\r\n\tWe accept scientific papers which can be presented as original research papers and review papers. The required length of the full chapters is 10-20 pages and the chapters should be original works (not republished). \r\n\tAs a self-contained collection of scholarly papers, the book will target an audience of practicing researchers, academics, Ph.D. students and other scientists. Since it will be published as an Open Access publication, it will allow unrestricted online access to chapters with no reading or subscription fees.
",isbn:null,printIsbn:"979-953-307-X-X",pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"a8274c7a57830fae9cfa2dd00780184f",bookSignature:"Associate Prof. Arpit Sand",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/8505.jpg",keywords:"Applications, PEG, Biotechnical, Biomedical, Water Structure, Cell Fusion, DSC Measurement, Phase Diagram, NMR Spectroscopy, Protein Interaction, Grafted PEG Surface, Monte Carlo ,Protein Hybrid Catalyst, Nano Protein ,Metal Complex",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 8th 2019",dateEndSecondStepPublish:"September 2nd 2019",dateEndThirdStepPublish:"November 1st 2019",dateEndFourthStepPublish:"January 20th 2020",dateEndFifthStepPublish:"March 20th 2020",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 years",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"287032",title:"Associate Prof.",name:"Arpit",middleName:null,surname:"Sand",slug:"arpit-sand",fullName:"Arpit Sand",profilePictureURL:"https://mts.intechopen.com/storage/users/287032/images/system/287032.jpg",biography:"Dr. Arpit Sand is currently an associate professor in the Department of Chemistry, Manav Rachna University, Faridabad, India. He received his BSc in Science and MSc in Chemistry from the University of Allahabad, India, in 2004 and 2006, respectively. He received his Ph.D. in Chemistry from the same university in 2010. Dr. Sand is an editorial board member for Polymer Synthesis Journal by Cambridge Scholars Publishing UK and Journal of Polymer Science. He is an academic book editor and a reviewer for international journals including Carbohydrate Polymers, International Journal of Biological Macromolecules, and Fibers and Polymers, among others.\r\nDr. Sand’s previous roles include assistant professor (guest faculty) in the Department of Chemistry, University of Allahabad; research associate at the National Physical Laboratory (NPL) New Delhi; postdoctoral fellow at Gwangju Institute of Science & Technology (GIST), Korea; postdoctoral fellow at Karolinska Institutet, Sweden; junior researcher at the Brno University of Technology, Czech Republic; and researcher at Soongsil University, South Korea.\r\nHe has more than ten years of teaching and research experience. He is also a life member of the Indian Science Congress and Green Chemistry Network center. 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1. Introduction
The application of engineering techniques into biomedical procedures has proved extremely beneficial in many areas of medicine. A developing area is in epidural analgesia and anaesthesia, a technique employed for the relief of pain in both acute and chronic, and for anaesthesia to enable pain-free surgery. The aim of this chapter is to demonstrate several specific areas of research and how biomedical engineering techniques are used to improve and enhance the experience and training in the epidural procedure. The overall goal is to reduce the risks and subsequent morbidity in patients using advanced technologies to recreate the epidural procedure replicating as far as possible the in-vivo procedure. This would allow anaesthetists to practice the procedure in a safe and controlled environment without risk to patients. This could be achieved by recreating the sensation of the needle passing through the tissues and ligaments and by the generation of forces that match exactly those felt in-vivo. Epidural simulators are currently used as a training aid for anaesthetists, however existing simulators lack realism to various degrees and their operation is not based on measured in-vivo data that can accurately simulate the procedure. The techniques of advanced simulation and biomedical engineering detailed in this chapter can provide a solution.
Haptic devices have been used previously to reproduce needle forces but the forces are often not based on measured data. Needle insertion forces in-vivo are largely unknown as there are few studies in this specific area. Without accurate measurement of resultant pressure on the syringe plunger of the epidural needle, as the needle passes through the various ligaments and tissues of the spine, it is difficult to create accurate simulation of the epidural procedure. The ideal model would require other features such as a palpable spine, ability to accommodate for patient variation, 3D graphics visualisation and an adjustable needle insertion point. Techniques in biomedical engineering can provide solutions throughthe design of devices capable of making precise measurements and utilising them in a novel high fidelity epidural simulator. Adequate training on an advanced simulator will help alleviate the risks of epidural failures from inaccurate placement and also reduce potential morbidity to patients thereby improving the safety of the procedure.
This chapter is laid out in various sections to illustrate different aspects of current epidural anaesthesia research. Section 2describes the actual epidural procedure and its challenges. Section 3 discusses the needle insertion forces in epidurals. Section 4 describes an interspinous pressure measurement device for wireless data collection during needle insertion leading to a porcine trial discussed in Section 5. Section 6 describes an image processing technique for non-contact needle depth measurement that could be used in conjunction with pressure measurement for fully characterising the needle insertion. In Section 7, 3D-modelling of spine with bending and flexing is discussed for flexibility of patient’s positions together with heterogeneous volumetric modelling of spinal ligaments in Section 8. Stereo 3D visualisation for depth perception of epidural procedure has been discussed in Section 9. Section 10 applies a haptic force feedback device configured with the measured force data to create an electronic human–computer interface which is described in Section 11. Finally, section 12 brings all these technologies together and demonstrates the complete system that makes up our current epidural simulator prototype with conclusions provided in section 13.
2. Epidural procedure and challenges of clinical simulation
Epidural analgesia and anaesthesia is commonly used as a form of pain relief during childbirth, for the treatment of chronic back pain or as a means to provide anaesthesia or analgesia during specific operations. Monitoring the depth of the needle during an epidural insertion is crucial because once the needle tip enters the epidural space, an epidural catheter is usually sited to a specific length. This enables the intermittent or continuous use of the epidural for anaesthesia or pain relief. If the needle is advanced too far it will puncture the dural sac and cause leakage of cerebrospinal fluid. Post dural puncture headaches may result, which can be extremely disabling for the patient. Other potential risks include nerve damage or bleeding which may very rarely lead to paralysis. If the needle is not within the epidural space, the analgesia or anaesthesia may be ineffective or absent due to incorrect placement of the catheter.
During an epidural insertion, the operator tries to perceive which tissue layer the needle tip is passing through by feeling the resistances on the needle. This is a process known as “haptic” feedback. A simulator can assist the development of this visuospatial awareness of spinal anatomy and ‘feel’ of the procedure to allow practice prior to attempts on patients. Not only will this serve to enhance patient safety but it also creates a safe and controlled environment in which to learn.
