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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"196",leadTitle:null,fullTitle:"Kidney Transplantation - New Perspectives",title:"Kidney Transplantation",subtitle:"New Perspectives",reviewType:"peer-reviewed",abstract:"Although many years have passed since the first successful kidney transplantation, the method, although no longer considered a medical experiment, is still perceived as controversial and, as such, it triggers many emotions and that's why conscious educational efforts are still needed for kidney transplantation, for many people being the only chance for an active lifestyle and improved quality of life, to win common social acceptance and stop triggering negative connotations. Apart from transplantation controversies piling up over years transplantologists also have to face many other medical difficulties. The chapters selected for this book are of high level of content, and the fact that their authors come from many different countries, and sometimes even cultures, has facilitated a comprehensive and interesting approach to the problem of kidney transplantation. 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\r\n\tIn this book, the technological and functional properties of barley will be highlighted comprehensively. Moreover, Nutritional and bioactive profiles and barley utilization in different baking products will also be in the limelight of this book. This depiction will be valuable for all consumers from health points of view.
\r\n\r\n\tFood security is an alarming issue in developing countries as the population is increasing day by day. So, researchers have to think about alternative sources of staple diet(wheat) that should have the same nutritional composition as compared to wheat. Among cereals, barley is an alternative source because of its nutritional and functional properties, despite all the functional ingredients it is rarely used in the food industry. From different researches, it is revealed that it contains 24 % dietary fiber, so it is beneficial for CVDs and other health-related disorders. Now a day, barley consumption is very rare. There are many barley products in the food market such as malt flour, grits, flakes, pot, and pearled barley. Bread formulations also involve the usage of barley flour and cracked barley. The possibility of high fiber barley utilization in breakfast cereals production through blending with other grains, flaking, puffing, and extrusion is becoming common. So, there is a dire need to do value addition of barley into various products. Furthermore, the most important reason for wheat replacement with barley is its allergy-causing nature in some cases. Keeping in view all of the above facts, the present book has been designed.
",isbn:"978-1-80356-924-6",printIsbn:"978-1-80356-923-9",pdfIsbn:"978-1-80356-925-3",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"996125d4599193b3b6b749f5d8aa3cb2",bookSignature:"Dr. Farhan Saeed and Dr. Muhammad Afzaal",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11793.jpg",keywords:"Cereal, Barley, Dietary Fibers, Nutritional Composition, Grains, Technology, Processing, Milling, Flour, Rheology, Bioactive Profile, Utilization",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 6th 2022",dateEndSecondStepPublish:"June 14th 2022",dateEndThirdStepPublish:"August 13th 2022",dateEndFourthStepPublish:"November 1st 2022",dateEndFifthStepPublish:"December 31st 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"2 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Farhan is an Assistant Professor at Government College University Faisalabad-Pakistan where he finished his Ph.D. at the age of 28 years. He has an h index of 16 and has published more than 70 papers in reputed journals with an impact factor of more than 140. His research focus is on finding innovative and effective practices to improve food production, quality, and safety, keeping in view the betterment of human health.",coeditorOneBiosketch:"Dr. Muhammad Afzaal is working as an Assistant professor in the Department of Food Science. Government College University Faisalabad. He has 10 years of teaching and research experience. He has more than 40 publications in well-reputed journals and 5 book chapters published. His research interests are food science and technology, food microbiology and biotechnology, microencapsulation, probiotics, prebiotics & synbiotics, biopreservation, and waste value addition.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"192244",title:"Dr.",name:"Farhan",middleName:null,surname:"Saeed",slug:"farhan-saeed",fullName:"Farhan Saeed",profilePictureURL:"https://mts.intechopen.com/storage/users/192244/images/system/192244.jpg",biography:"PERSONAL STATEMENT\r\nMy name is Farhan Saeed. During Master study, I received an Indigenous Fellowship from Higher Education Commission (HEC) Pakistan. The selection process was a rigorous process starting from a GRE-based test. After being short listed by HEC, part of the Fellowship was the opportunity to complete doctorate degree mainly within Food Science and Technology field. I did my Doctorate thesis entitled 'Biochemical characterization of non-starch polysaccharides in relation to end-use quality of spring wheats” under the supervision of Dr. Imran Pasha. The doctorate research was focused on value addition of bioactive components extracted from spring wheats. The addition of extracted non-starch polysaccharides enhances the quality of baked products as well as important in nutraceutical point of view. The products under proposed study were thoroughly investigated for assessment of nutritional and end use quality of bread. The output of the proposed research work was highly beneficial to the consumers as well as Government of Pakistan for their intended purposes. The awareness about nutritional significance of non-starch polysaccharides enriched bread was really set the new horizons in product development in Pakistan. In 2012, I joined Institute of Home & Food Sciences, Government College University Faisalabad as Assistant Professor. In 2014, I became HEC Approved Supervisor. During 2015, I have visited Massachusetts, Amherst, USA under Pakistan Program for Collaborative Research (PPCR), HEC Pakistan for two months training program for the development of innovative project. After that, I have been selected to receive a 2016 'Endeavour Research Fellowship” to undertake proposed program in Australia. I did work in Centre for Nutrition & Food Science, The University of Queensland, Brisbane, Australia under the supervision of Professor Mike Gidley. The commencing date of current program is May 17, 2016 and the expiry is on November 15, 2016. In October, 2018. I was promoted to Tenured Associate Professor. I have published more than 70 papers in reputed journals with impact factor more than 140. I have 20 book chapters in international books. I presented research works in international level at Huazhong University Wuhan, China and Conference on Food Properties in Sharjah. I also got two research projects funds from Higher Education Commission Islamabad, Pakistan. I would like to be granted the KGSP because it will offer me with the opportunity to partake in Post-Doctoral program of Food Science and Biotechnology at Kyungpook National University (KNU) among the best universities in Korea. In my home country, vital issues stressed in this particular degree program are quite overlooked, and this scholarship program will bring me a great chance to come within reach of them. By taking this course, I am optimistic for finding innovative and effective practices to improve food production, quality and safety, keeping in view the betterment of human health; and moreover, to improve the end-product quality for maintenance of customer’s health. To sum up, winning the KGSP will enable me not only to broaden my knowledge, but also to gain experience from people and culture of both countries Korea and Pakistan. 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The knowledge and expertise together with the international interaction developed through this project will finally be utilized for the development of laboratory of functional foods and nutraceuticals at my home institute.",institutionString:"Government College University, Faisalabad",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Government College University, Faisalabad",institutionURL:null,country:{name:"Pakistan"}}}],coeditorOne:{id:"245894",title:"Dr.",name:"Muhammad",middleName:null,surname:"Afzaal",slug:"muhammad-afzaal",fullName:"Muhammad Afzaal",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSF1qQAG/Profile_Picture_1618812051691",biography:"Dr. Muhammad Afzaal, Ph.D., is an Assistant Professor in the Department of Food Science, Government College University Faisalabad, Pakistan. 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From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. 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More than 200 genotypes have been identified; nearly 40–50 of these types cause genital infections. HPV 6, HPV 11 and HPV 16 are the most associated with genital warts. The transmission of the virus is by direct contact, but their infectivity is variable due to the number and the type of virus particles and the immune system of the infected human. Trauma, microabrasions and microdefects on the skin and mucosa promote the contagion. Less than 1–2% of infected people have clinically apparent anogenital warts [1, 2].
