle East and North Africa(MENA ) and where he holds the position of chief of the Epilepsy Epidemiology Section; Dr Mesraoua is a member of the American Academy of Neurology, the Europeen Academy of Neurology and the American Epilepsy Society.\n\nDr Mesraoua's main objectives are to encourage frequent gathering of the epileptologists/neurologists from the MENA region and the rest of the world, promote Epilepsy Teaching in the MENA Region, and encourage multicenter studies involving neurologists and epileptologists in the MENA region, particularly epilepsy epidemiological studies. \n\nDr. Mesraoua is the recipient of two research Grants, as the Lead Principal Investigator (750.000 USD and 250.000 USD) from the Qatar National Research Fund (QNRF) and the Hamad Hospital Internal Research Grant (IRGC), on the following topics : “Continuous EEG Monitoring in the ICU “ and on “Alpha-lactoalbumin , proof of concept in the treatment of epilepsy” .Dr Mesraoua is a reviewer for the journal \"seizures\" (Europeen Epilepsy Journal ) as well as dove journals ; Dr Mesraoua is the author and co-author of many peer reviewed publications and four book chapters in the field of Epilepsy and Clinical Neurology",institutionString:"Weill Cornell Medical College in Qatar",institution:{name:"Weill Cornell Medical College in Qatar",country:{name:"Qatar"}}},{id:"282429",title:"Prof.",name:"Covanis",middleName:null,surname:"Athanasios",slug:"covanis-athanasios",fullName:"Covanis Athanasios",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/282429/images/system/282429.jpg",biography:null,institutionString:"Neurology-Neurophysiology Department of the Children Hospital Agia Sophia",institution:null},{id:"190980",title:"Prof.",name:"Marwa",middleName:null,surname:"Mahmoud Saleh",slug:"marwa-mahmoud-saleh",fullName:"Marwa Mahmoud Saleh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/190980/images/system/190980.jpg",biography:"Professor Marwa Mahmoud Saleh is a doctor of medicine and currently works in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. She got her doctoral degree in 1991 and her doctoral thesis was accomplished in the University of Iowa, United States. Her publications covered a multitude of topics as videokymography, cochlear implants, stuttering, and dysphagia. She has lectured Egyptian phonology for many years. Her recent research interest is joint attention in autism.",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"259190",title:"Dr.",name:"Syed Ali Raza",middleName:null,surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259190/images/system/259190.png",biography:"Dr. Naqvi is a radioanalytical chemist and is working as an associate professor of analytical chemistry in the Department of Chemistry, Government College University, Faisalabad, Pakistan. Advance separation techniques, nuclear analytical techniques and radiopharmaceutical analysis are the main courses that he is teaching to graduate and post-graduate students. In the research area, he is focusing on the development of organic- and biomolecule-based radiopharmaceuticals for diagnosis and therapy of infectious and cancerous diseases. Under the supervision of Dr. Naqvi, three students have completed their Ph.D. degrees and 41 students have completed their MS degrees. He has completed three research projects and is currently working on 2 projects entitled “Radiolabeling of fluoroquinolone derivatives for the diagnosis of deep-seated bacterial infections” and “Radiolabeled minigastrin peptides for diagnosis and therapy of NETs”. He has published about 100 research articles in international reputed journals and 7 book chapters. Pakistan Institute of Nuclear Science & Technology (PINSTECH) Islamabad, Punjab Institute of Nuclear Medicine (PINM), Faisalabad and Institute of Nuclear Medicine and Radiology (INOR) Abbottabad are the main collaborating institutes.",institutionString:"Government College University",institution:{name:"Government College University, Faisalabad",country:{name:"Pakistan"}}},{id:"58390",title:"Dr.",name:"Gyula",middleName:null,surname:"Mozsik",slug:"gyula-mozsik",fullName:"Gyula Mozsik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/58390/images/system/58390.png",biography:"Gyula Mózsik MD, Ph.D., ScD (med), is an emeritus professor of Medicine at the First Department of Medicine, Univesity of Pécs, Hungary. He was head of this department from 1993 to 2003. His specializations are medicine, gastroenterology, clinical pharmacology, clinical nutrition, and dietetics. His research fields are biochemical pharmacological examinations in the human gastrointestinal (GI) mucosa, mechanisms of retinoids, drugs, capsaicin-sensitive afferent nerves, and innovative pharmacological, pharmaceutical, and nutritional (dietary) research in humans. He has published about 360 peer-reviewed papers, 197 book chapters, 692 abstracts, 19 monographs, and has edited 37 books. He has given about 1120 regular and review lectures. He has organized thirty-eight national and international congresses and symposia. He is the founder of the International Conference on Ulcer Research (ICUR); International Union of Pharmacology, Gastrointestinal Section (IUPHAR-GI); Brain-Gut Society symposiums, and gastrointestinal cytoprotective symposiums. He received the Andre Robert Award from IUPHAR-GI in 2014. Fifteen of his students have been appointed as full professors in Egypt, Cuba, and Hungary.",institutionString:"University of Pécs",institution:{name:"University of Pecs",country:{name:"Hungary"}}},{id:"277367",title:"M.Sc.",name:"Daniel",middleName:"Martin",surname:"Márquez López",slug:"daniel-marquez-lopez",fullName:"Daniel Márquez López",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/277367/images/7909_n.jpg",biography:"Msc Daniel Martin Márquez López has a bachelor degree in Industrial Chemical Engineering, a Master of science degree in the same área and he is a PhD candidate for the Instituto Politécnico Nacional. His Works are realted to the Green chemistry field, biolubricants, biodiesel, transesterification reactions for biodiesel production and the manipulation of oils for therapeutic