The procedure of inserting an epidural needle into the lumbar spine requires the operator to visualise in their mind a three-dimensional (3D) anatomical image of the bony alignments and the various tissue layers from skin, through to subcutaneous fat, supraspinous and interspinous ligaments, ligamentum flavum and then to the epidural space. Epidural needle insertion is essentially a blind procedure, but utilises a well-known technique referred to as “loss of resistance” (LOR). LOR essentially involves identification of the epidural space by compression of either fluid or air as the epidural needle encounters the various ligaments of the lumbar vertebral column [1]. Initially, the back of the patient is palpated, and using surface landmarks such as the iliac crests, an assessment is made of suitable intervertebral spaces and of midline. For lumbar epidurals, this may be between lumbar vertebra 3 (L3) and lumbar vertebra 4 (L4) for instance. The epidural or Tuohy needle, as it is commonly called, is inserted into the interspinous ligament and a syringe filled with saline is attached to the end of the needle. These LOR syringes are specially manufactured so that there is less friction between the plunger and the inner wall of the LOR syringe. A constant or intermittent force is then applied to the plunger by the operator’s thumb as the needle is slowly advanced forward. As the tougher and more fibrous ligamentum flavum is encountered, a higher resistive force to injection is encountered. Once the needle tip traverses the ligamentum flavum, the epidural space is then entered into and saline can be quite easily injected, hence the phenomenon of LOR. It is this haptic perception that informs the operator of needle location within the various tissue layers, obstruction from bone and loss of resistance from potential spaces such as those between the ligaments. Combining this with the creation in one’s mind of a three-dimensional image of lumbar spinal anatomy enables successful placement of an epidural catheter.
The ideal epidural simulator should be capable of replicating the above procedure and aim to recreate as far as possible the in-vivo procedure. A real Tuohy needle could be inserted at any intervertebral space in the lumbar or thoracic region using the midline or paramedian approach [2]. It would contain a force feedback haptic device, with force data originating from measured Tuohy needle insertions from patients. Using measured in-vivo data from patients and integrating this into the epidural simulator software, the resistance would automatically adjust to give patient variation on weight, height and body shape. This could simulate random patients or match measurements from a specific patient. The 3D virtual patient and virtual vertebrae can also be adjusted in size and shape to match measurements from actual patients. As the needle advances, the resultant force should represent each tissue layer and a LOR on reaching the epidural space. Once the epidural space is reached, saline would be released. During the entire insertion, a 3D virtual spine could be displayed on the monitor showing the trajectory of the needlein real time. The manikin could bend forwards to mimic spinal flexion to increase spacing between the vertebrae or alternatively bend backwards (extension) to simulate increased difficulty in locating the interspinous space for training purposes.
Variation in patient size, height, weightand other characteristics should be possible based upon actual patient measurements. Currently, most simulators have only two or three options such as obese, elderly and normal [3-6] which is perhaps not enough to encapsulate reality and could therefore be improved. Simulators could have unlimited patient variation by including parameters such as height, weight, body shape, age, obesity which could be adjustable. Ideally, the settings should match measurements from real patient data. The adjustments can be programmed to occur automatically based on basic patient data, so that the user does not have to manually configure all the settings. The simulator could then re-create a virtual model of a particular patient. Clinicians planning on performing the epidural can practice beforehand on a virtual model of the patient thereby reducing the learning curve during the procedure on the patient. The four common patient positions adopted during epidural insertion are sitting, sitting with lumbar flexion, lateral decubitus and lateral decubitus with lumbar flexion. These four common positions at least should be modelled in an epidural simulator to give a greater level of realism than static epidural simulators. Ideally, variable spine flexibility could be achieved by modelling 3D flexible spine vertebrae and extended to other positions to simulate difficult spinal anatomy. This may allow simulation of spinal conditions such as curvatures and rotations caused by kyphosis and scoliosis. These conditions cause difficulties in placing the needle due to unusually positioned landmarks. Also the accuracy of the forces in epidural simulators is a topic of recent discussion [7-9], so it is important that the forces required toinsert a needle during simulation match those achieved in reality. Skills learned during this simulation can then be transferred to the actual clinical environment.
3. Modelling the needle insertion forces
Epidural insertion consists of a complicated interaction of many forces, needle position and intrinsic properties of the epidural equipment: a) Each tissue has various viscosity, elasticity, density and frictional properties. b) Bubbles of air in saline can compress. c) The method of insertion can vary depending upon needle inclination angle, paramedian angle, speed of insertion and twisting of the needle. d) Properties of the needle can vary, including the angle of the tip, tip type - side tipped or two-plane symmetric, needle gauge from 15-20 and width of the metallic walls in hollow needles vary. e) Plunger resistance is caused by friction on the inner syringe walls. f) The flow of saline is restricted by the funnel narrow opening of the syringe at LOR. g) The needle orifice can plug with tissue obstructing saline release.
Theoretically, a model can partition reaction force down into its individual constituents. The thumb applies force onto the plunger of the syringe and this force interacting with the frictional and resistive tissue forces contributes to the ‘resultant pressure’, see Figure 1. This pressure cannot escape so it causes the needle to push forwards. This causes the ‘reaction force’ which is equal and opposite to the applied force and comprised of several factors: a) The cutting force required for the needle tip to pierce the tissue. b) Friction caused by needle shaft resistance on the tissue. c) Static friction to get the stationary needle moving. d) Side compression force is caused by the surrounding tissues. e) Torque is caused by twisting of the needle. f) All of these forces, resistances and torque vary according to depth and tissue stiffness.
It is not feasible to measure all of these forces individually in-vivo and it would not make sense to measure the exact proportions of each force that make up the reaction force. In practice, it may be sufficient to measure the resultant pressure of the saline instead. Measuring resultant pressure provides a combination of all reaction forces, which is felt by the anaesthetist during insertion, and this combination of all forces is what simulators need to re-create to simulate the feeling on insertion.
Figure 1.
Several forces involved with needle insertion
4. Pressure measurement for realistic epidural simulation
A sterile wireless measurement device was developed to record the resultant pressure of the saline inside the syringe during an epidural needle insertion. This measurement device is used to enable data collection to quantify the pressure during the epidural procedure. Quantifying the pressure will enable accurate configuration of an epidural simulator.