\n\t\tHPV infection is a common sexually transmitted infection worldwide. HPV may cause several reproductive tract diseases, including genital warts and cervical cancer. The incidence of HPV infections has been steadily increasing especially in the second decade of life. Genital warts affect both males and females, although slightly higher in men according to latest data [3].
\n\t\t\tThe prevalence of HPV infection is estimated currently at 10–15%, with substantial regional variation [4]. The most common benign genital HPV infection is genital warts, caused in about 90% of the cases by nononcogenic HPV types such as 6 and 11. HPV infection is detected for more than 90% of the cases of cervical cancer [3, 4].
\n\t\tHPVs are small, circular, double-stranded DNA viruses. The capsid is made up of 72 icosahedral structures. Different types of HPV come from their variable L1 code. L1 encodes primary structural protein in the virus capsid. Genital HPV is associated with a high risk of carcinogenesis, as the viral DNA integrates into the hosts’ DNA [5]. All HPVs target epithelia tissues and link their productive life cycles to differentiation of the infected host cell. HPVs are associated with a spectrum of manifestations ranging from unapparent infections to malignant neoplasias. The alpha-papillomaviruses contain viruses that infect mucosal epithelium, some of which are considered high risk (HR) and others low risk (LR) based on their association with cancers. The LR-HPVs can cause benign hyperproliferative lesions such as warts, and the High-risk HPV (HR-HPV) has been linked with progress tohifh-grade neoplasia and invasive malignant cancer [6, 7]. Low-risk HPV types include HPV 6 and 11 that have been associated with benign anogenital warts. At least 12 HR-HPV types, HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59, have been associated with anogenital cancers as well as precursor neoplastic lesions [8]. It is now established that HPV 16 and 18 are the major papillomavirus types responsible for cervical cancer. Two viral proteins, E6 and E7, are essential for the integration into host chromosomes during malignant progression. They interact with p53 protein that regulates DNA damage repair [6, 7]. The high-risk mucosal HPVs, such as HPV 16, 18, 31 and 33, appear to have relation to the function of the E5, E6 and E7 gene products and the regulatory mechanisms that govern their expression. The cellular tumor suppressor gene p16 is an important biomarker for HPV-associated intraepithelial neoplasia. The overexpression of p16 is found in examined LSIL (CIN) lesions, except for those being caused by “low-risk” HPV types. There was no expression in healthy cervical epithelium [7].
\n\t\t\tDirect genital mucosa contact during sexual intercourse is the classical way of HPV transmission. The risk of male-to-female transmission is lower than that of female-to-male transmission. Five prospective studies have reported a significantly higher female-to-male transmission rate of any type of HPV than that of male-to-female. This may be explained by: (a) more transient infections in men; (b) lower HPV viral load in men; and (c) lower seroconversion rate for HPV infection in men [9]. Concordance of HPV infection between sexual partners is 40–60%. Length of sexual relationship, frequency of intercourse, condom use and number of sexual partners may play a role for the transmission. There is also vertical transmission to newborn from the mother. Contact with vaginal and cervical mucosa, transmission by placental or by amniotic fluid is the way of vertical infection to newborn. The rate of vertical transmission changes between 20 and 30% [10].
\n\t\t\tHPV enters epidermis through small defects on the skin or mucosa and proceeds to the basal layer of keratinocytes. The infected cells cannot undergo terminal differentiation. After the viral replication, multinucleation, nuclear enlargement, parakeratosis and koilocytes are seen in the upper layer of the epidermis. As the infected cells cornify and are shed, virus particles lead to further infection or transmission [2, 10].
\n\t\tA clinical diagnosis can be made in apparent infection. If the lesion is suspicious, biopsy is possible for the differential diagnosis. To detect the HPV in subclinic infections, variable methods are used. HPV testing plays an important role adjunct to the cervical cytology after the Pap-smear categories. Serological tests have been developed for the early diagnosis of cervical cancer and to detect high risk HPV types. HPV-DNA testing includes PCR, southern blot hybridization and fluorescent in situ hybridization (FISH). PCR is highly sensitive in identifying small amounts of viral nucleic acids. The specimen can be taken from cervicovaginal area, vulva, urethra and anal anogenital area for PCR analysis [11]. Cytology and HPV testing are important for detecting cervical dysplasia. Because there is no treatment for asymptomatic HPV in men, routine HPV testing is not recommended in men [10, 11].
\n\t\tAnogenital warts are the most common clinical presentation of HPV infection. Although warts are benign lesions, they cause a lot of stress and discomfort in patients’ social life. Itching, bleeding, discomfort and pain are the rare symptoms, usually they are asymptomatic. Genital warts are highly infectious, and approximately 65% of people whose sexual partner has genital warts will develop warts themselves. The incubation period of HPV infection is estimated 2 weeks to 8 months, with the majority of genital warts appearing 2–3 months after an HPV infection. Approximately 20–30% of genital warts will spontaneously regress within 1 year; however, recurrence of warts is common [12].
