Issues and concerns in existing practice of public participation.
\r\n\tThere are different types of multiple pregnancies: fraternal twins, identical twins, triplets, and higher-order multiples. Symptoms of multiple pregnancies are larger uterus than expected for the date in pregnancy, increased morning sickness, increased appetite, and excessive weight gain. In this book, we will examine the clinical aspects of multiple pregnancies and management. Also, we will examine the management of cases of twins including antenatal care, delivery, and postpartum.
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According to Densham et al. [1], it has been stated that Geographical Information System is the technology to sustain PPGIS, but expert methods are needed to reinforce spatial decision-making in a collective way. However, now, Geographical Information System and PPGIS are not prototyped to assist multi-users associations but many approaches may require group-based involvement for decision-making. The idea of collaborative geographical information system, computer-supported cooperative work (CSCW), and collaborative decision support systems (DSS) were proposed as information technology to provide understanding about spatial complications and provide computer-based spatial decision-making [2].
Multi-user collaboration is playing its role in many works involving stakeholders from different departments and organizations, in which map making sometimes play a main role for giving visual information for the support to decision-making [3]. Web technology is rapidly expanding range and has made it possible for to take decisions over the Web. Due to demands for Web-based open mapping an Application Programming Interface (API) united with other information systems and CSCW tools have become more important for the support of real-time map sharing output. Accordingly, the development of map-based applications for real-time collaborative is one effective step taken by researchers that are efficiently working in many fields, e.g., emergency system, urban planning projects, municipality management, GIS data production, monitoring of urban sprawl and epidemic spread, and many more that assimilate collaborative role [4, 5, 6, 7, 8, 9].
A concurrent approach is made for the support of collaboration among the users [10]; although, little work has been done on developing and designing such Open Source Software (OSS) which is based on online map sharing tools which supports real-time collaboration. By assessing the researchers work and their contributions from the literature review, this study aims to develop an outline about the significance of the execution of irreplaceable and sufficient methods, tools, and techniques to fill the gap in the research. Multi-user synchronous discussions and communications among the people and between the community and stakeholders sometime improve the understanding that show an effective feedback and magnify decision-making [10, 11, 12, 13, 14]. This chapter actually shows a customizable framework used for an online system for collaboration with the installation of different Web GIS, OSGIS, OSS-based tools, and open mapping APIs on geographic information to solve the issues that are related to emergency disaster occurrence and municipal planning. Additionally, the study anticipates designing an open mapping API based real-time collaborative synchronous infrastructure with the option of installing local data for improving the involvement of during debate. Some of this research prototype elements based on this kind of model is still in development procedure and in its starting stage in the house applicable testing.
The study aims to develop a real-time map sharing mechanism, collaborative PPGIS (Co-PPGIS) and for collaborative assessment the amalgamation of other open source-based groupware solutions on an effective GIS-based meeting platform. The aim of this study was also to assure that: (1) Co-PPGIS model will help to improve or increase involvement of participants and will provide assistance to decision makers in reaching a final decision efficiently; (2) to explain certain facts or observations, i.e., core concepts, design and technology, etc., with an overview of enabling technologies for analyzing and designing a successful real-time map sharing framework; (3) to describe a prototype development based on case scenarios that looks into integrating CSCW principles and open source groupware tools with Web-based GIS. In order to assist municipal planning and development through a better and effective decision-making process the primary research goal is to develop a Web GIS-based contemporary collaborative participatory infrastructure. In order to fulfill the main research’s goal, this study will focus on achieving the following objectives:
To gain better and effective understanding of the PPGIS’ nature, its culture, its limitations, and basic requirements by modeling general as well as high-level participation requirements after proper and complete analysis of municipal Planning and Development (P & D) process workflows and by reviewing the existing online PPGIS applications.
To portray collaborative, real-time Web GIS-based participatory infrastructure that can employ open source geospatial data, standards, software tools, and Web services.
To develop and execute a system’s prototype (i.e., GeoMeeting) based on the Co-PPGIS model and Web GIS-based framework which encompasses a GIS-based forum, mapping APIs-based spatial component, a notification/feedback component, sub-workflows of information resource providers, and collaborative real-time Web Map sharing Infrastructure that accommodate the stakeholders to share their multiple ideas in real-time scenarios without leaving their place of residence or workspace.
This research primarily encompasses of the working mechanism of real-time collaborative Web map sharing framework that is going to be addressed within a fixed-time period.
Increasing importance of the need for an effective public participation in a decision-making process during municipal planning and development is on main focus in this section of study. Through the integration of GIS technologies, involvement of public or local stakeholders in decision-making can become more effective. Public meetings, which are one of the traditional methods of public participation, are integrated in some PPGIS projects to accumulate public ideas, values and preferences [15]. Collaborative use of GIS-based services encompasses the involvement of public and planners in the decision-making process with geo conceptualize a map and accommodate public and planners to build local spatial knowledge and exchange ideas. In order to get instantaneous access and conceptualize the spatial information and participate in decision-making process, collaborative GIS-based services provide opportunities to local stakeholder [16]. An increased public participation can lead to a better and effective decision-making because the processes of decision-making and public participation have a direct relationship, which means that better decision-making processes can also lead to an increase in a user’s participation and vice versa.
In almost every field of life planning process has certain defined goals or objectives just like in developing a small or large scale municipal plan, planning process has some objectives such as, to make planning process accessible, to accommodate in the conveyance or dissemination of ideas, and to support the decision-making process. Participation of public in municipal planning and management, according to traditional methods, includes neighbor notifications, interviews, exhibitions, public meetings/focus group discussions, and public enquires through telephone, letters, mails, fax, or public hearings [17, 18]. In order to disseminate the need of a proposed solution during public meeting, planners and decision makers present their plans through Power Point or point boards which is still considers one of the most commonly used participatory approach [19]. In the western world, public meetings are organized in order to accumulate feedback of public during planning and development-related workflows for effective and better decision-making. For example, in United States and Canada, local governments and many municipalities necessitate a level of participation in their decision-making processes.
Table 1 reveals issues and concerns which are commonly faced during planning and development-related processes in existing practices of public participation. It illustrates or portrays the complete assessment of existing public participation practices related to communication channels, notification, access of information, and exploring spatial data of municipal projects. Li et al. (2006) also disclosed several main issues regarding to traditional public participation practices like inadequate access to the information needed for public input, for exchange of ideas or information and for communication there is a lack of essential or creative platform, restricted awareness mechanisms, and notification channels. Factors like “successfully revealing and educating the public about the program before hearing, proper planning, and management of meeting, providing an understandable and media-rich demonstration of the issues and organizing a proper follow up” are those factors upon the success of public meetings depends.
Issues | Concerns | |
---|---|---|
Notification | Limited means, e.g., newspaper, flyer, etc. | |
Communication channels* | Public meetings/public calls/information resource center | Formal/informal presentation |
Open talk with public | ||
Flat board displays containing preliminary design/model solution | ||
Exploring spatial data | Using hardcopy maps, etc. | |
Access of information | Less feedback or public involvement | |
Lack in projects data management |
Issues and concerns in existing practice of public participation.
Establishing confrontational contact, dominated by higher authority, fix time, feedback lack and accessibility issues.
According to Meredith et al. [20], for successful public participation, proper and adequate access to information, effective connections to decision-making process and effective tools for getting input into a decision-making process are very essential. Public participation can became better and effective only if a large number of participants easily understand the message and give valuable feedback in a short time-frame.
Previous studies related to the depiction and execution of real-time collaborative mapping technologies is still in its stage of growth and development. Although in the last decade, many attempts have been made to the research of developing collaborative PPGIS but despite of this insufficient literature is obtainable in this field [21, 22, 23, 24]. The rapid developments in technologies like in GIS, OSGIS, GIT, CSCW, and groupware filed will have a notable impact on the transfer and/or integrate those technologies into collaborative contemporary GIS. Rinner [25] and Li et al. [13] recognize the need to support such technologies that provide a limited way of investigating spatial data or map information collaboratively by inaugurating asynchronous-based geo-referenced mapping architecture.
Baecker [26] defined groupware as information technology used to accommodate people to work together more effectively and efficiently. With the help of the CSCW application or groupware technologies, people in remote places can easily and effectively interact with each other by sharing the documents and files through voice, data, and video links [27, 28]. Using proprietary software approaches, e.g., PCI geo-conference, a few GIS-based tools encompassing groupware and CSCW technologies have been originated. Some attempts have been made to originate simple map sharing applications using open map services. As a result of modern developments in Geographic Information Technology (GIT), that assist large spatial databases, groupware technologies and Web-based GIS, several frameworks that accommodate real-time collaboration were designed and developed [29, 30, 31, 32]. Jankowski et al. [33] developed Spatial Group Choice, a spatial decision support framework, to assist the CSCW technique. Churcher and Churcher [34] proposed and developed Group ARC which offers a tool to geographically dispersed people to collaboratively view and explain map/spatial data. Pang and Fernandez [35] designed and developed Real-time Environment Information Network and Analysis System (REINAS) which encompasses functionalities that are helpful in the analysis of geospatial data. In order to support decision-making in Trane China, Trane China SDSS (TCSDSS) was designed by Xiang (2003) by adopting the unified software-development process.
By acquiring “argumentation philosophy,” argumap (which is an asynchronous perspective for spatial participation planning, to accommodate group discussions by connecting specific notations to map features) was developed by Rinner [25]. In order to support planning and decision-making processes, SoftGIS was developed which permitted mapping local knowledge and integrating it into urban planning practices [36]. Community Action Geographic Information System (CAGIS), a participatory GIS approach developed by Stewart et al. [37]. Virtual Emergency Operations Center (VEOC) framework was designed for the purpose to provide a collaborative virtual environment that allows connectivity among participants while implementing synchronous, script-driven tests and assumptions [38]. For amplifying collaborative decision-making among geographically distributed people, synchronous collaborative 3D GIS was designed by Chang [6] to assist synchronous collaboration. For participation in community planning, map chat is an online geospatial tool designed at the University of Waterloo. Collaboration in planning and/or emergency management related to decision-making, Rinner [39] recognized OSGIS technologies and OSS-based Web 2.0 concepts (that encompasses n-tiers application client-server architecture, Web mapping tools, Participatory Geographic Information System (PGIS), Web Mapping Services, 3-D GIS technology, CSCW, and Web-based groupware to accommodate consideration in spatial decision-making) that have played an essential role in this regard. The aim of this study is to describe core concepts, design, and technology with an examination of allowing technologies for analyzing and designing a successful real-time map sharing mechanism. This study also narrates a framework development based on a research project that looks into connecting CSCW principles, PGIS, and open source groupware tools with Web-based GIS.