Our novel pressure measurement device has wireless functionality and by using entirely sterile components allows in-vivo trials to be conducted with patients. A wireless data transmitter is utilized to minimize the equipment and disruption in the hospital room (Figure 2).
The design aims to minimise changes to the standard epidural set up. A small sterile three-way tap (BD ConnectaTM) is connected between the Tuohy needle and syringe (Figure 3). The tap is connected to the pressure transducer via a one metre length of saline-filled sterile manometer tubing. The transducer’s electrical plug is connected by a short electrical cable to our wireless transmitter. At the remote site, a wireless receiver is connected via Universal Serial Bus (USB) to the computer.
The UTAH Medical Deltran disposable transducer is used for the pressure measurement sensor. These transducers are commonly used in hospitals to monitor systemic blood pressure and central venous pressure. Transducers produce a small electrical signal based on the pressure of the liquid inside the manometer tubing. Disposable transducers are designed to have accuracy of +/- 3% with the average output of 100.03 +/- 0.55 mm Hg and the worst cases being 98.53 and 101.36 when 100 mm Hg was applied [10].
Figure 3.
Wireless Device for recording measured pressure of saline during insertion.
The computer can process pressure data, display a real-time graph on screen and simultaneously record the data to a file. When the anaesthetist presses on the syringe plunger, the saline inside the syringe is pressurised and the device quantifies this pressure. The computer runs our custom built software (Figure 4) which monitors pressure data as it arrives [11]. The software displays the live data on screen in the form of a real-time graph, can save graphs as images to file and writes data to a text file. The data files can be used for further analysis using statistical software. Before each insertion, the graph and start-time are reset and a new data file is created. Pressure can be converted into various units. In the current implementation the pressure is measured in mmHg or kPa and also a provision is given to determine force on the plunger in Newtons. This directly provides actual pressure measurement of saline inside the needle as applied to a continuum. To test this device a pilot trial was conducted on a porcine cadaver.
Figure 4.
Screen print of the software to monitor and record pressure of saline during insertion
5. Trial on porcine cadaver
A trial using a section of a porcine cadaver was conducted to test the pressure measurement device during epidural insertions. The pig is claimed to be the closest animal model for human spinal research and can be a representative anatomical model for the human spineand tissues [12]. The porcine tissue specimen was a double loin saddle cut. The cadaver was obtained from a livestock farm within 24 hours of slaughter without being frozen or modified in any way to avoid desiccation and deterioration of the spinal tissues which would affect the pressure measurements. The pig was a standard hybrid Large White cross Saddleback. The specimen contained the entire back in one piece, with the whole spine, and all tissue layers from external skin, through to the thoracic cavity. The porcine tissue was mounted vertically against a wooden support to mimic sitting position, resting upon, but not attached onto, a platform beneath (Figure 5).
Epidural insertions were performed by two experienced anaesthetists. The epidural space was located using a Portex 16-gauge Tuohy needle (Smiths Medical International Ltd, Kent, UK) at L2/3 or L3/4 intervertebral levels using a midline approach. Subsequently a number of different vertebral levels ranging from T12-L5 were targeted. The porcine spine was palpated to locate anatomical landmarks prior to insertion. The Tuohy needle with its introducer stylet penetrates the skin as is standard procedure. The recordings of pressure were then started and continuously recorded throughout needle insertion until after the loss of resistance had been experienced.
Figure 5.
Porcine cadaver set up for Tuohy needle insertions
The majority of insertions located the epidural space during the first attempt. Data from hitting bone was also recorded to analyse the effect on pressure. In some cases, the number of attempts to find the space was greater than three so those recordings were abandoned. The maximum pressure during ligamentum flavum was 500 mmHg. The highest pressures were obtained when the Tuohy needle hit bone.
The results demonstrated that during needle insertion the saline pressure started low and gradually built up, although the increase was not entirely steady due to the various tissues encountered. A similar pressure trend was found; a depression occurred on insertion 2 during 3-6 seconds and insertion 3 during 12-15 seconds(Figure 6, circular area). This may have been caused by the interspinous ligament and the pressure required to traverse this was 350 mmHg on insertion 2 and 470 mmHg on insertion 3. The final peak pressure was 500 mmHg which was caused by the ligamentum flavum (Figure 6, rectangular area). It wasalso noted that after the final drop of pressure there was often a ‘step’ before the bottom pressure was reached (square area). One explanation is that the initial pressure is the effect of opening up the epidural space which is a potential space and also saline pushing the dura away.
Figure 6.
Pressure recordings durings two successful insertions to the epidural space.
The opinion of the trial anaesthetists was that porcine tissue did feel like a close approximation to human tissue and the shape of the graphs were similar to graphs previously reported from human insertions [8]. In most cases the resulting pressure-time graphs clearly show a drop when the loss of resistance occurred as the needle entered the epidural space (Figure 6). The maximum pressure peak during successful insertions ranged from 470 to 500 mmHg (62.7 - 66.7 kPa) caused by ligamentum flavum. After this the needle tip enters the epidural space causing a sudden loss of pressure back to the starting pressure. The shapes of each graph in successive trials were similar but also different to reflect individual variations.
The results of this pilot trial demonstrate that the wireless pressure measuring system is accurate and responsive in the porcine model. Such measurements from patients could be used to create realistic epidural simulators.
6. Image processing for non-contact needle depth measurement
The reason why needle depth is important is that it relates the depths at which each resultant pressure occurred during the epidural procedure. This can also provide information about the depth of ligaments. We have developed image processing algorithms to measure the needle depth by a wireless camera during insertion [13].
During the epidural insertion procedure, the needle is slowly advanced through layers of tissue into the epidural space which is on average somewhere between 40-80mm deep. It is possible to record the depth of the needle tip by viewing the 10mm markings printed on the metallic needle; however, it is important to measure the needle depth precisely so that the needle travel can be guided with available measurements fromtechniques such as ultrasound scanning or magnetic resonance imaging for precise needle placement in the actual procedure. We have developed a novel image processing technique which aims to measure insertion depth of an epidural Tuohy needle in real-time. The implemented technique uses a single wireless camera to transmit depth data remotely to a host computer. Combining length and pressure data enables more accurate interpretation of the data in that the various changes in pressure can be linked to the actual depth at which the changes occurred.