\n\t\t\tLesions may be single or multiple, of varying sizes, and are usually asymptomatic. Condylomata acuminata are pale pink papules or nodules with a smooth and velvety surface. The difference from other warts is the lack of hyperkeratosis. They may grow exophytic and cauliflower-like mass. They are highly contagious. HPV 6–11 are the most common types detected in condylomata acuminata. These are low risk types. Many other types have also been described including HPV 2, 30–33, 35, 39, 41–45, 51–56 and 59, many of which are intermediate and high risk types. HPV 16–18 are the most common high risk types and can be found isolated or with HPV 6–11 [1, 13, 14]. The HR-HPV types, most often HPV 16 and 18, are considered to be the primary etiologic agents for cervical cancer and precancerous lesions in women (CIN, VIN, VaIN) [15]. HPV 16 is the main virus type to be associated with the development of VAIN. Also, HPV 16 infection, VIN or condylomata acuminata in the past medical history seemed to be significant factors for early relapse [16]. Multiple studies verified that persistent HPV infection is considered to play a key role in the development of cervical cancer. Cervical intraepithelial neoplasia (CIN) is the prelesion of cervical cancer, and high-grade squamous intraepithelial lesions (HSIL) with HPV infection can develop and progress to cervical cancer over a period of 8–12 years. HPV 16, 58, 52 and 18 are the predominant high risk types correlated with cervical lesion. The distribution of dominant HPV genotypes showed obvious regional differences. HPV 16 is more prevalent in Europe and North America, HPV 31 is more prevalent in South/Central America, HPV 33 and 45 are more prevalent in Africa and HPV 52 and 58 are more prevalent in Asia [17]. In male anogenital area, HPV is responsible for a subset of squamous cell carcinomas and associated precursor lesions (penile intraepithelial neoplasia, Bowenoid papulosis, erythroplasia of Queyrat (EQ)) [15]. The most typical locations in women are the external genitalia, but lesions can also be in the cervix and labia minor. In men, condylomas usually involve the coronal sulcus, glans penis and the penile shaft. Circumcision is reported to reduce HPV prevalence in men; however, the efficacy remains imprecise. Recurrences occur in up to one-third of cases [14, 18]. The warts may coalesce in the rectal and perianal area without practicing anal sex. In this region, cauliflower-like shape is the most typical. Since HPV thrives in the rectum, all patients with anal lesions should undergo anoscopy or proctoscopy [2, 13]. Differential diagnosis should be made with condylomata lata, nevi, acrocordon and pemphigus vegetans [2]. If there are anogenital warts in children, sexual abuse should be considered. It should also be reported to the authorities. However, most of the cases in children warts are caused by nongenital HPV types. The mechanism for perinatal and postnatal transmission includes vertical transmission, autoinoculation, sexual transmission and indirectly through contaminated objects and surfaces. This can be explained by mother with hand warts, or child can transfer warts from his/her hand to his/her own genital or anal area [1, 14].
\n\t\t\t\tHistopathological findings in warts are hyperkeratosis with parakeratosis, papillomatosis and marked acanthosis. Keratohyalin granules and koilocytes in the granular layer are characteristic for condylomata acuminata. Rete ridges tend to be elongated and point inward toward the center of the wart, and the dermis will often display an increased vascularization with the presence of thrombosed capillaries [14]. Cytoplasmic vacuolization is specific for condyloma when located within deeper portions of the epidermis such as the stratum spinosum, given that the upper portions of the epithelia of mucosal surfaces normally have some degree of cytoplasmic vacuolization already [15].
\n\t\t\tCondylomata plana are large flat warts mostly found on the cervix and prepuce. Identification of these warts often was possible only after applying acetic acid or colposcopic procedures. HPV 16–18 are usually responsible, and it is possible to progress in SCC of the genitalia [2].
\n\t\t\tBowenoid papulosis is characterized by multiple flat papules, plaques or macules less than 1cm in size in the genital area that may or may not be pigmented. The surfaces of the lesion mostly are flat, dome-shaped, papillomatous and verrucous. The color of the lesions can be shiny flesh-colored, reddish-brown, violaceous or black [19, 20]. It resembles clinically viral wart and histopathologically Bowen’s disease. The most common sites affected are the penis and vulva. In females, it is referred to as multifocal vulvar intraepithelial neoplasia [20]. Bowenoid papulosis is associated with HPV 16–18, but in a small number, HPV 31, 33, 35, 39 and 53, or mixed infections, have also been detected. Clinically, it should be differentiated from genital warts, seborrheic keratosis, lichen planus, molluscum contagiosum, Bowen’s disease (BD) and melanocytic nevus. Younger age and multiple lesions differentiate it from Bowen’s disease, but histologically it can be sometimes impossible to differ. Bowenoid papulosis and Bowen disease are clinical entities with similar histological findings of intraepithelial neoplasia. Bowenoid papulosis shows acrotrichial sparing, less pronounced cellular dysplasia and mitotic figures, which helps its differentiation [13, 20, 21]. The histopathological findings revealed full thickness epidermal atypia, acanthosis, papillomatosis, dyskeratotic cells and clumping cells with mild atypical nuclei [22, 23]. Bowenoid papulosis has a variable course, the lesions can stay for a few weeks or over 10 years, with a median of 8 months, but usually spontaneously resolves. Transformation to invasive carcinoma is rare occurring in <1% of cases, especially in immunocompromised [20, 22]. Women with BP have a risk of cervical dysplasia.
\n\t\t\tBuschke-Löwenstein tumor (BLT), also known as giant condyloma acuminatum, was first described by
Bowen’s disease is an in situ squamous cell carcinoma that rarely progress to invasive carcinoma. The disease is associated with the high-risk HPVP types, mostly HPV 16. Clinically, usually a single, sharply demarcated plaque without spontaneous regression is seen in the genital area. The lesions are generally asymptomatic; however, they may cause pruritus or burning pain. Genital BD usually is found in elderly men, especially on the mucosa of the penis (glans or prepuce). Some authors consider mucosal BD equal to the erythroplasia of Queyrat; however, some of them accept them as different histological patterns [13, 29]. Histological characteristics are atypia and anaplasia of cells from the mucous malpighian body with cellular loss of polarity and presence of some dyskeratotic cells, in both the basal and squamous layers [29].
\n\t\t\tErythroplasia of Queyrat is an in situ carcinoma that mainly occurs on the glans penis, the prepuce or the urethral meatus of elderly males. In females, vulva is the common area that is affected. The cause of erythroplasia of Queyrat is largely unknown. But in one study some HPV DNAs are detected; all patients were infected with the carcinogenic EV-associated cutaneous HPV type 8. HPV 16, 39 and 51 are other types that are found [30]. Sharply demarcated, erythematous, velvety and bright reddish plaques are characteristics for EQ. Progression to squamous cell carcinoma is more than 30% and is higher than the BD [13].
\n\t\t\tCervical carcinoma, which is caused by malignant transformation of cervical epithelial cells following persistent HPV infection, is one of the most common malignant cancer among women, approximately 10% of all cancers in the female population [31]. The relationship between HPV and cervical cancer is observed in many studies, and the persistent infection of the HPV carcinogenic types is found to be the cause in about 90–100% of the cases. HPV 16 and 18 are the two most common types that are responsible for about 70% of cervical carcinomas and 50% of intraepithelial neoplasia grade 3 [13].
\n\t\t\tCondoms can be a protective method from HPV infection in a limited way. It can lower the chance of transmitting HPV, but it may not be totally safe because of the infected areas that are not covered by condom. Avoiding sexual intercourse or reducing the number of sex partners can lower the risk for HPV. Abstaining from sexual activity is the most reliable method for preventing genital HPV infection. Pre-exposure vaccination is one of the most effective methods for preventing transmission of HPV. The Cervarix (bivalent) and Gardasil (quadrivalent) vaccines protect against most cases of cervical cancer. These vaccines are safe and effective [32]. Cervical cancer and its precursor lesions can be detected by screening women with screening technologies such as cytology-based screening, application of acetic acid during the inspection and HPV DNA test. By using these methods, cancer or precursor lesion is detected at an early stage, thereby improving the survival. The disease can also be prevented by HPV vaccination against oncogenic HPV types [33].