Already existing PPGIS’ applications or models assessment helped researchers to find limitations of applications’ framework and current practices. Three research models which are considered relevant to the present study are discussed below. Rinner [25] introduced the argumentation model, in his model he introduces argumentation maps as an object oriented model for geographically related discussions. As shown inFigure 1, it shows the relationships between an argumentation elements/discussion, a geographic reference object/map feature, and user-defined graphic reference objects/sketches [39].
Modified argumentation map model (source: Rinner [
The argumentation model object classes have reinforced many-to-many relationships. For example, an object which is geographic can associate many argumentation components and an argumentation component can be associated by many objects that are geographical. Additionally, as shown in Figure 1, the objects have their self-relationships to each other of the same class. For example, geographic reference class objects have spatial relations to other object, and argumentation components, class objects can have logical relations to other objects; again, many-to-many relationships are supported [39]. The argumentation model provides an open standard-based prototype with a special focus on the use of standards to confirm interoperability. The discussion component was developed using open source programming languages, i.e., JavaScript and Java applet. The map elements are based on an open source Java API, i.e., Geo Tools and libraries. Same kinds of models were established and acquired by Tang and Hall (2006) and Leahy (2006), but many other technologies were used to design the prototype of research Map Chat and GeoDF. Tang GeoDF model installed an open source-based PHP built in board with commercial-based ESRI Arci MS/spatial server to develop GeoDF prototype. Figure 2 shows several elements of GeoDF model.
Modified argumentation map model for GeoDF (source: Tang [
Every conversation is comprised of two main components, i.e., the textual component that is basically related to a respondent’s understanding about the shown as text and spatial components that is actually a part of spatial element and is a together term used is geographic features, map extent, location, and spatial relationships embedded in GeoDF discussion threads, which are the thoughts, views, or feedback submitted by a participant via the GeoDF. In other words, the spatial context is primarily comprised of graphic reference objects, i.e., annotation, sketch, and other respondent’s annotations and sketches together with other two spatial components, visible map layer, namely the map extent [40]. The Map Chat argumentation model (see Figure 3) engages the same classes and objects for spatial and textual relationship in comparison with previously discussed models. A new real-time map discussion class was introduced in this model, which provided the functionality of real-time geo-chatting in connection with every graphic related object. An open source application infrastructure is provided by Map Chat argumentation model. It appoints open standards in relation of the overall system specification and it uses open source coding in PHP and JavaScript based, and it uses a reliable architecture to give the installation of other tools of models [41].
Modified argumentation map model for map chat (source: Hall and Leahy [
These models have some sort of similarities like to introduce an open standard-based object model, to share a same map extent during discussion, making a spatial relationship with graphic reference objects, and adopting an asynchronous participatory approach for map-based discussion. All three argumentation models allocate structured discussion, about different features of map and geographic related objects, in many geographically meeting respondents to provide an approach of the asynchronous spatial data. For example, the approach with the asynchronous spatial data sharing, it is not possible to find out an argumentation component related to the object of real world simultaneously in different respondents/members. The Map Chat provides geo-chatting discussion functionality with real-time, which cannot be implemented over other two models that used discussion threads with relation objects for geographic referencing. Unifying the chat with discussion elements gives a flexible and a powerful way of managing discussions that are geographically referenced, but participants should train themselves with this function, that is amalgamation, which gets advantage from this reliability.
The prosperity of developing and establish a Geospatial enabled Co-PPGIS, for enhancing the ability of people participation in collaborative decision-making during management workflows and municipal planning, most importantly it depends on a brief understanding of firstly the ideas of community participation in management and planning which involves basics ideas of role in participation, amount of community participation, and already existing participation of community at the time of municipal development, planning and management and second important concern is on functional and non-functional requirements, that are identified by existing PPGIS and that is related to research models, which are developed during municipality management to support public participatory processes. It begins with an explanation and overview of a Co-PPGIS idea, which executes the role of a real-time synchronous and asynchronous participatory approach to help the decision makers to make decisions to assimilate people role at the time of a municipal planning process. Some are the information sources and withdraw for the requirements of modeling of an advance Co-PPGIS for planning and management of municipal related projects. Although, it gives an introductory source of information that introduce an idea of advance Co-PPGIS to understand the infrastructure of a Co-PPGIS and to find out the gaps between existing municipal planning processes and possible improvements in Co-PPGIS.
An idea or concept is a plane, intention image of a specific thing, institution, or a class, and a framework is introduced as a form which gives support to the number of elements and fulfill as a package. Basically, a conceptual framework is a structure of interlinked ideas, which gives support of a certain phenomenon or process to build understanding. Public participation is necessary for the evolution of a country, city, and municipality planning, development, management, and decision-making which will speed up the process of planning. During planning, development, and management of municipality in a city or state, the management of geospatial data remains a challenge. Co-PPGIS gives us a planning and management related spatial and non-spatial information to the decision makers, higher authorities, and government bodies on a basis of real-time basis geospatial Web conferencing infrastructure. In this chapter, the advance Co-PPGIS has focus on municipal projects through developing a GIS-enabled virtual meeting idea. The advance Co-PPGIS framework is showed as five viewpoints, which are shortly discussed below:
Conceptual framework for proposed collaborative PPGIS.
Shortly, Co-PPGIS environment is an online meeting procedure for supporting participant’s collaborations on geographical information like mapping and imageries, and collecting and sharing data during processes of management. Figure 5 shows Co-PPGIS virtual meeting workflow processes, service abilities, and to describe situations when its functional capabilities are useful.
Co-PPGIS workflow processes and service abilities.
This kind of environment allows combination of geospatial data from other sources from Web services and collaborators input through geo-referenced comments. It involves components such as audio/video conferencing, map sharing, geo-referenced textual, real-time chatting and graphical annotation, and user or session management.
Co-PPGIS is basically a GIS-enabled collaborative and multi-function, essential meeting participatory infrastructure, which combines different information technology tools to accommodate participation and cooperation activities before public meetings (i.e., the major activities before public meetings is focused on information access, communication, and cooperation of stakeholders), during public meetings (i.e., real-time access to the meetings and their demonstration become paramount tasks), and after public meetings (the focus alters to the demonstration of syntheses of public participation, access to decisions, and receiving of feedbacks). As from above discussion, it is concluded that Co-PPGIS primarily centers on public meetings engaged during the municipal planning and development-related activities (Figure 6).
Public meeting scenario at three stages/levels of interaction.
In order to properly and easily understand Co-PPGIS system completely, Co-PPGIS may be categorized as and/or mainly composed of two major application infrastructures. In other words, we can say that recommended Co-PPGIS is basically an amalgamation of two mechanisms of participation, cooperation, and communication between members, i.e., Co-PPGIS asynchronous and Co-PPGIS synchronous. In Co-PPGIS asynchronous participatory environment, Web-based GIS geo-referenced conversation platform and/or GIS Blog techniques are used to accommodate public input and discussion. In Co-PPGIS synchronous participatory map sharing environment, synchronous collaborative GIS processes are executed by applying computer supported cooperative work (CSCW) or groupware application principles. By this, participants can easily share comments, ideas, or suggestions after investigating spatial data by using digital multimedia tools and technologies (Figure 7).
Co-PPGIS virtual meeting components for concept of planning and management.
Exploring and contrasting of existing PPGIS application’s performance is essential or helpful in recognizing the functionality gaps between those collaborative PPGIS applications which organized crucial basis for Co-PPGIS requirement analysis and architectural design. Figure 8 depicts the research gaps in current or existing communication mediums or participation practices found during the literature review and recommended how the Co-PPGIS contributes to the existing practice in order to increase public participation in municipality planning and development projects. It also explains how the approaches in relation to the proposed/enhanced infrastructure of Co-PPGIS will organize, improve, stimulate, accommodate, and contribute to the existing public participation practices.
Identifying relation between existing participation practices and the suggested Co-PPGIS.
Issues and the improvements of these issues through Co-PPGIS are explained in this section. For instance: (1) through or by using Co-PPGIS meeting environment, the issue of inadequate communication, generated due to fixed-time meeting schedules, accessibility issues, lengthy presentations, and open talks with authorities can be accompanied because Co-PPGIS supports anywhere/anytime/anyone accesses with real-time participation support. (2) Through a spatial component of GIS-based platform or through real-time map sharing cooperative component of the Co-PPGIS the issue of inadequate way of investigating spatial data, i.e., using hard copy maps in the meeting sessions because Co-PPGIS increase the degree of public participation along with spatial data investigation during essential meeting sessions. (3) Through meeting scheduling/notifying and/or by the e-newsletter components of Co-PPGIS Blog, the issue of inadequate process of sending notification related to existing municipal development projects can be self-regulating/self-operating. (4) Information’s access associated to a municipality project’s level data can facilitate through project information blog which exhibit the existing or future municipal project’s notice detail, minutes of the meeting, presentation, document, location, and all valuable information. (5) Through Co-PPGIS, the absence of support to quick decision-making can be encouraged because Co-PPGIS upgrade or improve public participation or input as well as assist scattered decision makers to work coincidentally on a real-time basis to conclude the decision in timely manners, which eventually diminish the time span of planning and probability of failure.
The upcoming sections demonstrate prototypes’ execution of the proposed framework to assist its real-time synchronous participatory procedures that exhibit the innovations to be expected when trying to perceive the concepts established in this research.
The way in to GeoMeeting services can be through login authentication. With direct way in, the user can log in by just choosing a screen name; on the other hand, in login mechanism, user only have to register the user’s login for sharing the data and services (see Figure 9) provided by Co-PPGIS.
GeoMeeting components-based services.
Some of the components-based services provided in the GeoMeeting are explained as follows:
Another way of developing basic geometry elements in GeoMeeting is through WMS, which is served through GeoServer. The stored characteristics and geometry are declare to GeoServer and can way in or read by browsers through open layer functions and JavaScript. When a new element is developed on a map, JavaScript function take the ID of each element and deliver to the Blazeds, elements are shared to all the other users those are on board.
In order to aid the Co-PPGIS synchronous participation procedure, which is originally developed and designed to resolve the issues associated with the municipality planning and management, GeoMeeting Prototype is executed as a proof of concept. GeoMeeting Prototype was developed and designed for effective geo-cooperation among National Society, government, local, and international NGOs. GeoMeeting prototype is basically a Web-based geospatially enabled conferencing system that accommodates synchronous and real-time amalgamation of data from different sources through Web map services like APIs, and supports the amalgamation of local knowledge demonstration by meeting participants. It also supports real-time map sharing, geo-referenced map notations, geo-chatting, user and meeting management for accommodating conversations among multiple users that are geographically located at different places. GeoMeeting is developed from scratch, amalgamating the technologies of open layer and flex technologies, having associated step by step development processes (that mean limitations discovered during the first version of prototype is enhanced in the next version of the development).