The 16 gauge Portex Tuohy needle of 80mm length (Figure 7) is the most common epidural needle used in hospitals. The needle has grey and silver markings on the metallic shaft at 10mm intervals which are used by the software as a reference length. The blue handle is the plastic part at the base which is held by the operator and connected to a LOR syringe. This is used for colour detection.
Figure 7.
Properties of the 80mm Tuohy needle used for image processing
The actual technique of length and size measurement by digital image processing is well established, however, in this specific circumstance, image processing is much more complex and challenging due to many reasons; (i) the needle is a thin, narrow object, (ii) the needle is composed of reflective stainless steel, (iii) the needle is circular in cross-section causing colour changes around the shaft of the needle, (iv) wireless camera introduces transmission noises, (v) as the needle is tilted it reflects in different directions, (vi) the needle will not be the only object in the foreground due to the operator’s hands and patient’s back, (vii) lighting conditions vary from room to room. We have overcome these problems by advanced analysing techniques focusing on a small area of the dynamic environment.
The actual technique involves placing a wireless camera in the procedure room, one metre away from the needle insertion, which will transmit data to a remotely located computer. The camera transmits a 640x480 pixel image in full colour over a 20MHz wireless link. The computer contains the image processing algorithm to detect the visible needle in the image and measure its length. The first step in the algorithm is to automatically calibrate the background model. For ten seconds, with no objects in the foreground, the colour values (HSV) for each pixel are analyzed. Maximum and minimum values are stored in an array and used later as a background model. HSV values from each frame are compared to the background model. Foreground objects are identified by HSV values outside of the expected range. The pixels from foreground objects are scanned for HSV values which match the blue handle. The centre point of the blue handle is found by taking an average and is stored for object tracking in subsequent frames, and is assumed to be approximately at the level of the needle shaft. The rightmost edge is stored and assumed to be the start point of the metal shaft. The blue handle is removed from further processing. The algorithm scans horizontally from the position of the blue handle to find the metal needle shaft by matching HSV values. The leftmost and rightmost pixels in the metal shaft are identified. These are stored for tracking in subsequent frames. At this point a strip of image remains over the needle. For each column, an average HSV value is taken. This average is used to create four separate histograms for H, S, V and the total along the length of the metallic shaft. The histograms identify sudden changes in colour, caused by the boundaries between 10mm markings (Figure 8). Histograms make the markings more detectable under reflective conditions. The number of visible 10mm markings is counted. The number of pixels in each division is counted to find how many pixels equate to 10mm. If the final marking is only partially visible the length is calculated by comparing it to a full division.
Figure 8.
Output of the algorithm to measure needle length with histograms
The image processing algorithm was tested during insertions. The needle was successfully detected and measured accurately in most frames. The developed software was used to draw a graph of the length in real time and write the length data into a data file. Figure 9 shows the graph during an insertion in which the needle was slowly advanced and then rapidly withdrawn. We found that length measurement was accurate to within +/-3mm, when the needle was 500mm from the camera. The graph shows two erroneous readings at about 4 and 8 seconds, which was due to camera noise and in these frames the needle shaft was not detected properly, but all other frames were successfully measured and verified by the actual measurement. The total insertion took about fifteen seconds with 10 frames per second. The failure rate was 3 frames out of 150 which gave an overall 97.8% reliability during this insertion [13]. Errors like this could potentially be removed by ignoring sudden jumps in the data. The graph currently displays length but this can be converted from length to needle depth by simply subtracting the value from 80 mm, which is the total length of the needle.
Figure 9.
Software showing plot of needle length during insertion
The distance between needle and camera can be varied because length is measured using the 10mm markings as a reference length. At distances over 150cm the reliability dropped but this could be improved with a higher resolution camera. The needle can be tilted up or down to +/-30 without any adverse effect to measurements. Tilting towards or away from the camera does not affect measurement as long as the divisions are clearly visible because division length differentiates between length reductions caused by tilt and caused by insertion. Failures occurred on some frames, due to blur in the image, or at certain angles where silver and grey areas became merged. The background model successfully removed the majority of background, even with cluttered multi-colour backgrounds.
7. 3Dspine modelling for epidural training
In order to simulate the whole epidural procedurea realistic user interface must be provided together with the flexibility of 3D visualization and haptic interaction. The 3D models for the epidural simulator were generated with an object modelling software. Each vertebra is an individual wireframe model, constructed from 514 vertices. The vertices are positioned and then wrapped by a texture. Shadows and light sources are applied through OpenGL interfaces. The spine in the simulator contains 26 separate objects for the thoracic, cervical and lumbar spinal vertebrae, sacrum and coccyx. Layers of tissue, fat, muscle and skin were appended as layers above the bones. The different parts of the model were exported into separate format files. The format is text based with each vertex on a separate line. A custom C++ OpenGL graphics application then parses the text file to re-create each vertex. The epidural Tuohy needle was created as separate 3D models allowing it to be moved around independently. This is important to allow the operator to place the needle anywhere along the spine for training purposes.
The 3D objects can be viewed as stereograms (Figure 10) by displaying two images of the same object side by side with slight rotation around the Y axis [14]. The epidural simulator also supports this method of stereo in addition to page-flip stereo.
Figure 10.
Stereogram view of the spine model with two perspectives and binocular parallax
Transparency is applied to skin, subcutaneous fat, supraspinous ligament, interspinous ligament and ligamentum flavum. This allows the user to see the position of the needle tip in the tissue layers. Transparency can be adjusted during the simulation by a control on the keyboard. Rotation is enabled allowing the camera angle to rotate around the scene. This is applied by OpenGL translation and rotation which gives an effect of camera movement whilst the other objects all remain stationary. During rotation, the tip of the needle remains at the central focus point of the screen. Zoom can be applied to move closer or further away from the site of insertion in the working epidural simulator. Pan can also be applied which is a translation of the camera which allows the user to view other areas or to move up and down the spine when selecting the insertion site.
Another issue equally important is the flexibility built into the spine model. There are four common patient positions adopted during the administration of spinal or epidural anaesthesia [15]. Lateral decubitus (Figure 11) involves lying down sideways on the patients left or right, usually the right side is used for caesarean patients, because it is the opposite side from which the patient will lie on during surgery in the left lateral tilt position, which helps to increase the spread of anaesthetic. When the patient lies in lateral positions their back should be close and parallel to the edge of the bed, with their spine in a straight line. However, a variation to this position, maximal lumbar flexion in the lateral decubitus position can be used. The sitting position is preferred and often required in obese patients to enable the palpation of spinal processes and identification of the midline. Finally, the sitting position combined with maximal lumbar flexion is also used, and having the patient bend forward is advantageous to the anaesthetists because it increases the space between the vertebrae, which increases the target space for the needle to pass through.