purposes.",institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"196544",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/196544/images/system/196544.jpg",biography:"Angel Catalá studied chemistry at Universidad Nacional de La Plata, Argentina, where he received a Ph.D. in Chemistry (Biological Branch) in 1965. From 1964 to 1974, he worked as an Assistant in Biochemistry at the School of Medicine at the same university. From 1974 to 1976, he was a fellow of the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor of Biochemistry at the Universidad Nacional de La Plata. He is a member of the National Research Council (CONICET), Argentina, and the Argentine Society for Biochemistry and Molecular Biology (SAIB). His laboratory has been interested for many years in the lipid peroxidation of biological membranes from various tissues and different species. Dr. Catalá has directed twelve doctoral theses, published more than 100 papers in peer-reviewed journals, several chapters in books, and edited twelve books. He received awards at the 40th International Conference Biochemistry of Lipids 1999 in Dijon, France. He is the winner of the Bimbo Pan-American Nutrition, Food Science and Technology Award 2006 and 2012, South America, Human Nutrition, Professional Category. In 2006, he won the Bernardo Houssay award in pharmacology, in recognition of his meritorious works of research. Dr. Catalá belongs to the editorial board of several journals including Journal of Lipids; International Review of Biophysical Chemistry; Frontiers in Membrane Physiology and Biophysics; World Journal of Experimental Medicine and Biochemistry Research International; World Journal of Biological Chemistry, Diabetes, and the Pancreas; International Journal of Chronic Diseases & Therapy; and International Journal of Nutrition. He is the co-editor of The Open Biology Journal and associate editor for Oxidative Medicine and Cellular Longevity.",institutionString:"Universidad Nacional de La Plata",institution:{name:"National University of La Plata",country:{name:"Argentina"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",slug:"francisco-javier-martin-romero",fullName:"Francisco Javier Martin-Romero",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",biography:"Francisco Javier Martín-Romero (Javier) is a Professor of Biochemistry and Molecular Biology at the University of Extremadura, Spain. He is also a group leader at the Biomarkers Institute of Molecular Pathology. Javier received his Ph.D. in 1998 in Biochemistry and Biophysics. At the National Cancer Institute (National Institute of Health, Bethesda, MD) he worked as a research associate on the molecular biology of selenium and its role in health and disease. After postdoctoral collaborations with Carlos Gutierrez-Merino (University of Extremadura, Spain) and Dario Alessi (University of Dundee, UK), he established his own laboratory in 2008. The interest of Javier's lab is the study of cell signaling with a special focus on Ca2+ signaling, and how Ca2+ transport modulates the cytoskeleton, migration, differentiation, cell death, etc. He is especially interested in the study of Ca2+ channels, and the role of STIM1 in the initiation of pathological events.",institutionString:null,institution:{name:"University of Extremadura",country:{name:"Spain"}}},{id:"217323",title:"Prof.",name:"Guang-Jer",middleName:null,surname:"Wu",slug:"guang-jer-wu",fullName:"Guang-Jer Wu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217323/images/8027_n.jpg",biography:null,institutionString:null,institution:null},{id:"148546",title:"Dr.",name:"Norma Francenia",middleName:null,surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/148546/images/4640_n.jpg",biography:null,institutionString:null,institution:null},{id:"272889",title:"Dr.",name:"Narendra",middleName:null,surname:"Maddu",slug:"narendra-maddu",fullName:"Narendra Maddu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272889/images/10758_n.jpg",biography:null,institutionString:null,institution:null},{id:"242491",title:"Prof.",name:"Angelica",middleName:null,surname:"Rueda",slug:"angelica-rueda",fullName:"Angelica Rueda",position:"Investigador Cinvestav 3B",profilePictureURL:"https://mts.intechopen.com/storage/users/242491/images/6765_n.jpg",biography:null,institutionString:null,institution:null},{id:"88631",title:"Dr.",name:"Ivan",middleName:null,surname:"Petyaev",slug:"ivan-petyaev",fullName:"Ivan Petyaev",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Lycotec (United Kingdom)",country:{name:"United Kingdom"}}},{id:"423869",title:"Ms.",name:"Smita",middleName:null,surname:"Rai",slug:"smita-rai",fullName:"Smita Rai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424024",title:"Prof.",name:"Swati",middleName:null,surname:"Sharma",slug:"swati-sharma",fullName:"Swati Sharma",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"439112",title:"MSc.",name:"Touseef",middleName:null,surname:"Fatima",slug:"touseef-fatima",fullName:"Touseef Fatima",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424836",title:"Dr.",name:"Orsolya",middleName:null,surname:"Borsai",slug:"orsolya-borsai",fullName:"Orsolya Borsai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca",country:{name:"Romania"}}},{id:"422262",title:"Ph.D.",name:"Paola Andrea",middleName:null,surname:"Palmeros-Suárez",slug:"paola-andrea-palmeros-suarez",fullName:"Paola Andrea Palmeros-Suárez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Guadalajara",country:{name:"Mexico"}}}]}},subseries:{item:{id:"93",type:"subseries",title:"Inclusivity and Social Equity",keywords:"Social contract, SDG, Human rights, Inclusiveness, Equity, Democracy, Personal learning, Collaboration, Glocalization",scope:"
\r\n\tThis topic is dedicated to the efforts and promotion of UNESCO SDG4, the UNESCO initiative on the future of education, and the need for a new social contract for education. It aims to disseminate knowledge on policies, strategies, methods, and technologies that increase the resilience and sustainability of the development of the future of education and the new social contract for education. It will also consider the global challenges such as globalization, demographic change, digital transformation, climate change, environment and the social pillars of sustainable development.