GeoMeeting system which is Geo-enabled comprises the following capabilities:
As all the multiple users and participants in a GeoMeeting can sight the same geo-referenced map simultaneously that is why it is called geo-enabled GeoMeeting system.
In order to undertake synchronous conferencing, the GeoMeeting server application employ a push technology procedure like real-time instantaneous messaging are typical examples of push services.
GeoMeeting provides Real-Time Map sharing among multi-users or participants.
GeoMeeting is provided by geo-referenced pointer with a purpose of pointing at the shared view of map.
With the aid of whiteboard facility, multiple users or participants can produce geometry-based incidents
GeoMeeting provides the opportunity of proper handling of maps (like modifying layers, map scale, and its position) to participants and users. It is very easy to rotate or change map view among different base map layers like street map, satellite, hybrid, and terrain in GeoMeeting prototype.
In GeoMeeting, participants or multiple users can easily produce and share geo-referenced notations.
Construction and installation of GeoMeeting prototype, a Web-based client-server architecture, is very easy; we just need to plug and play.
Through the use of any browser like Chrome, Opera, Internet Explorer, or Firefox, GeoMeeting prototype provides the opportunity of easy accessibility of the main interface of a prototype to the users.
Online map sharing application is depicted using open source technologies, APIs and programming languages like Flex SDK, MXML, Adobe blaze DS, Java Script, Action Script, and open layer API, etc.
GeoMeeting application is considered extremely useful during collaborating decision-aimed events such as emergency response, disaster management, and urban planning activities because GeoMeeting is a live conference technology.
GeoMeeting has myriad of capabilities but its operational status is still in its progressive stage. Figure 10 demonstrates a conceptual architecture of the GeoMeeting system.
Conceptual architecture of the GeoMeeting system.
The upcoming section’s discussions are based on the execution of different versions associated with the GeoMeeting prototype development.
This section explains functionality requirements and enabling technologies of three GeoMeeting prototype’s design.
Participants may visit the log-on page for GeoMeeting using a standard Web browser such as Mozilla Firefox 13+. Once the log-on page is displayed, the person can enter a user name and connect the GeoMeeting environment. After the meeting session is entrenched, the GeoMeeting elements will charge its default interface as shown in Figure 11.
GeoMeeting interface.
Depending on your connection speed, the loading of Web services from different sources may take only a few minutes or sometimes take few seconds. The GeoMeeting component provides the following key functions:
Prototype Web client interface is executed in JavaScript, Adobe Flex, and Action Script. The clients communicate with each other with the application server which is known as Tomcat and real-time messaging server which is Blazeds using a typical set of protocols, i.e., HTTP. The construction of this GeoMeetingV1 makes use of the following technologies such as Web servers (Tomcat), Web map server and tools (GeoServer), Server-side programming (MXML), Client side programming (HTML, JavaScript, Dynamic HTML, ActionScript), Real-time Messaging Server (BlazeDS), and APIs: Google map API V2 and Open layer.
The GeoMeeting elements are basically the technological breakthrough in the field of geo-information management. The GeoMeeting is an evolution of map sharing component built previously based on collaborative PPGIS framework, which supports innovative map sharing component technology for better decision-making. There are some issues that need to be addressed and minimized in the upcoming versions of the advanced prototype. At first step, the mouse pointer was used with pixel value that uses screen coordinates for movement of pointer on a map element. But, when it comes to higher or lower resolution, the technique of pointer displays a wrong geographic area. This issue was resolved by justifying the map panel to be left aligned as the problem remained same in center and right alignment, the screen coordinates to initialize from a top-left corner which will be same in all screen sizes, but another problem arises that when mapsharing component was left aligned and displayed on a bigger screen, there is a lot of vacant/empty white space generated on the right-hand side of the screen. This issue will be resolved in the GeoMeeting V2 in which the mouse pointer is synchronized with map coordinates transformation technique instead of using screen coordinates, and participants get the same geographic area as of the moderator.
To make the interface eye catching, the map should be center aligned, but when we center align the map, flash div was moving toward a problem. Flash div is just like a receptacle in the programming language which saves different type of codes in it. Map chat panel and user list are all in different div’s and all in the specific percentage, i.e., 100%; when we center align, the flash div’s does not visualize the map, chat, and user panel properly. Its solution is sorted out in GeoMeeting V2 by assigning pixel value to chat, and users list div same as of map div in order to visualize it properly. Editing toolbar is used for the demarcation of point, line, and polygon, and a hand tool is used for map panning. Initially, it creates a problem as we select any of them (point, line, polygon, and hand) it did not select properly. In fact, the map container (window) was placed over the editing toolbar, that is why it was creating a problem. As a solution, the editing toolbar’s z-axis position was changed (by increasing its z-index value) on the map so that selection of the editing tools can be developed properly and easily. Another issue in the GeoMeeting V1 is that when tools are selected from the editing toolbar and we draw any feature on a map it was not drawn correctly. Many times elements got stuck with the map panel and not allowed it to draw. At the time of development, this issue was seen because of the conflict in different versions launched at different timings. As a solution, old version 2.10 open layer library was replaced with version 2.12 until it was identified and detached from the open layer libraries.
GeoMeeting prototype has been used in myriad different fields of studies like public security, crime mapping, disaster occurrences, layout frameworks for preparedness and emergency responses during a disaster, environmental and resources and local government. The section below is comprised of the demonstration of some points using the scenario-based discussion (i.e., the instances come from incidents or cases developed in different regions of the world).
As parks are crucial to communities, because parks provide opportunities to people or public for exercise and experience nature which are paramount for physical and mental well-being of humans, it helps in revitalizing local economies; so there is a dire need to estimate park areas and raise municipality residents’ living standards. For recognition and generation of easy access to basic essentials of life, such as national parks, green infrastructure, recreation, etc., Government bodies are primarily accountable or answerable because they maintained the available park data but they are not sufficient to fulfill the challenges of data handling and sharing. Therefore, a Web-based GeoMeeting system has been launched to handle and share real-time data, support cooperative meeting sessions at regular intervals, and provide a set of tools like point that helps to recognize park areas and unrevealed base map information about the infrastructure. Video- or audio-based map sharing and Geo-teleconference have been made easy for decision makers to make a decision quickly. Every sort of editing, made by presenter, associated to park marking, will be displayed to all users simultaneously for collaborative decision-making. The presenter can spot a place, add comments, and interpret information related to: park access analysis at city level, complete information and data about every city park, identifying the areas where need of parks is most essential, and recognizing which improvements would provide the greatest advantage to local park system. This sort of information is accumulated in a database and can be easily recovered. Figure 12 represents the identified park areas.
GeoMeeting for municipality parks mapping.
Through GIS land use survey techniques, parks are easily determined. In this scenario, android-based techniques are used for collection of park points’. As parks can be easily inspected in high resolution imagery, therefore, high-resolution satellite imagery is used for discussion as a base map. GeoMeeting environment offers the platform for stakeholders to share and execute their views related to area’s enhancement by offering better utilities, facilities, and living standards to residents.
Evaluating the usability testing of GeoMeeting prototype using a case study scenario is helpful to make it effective and usable. A brief summary of steps performed during the usability evaluation of the prototype is discussed as follows.
The evaluation will organized in three parts: (1) a pre-questionnaire comprised of queries related to the user’s background, their experience of other Web GIS applications, their computers expertise, and GIS knowledge. (2) Second part of evaluation is the actual user’s interaction with the GeoMeeting system using the analytical method with the help of TeamViewer, Session Cam, and Google Analytics tool, which is easy to use, free, and user-friendly usability-evaluating tool that provides a comprehensive set of Website data tracking and analysis tools. By using the TeamViewer and Session Cam recording components, it is possible to collect highly detailed and useful information about the actual usage of the GeoMeeting Website and its components. Data elements are valuable for evaluating the usability as well as estimating the degree of public input during the process of participatory planning and effective decision-making. A Web-based feedback component was developed to evaluate and measure the usability aspects collected using pre-post questionnaires and Web analytic tools, i.e., TeamViewer, Google Analytics, and Session Cam. (3) Finally, the users were asked to fill out a post-questionnaire comprised of queries related to usefulness, ease of use or interactivity of using GeoMeeting interfaces in order to collect feedback concerning the usability of the system.
Co-PPGIS, a Web-based geospatially enabled conferencing system, assists a real-time participation to facilitate and improve public participation for collaborative decision-making which will bring fundamentally more understandability in any system. This Web system provides real-time amalgamation of data from different sources through Web map services, such as APIs, and supports the amalgamation of local knowledge expressed by meeting participants. In order to aid the Co-PPGIS synchronous participation procedure, which is originally developed and designed to resolve the issues associated with the municipality planning and management, GeoMeeting Prototype is implemented as a proof of concept. GeoMeeting Prototype framework facilitates any sort of e-governance, management, and emergency scenarios (e.g., municipal planning, forest management, urban sprawl, lands state, crime mapping, disaster response, etc.) related to collaborative decision-making and provides an effective, valid, and see-through system in which all the discussion and recommendations between authorities/participants are conserved in the database and can be viewed anytime to know the irresponsibility of even a common person to some authority handling the entire situation. The GeoMeeting is an evolution of map sharing component built previously based on Collaborative PPGIS framework which accommodate effective and better decision-making through its innovative map sharing component technology.
The infrastructure of GeoMeeting was established on several components-based services such as Login Management, Floor Control, Map sharing, Android, feature-based chat, feature popup service, Geometry and Multimedia Sharing feature Services, Bookmark, and Live Video Services. Registered users can have direct access to GeoMeeting through login authentication. The component also includes chat facility, drawing specific location (point, line, and polygon/area); base layer switcher for better understanding of map and search any area of interest; synchronously. These components-based services make it an effective and efficient platform for information/data sharing. Previously, teleconferencing was the only medium used during emergency management planning, but the drawback for teleconferencing was the absence of any geo-collaborative console, i.e., map sharing. GeoMeeting provides real-time geo-collaboration; which improves accuracy and efficiency as well as saves cost and time of the emergency management organization. Consequently, this Co-PPGIS framework-based GeoMeeting provides an interactive interface to have Geo-enabled collaborative participatory discussion platform among decision-making authorities and common people.