Figure 11.
Four common patient positions used for epidural insertion
Based on this, the patient could bend the spine to various positions, so the epidural simulator is required to use computer graphics models of the human spine which can bend, flex and twist. The model can realistically duplicate the shape of the spine during various sitting positions adopted by patients during surgery and epidural anaesthesia. The extent of bending and flexing is kept within the limits of human spine flexibility. Also the model vertebrate adapt in size to match weight and height of specific patient bodies based on parametric modelling [16]. Our spine model is flexible for epidural simulation which offers accurate models of spinal vertebrae.
The human spine consists of twenty six vertebrae. Each of the vertebrae connects with numerous ligaments. Internally, there is a protective space running through the centre of the spine, housing the spinal cord. The column of vertebrae also provides connection points with the ribs and back muscles. The twenty six vertebrae are segmented into five regions, each with varying characteristics. From cranial to caudal there arecervical vertebrae (C1-C7), thoracic vertebrae (T1 – T12), lumbar vertebrae (L1 – L5), sacrum and coccyx. The human spine is able to bend, flex and rotate in various directions. Lumbar flexion occurs when the patient bends forwards and lumbar extension occurs when bending backwards. The spine was modelled using 3D design software, formed from 26 individual vertebrae, shown in Figure 12. The 26 vertebrae were each loaded as 3D models into a custom made software graphics application. The software renders 3D objects using vertices with the OpenGL graphics library and its utility toolkit (GLUT). The colours of each region of vertebrae bone, flesh and the spinal discs were set using materials.
Figure 12.
The model spine consisting of 26 individually rendered 3D vertebrae
Initially the vertebrae are positioned in the standing position and are then adjusted by mathematical equations to match the current patient position. The curvature of the spine for four common patient positions was calculated using the equations. The shape of the spine was based on the four common patient positions used for epidural insertion. Our model’s prediction for the spine shape for each of the positions is shown in Figure 13 [14].
Figure 13.
The spine model with flexion for four common patient positions
The ability to flex and rotate the spine has provided the opportunity to simulate epidural insertions on patients in various positions. This is important because the feeling of insertion is different for each patient position. This novel aspect has not been attempted in epidural simulation before and will increase versatility of the simulation.
8. Heterogeneous ligament modelling
Since the introduction of traditional computer graphics and modelling techniques, the primary focus has been to display and modelling of homogenous objects which have uniform interior and consist of one material throughout. This was acceptable for many situations, however, such surface-based approaches were aimed to represent the visual appearance of the external layer of objects, leaving the interior untouched. Recently, with the availability of increased computing power, the focus has shifted from surface-based to volume-based graphics, whereby volume-based architecture attempt to describe the material structure of internal regions by the use of voxels [17]. This can allow manipulation and experimentation on the physical properties of the materials, such as density, friction, elasticity, tensile strength and in so doing opens up new possibilities for experimentation. Heterogeneous objects are a step further, being solid physical objects, which consist of two or more material primitives but offering the advantage of materials that may be distributed continuously blending with each other.
For epidural needle insertion, the needle passes through several ligaments along its path to the epidural space, with each of the ligaments having different properties such as density, resistance to insertion and friction (see Section 3). A model is required to encompass these aspects of each ligament if the graphics are to be capable of displaying a true likeness of the materials in-vivo. Ligamentum flavum (LF) is heterogeneous in nature, containing both elastic tissue and fibrous tissue. Certain data describing the ligamentum flavum has been recorded in the literature and can be used to set up a heterogeneous model of the ligament. As LF thickness increases, fibrosis increases and elastic tissue decreases. The dorsal side of LF contains more fibrous tissue and less elastic tissue than the dural and middle sides, as indicated by a fibrosis Score of 1.58, 1.63, and 2.63 for dural, middle, and dorsal sides respectively [18]. The loss of elastic fibres caused by increased thickness is more pronounced along the dorsal side. A single patient has several ligamentum flava, one at each spinal level between the lamina and their thicknesses vary according to the spinal level. A study of 77 patients measured LF at spinal level L2/3, L3/4, L4/5, and L5/S1, the mean LF thickness is 2.41, 3.25, 4.08, and 2.68 mm [18]. It was shown that the thickest part of ligamentum flavum is consistently at L4/5, which is the level that endures the greatest mechanical stress. LF is crescent shaped in cross section on the horizontal plane with the thickest part in the middle. It wraps around the circular epidural space and dura. It connects to lamina above and below. The elastic fibres are yellow in colour, hence ‘flava’ being Latin for yellow. Each flava is a separate ligament which is clearly seen from the side of the lamina.
Object modelling software was used to create a model of the vertebrae. At the location of L2/L3 a ligamentum flavum was modelled with the thickness 2.41mm which was internally comprised of bundles of fibres (Figure 14).
Figure 14.
The modelled ligamentum flavum between L2/L3 vertebrae.
The interior structure of the ligamentum flavum has been modelled by numerous bundles of fibres extending vertically and parallel to one another, as do the elastic and fibrous tissues in-vivo. By creating this heterogeneous model of the internal structure of ligamentum flavum, the model will describe more accurately how the material responds to a needle being inserted through it. Similar models may be created for interspinous ligament and supraspinous ligament which are also both heterogeneous in nature, consisting of over three types of elastic fibres that can used to provide realistic haptic feedback.
9. 3D visualisation of epidural procedure
We have applied stereoscopic 3D computer graphics for visualization of epidural insertions. The stereoscopic images are viewed through a head mounted visor containing two OLED micro-displays in stereo using the page-flipped method. The 3D graphics are built from several vertex models of the anatomical structures as described in section 7. The stereo simulation allows depth to be perceived so that the operator can judge depth of the needle tip in relation to tissue layers and bones, which aids to the location of the epidural space. Applying stereoscopic vision to epidural simulators helps the operator to visualize the depths required for correct needle placement in the epidural space [14].