\n\t\t\tHPV infections and associated diseases remain a serious burden worldwide. The incidence of HPV-related carcinomas has been increasing every year. Vaccines have been used for over a decade, but widespread vaccine administration is still problematic for multiple reasons in some countries and areas. Many socioeconomically developed countries have been applying the vaccine programs for females and some of the countries are also starting to include the males between the ages of 9–26 for vaccine programs [34].
\n\t\t\t\tIn 1991, Zhou et al. were the first to develop an innovative vaccine technology based on noninfective recombinant virus-like particle (VLP) of L1, the so-called major papillomavirus virion protein. The VLPs do not contain the viral DNA, and they are completely noninfectious and nononcogenic. Three HPV vaccines are available on the market: bivalent HPV vaccine, quadrivalent HPV and nine-valent HPV vaccine. In bivalent HPV vaccine, there are the VLP form antigens of oncogenic HPV types 16 and 18. Quadrivalent HPV vaccine contains HPV types 6, 11, 16 and 18 L1 proteins. Antigens of HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58 types are in the nine-valent HPV vaccine [35]. According to the recent 58 studies in nine countries from 2007 to February 2016, it is found that a nearly 90% decrease in HPV infection, anogenital warts and cervical lesions in countries with the highest vaccination rates is seen [36]. Gardasil (quadrivalent) is European Medicines Agency (EMA)-approved for males and females, whereas the EMA-approval for Cervarix (bivalent) is currently limited to females only. Gardasil-9 (ninevalent) is a newly EMA-approved nonavalent vaccine in 2015 [37]. All HPV vaccines are administered as three doses i.m. injections in a 6-month period, with the second and third doses given 2 and 6 months after the first dose. The same vaccine product should be used for the three injections. Vaccine is applied in the age of 11–12 for girls and also can be administered at 9-year-old girls. But if the girls or women aged 13–26 years have not been administered the vaccines, they should receive the vaccine as it is possible. The quadrivalent or 9-valent HPV vaccine is also recommended routinely for boys aged 11–12 years. For the unvaccinated, immunocompromised patients, vaccination is recommended through age 26 years. HPV vaccines cannot be used in pregnant women. Women who have received HPV vaccine should continue cervical cancer screening routinely after 21 years of age [32]. Common adverse effects of HPV vaccines are pain, redness, swelling, syncope, dizziness, nausea, headache, fatigue and fewer. Life-threatening side effects are very low with autoimmune responses [34, 35].
\n\t\t\t\tDuration of efficacy is a key question when discussing the HPV vaccines. All three vaccines provide very high immunogenicity with antibody titers that are higher than the natural infections and remain high enough to prevent new infections. Booster doses’ necessity is still unknown. Up to now, it has been shown that the duration of vaccines may last 5–9 years. But more studies are needed about these important issues [35, 38]. The development of HPV vaccine is a milestone in the prevention of HPV-related infections and probably in the prevention of cervical cancer. But HPV screening still has a major role in cancer prevention and should be improved in low-income countries. It is clear that early vaccination before exposure provides the best results. The Global Alliance for Vaccination and Immunization (GAVI) has demonstrated that a reasonable price and wide distribution can be achieved. Projects in Rwanda and Bhutan have showed that a well-organized, school-based program can achieve excellent coverage. In countries with screening programs, the prevention of abnormal Papanicolaou tests and treatments for precancerous lesions will lower costs [39].
\n\t\t\tAnogenital warts can potentially heal without treatment. Waiting a period of time before starting treatment is an option. However, there is uncertainty around the frequency of spontaneous resolution of lesions, with reports of rates of clearance without treatment ranging between 0 and 50% of people affected. A delay in treatment could result in a worsening of anogenital warts and increase the transmission rates. First-line treatment is not always successful in achieving complete clearance of warts and repeated treatments might be required to eradicate large or persistent lesions. Treatment of the warts does not mean to clear the HPV deoxyribonucleic acid (DNA). Cells that remain infected with HPV DNA can stay dormant (latent) for prolonged periods of time, and there can be a recurrence after months, or even years, after initial infection. Thus, those who do not become HPV DNA negative can also pass on the virus, even after treatment or clearance of lesions. These are the important information that should be given and explained in detail to the patients. A wide range of therapies are presently in use, which are highly variable and can differ dramatically with respect to effectivity, cost, side effects, dosing schedules and duration of treatment [32, 40].
\n\t\t\tIn 2010, the FDA approved imiquimod 3.75% cream for the treatment of anogenital warts in patients 12 years of age or older. Imiquimod 3.75% should be applied to warts daily for 2-weeks and then with repeat of 2-weeks treatments after a 2-weeks rest period. The cure rates for the 3.75% imiquimod are not as high as the 5% imiquimod; however, the newer product has fewer side effects and is more appropriate for patient compliance [44].
\n\t\t\t\t\tPatients who have condyloma acuminata during pregnancy are a risky group. During pregnancy, vaginal secretions contacting the skin and mucous membranes are more abundant, meaning that the vulva will remain in a moist and immersed state. In pregnancy, hormones and reduced immunoresponsiveness can promote the growth of HPV-induced lesions. The warts are characterized by fast-growing and a reduced tolerance and poor compliance to treatment. Only a few treatments have been tested and recommended in pregnancy [55]. Podofilox (podophyllotoxin), podophyllin and sinecatechins should not be used during pregnancy. Trichloroacetic acid, cryotherapy, electrocautery and surgical excision, including laser treatment, are recommended treatments. But the resolution might be incomplete or poor until pregnancy is complete. Significant side effects have been observed for some of these methods, including local ulceration and scar formation, which may reduce a patient’s compliance with treatment requirements. Medicine could potentially cause fetal malformation, and laser treatment and surgical excision may cause uterine contraction, or even abortion [32, 55]. The safety of imiquimod has not been established, but a small number of patients worldwide have been treated with imiquimod and found to be effective and promising. No adverse fetal outcomes or fetal and neonatal abnormalities were observed. No complications were observed in the postpartum and follow-up period [56]. Photodynamic therapy with topical ALA seems to be safe and effective in the treatment of condyloma acuminata in pregnancy. In case reports, it demonstrated high clearance rate of warts, was well-tolerated by patients and showed no adverse effects on mothers or fetuses [57]. Cryotherapy appears to be the best choice. During the cryotherapy procedure, liquid nitrogen freezes the tissue and thereby causes necrosis; the treatment also stimulates specific immune responses, such as an immunomodulatory action of T lymphocytes against the remaining viable wart tissue. It is also a simple and inexpensive procedure, rarely causes scarring or depigmentation, and is safe for use in pregnancy. The transmission (transplacental, perinatal or postnatal) of virus to the baby is not completely understood. So the necessity of cesarean section in the presence of genital warts is also unclear. Cesarean delivery is indicated for women with anogenital warts if the pelvic outlet is obstructed or if vaginal delivery would result in excessive bleeding [32]. Prophylactic cesarean delivery is not recommended to prevent the respiratory papillomatosis in infants and children, because it is reported that only 7 infants of 1000 in mothers with external genital warts developed respiratory papillomatosis, and cesarean delivery did not reduce this risk [42].