The antiphospholipid syndrome (APS) is an acquired autoimmune disorder, defined by the combination of generally accepted laboratory and clinical criteria [1]. The latest laboratory criteria include repeated (at least 12 weeks apart) positive testing for at least 1 of 3 selected antiphospholipid antibodies (aPL): lupus anticoagulant (LA), anticardiolipin (aCL), anti-beta2-glycoprotein I (anti-B2GPI) antibodies. Clinical criteria emphasize the arterial and venous thromboembolic and pregnancy-related (recurrent miscarriages in the first trimester, fetal death in the second or third trimesters, severe pre-eclampsia requiring delivery of a premature infant before 34 weeks of gestation) events. However, other laboratory and clinical complications with clear association to aPL, referred to as non-criteria manifestations, have been described. Based on the affected organ system, the clinical non-criteria manifestations divide into several subgroups: cardiovascular, neurologic, skin, renal, hematologic, and other [2, 3]. Hematologic complications include thrombocytopenia, hemolytic anemia, and functional changes or deficiencies of coagulation factors with both thrombotic (acquired resistance to activated protein C, protein S deficiency) or bleeding tendencies. As mentioned above, the association of aPL with thromboembolic events is extensively and well documented. However, the acquired coagulopathy caused by the aPL is complex and might occasionally manifest as a hemorrhagic event with various clinical severity or combined thrombo-hemorrhagic syndrome. The latter is common in catastrophic APS (CAPS), a rare but often fatal variant with excessive activation of hemostasis, consumption of its components, and micro-thrombotic damage in multiple organs.
aPL can interact with different blood and vascular components and cause hemorrhage through several mechanisms (Figure 1) [1]. Firstly, aPL-positive patients frequently develop thrombocytopenia. Secondly, acquired immune-mediated coagulation factor deficiencies, such as hypoprothrombinemia, can appear after the interaction between aPL and coagulation factors.
Pathomechanisms involved in hemorrhage in aPL patients. CAPS, catastrophic antiphospholipid syndrome; DIC, disseminated intravascular coagulation; F, factor; vWF, von Willebrand factor; * most common pathomechanisms.
Thirdly, the microvascular system damage with an extensive thrombotic or inflammatory insult via the monocyte, endothelial, and complement activation can result in secondary bleeding to the affected tissue. Thrombotic microangiopathies (TMAs) such as CAPS, as well as diffuse alveolar hemorrhage (DAH) and adrenal hemorrhage (AH), the pathognomic complications of APS, are representative examples of this pathomechanism. Since the antithrombotic therapy remains a mainstay of management of aPL, the extensive use of antithrombotics, typical for patients afflicted with their presence, can contribute to bleeding events and represents the fourth cause. Severe thrombocytopenia (platelet count lower than 50000/μL) and prothrombin deficiency are the most prominent causes of bleeding [4]. The discussion of the given pathomechanisms follows.
Though not included in the current diagnostic criteria for APS (Sydney 2012 criteria), thrombocytopenia represents a complication directly linked to aPL [1]. Thrombocytopenia is a frequent finding in aPL-positive patients; it is their most common non-criteria hematologic manifestation. The Euro-Phospholipid project, a large prospective multicenter international study evaluating 1000 European patients with both primary and secondary APS, found thrombocytopenia in 296 (29.6%) of its participants [5]. Other studies focused on the whole population of aPL-positive patients reported comparable incidence, ranging from 20 to 53% [6, 7, 8, 9, 10]. Of interest, particular subgroups seem to be more prone to develop thrombocytopenia. Patients with secondary APS associated with systemic lupus erythematosus (SLE) have thrombocytopenia approximately 2-times more often than those with primary APS (reported incidence 40 vs. 21% in the Euro-Phospholipid project) [5]. A low platelet count is more frequent in patients with CAPS [10, 11].
Thrombocytopenia tends to be mild to moderate with the nadir above 50000/μL in most cases. Only a small portion of patients (approximately 10%) develop severe thrombocytopenia, and its occurrence is often associated with other complications, such as TMAs (disseminated intravascular coagulation (DIC), CAPS) [8]. Rapid (within days) progression of thrombocytopenia or its new occurrence in patients with previously normal platelet count can be the first indication of CAPS [11, 12].
Despite being common, thrombocytopenia alone is not usually responsible for clinically relevant bleeding. For example, in the Italian Registry of aPL, only four patients out of 90 with thrombocytopenia experienced major hemorrhagic events [8]. On the other hand, nor it protects, especially if mild to moderate, from thromboembolism. Notwithstanding, if severe and without CAPS, it can account for a minor protective effect. In the Italian Registry with 360 patients included, severe thrombocytopenia was associated with a significantly lower rate of thrombotic events in comparison to the group with normal platelet count; however, the group with mild thrombocytopenia did not show a significant difference (9 vs. 40 vs. 32%) [8]. A recent study analyzing altogether 305 patients with primary APS, 51 with thrombocytopenia included, observed a higher rate of thrombotic relapses (29% vs. 19%) during a long (median 11 years) follow-up in the group with thrombocytopenia, though the difference did not reach statistical significance [13]. Despite comparable antithrombotic therapy, no difference in major hemorrhage (4% vs. 3%) was observed between the thrombocytopenic and non-thrombocytopenic group, albeit the significantly higher rate of overall bleeding (17% vs. 8%) was in the thrombocytopenic group. The authors conclude that thrombocytopenia may have a prognostic value in primary APS and help identify high-risk patients for APS-related complications [13].
The evidence concerning the association between thrombocytopenia and other clinical features of APS such as hemolytic anemia, livedo reticularis, skin ulcerations, chorea, and cardiac valve dysfunction is conflicting. Some studies, but not all, observed more frequent occurrence of those symptoms in patients with thrombocytopenia.
The pathogenesis of aPL-related thrombocytopenia is likely heterogeneous. aPL can directly or indirectly via B2GPI interact with several platelet membrane glycoproteins (GP) and phospholipids and thus initiate two processes: 1) pathologically enhanced platelet activation and aggregation after their initial activation or damage with subsequent platelet thrombus formation and platelet consumption; 2) immune-mediated pathological platelet clearance. The interaction with platelets involves the binding of anti-B2GPI via B2GPI to the activated platelet surface or direct interaction of aPL with specific platelet membrane glycoproteins (GPIb/IX, GPIIb/IIIa, GPIV) [14]. Particular subtypes of aPL and their quantity likely play a prominent role in the pathogenesis of thrombocytopenia. Anti–B2GPI antibodies of IgG class, LA, a higher titer of aCL of IgG class, and triple aPL positivity were a more common finding in patients with thrombocytopenia [13, 15, 16]. LA and a high titer of aCL were frequent among patients with severe thrombocytopenia. Since LA is associated with the highest prothrombotic risk among aPL, its higher prevalence in these patients could mitigate the bleeding tendencies and contribute to a relatively low rate of major bleedings.
Other pathomechanisms may occasionally contribute to thrombocytopenia in aPL-positive patients. The association, albeit anecdotal, between aPL and the hemophagocytic syndrome (a hyperinflammatory disorder with pathological phagocytosis of blood cells and their precursors in the bone marrow and other tissues) and bone marrow necrosis was described [17, 18]. These disorders decrease platelets via impairing megakaryopoiesis. Splenomegaly after splenic or portal vein thrombosis leads to increased platelet pooling and redistribution from circulation [7].
It should be emphasized that the etiology of thrombocytopenia in aPL-positive patients can be multifactorial and not exclusively linked to these antibodies. Other diseases can contribute to and further deepen the decrease in platelet count. Coincidence with immune thrombocytopenia (ITP), drug-induced thrombocytopenia with heparin-induced thrombocytopenia included, thrombocytopenia related to infections, TMAs, and pregnancy-related thrombocytopenia have been described [18, 19].
The relationship with ITP seems to be particularly interesting and complex. Patients with ITP are frequently positively tested for aPL, with a reported incidence ranging from 25 to 75% [20]. A recent retrospective study of 159 adult patients with primary and secondary severe ITP (platelet count below 50000/μL) identified aPL in 37 (23.2%), with 14 being triple positive. Triple positivity was associated with a lower platelet count [21]. Clinical implications of the relation between ITP and aPL are still discussed and not clear. The available data regarding the risk of thrombosis and treatment are inconclusive. However, a recent study with altogether 196 patients with primary ITP, 49 aPL-positive included, did observe a significantly higher risk of thrombotic events. Other monitored characteristics (hemorrhage, response to therapy, clinical course, changes in platelet counts) were comparable [19]. Analogically to the observation in APS, it seems that the risk of thrombosis in patients with concomitant ITP and aPL positivity, particularly in those undergoing therapy with corticosteroids and other immunosuppressive agents, is more prominent than the risk of bleeding.
The diagnostic approach has to consider the possibility of aPL as a sole cause of thrombocytopenia as well as the coincidence of other disorders with aPL, especially TMAs. Since patients with aPL/APS are often anticoagulated and treated with immunosuppressives, heparin-induced thrombocytopenia and infectious causes should be addressed in the diagnostic process.
Since thrombocytopenia in aPL-positive patients is predominantly mild and without significant bleeding, outside of CAPS, most patients do not require specific treatment. As a general rule, the goal is to maintain the platelet count above 30000/μL – a critical threshold for the development of severe spontaneous bleeding. When immune etiology is behind thrombocytopenia, strategies effective in ITP are preferably used [22, 23]. Corticosteroids, initially in high-dose with gradual tapering, alone or combined with intravenous immunoglobulins (IVIg), represent the first-line treatment. In contrast to ITP, the use of IVIg as a first-line treatment is controversial in aPL-positive patients since their administration is potentially associated with an increased risk of thrombotic events [24]. Other immunosuppressive or immunomodulatory agents or procedures (danazol, chloroquine, dapsone, rituximab, plasmapheresis) or splenectomy can be chosen as alternatives for those with inadequate response. Rituximab seems to be a particularly perspective agent. Though only limited clinical data from a small number of patients are available so far, the response and persisting stable platelet count after rituximab have been observed in a reasonably high number (50–83%) of treated patients [25, 26]. It is important to emphasize that most of the included patients had refractory thrombocytopenia without a satisfactory response to previous treatment modalities. Rituximab was tolerated well with no significant increase in thrombotic risk. Its risk profile in the aPL setting appears to be comparable to ITP [25].
The use of thrombopoietin mimetics (TPOMs) remains controversial due to the conflicting clinical data. There is a general agreement on their effectiveness in increasing platelet count, but safety remains an open issue. Several authors did not observe any increase in the thrombotic events during the administration of TPOMs [27, 28]. Others, including those who analyzed larger patient groups, report a prothrombotic risk associated with this therapy in the a-PL positive subgroup [29, 30, 31]. Gonzales et al. found in their retrospective study of 46 patients with thrombocytopenia and various systemic autoimmune disorders, all treated with eltrombopag, that 3 (6.5%) participants suffered from thrombotic events while on treatment. Crucially, 6 out of 46 participants had concurrent APS, and 2 of them (33% of all patients with aPL) were among those with thrombosis [30]. Guitton et al. retrospectively studied 18 patients with thrombocytopenia and SLE treated with romiplostim or eltrombopag; 10 had been diagnosed with concurrent aPL/APS. 5 patients developed thrombosis; 3 of them (30% of all patients with aPL) had APS [31]. These observations suggest a higher thrombotic risk in the aPL-positive group. Though well established in therapy of ITP, the use of TPOMs in aPL-positive patients requires caution and individual evaluation of thrombotic risk. Minimized dosing of TPOMs, aimed to maintain platelet count around 50000/μL, was suggested to decrease thrombotic risk since the thrombotic events are more frequent at platelet count greater than 100000/μL [22].