Depth judgement is crucial to the technique and since stereographics allows the perception of depth in 3D graphics, epidural simulators can benefit greatly from stereo-technology. Here the aim is to apply stereo vision technology to simulate epidural needle insertion. Without stereo graphics the depths of objects in simulations are not perceived accurately. By viewing 3D graphics on a flat computer screen there is no way of knowing the actual distance between objects other than by estimating their size. Estimation is not always accurate and some medical applications may require far more precision in depth perception. Epidural simulators require the needle tip to penetrate several layers of tissue between 42-47mm thick and must stop within the 6mm epidural space [19], which is difficult to achieve without depth perception. With stereo vision, distance can be perceived natively allowing the user to intuitively view the depth and distance between objects by perceiving differences between the two images, if images are appropriately scaled.
Stereo glasses contain two small OLED screens, one for each eye. Alternatively, glasses can be polarized, which allows viewing of a polarized screen, which has both images superimposed, one of which arrives at each eye. Shutter glasses can be used which contain moving mechanisms to consecutively close each eye similar to a camera shutter. The screen then displays images for left and right eye consecutively at the same shutter speed. Alternatively, a glasses free approach, vertically dispersive holographic screen (VDHS) can be used by directing two beams of light containing the images into each eye separately [20]. Mirror screens contain two monitors mounted at 110 degrees with a plane of silver-coated glass combining the two images and cross-polarized glasses are worn to separate the images. For all stereo systems, once the two images arrive separately at each eye, the brain combines them to generate 3D with depth perception based on some calibrated data.
For this epidural simulator, we have used stereo glasses containing two OLED micro-displays, one for each eye, with magnifying lenses. Figure 15 shows how the epidural simulator is being used with the stereo glasses displaying the 3D spine model. The glasses have advantages that the user can see the image whichever direction they look in and as they turn their head motion detectors can rotate the image to follow. The glasses produce a 40-degree diagonal field of view for each eye. The image appears the same size as a 105 inch projection screen viewed from 12 feet. Magnifying lenses allow the eye to focus further away avoiding eye strain. The graphic resolution must be fixed at 800x600 pixels which display sufficient details. Two separate images are displayed on each eye display. Stereo is achieved by using the page-flip method. A signal is generated by the graphics card at 60Hz, with the images consecutively swapped between left eye and right eye. The swapping is done by the graphics card drivers. The hardware inside the 3D glasses splits this into two separate 30Hz signals and delivers one to each eye, this results in stereoscopic images.
Figure 15.
Stereo glasses used for epidural insertion visualization
The epidural simulator software interfaces with head motion detectors. When the user turns their head, the 3D objects rotate by the same degree in the opposite direction to create an illusion of camera rotation. This interface allows the user to change the view point to different directions by turning their head, so that the mouse and keyboard are no longer required. The feedback from experienced anaesthetists suggested that the flexible spine model will be useful for modelling patient position. The options for adjustable body shape and size was seen as a positive step to encapsulate the variety of patients which has not previously been accomplished.
10. Haptic interface for epidural insertion
Haptic devices have become a more popular and accepted tool for medical simulation and provide an accurate way of re-creating the feel of surgery [21, 22]. The insertion of an epidural is a procedure which relies almost entirely upon feeling the forces on the needle. Epidural simulators are therefore ideallysuited to haptic technology. This section describes methods for configuration of a haptic device to interact with 3D computer graphics as part of a high fidelity epidural simulator development program.
Haptic devices have been used in epidural simulators previously, although they are not based on measured patient data from needle insertions. Instead, they are configured by ‘experts’ trialling and adjusting the system. It is therefore hard to assess the accuracy of the forces generated and so creates a real potential for improvement. The haptic device has currently been set up to reconstruct the force data found during the porcine trial. The force data from the graphs were divided into sections to represent each of the tissue layers separately [23].
A haptic device has been connected and used as an input to move the needle in 3D, and also to generate force feedback to the user during insertion(Figure 16). A needle insertion trial was conducted on a porcine cadaver to obtain resultant pressure data (Section 5). The data generated from this trial was used to recreate the feeling of epidural insertion in the simulator. The interaction forces have been approximated to the resultant force obtained during the trial representing the force generated by the haptic device. The haptic device is interfaced with the 3D graphics (see Sections 7-9) for visualization. As the haptic stylus is moved, the needle moves on the screen and the depth of the needle tip indicates which tissue layer is being penetrated. Different forces are generated by the haptic device for each tissue layer as the epidural needle is inserted. As the needle enters the epidural space, the force drops to indicate loss of resistance. An advantage to the use of haptic devices for epidural simulators is that they can accept various adjustable settings, so that patient variation including weight, height, age and sex can be accounted for, which helps to train for a range of patients. Patient variety is becoming an even more important aspect than ever since the current obesity epidemic poses great challenges for the anaesthetist. In obese patients, the depth to the epidural space is increased, anatomical landmarks are harder to feel and the midline is more difficult to locate. The resultant effect is that the risk of injury is increased.
Figure 16.
The haptic device interfaced with the graphics
To apply different forces to each layer, 3D vector regions were defined within the graphics model. As the needle tip enters these regions, the software identifies which tissue layer the needle is in, based on the depth data from the trial (Table 1). The software then uses a lookup table to find the appropriate force for each layer, and instructs the haptic device to generate that force. The forces generated represent the resultant pressure on the syringe which is a sum of all resistances to insertion, which are the equal and opposite to the force applied by the user. For example, if a particular layer has insertion force of 4.3N, and the user is pressing with only 3.2N, then the haptic device exerts 3.2N, so the stylus remains stationary. Only if the user increases the force to over 4.3N the stylus will move forward. Table 1 is based on measurements taken from our porcine trial in line with [24].
The haptic device is also able to simulate palpation of the lumbar region. Palpation is the process for choosing which location to insert the needle. The haptic device was configured for palpation by creating a surface hardness profile of the lumbar region, with a hardness value for each point in the region (see Section 8). The haptic device can be used to press at any point and the user can feel the hardness at that point. This allows the user to locate landmarks and choose a point to commence needle insertion. Our advanced haptic interface is based on the measured data and the aim is to develop a generic simulator based on measured data to offer a realistic in-vitro experience before attempting the procedure on actual patients.
11. Human-computer interface for loss of resistancesyringe
With the above developed components, a hardware device has been created consisting of a regular Portex LOR syringe connected to the computer via a serial data transfer device. This allows a regular clinical syringe to be used as part of an interactive system for the epidural simulator development. The syringe was also combined with the haptic device to create a comprehensive human-computer interface. The simulator can measure force applied to the plunger and the resultant pressure of the saline inside the syringe barrel. This interface enables a real clinical syringe to interface with a 3D graphical visualization showing the simulated insertion of the Tuohy epidural needle through the spinal ligaments.