\r\n
\r\n\tResponses to the pandemic and the widespread discontent that preceded it must be based on a new social contract and a New Global Deal for education that ensures equal opportunities for all and respects all people’s rights and freedoms (UNESCO; 2021). Such a new social contract, as proposed by UNESCO, must be based on the general principles underlying human rights - inclusion and equality, cooperation and solidarity, and collective responsibility and interconnectedness - and be guided by the following fundamental principle: Ensure that everyone has access to quality education throughout their lives.
\r\n
\r\n\tWe face the dual challenge of delivering on the unfulfilled promise of ensuring the right to quality education for every child, youth, and adult, as well as fully realizing the transformative potential of education as a pathway to a more sustainable collective future. To achieve this, we need a new social contract for education that eliminates inequities while transforming the future. This new social contract must be based on human rights and the principles of non-discrimination, social justice, respect for life, human dignity, and cultural diversity. It must include an ethic of care, reciprocity and solidarity. The new social contract builds on inclusiveness, equity, lifelong learning, SDG, collaboration and personal learning in a global context for democracy.
\r\n
\r\n\tAt an international level, the adoption of the Open Educational Resources recommendation and the Open Science recommendation represents an important step towards building more open and inclusive knowledge societies as well as the achievement of the UN 2030 Agenda. Indeed, implementing the recommendations will help to achieve at least five more Sustainable Development Goals (SDGs) that are intertwined with the topic of this book series, namely SDG 5 (Gender equality), SDG 9 (Industry, innovation and infrastructure), SDG 10 (Reduced inequalities within and across countries), SDG 16 (Peace, justice and strong institutions) and SDG 17 (Partnerships for the goals).
",coverUrl:"https://cdn.intechopen.com/series_topics/covers/93.jpg",hasOnlineFirst:!1,hasPublishedBooks:!1,annualVolume:11977,editor:{id:"210060",title:"Prof. Dr.",name:"Ebba",middleName:null,surname:"Ossiannilsson",slug:"ebba-ossiannilsson",fullName:"Ebba Ossiannilsson",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6LkBQAU/Profile_Picture_2022-02-28T13:31:48.png",biography:'Professor Dr. Ebba Ossiannilsson is an independent researcher, expert, consultant, quality auditor and influencer in the fields of open, flexible online and distance learning (OFDL) and the "new normal". Her focus is on quality, innovation, leadership, and personalised learning. She works primarily at the strategic and policy levels, both nationally and internationally, and with key international organisations. She is committed to promoting and improving OFDL in the context of SDG4 and the future of education. Ossiannilsson has more than 20 years of experience in her current field, but more than 40 years in the education sector. She works as a reviewer and expert for the European Commission and collaborates with the Joint Research Centre for Quality in Open Education. Ossiannilsson also collaborates with ITCILO and ICoBC (International Council on Badges and Credentials). She is a member of the ICDE Board of Directors and has previously served on the boards of EDEN and EUCEN. Ossiannilsson is a quality expert and reviewer for ICDE, EDEN and the EADTU. She chairs the ICDE OER Advocacy Committee and is a member of the ICDE Quality Network. She is regularly invited as a keynote speaker at conferences. She is a guest editor for several special issues and a member of the editorial board of several scientific journals. She has published more than 200 articles and is currently working on book projects in the field of OFDL. Ossiannilsson is a visiting professor at several international universities and was recently appointed Professor and Research Fellow at Victoria University of Wellington, NZ. Ossiannilsson has been awarded the following fellowships: EDEN Fellows, EDEN Council of Fellows, and Open Education Europe. She is a ICDE OER Ambassador, Open Education Europe Ambassador, GIZ Ambassador for Quality in Digital Learning, and part of the Globe-Community of Digital Learning and Champion of SPARC Europe. On a national level, she is a quality developer at the Swedish Institute for Standards (SIS) and for ISO. She is a member of the Digital Skills and Jobs Coalition Sweden and Vice President of the Swedish Association for Distance Education. She is currently working on a government initiative on quality in distance education at the National Council for Higher Education. 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Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. 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Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. 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