Except for severe thrombocytopenia, a decrease in platelet count does not fully protect patients with aPL/APS from thromboembolic events, and antithrombotic prevention or therapy should be continuing as long as possible. However, bleeding risk has to be considered, and an individualized approach is mandatory. In general, full anticoagulation can be given in the setting of platelet count over 50000/μL, and its stopping should be considered seriously in platelet count below 25000/μL. The patients with platelets between these values should be treated individually with anticoagulants in reduced doses. Half-dose low molecular weight heparins (LMWHs) represent the usual first-choice treatment [22].
Acquired deficiency of prothrombin, referred to as lupus anticoagulant hypoprothrombinemia syndrome, is the most known and well defined of all coagulation factor deficiencies associated with aPL. Its precise incidence is unclear, but with the order of magnitude of hundreds of reported cases, it appears to be a rare complication [32, 33]. It typically occurs in the child or adolescent female patients with aPL after viral infections or with systemic immune disorders, most commonly SLE [34]. Adults can be affected as well, albeit less frequently [35]. The preexisting systemic immune disease is not obligatory since cases without were identified; other precipitating conditions include tumors such as lymphomas, particularly with the production of pathological immunoglobulins and drug reactions.
Bleeding severity varies from mild mucocutaneous (epistaxis, ecchymosis), which is the most common, to severe and life-threatening, including localizations such as muscles, genitourinary tract, gastrointestinal tract (GIT), and central nervous system (CNS) [32, 33, 34, 35, 36, 37, 38]. A substantial number of patients (up to 50%) have no significant bleeding events and can be even asymptomatic [36]. Concomitant presence of thrombotic events, hemorrhagic-thrombotic syndrome, and CAPS were occasionally described [39, 40, 41]. The condition is usually self-limiting when associated with viral infections, whereas it can have a lasting duration or relapses in the presence of autoimmune diseases [36]. Despite the possibility of severe bleeding events, the overall prognosis is good in general, with a reported mortality rate of less than 5%.
Laboratory findings include the prolongation of both prothrombin (PT) and activated partial thromboplastin time (aPTT), variably decreased prothrombin activity (about 10–20% on average, although it may be extremely low or unmeasurable) with a proportional decrease of prothrombin antigen. As mentioned above, a deficiency of other coagulation factors might be present. Therefore, their activity should be checked [32]. Positive testing for LA complements the picture. The finding of PT prolongation in an aPL-positive patient should prompt the testing for prothrombin deficiency even if no bleeding is apparent at the time.
The traditional view based on the initial analyses in the 1980s defined the involved antibodies as non-neutralizing, unable to directly inhibit the prothrombin coagulation activity [42]. Cross-reactivity between the aPL and phospholipid epitopes in the prothrombin molecules is a likely explanation. The aPL form prothrombin antigen–antibody complexes, and their subsequent elimination results in the proportional decrease of both prothrombin activity and antigen. If the clearance is extensive enough to lead to a relevant prothrombin decrease with its activity below 20%, bleeding manifestations may occur. However, some researchers provided conflicting evidence with hints on more complex changes of hemostasis. In the recent analysis of a relatively large cohort of 41 patients, Japanese authors did not observe an exact correlation between prothrombin levels, anti-FII antibody quantity, and bleeding phenotype. They also identify different autoantibodies directed against FVIII besides the anti-prothrombin ones in several patients with the disorder [43]. They confirmed combined coagulation factor deficiencies in a small number of the studied cases as well. Based on this observation and a known heterogeneity of the clinical presentation, it is reasonable to conclude that hypoprothrombinemia is not an isolated change in aPL-positive patients, and a complex evaluation of hemostasis is always required.
The therapeutic approach aims at (1) stopping the active bleeding; (2) eradicating antibodies responsible for prothrombin deficiency; (3) preventing further thromboembolic events [35, 37]. The withdrawal of antithrombotic agents, supplementation of blood components (transfusion of packed red blood cells and fresh frozen plasma), activation of coagulation factor production (vitamin K administration), hemostatic agents (styptics, antifibrinolytics) represent the strategies for bleeding cessation [35]. However, all these approaches can in aPL-positive patients, especially in prolonged use, lead to the increased thrombotic risk. Immunosuppression, with corticosteroids as the first-line choice or other agents (azathioprine, rituximab, cyclophosphamide) and procedures (plasma exchange) as alternatives, leads to antibody eradication. Monotherapy with corticosteroids is efficient in most cases. Measurement of prothrombin levels, whether by clotting, chromogenic or immunologic methods, can be used for the treatment monitoring. Since the risk of thrombosis usually remains significantly increased even in the presence of bleeding and bleeding itself does not protect from thromboembolism, the therapies aimed at bleeding cessation has to be counterweighted by antithrombotic therapy. Both bleeding and thromboembolic risks have to be evaluated carefully in all cases.
Few case reports of concurrent acquired von Willebrand syndrome (AWS), an acquired vWF deficiency, with the presence of aPL were described [44, 45, 46, 47, 48]. Interestingly, other disorders with well-defined relation to AWS (myeloproliferative neoplasm, aortic valve stenosis, connective tissue diseases such as SLE) were identified in most cases. Therefore, aPL are not regarded as a usual cause of AWS, but rather as a coincidental finding in underlying immune disorders. Some researchers speculated that aPL might modify and counterbalance the bleeding phenotype typical for AWS [44, 48]. Thrombotic event after normalization of vWF was reported [44]. Immunosuppression, the standard treatment of AWS, combined with antithrombotic prevention, was given in reported cases with good clinical outcomes.
Acquired deficiencies of other clotting factors, namely FVII, FVIII, FX, and FXI, were reported [49, 50, 51, 52]. In summary, these deficiencies are extremely rare, and clinical data are limited to case reports or series. Bleeding manifestations are variable, with varying severity. The therapeutic strategies are similar to the approach used in AWS.
DAH is a severe and life-threatening pulmonary complication of aPL. Inflammatory damage to the pulmonary microcirculation, namely to alveolar arterioles, capillaries, and venules, with subsequent necrotic changes and secondary hemorrhage, define the disorder [53]. A microscopic pathoanatomical picture typically reveals capillaritis with interstitial neutrophilic infiltrate, thrombi in small muscular pulmonary arteries, myointimal thickening, and the remodeling of the muscular pulmonary arteries and arterioles [53, 54]. The condition is rare and appears in less than 1% of all aPL-positive patients, though it is considerably more frequent and clinically relevant in those with CAPS, affecting 5–10% [54, 55, 56, 57]. Both genders are affected, but males constitute approximately 2/3 of cases with primary APS, whereas women dominate the group with APS secondary to SLE [54]. The patients with DAH are more likely to have a higher titer of aPL and suffer from other comorbidities associated with aPL than those without DAH. Cardiac valve disease, pulmonary hypertension, livedo reticularis, skin ulcers, CNS involvement (stroke or seizure), and pregnancy complications are among the reported concomitant disorders [54, 57].
Several pathomechanisms are likely to participate in the damage of the alveolar structures in DAH in aPL-positive patients. aPL-mediated activation of endothelial cells, resulting in the increased expression of tissue factor, platelet, and complement activation with C5a-mediated neutrophil recruitment and the subsequent lung tissue injury is likely behind thrombi formation in the pulmonary microcirculation. aPL-induced systemic inflammatory response syndrome with the excessive cytokine activation (e. g. tumor necrosis factor-α, interleukin-1, interleukin-6, interleukin-18, macrophage migration inhibitory factor) as well as L-ficolin-induced lung injury and interstitial neutrophilic infiltration lead to the loss of the integrity of the alveolar-capillary basement membrane. Disruption of alveolar structure and its veins through the combination of inflammation and thrombosis result in the extravasation of red blood cells into the alveoli [58].
The usual clinical presentation of DAH includes fever, chest pain, cough with hemoptysis, and dyspnea with the signs of hypoxemic respiratory failure [4]. However, not all symptoms, including hemoptysis, need to be present in every case. The symptoms are not specific and appear in other pulmonary diseases such as pulmonary embolism, pneumonia, and pulmonary edema. The complex differential diagnostics is of utmost importance. Laboratory and complementary tests are critical for the distinction of DAH. Anemia, aPL positivity, high diffusing capacity for carbon monoxide in pulmonary function tests, patchy or perihilar opacities on the chest X-ray and signs of hemorrhage, ground-glass infiltrates, and reticular interstitial opacities on pulmonary CT scans belong to the typical findings. Bronchoscopy with bronchoalveolar lavage and biopsy can document alveolar hemorrhage, exclude infections, and provide biological material for cytologic and histologic evaluation. Lung biopsy remains the gold standard for the definitive diagnosis, albeit the patient′s condition and benefit–risk ratio should be evaluated before the procedure. As mentioned above, DAH is quite frequently associated with CAPS. Treating physicians should actively search for its signs in all cases.
Immune suppression remains the mainstay of the therapy. High-dose corticosteroids are the preferred initial treatment. The use of other immunosuppressives remains without a clear consensus due to the rarity of the condition and limited clinical data. However, available clinical data support the combined immune suppression (corticosteroids plus another immunosuppressive agent) over monotherapy with corticosteroids. The combined therapy seems to improve the clinical outcome and rate of long-term remission. Cyclophosphamide and rituximab have been showing encouraging results, whereas mycophenolate mofetil and azathioprine seem to be less effective [4]. Other therapeutic modalities that could be beneficial, especially in the presence of underlying CAPS, include plasma exchange and IVIg.
AH is a potentially devastating complication of aPL due to the resulting adrenal insufficiency. AH represents an infrequent cause of adrenal insufficiency, and besides aPL, it can be caused by other disorders, namely adrenal tumors and anatomical malformations, infections, and bleeding disorders (thrombocytopenia, heparin exposure) [59]. AH is a rare complication of aPL with its prevalence not precisely established. However, a significant proportion - one third - of affected patients have CAPS. The incidence in this subgroup is thus relatively high, between 10 to 16% [56]. A provoking moment usually initiates aPL-induced AH. Trauma, invasive procedures, infections, and warfarin withdrawal have been identified as such moments [60].