\n\t\t\tPatients with significant immunosuppression (patients with HIV infection, immunosuppressive therapy to suppress transplant rejection, or other concomitant disease) might have larger or more numerous lesions, might not respond to therapies and might have more frequent recurrences after treatment. They are also at increased risk of squamous cell carcinoma, which may be clinically similar to genital warts. Lesions that ulcerate, grow rapidly, or are atypical should be biopsied to rule out squamous cell carcinoma [32, 42]. Cryotherapy, electrosurgery, excision and laser therapy can be applied to these patients.
\n\t\t\tGenital warts, also known as condylomata acuminata, are one of the most common forms of sexually transmitted diseases affecting the general population. Most infections do not result in the manifestation of genital warts. Genital warts are not themselves cancerous, but warts caused by high risk types of HPV are predisposed to oncogenic transformation. Because of the contagiousness and the progression to precancerous lesions, HPV infections should be underestimated. Selection of a treatment modality may depend on the patient, all the propriate choices should be explained to patients, and they should be informed what risks can be seen. Given the strikingly high prevalence of genital warts among the population, and the lack of adequate therapies, HPV vaccines may play a significant role in reducing the burden of disease by preventing viral infection and transmission.
\n\t\tThe first account of giant cell arteritis (GCA) can be traced back to tenth-century Baghdad by Arab ophthalmologist of medieval Islam Ali ibn Isa al-Kahhal. It was then more precisely described by Sir Jonathan Hutchinson in 1890, who noted the peculiar thrombotic appearance of the temporal artery (TA), a defining feature of the course of GCA. With the progression of the discovery of this disease and various case studies exploring its nature, ophthalmologists have additionally attempted to view how GCA could affect certain populations. During the second half of the twentieth century and the course of the twenty-first century, facilities across continents have published their findings on the tendencies of GCA to affect certain individuals more than others. In this chapter, we describe the epidemiology of GCA across continents and countries from individual reports and studies presenting the incidence rate of this vasculitis in their respective locations or populations.
Europe remains the continent with the most abundant publications pertaining to the epidemiology of GCA. One of the longest studies on the epidemiology of GCA was conducted in Western Norway, a retrospective study encompassing cases from 1972 to 2012 [1]. This study was one among many that noted how changing the criteria for the identification of GCA could greatly alter its incidence, especially due to the rarity of this vasculitis. For instance, the incidence rate of patients potentially affected by GCA satisfying the ACR 1990 criteria was 16.7 per 100,000 persons over 50 years of age. The incidence of patients clinically diagnosed as having GCA was 18.4 per 100,000 persons aged 50 years or more. Meanwhile, the incidence of biopsy-proven GCA was 11.2 per 100,000 persons over 50 years of age. The extended period of this study additionally contributed to the lowering of the mean annual incidence. When solely evaluating cases during a certain 5-year period (from 1992 to 1996), the incidence rate was found to be 26.7 per 100,000 persons over 50 years of age. Regardless of this, the prevalence remained among the highest recorded globally. This study also describes the increasing GCA incidence with age, where an older individual has a greater susceptibility to acquiring this vasculitis, as well as a greater ratio of women having this disease. Similarly, in the southern region of Norway, comparisons with past records from the same set of population were provided [24]. In a study spanning a period of 14 years (2000–2013), the Hospital of Southern Norway presented a GCA occurrence rate of 16.8 per 100,000 persons over the age of 50 years, one of the highest recorded globally and in line with other epidemiological findings from the Scandinavian region. As previously noted, one must consider that a small study sample and a short study period both have the potential of overestimating the incidence of a disease, as demonstrated by this study. In the same vicinity, the rate of giant cell arteritis in Western Nyland, Finland was examined [2]. From 1984 and 1988, 54 patients were diagnosed with GCA, among which 16 patients had a positive biopsy. The retrospective annual incidence of GCA was 69.8 for every 100,000 individuals older than 50 years. From 1984 to 1990, 133 patients in Iceland fulfilling the ACR criteria for GCA were identified, rendering an incidence rate of 27 in 100,000 people older than 50 years [3]. This study also suggests that the clinicians’ greater tendency to suspect GCA and perform TA biopsies (TABs) may have contributed to a higher statistical incidence. The results of these studies and their reported high mean annual incidence rates go on to highlight the possibility of a greater susceptibility to GCA among Scandinavian population. These are among the highest globally, supporting the claim that the Scandinavian population is most considerably afflicted by this inflammatory disease.
When gauging the incidence of GCA cases in other parts of Europe, we witness a lowering in the number of cases. For instance, in Italy, 285 cases of biopsy-proven GCA were observed in the Reggio Emilia area from 1986 to 2012 [4]. The adjusted incidence rate was 5.8 per 100,000 people older than 50 years of age and was significantly greater in women. In Lugo, Spain, a retrospective study was conducted from 1986 to 1995 to identify the occurrence rate of biopsy-proven GCA [5]. The mean annual incidence was computed for each 5-year period, rendering a rate of 8.26 and 10.49 per 100,000 people older than 50 years, respectively. Nearby countries and regions in the southern part of Europe presented similar incidence rates, demonstrating the moderate tendency of individuals from this area of the continent of being acquiring GCA. Namely, the incidence rate in France was concluded to be between 7 and 10 individuals out of 100,000 older than 50 years [6]. Likewise, in Slovenia, the estimated annual incidence rates of GCA were overall 8.7 per 100,000 aged greater than 50 years. This lowered rate suggests a different ethnical make up in the region that is perhaps less susceptible to acquiring this vasculitis, suggesting a genetic factor, while the geographical location in a lower latitude than the Scandinavian region may imply an environmental etiology. The exact etiology remains unknown.
Epidemiological studies from 2002 to 2008 in Southern Europe and Northwestern Turkey aimed to assess the epidemiology of GCA by following patients at Trakya University Medical Faculty [7]. During this period, the incidence of GCA was found to be 1.13 patients per 100,000 persons 50 years of age or older. The incidence of GCA for females was slightly greater than that for males. The fact that this study relied on a single center presents the possibility of missing individuals who sought care in a different location or simply neglected their condition. Regardless of this, the contribution of this report is crucial due to the paucity of epidemiological outlook on GCA in this space.