The developed hardware interface makes use of the equipmentas developed in Sections 4&6 by incorporating custom made hardware with the developed software and the graphical visualization of the needle insertion procedure. The hardware device takes measurements of the forces applied onto the needle and the resultant pressure of the saline inside the barrel of the syringe caused by the pressure from the operators thumb on the plunger. The measurements are sent to the computer by a custom-made hardware interface device (see Sections 4&6). The graphical simulation uses these measurements to update the needle in the simulation and calculates the needle position. The graphical software calculates if any collisions have occurred between the needle and any bone structures, plus the resistance of insertion to saline, and the force required for the needle to move forwards through the current ligament.
The developed human-computer interface uses an actual syringe and an epidural Tuohy needleas shown in Figure 17. During insertions, the LOR syringe is normally connected directly onto the Tuohy needle. We have introduced a three-way tap between the needle and syringe. This connects onto a one metre length of saline manometer tubing which runs to a disposable pressure transducer. The transducer converts the pressure of the saline into an electrical signal. The electrical signal is connected into a hardware device which amplifies and sends the pressure reading to the computer. This allows the graphics visualization to update according the pressure applied by the operator’s thumb on the plunger of the syringe. This has the advantage that the user can control the visualization with the same equipment that would be used in-vivo, which is a more natural interface than simply using keyboard or mouse. Additionally, since the saline line separates the hardware device from the needle, the user can move the needle around since it is attached only by the saline line.
Figure 17.
The syringe connected to the computer as an input device.
The hardware device runs at 8MHz. Data is transmitted from the hardware device to the computer using the serial RS232 port. The serial bit rate is running at 22000 bits per second. The serial data transfer protocol uses -12V DC as a positive bit and +12V DC as a negative bit. The serial transfer cycle starts with a negative start bit, followed by 8 data bits sent consecutively and finished with a positive stop bit. As shown in Figure 18, the following start bit can then occur either immediately or after a pause of arbitrary length.
Figure 18.
Binary serial data transfer protocol.
The 8 data bits are received and interpreted as binary and converted into a decimal number from 0 to 255 for use in the software. The decimal value represents the pressure of the saline between 0 to 70 kPa, which is 0 to 550 mmHg. The 256 possible values give an accuracy resolution to within +/- 0.14 kPa. This can be easily increased to 1024 with 10 bits data transfer which will then provide accuracy of within +/- 0.03kPa. The speed could also increase beyond the current 22000 bits per second but it does not seem necessary since no delay is noticed between pressing the plunger and seeing the results on screen. Currently at 22000 bits per second the time delay between bits is 45μS so the start bit is identified by testing the pin for +12V, and then checking again after 22μS for the same high value. The computer runs the custom designed software which monitors the data as it arrives. Also the values are received by the graphics application which updates the visualisation to match the pressure applied on the physical syringe.
This study has demonstrated the development of a human-computer interface based around a clinical Portex LOR syringe connected via a custom made hardware interface device to a computer for use in an epidural simulator. The results show that the device is both fast and accurate enough to be used seamlessly in the simulation. The addition of the Portex LOR syringe with a pressure monitoring device has undoubtedly improved the human-computer interaction. Using the actual medical components in the implementation is beneficial because epiduralists will be familiar with the syringe and use it to interact with the 3D graphics visualization intuitively. The interface could be modified to be bi-directional i.e. the graphics software could send back data to the device which could control a motor to cause forces whichaffect the physical needle so that the user can feel the forces through the needle as in-vivo.
12. Creation of a novel epidural simulator
The presented biomedical engineering ideas have enabled us to develop a simulator with a combination of engineering, computing and clinical technologies as discussed in previous sections above. Data from the developed measurement devices have been used to configure a realistic force feedback epidural simulator [25]. Numerous improvements have been identified that could enhance existing epidural simulators. Manikin models are generally static and only able to represent one or two patient variations, such as normal and obese. An advanced simulator would be able to simulate insertions on a variety of body mass indices because excess fat deposition has the potential to generate very different changes in patient characteristics.
The developed system offers a virtual reality based epidural simulator (Figure 19) incorporating a 3D graphically modelled spine complete with skin, fat and tissue layers, supraspinous, interspinous ligaments and ligamentum flavum. In the current prototype, a Novint Falcon haptic device is used in combination with a Portex LOR syringe connected as a human-computer interface via a custom made electronic serial interface. As the haptic stylus is moved, the needle follows on the screen in 3D in real time. When pressure is applied to the plunger by the operator’s thumb, this is displayed in the graphic model. As the needle is advanced through the tissues, the forces are generated by the haptic device to reconstruct the feelings of needle insertion through each tissue layer. The forces of the needle insertion are based on the recorded forces measured during the clinical trial, and this data based approach is more accurate than previous simulators which have used a user evaluation approach to configure the forces.
Figure 19.
Prototype 3D graphics epidural simulator with haptic device interface
Novel aspects of our epidural simulator include stereo graphics, modelled vertebrae, spine flexibility, patient variation, haptic force feedback based on measured needle insertion data, custom made syringe interface. The simulated needle can be inserted at any spinal position from T2 – L5 and needle direction from midline to paramedian.The 3D graphics allow a close-up real time view of the needle internally during insertion. The virtual patient can adjust to various body shapes, weights and heights since body size considerably affects insertion force. These all have roots in biomedical engineering that can potentially enhance many clinical procedures.
13. Conclusions
The application of biomedical engineering approaches can help simplify many clinical problems as demonstrated for the epidural procedure.
We havedescribed in this chapter, the developed measuring devices which have successfully recorded the data on resultant pressure and depth of epidural Tuohy needles during insertions in a porcine model. These data are very useful in developing a realistic high fidelity epidural simulator. We aim to measure pressures in-vivo with obstetric patients in labour of differing body mass indices and integrating this data with ultrasound and MRI scan imaging data. It is our belief that the resulting epidural simulator based on such data will replicate the in-vivo procedure more accurately since it is going to be based on patient specific information. No such simulator exists at the present time.
The overall benefits of applying biomedical engineering techniques to this research are that we are able to achieve a high degree of accuracy and improved technology for replicating the epidural procedure. By achieving higher realism and accuracy of simulation, epiduralists will be better trained with the procedure and this in turn will improve patient safety by minimizing the risk of failure and harm to patients.