The main pathomechanism in aPL-induced AH, supported by the autopsy evidence, is multiple thromboses in the adrenal plexus leading to the secondary hemorrhage and destruction of the adrenal cortex. Due to its unique vascular anatomy (complex arterial system with three supplying arteries, rich vascular plexus in the zona reticularis, single drainage vein), the adrenal gland is prone to develop intraparenchymal hemorrhage in a case of venous obstruction. Vasculitis has not been found in aPL-induced AH [61].
AH usually manifests with back pain. Symptoms related to acute adrenal insufficiency (hypotension, malaise, fever, altered mental status, gastrointestinal symptoms including nausea, vomiting, and diarrhea) complement the clinical picture. Apart from the chronic adrenal insufficiency, skin hyperpigmentation is not present in the aPL-induced AH [59].
Laboratory tests and radiological imagining studies are critical for the confirmation of AH. Decreased cortisol levels and the lack of increase in cortisol levels after an adrenocorticotropic hormone stimulation test represent a typical laboratory finding. Abdominal contrast CT is the standard imagining method. However, CT has its limits, and if performed in the early phases of the bleeding, it may be falsely negative. A repeated CT scan is a must in the case of high clinical suspicion despite an initial negative result. Abdominal magnetic resonance is an alternative imagining method with the best imaging of the adrenal glands [62]. If the laboratory and imaging studies are inconclusive, adrenal biopsy remains the definitive diagnostic procedure. However, it is a high-risk procedure in terms of bleeding, and the risk–benefit ratio has to be evaluated individually. As a general rule, adrenal biopsy should be avoided in aPL-positive patients.
Clinical management has two goals: 1) to provide substitution of adrenal hormones, especially glucocorticoids; 2) to prevent further complications of aPL, namely thromboembolism. Since CAPS is a frequent finding in aPL-positive patients with AH, antithrombotics should be administered as long as possible despite hemorrhage. If their withdrawal is necessary, usually due to the extensive bleeding, the restart should be as soon as possible. The clinical experience stresses the critical importance of antithrombotic therapy. The study with aPL-positive patients and AH observed concurrent thrombotic events during the acute phase in 7 (43%) out of 16 participants. Five of 7 patients with confirmed thrombosis were diagnosed with CAPS [60]. Apart from the glucocorticoid substitution due to adrenal insufficiency, immunosuppressives are not a standard part of treatment since the available evidence does not confirm an effect on the clinical outcome [61]. However, their addition, alone or in combination with IVIg and plasma exchange, can be beneficial in the presence of CAPS.
The long-term prognosis of AH is relatively favorable after the acute phase, especially if antithrombotics are uninterrupted. In a review of 62 patients with AH followed for a mean of 25 (2–60) months, 90% (32 out of 35) of anticoagulated patients survived. Interestingly, overall mortality in the study reached 36% (25 out of 69 participants) [61]. Adrenal dysfunction is irreversible in most cases, although occasional recovery remains possible.
CAPS represents the most severe and potentially fatal variant of APS. It is characterized by excessive activation of hemostasis, rapid, multiple, and progressive thrombotic events, typically affecting small vessels, resulting in acute multiple organ dysfunction (usually kidneys, lungs, CNS, heart, skin) and TMAs [63]. Fortunately, CAPS is a relatively infrequent complication, affecting approximately 1% of patients with APS [2]. CAPS is the first manifestation of previously unrecognized or newly formed aPL in up to 50% of patients [10]. However, it can be the complication of preexisting and known aPL or APS as well. Its onset is usually - in about 2/3 of cases - related to precipitating factors such as infections, malignancies, trauma, invasive procedures, activation of underlying autoimmune disease, pregnancy complications, certain medications (oral contraceptives), and withdrawal or inadequate antithrombotic therapy. Pathological complement activation plays a critical role in its development [64].
Thromboembolic events and their complications dominate the clinical picture. Bleeding is typically secondary to the initial thromboembolism, although rarely can be among the initial clinical manifestations [65, 66]. The etiology of hemorrhage in CAPS is complex. It involves thrombocytopenia secondary to excessive platelet activation and consumption, consumption of coagulation factors, endothelial damage and dysfunction, thrombocytopenic thrombotic purpura (TTP)-like hemostatic changes, and development of DIC [67, 68]. Thrombocytopenia is a dominant change in CAPS, affecting up to 40% of patients with the complication. Thrombocytopenia, mainly if it manifests as the acute drop in platelet count in patients with aPL/APS and previously normal platelets, can be the first sign of impeding CAPS and precede the full clinical picture of CAPS for several days [11]. TTP-like changes frequently accompany thrombocytopenia [68]. Clinical presentation of hemorrhage is variable, with every organ system being a possible target. Life-threatening hemorrhage, including bleeding in the CNS and GIT, can occur [65, 66]. As mentioned before, DAH and AH are relatively frequent complications of CAPS.
The therapeutic approach is aggressive with several goals: 1) to suppress the immune system and production of aPL; 2) to prevent and treat thromboembolic events; 3) treat the underlying or provoking disorder. The combined immunosuppressive and immunomodulatory therapy (corticosteroids, IVIg, plasma exchange) together with full anticoagulation (preferably with heparin or LMWHs in the acute phase with the transition to warfarin) represents the initial therapeutic step [63]. Cyclophosphamide is the preferred immunosuppression in patients with underlying SLE. Rituximab and eculizumab are novel therapeutic possibilities that seem to be efficient in patients with predominant hematologic or microthromboangiopathic manifestations or resistant to first-line treatment [63, 69, 70]. Despite aggressive treatment and novel agents, the prognosis remains unfavorable in a significant number of cases, with a mortality rate reaching up to 40% [2]. The individual assessment of thrombotic and bleeding risk is an indispensable part of therapeutic management. The continuation of antithrombotic therapy is preferred over its tapering or withdrawal. Its continuation has to be considered even in the presence of hemorrhage.
Bleeding events, particularly those involving the CNS and GIT, are regarded as potentially serious, but the expected adverse events of antithrombotic therapy. The incidence of major bleeding ranges from 3 to 6 per 100 person-years depending on the anticoagulant. It is high for patients on warfarin in particular [71]. The incidence of bleeding on antiplatelet therapy is generally lower, 3 to 4 per 1000 person-years [72]. The risk increases with the intensity of treatment or concomitant use of several agents. The combination of the anticoagulant with antiplatelet agent increases the risk of bleeding approximately 1.5 to 2-fold in comparison to anticoagulant therapy alone [73].
Since the presence of aPL represents a high-risk thrombophilia, antithrombotics – anticoagulants, antiplatelet agents, or their combination - are administered for a prolonged period, frequently life-long in most aPL-positive patients. The continuous administration of antithrombotic agents is used even in asymptomatic individuals with estimated high prothrombotic risk. Warfarin remains the preferred agent for anticoagulation, with the intent to achieve a higher INR range of 3.0–4.0 in specific clinical situations (recurrent thrombotic events, arterial events) [74].
Based on the current clinical practice and preferred intensity of therapy, aPL-positive patients receiving antithrombotics may seem to have an increased risk of treatment-related bleeding. However, available data show that hemorrhage does not represent the main clinical issue. The mortality rate due to thrombosis and its recurrence remains several times higher than the mortality rate related to bleeding. For example, a review of clinical studies documented 18 deaths related to recurrent thrombosis and only one due to hemorrhage [75]. The analysis of a prospective 10-year follow-up of 1000 patients with APS, performed as a part of the Euro-Phospholipid project, identified 34 deaths attributed to thromboembolism and only 10 to bleeding [76]. Reviews of clinical studies focused on anticoagulant therapy in APS suggest that, if INR on warfarin is within the standard therapeutic range, the major bleeding does not appear to be significantly more frequent in comparison to other patient groups on warfarin and is about 1.5–2.0% per year [77]. If higher INR levels (3.0–4.0) are needed, the risk of bleeding, but predominantly mild, increases significantly, approximately 2 to 2.5 times [77, 78]. As for antiplatelet agents, the rate of bleeding during their prophylactic or therapeutic use appears to be low, and major bleeding is rare [78, 79]. The risk of bleeding increases after invasive procedures, likely due to the use of bridging therapy, the early reintroduction of antithrombotics, and aggressive antithrombotic policies [80, 81]. Then again, thrombotic risk after surgery increases considerably as well despite preventive measures.
Independent predictors of major bleeding include overdose with warfarin (e. g. INR above 4.0), combined antithrombotic therapy, polypharmacy, age over 75 years, history of major bleeding (mostly gastrointestinal), malignancy, uncontrolled arterial hypertension, leukoaraiosis, and patient non-compliance [76, 77, 78]. It is critical to evaluate individual bleeding and prothrombotic risk and purposely identify potential risk factors. Caution is especially required when high-intensity anticoagulation or a combination of antithrombotics are indicated.
Bleeding is a rare but potentially severe complication of aPL and APS. Its etiology is heterogeneous; aPL-positive patients can develop bleeding due to thrombocytopenia, acquired coagulation factor deficiencies (predominantly hypoprothrombinemia), TMAs, or the adverse events of antithrombotic therapy (mostly with warfarin). However, thromboembolic events represent the most dangerous complications for aPL-positive patients, and the thrombotic risk remains clinically relevant even in the presence of hemorrhage in the majority of patients.
The management of bleeding is challenging. It is necessary to balance both thrombotic and bleeding stimuli and to continue antithrombotic prevention or therapy for as long as possible. The individual approach is critical for a favorable clinical outcome. Specific treatment can be necessary for eliminating the cause of bleeding and achieving its control. Immunosuppressive agents, especially corticosteroids, are the first-choice treatment for aPL-associated thrombocytopenia, coagulation factor deficiencies, CAPS, and DAH. Other immunosuppressive or immunomodulatory agents can be efficient in case of unsatisfactory clinical response. Rituximab appears to be the most promising alternative. Corticosteroids are also fundamental for the diffuse alveolar hemorrhage, albeit firstly for the correction of consequential adrenal insufficiency. aPL-positive patients receiving antithrombotics should be monitored closely, and their compliance ensured, especially in the scenario with the high-intensity or combined antithrombotic therapy.
The authors declare no conflict of interest.
anticardiolipin antibodies adrenal hemorrhage anti-beta2-glycoprotein I antibodies antiphospholipid antibodies antiphospholipid syndrome activated partial thromboplastin time acquired von Willebrand syndrome beta2-glycoprotein I catastrophic antiphospholipid syndrome central nervous system diffuse alveolar hemorrhage disseminated intravascular coagulation gastrointestinal tract immune thrombocytopenia intravenous immunoglobulin lupus anticoagulant low molecular weight heparins prothrombin time systematic lupus erythematosus thrombotic microangiopathies thrombopoietin mimetics thrombocytopenic thrombotic purpura von Willebrand factor
These Terms and Conditions outline the rules and regulations pertaining to the use of IntechOpen’s website www.intechopen.com and all the subdomains owned by IntechOpen located at 5 Princes Gate Court, London, SW7 2QJ, United Kingdom.