A retrospective study of patients with giant cell arteritis in China was performed from August 1992 to May 2014 at the Peking Union Medical College Hospital [8]. A total of 70 patients were diagnosed with GCA. The demographic data of these patients differed from that in the previously discussed epidemiological studies in Europe. First, the average age of Chinese GCA patients was 65.2 years. This age at onset is lower than the mean reported age in other populations, which hovered between 70 and 80 years. In addition, male patients with GCA predominated the study, which differed from most reports globally. Chinese male may be more susceptible to GCA than female or they may present greater health-seeking behavior. It is important to note that patients in this study were identified from a single healthcare center, which may substantially underestimate the occurrence of this vasculitis despite its current rare occurrence. On a similar note, statistical records, pathology records, and case records from university hospitals were gathered to estimate an annual incidence of one out of 100,000 people aged older than 50 years in Hong Kong [9]. These findings suggest the particularly lower frequency of GCA among the Chinese population. In 1998, a nationwide survey was performed in Japan, revealing 690 patients treated for GCA in the previous year [10]. An incidence rate of the population was calculated to be 1.47 per 100,000 people older than 50 years of age. In conclusion, the epidemiological reports of GCA from East Asian countries reveal extremely low prevalence of GCA among this population.
From 2008 to 2014, a total of 17 patients fulfilling the classification criteria for GCA in India were identified [11]. Comparably to a previously discussed study in China, the mean age of GCA patients in the Indian population was 67 years, lower than the mean age from European reports. In addition, individuals with GCA in India were predominately male. The reasoning behind a lower mean age and a male predominant patient status is unknown and was hypothesized to be due to the greater likelihood of individuals with these characteristics to seek healthcare.
The rarity of GCA among the Indian population was demonstrated at Moorfields Eye Hospital, a center in London, UK [12]. From 2006 to 2014, patients of Indian descendance were significantly less likely to have a biopsy-positive GCA. Perhaps, some ethnicities are less likely to present a positive result to the TA biopsy or clinicians may simply be more likely to diagnose these individuals with GCA. A study of this nature, in which ethnicities are compared in a population, could provide important findings on the vulnerability of certain individuals to present with this vasculitis Figures 1 and 2.
A temporal artery biopsy involves acquiring a small section of the artery, which can potentially appear thrombotic. The length of the segment can vary across studies and may influence the results of the biopsy [
Graphical representation of incidence rates of GCA among some of the populations described in the literature. The highest incidence rates appear to be among the Scandinavian countries, regardless of the criteria utilized to diagnosis the incidence of GCA.
The true incidence of GCA in the Arab population is difficult to assess due to the absence of a more nationwide perspective as well as a lack of population-based study in Arab countries. In a 22-year study, the epidemiology of GCA in Saudi Arabia was investigated [13]. From 1983 to 2004, 102 patients at King Khaled Eye Specialist Hospital underwent TAB, as seen in Figure 1, and seven patients were identified with biopsy-proven GCA. They noted that the incidence of GCA increases with age. Regardless of this, many aspects of the healthcare system in Saudi Arabia closely resemble that of the United States, with a similar life expectancy and a ratio of ophthalmologists relative to the size of the population.
In 1980, the incidence of giant cell arteritis in Jerusalem over a 25-year period was evaluated in a study involving four general hospitals in Jerusalem [14]. Among them, 170 patients with GCA had a positive TA biopsy. Furthermore, 36 biopsy-negative cases were also considered as they fulfilled the 1990 ACR criteria for GCA classification and responded adequately to steroid therapy. The age-adjusted incidence rate was computed to be 11.3 per 100,000 people ≥50 years of age for all incorporated GCA cases, but lower at 9.5 for the biopsy-proven cases. Moreover, this study observed seasonal patterns with a statistically insignificant rise in GCA diagnosis during the summer. The incidence rate of GCA in this study is comparable with those in other Mediterranean countries, with a less prominent frequency of female patients.
The results of a cohort of 114 patients who met the 2016 rACR criteria for the diagnosis of GCA and underwent TAB over a 10-year period in a tertiary center, Rassoul Akram Hospital, in Tehran, Iran were described [15]. This finding reflects the increase in GCA incidence with age. Although this study did not sufficiently provided a macroscopic account of the incidence and manifestation of GCA in a population, it was the first study performed in Iran assessing the intricacies of characterizing GCA and the discrepancies that may arise as a result of heterogeneous studies, especially due to the absence of definite criteria for the diagnosis of GCA.
Africa stands out for its scarcity of information on GCA and its epidemiology. Perhaps, this could be due to an underdeveloped healthcare system, which hinders the proper equipment and tools for an adequate diagnosis, which could ultimately serve as data to be studied on a larger scale. It may also be that the African population has a lower susceptibility to GCA. In addition, the life expectancy in Africa is lower, which could influence statistics related to a disease with an increased likelihood of manifesting at a later stage in life. Therefore, it can be hypothesized that this region presents with lower rates of this vasculitis. The two studies discussing the epidemiology of GCA in the African population both pertain to French-colonized islands. From 1991 to 2016, data from two pathology units in Martinique, West Indies were reviewed to discuss the features of cases of biopsy-proven giant cell arteritis [16]. The findings fortified the assumption that GCA is less prevalent in an African descent population. Nevertheless, the retrospective nature of the study and the exclusion of a biopsy-negative GCA may have led to an underestimation of cases of GCA.
In a retrospective study from La Reunion near the Southwest region of the Indian Ocean from 2005 to 2017, an incidence rate roughly 4–12 times lower than in most European countries was calculated [17]. An exact count was difficult to provide due to the presence of a diverse group of ethnicities in La Reunion, especially from regions of the world with a lower prevalence of GCA. A shorter life expectancy may contribute to a lower frequency of cases observed as GCA increases with age. Other characteristics were found to be analogous observations made in previous epidemiological studies.
Studies conducted in the United States have the potential of presenting important findings due to the possibility of comparing and contrasting features of a disease between ethnicities. A retrospective study spanning 11 years was conducted in the Texas Gulf Coast. Twenty-seven out of 101,239 patients aged 40 years or older had GCA. Intriguingly, 13 of these patients were black females, rendering it a noteworthy aspect of this study in which a significantly greater proportion of patients with GCA were black individuals [18].
A report from a study spanning from 1971 to 1980 in Shelby County, Tennessee identified 26 cases of GCA [19]. The average annual incidence was computed to be 1.58 per 100,000 individuals older than 50 years of age. The predominant patient from this study was white and female. This study presents one of the lowest frequencies of GCA cases across the globe. This could partially be due to the racial makeup of this population, which has a high percentage of black residents. African descent population is assumed to present a lower incidence rate of GCA. Among other contributions to a low incidence rate such as a retrospective design as well as inconsistencies in the diagnosis criteria, this study urged the need to consider environmental factors as potential causes for the onset of the vasculitis, such as the climate, exposure to the sun, frequency of rainfall, elevation, etc.