',metaTitle:"Terms and Conditions",metaDescription:"These terms and conditions outline the rules and regulations for the use of IntechOpen Website at https://intechopen.com and all its subdomains owned by Intech Limited located at 7th floor, 10 Lower Thames Street, London, EC3R 6AF, UK.",metaKeywords:null,canonicalURL:"/page/terms-and-conditions",contentRaw:'[{"type":"htmlEditorComponent","content":"By accessing the website at www.intechopen.com you are agreeing to be bound by these Terms of Service, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. Use and/or access to this site is based on full agreement and compliance of these Terms. All materials contained on this website are protected by applicable copyright and trademark laws.
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\n\nThe following terminology applies to these Terms and Conditions, Privacy Statement, Disclaimer Notice, and any or all Agreements:
\n\n“Client”, “Customer”, “You” and “Your” refers to you, the person accessing this website and accepting the Company’s Terms and Conditions;
\n\n“The Company”, “Ourselves”, “We”, “Our” and “Us”, refers to our Company, IntechOpen;
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\n'}]},successStories:{items:[]},authorsAndEditors:{filterParams:{},profiles:[{id:"396",title:"Dr.",name:"Vedran",middleName:null,surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/396/images/7281_n.png",biography:"After obtaining his Master's degree in Mechanical Engineering he continued his education at the Vienna University of Technology where he obtained his PhD degree in 2004. He worked as a researcher at the Automation and Control Institute, Faculty of Electrical Engineering, Vienna University of Technology until 2008. His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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The hydration processes of biopolymers have been extensively studied in the past 20 years with reference to a considerable variety of models and concepts. In all recent works, a distinction is made between intracellular water that maintains the ordinary liquid state (bulk water) and water ordered in extended hydrogen‐bonded lattices at the surface and structured in the internal grooves of macromolecules (hydration water) in dependence on the chemical properties of the macromolecule surface. FTIR spectroscopy has been implemented in this field both for the sensitivity in the conformational analysis of biological macromolecules and the reliability in the investigation of the water network. A perturbation technique such as dehydration‐rehydration treatment modifies the macromolecule structure and water distribution. It was applied to two structurally different proteins: lysozyme, a globular (α + β) protein and collagen, a fibrous protein characterized by the triple helix structure. Submitted to the treatment both of them display irreversible conformational changes.",book:{id:"5411",slug:"fourier-transforms-high-tech-application-and-current-trends",title:"Fourier Transforms",fullTitle:"Fourier Transforms - High-tech Application and Current Trends"},signatures:"Maria Grazia Bridelli",authors:[{id:"108760",title:"Dr.",name:"Maria Grazia",middleName:null,surname:"Bridelli",slug:"maria-grazia-bridelli",fullName:"Maria Grazia Bridelli"}]},{id:"74096",doi:"10.5772/intechopen.94521",title:"Time Frequency Analysis of Wavelet and Fourier Transform",slug:"time-frequency-analysis-of-wavelet-and-fourier-transform",totalDownloads:1220,totalCrossrefCites:6,totalDimensionsCites:8,abstract:"Signal processing has long been dominated by the Fourier transform. However, there is an alternate transform that has gained popularity recently and that is the wavelet transform. The wavelet transform has a long history starting in 1910 when Alfred Haar created it as an alternative to the Fourier transform. In 1940 Norman Ricker created the first continuous wavelet and proposed the term wavelet. Work in the field has proceeded in fits and starts across many different disciplines, until the 1990’s when the discrete wavelet transform was developed by Ingrid Daubechies. While the Fourier transform creates a representation of the signal in the frequency domain, the wavelet transform creates a representation of the signal in both the time and frequency domain, thereby allowing efficient access of localized information about the signal.",book:{id:"10065",slug:"wavelet-theory",title:"Wavelet Theory",fullTitle:"Wavelet Theory"},signatures:"Karlton Wirsing",authors:[{id:"325178",title:"Dr.",name:"Karlton",middleName:null,surname:"Wirsing",slug:"karlton-wirsing",fullName:"Karlton Wirsing"}]},{id:"52810",doi:"10.5772/65776",title:"Study of Green Nanoparticles and Biocomplexes Based on Exopolysaccharide by Modern Fourier Transform Spectroscopy",slug:"study-of-green-nanoparticles-and-biocomplexes-based-on-exopolysaccharide-by-modern-fourier-transform",totalDownloads:2028,totalCrossrefCites:2,totalDimensionsCites:6,abstract:"The intention of this chapter is to contribute in clarification of nanoparticle synthesis and biocomplexes based on exopolysaccharide, green synthetic method development, their physico‐chemical characterization by modern spectroscopy, as well as testing of their antimicrobial activity. Silver nanoparticles of polysaccharide type have scientific interest, but practical importance too, because of their application in pharmaceutical and cosmetic product development due to proven antimicrobial and antioxidant activities. On the other hand, the biocomplexes based on exopolysaccharides are important in treatment of biometal deficiency in human and veterinary medicine, as well as in metal ion transporting in organism. Despite a number of studies of this kind of complexes, the investigations of effect of their structure to pharmaco‐biological activity are still interesting. It is important that question of interaction between reducing and stabilizing agents with metal ions is still opened. In this respect, the presented chapter offers further progress in the examination of silver nanoparticles and cobalt biocomplex synthesis with dextran oligosaccharides and its derivatives (such as dextran sulfate and carboxymethyl dextran). The complex structure, spectroscopic characterization, and the spectra‐structure correlation have been analyzed by different Fourier transform infrared (FTIR) spectroscopic techniques combined with energy‐dispersive X‐ray (EDX), X‐ray diffraction (XRD), scanning electron microscopy (SEM), and surface plasmon resonance UV‐Vis methods.",book:{id:"5411",slug:"fourier-transforms-high-tech-application-and-current-trends",title:"Fourier Transforms",fullTitle:"Fourier Transforms - High-tech Application and Current Trends"},signatures:"Goran S. Nikolić, Milorad D. Cakić, Slobodan Glišić, Dragan J.\nCvetković, Žarko J. Mitić and Dragana Z. 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This content can be helpful to recognize the chemical nature of the materials within the scene or to calculate their colours under particular conditions. Different solutions of hyperspectral imager have been realized with different spatial resolution, spectral resolution and range in the electromagnetic spectrum. In particular, improving the spectral resolution allows discriminating smaller features in the spectrum and the unambiguous detection of the absorption bands characteristic of superficial materials. Hyperspectral imagers based on interferometers have the advantage of having a spectral resolution that can be varied according to the needs by changing the optical path delay of the interferometer. A spectrum for each pixel is obtained with an algorithm based on the Fourier transform of the calibrated interferogram. We present the results of the application of a hyperspectral imager based on Fabry‐Perot interferometers to the field of cultural heritage. On different artworks, the hyperspectral imager has been used for pigment recognition, for colour rendering elaborations of the image with different light sources or standard illuminants and for calculating the chromatic coordinates useful for specific purposes.",book:{id:"5411",slug:"fourier-transforms-high-tech-application-and-current-trends",title:"Fourier Transforms",fullTitle:"Fourier Transforms - High-tech Application and Current Trends"},signatures:"Massimo Zucco, Marco Pisani and Tiziana Cavaleri",authors:[{id:"20909",title:"Dr.",name:"Marco Q.",middleName:null,surname:"Pisani",slug:"marco-q.-pisani",fullName:"Marco Q. Pisani"},{id:"20910",title:"Dr.",name:"Massimo E.",middleName:null,surname:"Zucco",slug:"massimo-e.-zucco",fullName:"Massimo E. Zucco"},{id:"194761",title:"Dr.",name:"Tiziana",middleName:null,surname:"Cavaleri",slug:"tiziana-cavaleri",fullName:"Tiziana Cavaleri"}]},{id:"53524",doi:"10.5772/66733",title:"Fourier Analysis for Harmonic Signals in Electrical Power Systems",slug:"fourier-analysis-for-harmonic-signals-in-electrical-power-systems",totalDownloads:4525,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"The harmonic content in electrical power systems is an increasingly worrying issue since the proliferation of nonlinear loads results in power quality problems as the harmonics is more apparent. In this paper, we analyze the behavior of the harmonics in the electrical power systems such as cables, transmission lines, capacitors, transformers, and rotating machines, the induction machine being the object of our study when it is excited to nonsinusoidal operating conditions in the stator winding. For this, a model is proposed for the harmonic analysis of the induction machine in steady‐state regimen applying the Fourier transform. The results of the proposed model are validated by experimental tests which gave good results for each case study concluding in a model proper for harmonic and nonharmonic analysis of the induction machine and for “harmonic” analysis in an electrical power system.",book:{id:"5411",slug:"fourier-transforms-high-tech-application-and-current-trends",title:"Fourier Transforms",fullTitle:"Fourier Transforms - High-tech Application and Current Trends"},signatures:"Emmanuel Hernández Mayoral, Miguel Angel Hernández López,\nEdwin Román Hernández, Hugo Jorge Cortina Marrero, José\nRafael Dorrego Portela and Victor Ivan Moreno Oliva",authors:[{id:"187793",title:"Dr.",name:"Emmanuel",middleName:null,surname:"Hernández",slug:"emmanuel-hernandez",fullName:"Emmanuel Hernández"},{id:"202757",title:"Dr.",name:"Miguel Angel",middleName:null,surname:"Hernández López",slug:"miguel-angel-hernandez-lopez",fullName:"Miguel Angel Hernández López"},{id:"202758",title:"Dr.",name:"Hugo Jorge",middleName:null,surname:"Cortina Marrero",slug:"hugo-jorge-cortina-marrero",fullName:"Hugo Jorge Cortina Marrero"},{id:"202759",title:"Dr.",name:"Edwin Román",middleName:null,surname:"Hernández",slug:"edwin-roman-hernandez",fullName:"Edwin Román Hernández"},{id:"202760",title:"Dr.",name:"Victor Iván Moreno",middleName:null,surname:"Oliva",slug:"victor-ivan-moreno-oliva",fullName:"Victor Iván Moreno Oliva"},{id:"202761",title:"Dr.",name:"José Rafael Dorrego",middleName:null,surname:"Portela",slug:"jose-rafael-dorrego-portela",fullName:"José Rafael Dorrego Portela"}]}],mostDownloadedChaptersLast30Days:[{id:"74096",title:"Time Frequency Analysis of Wavelet and Fourier Transform",slug:"time-frequency-analysis-of-wavelet-and-fourier-transform",totalDownloads:1220,totalCrossrefCites:6,totalDimensionsCites:8,abstract:"Signal processing has long been dominated by the Fourier transform. However, there is an alternate transform that has gained popularity recently and that is the wavelet transform. The wavelet transform has a long history starting in 1910 when Alfred Haar created it as an alternative to the Fourier transform. In 1940 Norman Ricker created the first continuous wavelet and proposed the term wavelet. Work in the field has proceeded in fits and starts across many different disciplines, until the 1990’s when the discrete wavelet transform was developed by Ingrid Daubechies. While the Fourier transform creates a representation of the signal in the frequency domain, the wavelet transform creates a representation of the signal in both the time and frequency domain, thereby allowing efficient access of localized information about the signal.",book:{id:"10065",slug:"wavelet-theory",title:"Wavelet Theory",fullTitle:"Wavelet Theory"},signatures:"Karlton Wirsing",authors:[{id:"325178",title:"Dr.",name:"Karlton",middleName:null,surname:"Wirsing",slug:"karlton-wirsing",fullName:"Karlton Wirsing"}]},{id:"74032",title:"Wavelets for EEG Analysis",slug:"wavelets-for-eeg-analysis",totalDownloads:1209,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"This chapter introduces the applications of wavelet for Electroencephalogram (EEG) signal analysis. First, the overview of EEG signal is discussed to the recording of raw EEG and widely used frequency bands in EEG studies. The chapter then progresses to discuss the common artefacts that contaminate EEG signal while recording. With a short overview of wavelet analysis techniques, namely; Continues Wavelet Transform (CWT), Discrete Wavelet Transform (DWT), and Wavelet Packet Decomposition (WPD), the chapter demonstrates the richness of CWT over conventional time-frequency analysis technique e.g. Short-Time Fourier Transform. Lastly, artefact removal algorithms based on Independent Component Analysis (ICA) and wavelet are discussed and a comparative analysis is demonstrated. The techniques covered in this chapter show that wavelet analysis is well-suited for EEG signals for describing time-localised event. Due to similar nature, wavelet analysis is also suitable for other biomedical signals such as Electrocardiogram and Electromyogram.",book:{id:"10065",slug:"wavelet-theory",title:"Wavelet Theory",fullTitle:"Wavelet Theory"},signatures:"Nikesh Bajaj",authors:[{id:"326400",title:"Dr.",name:"Nikesh",middleName:null,surname:"Bajaj",slug:"nikesh-bajaj",fullName:"Nikesh Bajaj"}]},{id:"53524",title:"Fourier Analysis for Harmonic Signals in Electrical Power Systems",slug:"fourier-analysis-for-harmonic-signals-in-electrical-power-systems",totalDownloads:4525,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"The harmonic content in electrical power systems is an increasingly worrying issue since the proliferation of nonlinear loads results in power quality problems as the harmonics is more apparent. In this paper, we analyze the behavior of the harmonics in the electrical power systems such as cables, transmission lines, capacitors, transformers, and rotating machines, the induction machine being the object of our study when it is excited to nonsinusoidal operating conditions in the stator winding. For this, a model is proposed for the harmonic analysis of the induction machine in steady‐state regimen applying the Fourier transform. 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An overview about Fourier transform spectroscopy (FTS) used like a powerful and sensitive tool in medical, biological, and biomedical analysis is provided. The advanced spectroscopic techniques of FTS, such as Fourier transform visible spectroscopy (FTVS), Fourier transform infrared-attenuated total reflectance (FTIR-ATR), Fourier transform infrared-photoacoustic spectroscopy (FTIR-PAS), Fourier transform infrared imaging spectroscopy (FTIR imaging), and their biomedical applications are described. A special attention has been paid to the description of the FTVS method of commercial quantum dots like an innovative and reliable technique used in the field of nanobiotechnology.",book:{id:"5411",slug:"fourier-transforms-high-tech-application-and-current-trends",title:"Fourier Transforms",fullTitle:"Fourier Transforms - High-tech Application and Current Trends"},signatures:"Anca Armăşelu",authors:[{id:"189080",title:"Dr.",name:"Anca",middleName:null,surname:"Armăşelu",slug:"anca-armaselu",fullName:"Anca Armăşelu"}]},{id:"53419",title:"Fourier Transform Infrared Spectroscopy in the Study of Hydrated Biological Macromolecules",slug:"fourier-transform-infrared-spectroscopy-in-the-study-of-hydrated-biological-macromolecules",totalDownloads:2474,totalCrossrefCites:3,totalDimensionsCites:15,abstract:"The interaction between biological macromolecules (proteins, nucleic acids, lipids and other biomolecules in the cell) and environmental water is an important determining factor in their conformational properties, stability and function. The hydration processes of biopolymers have been extensively studied in the past 20 years with reference to a considerable variety of models and concepts. In all recent works, a distinction is made between intracellular water that maintains the ordinary liquid state (bulk water) and water ordered in extended hydrogen‐bonded lattices at the surface and structured in the internal grooves of macromolecules (hydration water) in dependence on the chemical properties of the macromolecule surface. FTIR spectroscopy has been implemented in this field both for the sensitivity in the conformational analysis of biological macromolecules and the reliability in the investigation of the water network. A perturbation technique such as dehydration‐rehydration treatment modifies the macromolecule structure and water distribution. It was applied to two structurally different proteins: lysozyme, a globular (α + β) protein and collagen, a fibrous protein characterized by the triple helix structure. Submitted to the treatment both of them display irreversible conformational changes.",book:{id:"5411",slug:"fourier-transforms-high-tech-application-and-current-trends",title:"Fourier Transforms",fullTitle:"Fourier Transforms - High-tech Application and Current Trends"},signatures:"Maria Grazia Bridelli",authors:[{id:"108760",title:"Dr.",name:"Maria Grazia",middleName:null,surname:"Bridelli",slug:"maria-grazia-bridelli",fullName:"Maria Grazia Bridelli"}]}],onlineFirstChaptersFilter:{topicId:"974",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:31,numberOfPublishedChapters:315,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:11,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:105,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:14,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403",scope:"Artificial Intelligence (AI) is a rapidly developing multidisciplinary research area that aims to solve increasingly complex problems. In today's highly integrated world, AI promises to become a robust and powerful means for obtaining solutions to previously unsolvable problems. 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Prior to his appointment at Stellenbosch University, he has been at the University of Pretoria, Department of Computer Science (1998-2018), where he was appointed as South Africa Research Chair in Artifical Intelligence (2007-2018), the head of the Department of Computer Science (2008-2017), and Director of the Institute for Big Data and Data Science (2017-2018). 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A dynamic career research platform which is based on the thematic areas of comparative vertebrate physiology, stress endocrinology, reproductive endocrinology, animal health and welfare, and conservation biology. \nEdward has supervised 40 research students and published over 60 peer reviewed research.",institutionString:null,institution:{name:"University of Queensland",institutionURL:null,country:{name:"Australia"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"258334",title:"Dr.",name:"Carlos Eduardo",middleName:null,surname:"Fonseca-Alves",slug:"carlos-eduardo-fonseca-alves",fullName:"Carlos Eduardo Fonseca-Alves",profilePictureURL:"https://mts.intechopen.com/storage/users/258334/images/system/258334.jpg",institutionString:null,institution:{name:"Universidade Paulista",institutionURL:null,country:{name:"Brazil"}}},{id:"191123",title:"Dr.",name:"Juan José",middleName:null,surname:"Valdez-Alarcón",slug:"juan-jose-valdez-alarcon",fullName:"Juan José Valdez-Alarcón",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBfcQAG/Profile_Picture_1631354558068",institutionString:"Universidad Michoacana de San Nicolás de Hidalgo",institution:{name:"Universidad Michoacana de San Nicolás de Hidalgo",institutionURL:null,country:{name:"Mexico"}}},{id:"161556",title:"Dr.",name:"Maria Dos Anjos",middleName:null,surname:"Pires",slug:"maria-dos-anjos-pires",fullName:"Maria Dos Anjos Pires",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS8q2QAC/Profile_Picture_1633432838418",institutionString:null,institution:{name:"University of Trás-os-Montes and Alto Douro",institutionURL:null,country:{name:"Portugal"}}},{id:"209839",title:"Dr.",name:"Marina",middleName:null,surname:"Spinu",slug:"marina-spinu",fullName:"Marina Spinu",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRLXpQAO/Profile_Picture_1630044895475",institutionString:null,institution:{name:"University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca",institutionURL:null,country:{name:"Romania"}}},{id:"92185",title:"Dr.",name:"Sara",middleName:null,surname:"Savic",slug:"sara-savic",fullName:"Sara Savic",profilePictureURL:"https://mts.intechopen.com/storage/users/92185/images/system/92185.jfif",institutionString:'Scientific Veterinary Institute "Novi Sad"',institution:{name:'Scientific Veterinary Institute "Novi Sad"',institutionURL:null,country:{name:"Serbia"}}}]},{id:"20",title:"Animal Nutrition",coverUrl:"https://cdn.intechopen.com/series_topics/covers/20.jpg",editor:{id:"175967",title:"Dr.",name:"Manuel",middleName:null,surname:"Gonzalez Ronquillo",slug:"manuel-gonzalez-ronquillo",fullName:"Manuel Gonzalez Ronquillo",profilePictureURL:"https://mts.intechopen.com/storage/users/175967/images/system/175967.png",biography:"Dr. Manuel González Ronquillo obtained his doctorate degree from the University of Zaragoza, Spain, in 2001. He is a research professor at the Faculty of Veterinary Medicine and Animal Husbandry, Autonomous University of the State of Mexico. He is also a level-2 researcher. He received a Fulbright-Garcia Robles fellowship for a postdoctoral stay at the US Dairy Forage Research Center, Madison, Wisconsin, USA in 2008–2009. He received grants from Alianza del Pacifico for a stay at the University of Magallanes, Chile, in 2014, and from Consejo Nacional de Ciencia y Tecnología (CONACyT) to work in the Food and Agriculture Organization’s Animal Production and Health Division (AGA), Rome, Italy, in 2014–2015. He has collaborated with researchers from different countries and published ninety-eight journal articles. 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Among them are those associated with pollution, resource extraction and overexploitation, loss of biodiversity, soil degradation, disorderly land occupation and planning, and many others. These anthropic effects could potentially be caused by any inadequate management of the environment. However, ecosystems have a resilience that makes them react to disturbances which mitigate the negative effects. It is critical to understand how ecosystems, natural and anthropized, including urban environments, respond to actions that have a negative influence and how they are managed. It is also important to establish when the limits marked by the resilience and the breaking point are achieved and when no return is possible. The main focus for the chapters is to cover the subjects such as understanding how the environment resilience works, the mechanisms involved, and how to manage them in order to improve our interactions with the environment and promote the use of adequate management practices such as those outlined in the United Nations’ Sustainable Development Goals.
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