In another region of the United States, Olmsted County, Minnesota holds a population with northern European ancestry, which appears to be the group of people most severely afflicted by GCA. Therefore, the observation of a greater incidence rate may indicate a genetic factor in the onset of GCA. Between 1950 and 1991, 125 Olmsted County inhabitants were diagnosed with giant cell arteritis. The incidence per 100,000 persons 50 years of age or older was 17.8, which was significantly higher in women than in men. The incidence of GCA had increased to 19.8 from 2000 to 2009. The annual incidence rates substantially increased over the study period and with congregated cases of GCA, suggesting a regular cyclic pattern over time, which suggested the possibility of an infectious root for giant cell arteritis.
Previous studies suggested a low incidence of GCA in black patients, although conclusions were drawn from relatively small sample sizes. Nevertheless, the impression that GCA rarely impacts black individuals is generally assumed. Some reports have sought to compare GCA more directly between two races. A multicenter study involving 10 healthcare institutions was conducted to evaluate the presentation of GCA in African Americans [20]. An African American group of patients was compared with a cohort of Caucasian patients with a positive biopsy for ophthalmic GCA. Both the groups appeared to have a similar sex distribution, as around 70% of patients in both the cohorts were females. At Johns Hopkins Wilmer Eye Institute, findings notably challenging the commonly held belief that GCA is uncommon in African Americans were presented [21]. However, annual rates may not be directly calculated due to racial distributions in patients not reflecting that of the census population of the city of Baltimore, a detail that needs to be approached diligently prior to establishing conclusions. Furthermore, the screening and diagnosis process may differ among races and ethnicities due to physicians and clinicians holding preconceived perception of a greater prevalence in certain populations.
When comparing the rate of GCA between Caucasians and Asians, a significant lower occurrence rate of GCA in Asians was identified, which they computed to be 0.26–3.8 per 100,000 individuals older than 50 years of age, in parallel with studies from Asia [22]. The data for this study were collected from the University of California San Francisco computer database for patients from July 1989 to July 2006.
Similarly, giant cell arteritis has been reported to be very rare in Hispanics. From 1996 to 2002, patients with GCA at the Bascom Palmer Eye Institute were assessed [23]. Rates of a positive temporal artery biopsy were similar among Hispanic and non-Hispanic patients. Thirty-two patients with biopsy-proven GCA revealed similar mean age, symptoms, and final visual acuity between Hispanic and non-Hispanic cohorts. Hispanic and non-Hispanic cases are similarly impacted by the onset of giant cell arteritis.
A retrospective review was performed of all the biopsy-positive cases of giant cell arteritis presenting to a neuro-ophthalmology practice in Saskatoon, Saskatchewan [24]. Records of 141 consecutive patients who underwent temporal artery biopsy at the Saskatoon Eye Centre from July 1998 to June 2003 were reviewed. The average age of the biopsy-positive patients was 76.5 years, and the patients were 2.4 times more likely to be women. A total of 35 patients had a European ancestry, while two patients were of Aboriginal descent. The estimated incidence of GCA for Saskatoon was 9.4 per 100,000 for people over the age of 50 years. This study reveals the prospect of GCA to affect the people of Aboriginal descent despite a probable low incidence rate.
Very few studies pertaining to the epidemiology of GCA have come from South American countries. One that most closely attempted to depict the status of GCA nationwide collected findings from three university hospitals in Brazil for patients with GCA between 2009 and 2010 [25]. This was, in fact, the first study addressing the features of GCA in Brazilian patients having the disease. Most GCA patients were Caucasians, while a few were of a combined European and Indigenous lineage. The Caucasian cohort was mostly of Portuguese, Italian, or Spanish ancestry. These suggested the possibility of asymptomatic manifestations, which may skew the epidemiological perspective of this disease.
The last geographic region to be discussed is Oceania, which can be hypothesized to most closely resemble findings from Europe. From 1992 to July 2011, 314 cases of biopsy-proven GCA in South Australia were studied, in which the incidence for people over the age of 50 was 3.2 per 100,000 individuals [26]. Most characteristics of the disease were in line with observations described in studies from Europe, including a similar mean age and female predominance. Seasonal variations were additionally perceived, with a greater amount of diagnosis occurring during the summer season.
Cyclical variations were similarly noted in a study conducted in Otago, New Zealand. Records of 363 consecutive patients who underwent temporal artery biopsy at Dunedin Hospital between 1996 and 2005 were reviewed, with biopsy-proven GCA diagnosed in 70 patients. The mean annual incidence of GCA in Otago for people older than 50 years was 12.73 per 100,000 persons ≥50 years of age [26].
Nordic countries present the highest annual incidence rates of GCA. This vasculitis moderately affects southern European countries (Italy, Spain, France, etc.). The lowest incidence rates have been reported in East Asia. The diverse ethnical populations in countries such as United States lead to variations across regions, such as a higher incidence rate in the Northern states due to Scandinavian ancestry. Different ethnicities may present varying susceptibility because clinicians may exhibit different degree of suspicion with certain races, leading to influence on the number of biopsies performed and diagnosis made. In some regions, race and ethnicity is self-identified, which may reveal limited information on genetic background. Figure 2 reveals the varied incidence rate observed in different populations across the globe.
The incidence rate increases substantially with age and a greater ratio of patients are women in most regions, except for Asian countries. Whether female susceptibility is genuinely lower in that region or whether this discrepancy is due to different health-seeking behavior is unknown. Although seasonal and cyclic patterns were observed in a few studied and environmental factors were suggested, such influence remains inconclusive.
The definition of giant cell arteritis is inconsistent across literature, resulting in the inclusion of heterogeneous data during extensive review. Hence, there may be an over- or underestimation of statistical values. The criteria for the diagnosis of this disease substantially varied, with incidence rates presented based on biopsy-proven cases, ACR-criteria-fulfilling cases, or unspecified clinical diagnosis. Therefore, data may vary depending on which inclusion criteria were used.
Moreover, the technicality for biopsy-proven cases (length of the segment or threshold for diagnosis) may also alter the rate of incidence. In many reviews, the length of the arterial specimen remains unmentioned.
In 2016, an alteration to the list of criteria for a more comprehensive diagnosis of GCA was submitted. Furthermore, additional diagnostic tools have recently emerged, including the color Doppler ultrasound (CDUS), despite requiring extensive experience for utilization and a proper diagnosis. Other high-resolution magnetic resonance imaging technologies include magnetic resonance angiography (MRA), positron emission tomography (PET), computed tomography (CT), CT with angiography, and conventional MRA, which alternatively permit the visualization of the temporal artery. Although most reports attempted to thoroughly describe the equipment and tools for diagnosis, the heterogeneous approach across studies hinders appropriate comparisons, which may limit a precise epidemiological outlook of the disease in question.
Although this study repeatedly describes the rarity of GCA, it remains the most common vasculitis with severe consequences if remained untreated, ultimately resulting in permanent visual loss. Therefore, clinicians should remain diligent when coming across individuals presenting symptoms of the disease because an immediate course of action may greatly influence a person’s course of life and impact their well-being physiologically and psychologically.
This is a brief overview of the main steps involved in publishing with IntechOpen Compacts, Monographs and Edited Books. Once you submit your proposal you will be appointed a Author Service Manager who will be your single point of contact and lead you through all the described steps below.
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\n\nPlease complete the publishing proposal form. The completed form should serve as an overview of your future Compacts, Monograph or Edited Book. Once submitted, your publishing proposal will be sent for evaluation, and a notice of acceptance or rejection will be sent within 10 to 30 working days from the date of submission.
\n\n2. SUBMIT YOUR MANUSCRIPT
\n\nAfter approval, you will proceed in submitting your full-length manuscript. 50-130 pages for compacts, 130-500 for Monographs & Edited Books.Your full-length manuscript must follow IntechOpen's Author Guidelines and comply with our publishing rules. Once the manuscript is submitted, but before it is forwarded for peer review, it will be screened for plagiarism.
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\n\nThe Open Access Publishing Fee of your IntechOpen Compacts, Monograph or Edited Book depends on the volume of the publication and includes: project management, editorial and peer review services, technical editing, language copyediting, cover design and book layout, book promotion and ISBN assignment.
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On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. 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This response can be blunted with the appropriate mix of biocompatible materials and anticoagulation therapy. The use of anticoagulants, in turn, requires appropriate laboratory testing to determine whether the patient is appropriately anticoagulated. Physicians must balance the risks of bleeding with the risks of thrombosis; the proper interpretation of these tests is often shrouded in mystery. It is the purpose of this chapter to help demystify the coagulation system, anticoagulants, biocompatible surfaces, and coagulation testing so that ECMO practitioners can make informed decisions about their patients and to spur coordinated efforts for future research to improve our understanding of these complex processes.",book:{id:"5202",slug:"extracorporeal-membrane-oxygenation-advances-in-therapy",title:"Extracorporeal Membrane Oxygenation",fullTitle:"Extracorporeal Membrane Oxygenation - Advances in Therapy"},signatures:"Timothy M. Maul, M Patricia Massicotte and Peter D. 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In this chapter we discuss various cannulation techniques used.",book:{id:"5202",slug:"extracorporeal-membrane-oxygenation-advances-in-therapy",title:"Extracorporeal Membrane Oxygenation",fullTitle:"Extracorporeal Membrane Oxygenation - Advances in Therapy"},signatures:"Chand Ramaiah and Ashok Babu",authors:[{id:"183646",title:"Dr.",name:"Chand",middleName:null,surname:"Ramaiah",slug:"chand-ramaiah",fullName:"Chand Ramaiah"},{id:"189073",title:"Dr.",name:"Ashok",middleName:null,surname:"Babu",slug:"ashok-babu",fullName:"Ashok Babu"}]},{id:"27955",title:"Transfusion-Associated Bacterial Sepsis",slug:"transfusion-associated-sepsis",totalDownloads:8288,totalCrossrefCites:1,totalDimensionsCites:2,abstract:null,book:{id:"802",slug:"severe-sepsis-and-septic-shock-understanding-a-serious-killer",title:"Severe Sepsis and Septic Shock",fullTitle:"Severe Sepsis and Septic Shock - Understanding a Serious Killer"},signatures:"Jolanta Korsak",authors:[{id:"72828",title:"Prof.",name:"Jolanta",middleName:null,surname:"Korsak",slug:"jolanta-korsak",fullName:"Jolanta Korsak"}]},{id:"51211",title:"Triple Cannulation ECMO",slug:"triple-cannulation-ecmo",totalDownloads:4889,totalCrossrefCites:3,totalDimensionsCites:8,abstract:"Extracorporeal membrane oxygenation (ECMO) has emerged as an invaluable tool for bridging severe isolated or combined failure of lung and heart. Due to massive technical improvements, the application of ECMO is growing fast. While historically ECMO was initiated and maintained by cardiac surgeons, in recent times interventional cardiologists and intensive care specialists increasingly run ECMO systems independently with great success. Percutaneous ECMO circuits are usually set up in a dual cannulation mode, either as veno-venous or as veno-arterial configuration. A novel advanced strategy is the cannulation of three large vessels (triple cannulation), resulting in veno-veno-arterial or veno-arterio-venous cannulation. Both veno-venous and veno-arterio-venous cannulation may further be upgraded to veno-pulmonary-arterial or veno-arterial-pulmonary arterial cannulation, respectively. Triple cannulation expands the field of ECMO application but substantially increases the complexity of ECMO circuits. In this chapter, we review percutaneous dual and triple cannulation strategies, featuring a recently proposed unifying nomenclature. This unequivocal code universally applies to both dual and triple cannulation strategies (VV, VPa, VA, VVA, VAV, VAPa). The technical evolution of ECMO is growing fast, but it has to be noted that current knowledge of ECMO support is mainly based on observation. Thus controlled trials are urgently needed to prospectively evaluate different ECMO modes.",book:{id:"5202",slug:"extracorporeal-membrane-oxygenation-advances-in-therapy",title:"Extracorporeal Membrane Oxygenation",fullTitle:"Extracorporeal Membrane Oxygenation - Advances in Therapy"},signatures:"L. Christian Napp and Johann Bauersachs",authors:[{id:"180959",title:"Dr.",name:"L. Christian",middleName:null,surname:"Napp",slug:"l.-christian-napp",fullName:"L. 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He completed a one-year Post-Doctoral Fellowship awarded by the DFAIT (Foreign Affairs and International Trade Canada) at the Institute of Biomedical Engineering of the University of New Brunswick (Canada) in 2010. Currently, he is Professor in the Faculty of Electrical Engineering (UFU). He has authored and co-authored more than 200 peer-reviewed publications in Biomedical Engineering. He has been a researcher of The National Council for Scientific and Technological Development (CNPq-Brazil) since 2009. He has served as an ad-hoc consultant for CNPq, CAPES (Coordination for the Improvement of Higher Education Personnel), FINEP (Brazilian Innovation Agency), and other funding bodies on several occasions. He was the Secretary of the Brazilian Society of Biomedical Engineering (SBEB) from 2015 to 2016, President of SBEB (2017-2018) and Vice-President of SBEB (2019-2020). 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Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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