\n',keywords:null,chapterPDFUrl:"https://cdn.intechopen.com/pdfs/41781.pdf",chapterXML:"https://mts.intechopen.com/source/xml/41781.xml",downloadPdfUrl:"/chapter/pdf-download/41781",previewPdfUrl:"/chapter/pdf-preview/41781",totalDownloads:2708,totalViews:376,totalCrossrefCites:2,totalDimensionsCites:6,totalAltmetricsMentions:0,impactScore:2,impactScorePercentile:76,impactScoreQuartile:4,hasAltmetrics:0,dateSubmitted:"December 7th 2011",dateReviewed:"June 18th 2012",datePrePublished:null,datePublished:"January 9th 2013",dateFinished:"January 3rd 2013",readingETA:"0",abstract:null,reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/41781",risUrl:"/chapter/ris/41781",book:{id:"3008",slug:"practical-applications-in-biomedical-engineering"},signatures:"Venketesh N. Dubey, Neil Vaughan, Michael Y. K. Wee and Richard Isaacs",authors:[{id:"93315",title:"Dr.",name:"Venketesh",middleName:"N.",surname:"Dubey",fullName:"Venketesh Dubey",slug:"venketesh-dubey",email:"vdubey@bmth.ac.uk",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Bournemouth University",institutionURL:null,country:{name:"United Kingdom"}}},{id:"148492",title:"Mr.",name:"Neil",middleName:null,surname:"Vaughan",fullName:"Neil Vaughan",slug:"neil-vaughan",email:"nvaughan@bournemouth.ac.uk",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"148493",title:"Prof.",name:"Michael",middleName:null,surname:"Wee",fullName:"Michael Wee",slug:"michael-wee",email:"m.wee@virgin.net",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"148494",title:"Dr.",name:"Richard",middleName:null,surname:"Isaacs",fullName:"Richard Isaacs",slug:"richard-isaacs",email:"risaacs@doctors.org.uk",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Epidural procedure and challenges of clinical simulation",level:"1"},{id:"sec_3",title:"3. Modelling the needle insertion forces",level:"1"},{id:"sec_4",title:"4. Pressure measurement for realistic epidural simulation",level:"1"},{id:"sec_5",title:"5. Trial on porcine cadaver",level:"1"},{id:"sec_6",title:"6. Image processing for non-contact needle depth measurement",level:"1"},{id:"sec_7",title:"7. 3Dspine modelling for epidural training",level:"1"},{id:"sec_8",title:"8. Heterogeneous ligament modelling",level:"1"},{id:"sec_9",title:"9. 3D visualisation of epidural procedure",level:"1"},{id:"sec_10",title:"10. Haptic interface for epidural insertion",level:"1"},{id:"sec_11",title:"11. Human-computer interface for loss of resistancesyringe",level:"1"},{id:"sec_12",title:"12. Creation of a novel epidural simulator",level:"1"},{id:"sec_13",title:"13. 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K.IsaacsR.Epidural Needle Length Measurement by Video Processing, The IET Image Processing Conference 2012201234July, London.'},{id:"B14",body:'VaughanN.DubeyV.WeeM.IsaacsR.Virtual Reality based Enhanced Visualisation of Epidural Insertion, ASME 2012International Design Engineering Technical Conferences & Computers and Information in Engineering Conference, DETC201270951August 12-15, 2012, Chicago, IL, USA.'},{id:"B15",body:'Chestnut DH. Obstetric anesthesia: principles andpractice: 2009'},{id:"B16",body:'KasapM.Magnenat-ThalmannN.Skeleton-aware size variations in digital mannequins. The Visual Computer 201127263274'},{id:"B17",body:'PaskoA.AdzhievV.ComninosP.HeterogeneousObjects.ModellingApplications2008Springer, Germany.'},{id:"B18",body:'SairyoK.BiyaniA.GoelV.LeamanD.BoothR.ThomasJ.GehlingD.VishnubhotlaL.LongR.EbraheimN.Pathomechanism of Ligamentum Flavum Hypertrophy: A Multidisciplinary Investigation Based on Clinical, Biomechanical, Histologic, and Biologic Assessments, Spine. Issue: 30December 200526492656'},{id:"B19",body:'ChengP. A.1963The anatomical and clinical aspects of epidural anesthesia, Anesthesia and Analgesia; 42(1), 398406'},{id:"B20",body:'MagalhãesD. S. F.SerraR. L.VannucciA. L.MorenoA. B.LiL. M.2012Glasses-Free 3D Viewing Systems for Medical Imaging, Optics and Laser Technology, 44(3), 650655'},{id:"B21",body:'ColesT. R.MeglanD.JohnN. W.2011The Role of Haptics in Medical Training Simulators: A Survey of the State of the Art, IEEE Transactions on haptics, 4(1), 5166'},{id:"B22",body:'HalvorsenF. H.ElleO. J.FosseE.2005Simulators in Surgery, Minimally Invasive Therapy and Allied Technologies, 14(4), 214223'},{id:"B23",body:'VaughanN.DubeyV. N.WeeM. Y. K.IsaacsR.Haptic interface on measured data for epidural simulation, ASME 2012International Design Engineering Technical Conferences & Computers and Information in Engineering Conference DETC201270891August 12-15, 2012, Chicago, IL, USA.'},{id:"B24",body:'HiemenzL.2001Force models for needle insertion created from measured needle puncture data, Medicine meets virtual reality, 180186'},{id:"B25",body:'VaughanN.DubeyV. N.WeeM. Y. K.IsaacsR.Advanced Epidural Simulator with 3D Flexible Spine and Haptic Interface, DMD20126837ASME Design of Medical Devices Conference (DMD 2012April, Minneapolis (USA).'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Venketesh N. Dubey ",address:null,affiliation:'
School of Design, Engineering and Computing, Bournemouth University, Bournemouth, UK
Department of Anaesthesia, Poole Hospital NHS Foundation Trust, Poole, UK
'}],corrections:null},book:{id:"3008",type:"book",title:"Practical Applications in Biomedical Engineering",subtitle:null,fullTitle:"Practical Applications in Biomedical Engineering",slug:"practical-applications-in-biomedical-engineering",publishedDate:"January 9th 2013",bookSignature:"Adriano O. Andrade, Adriano Alves Pereira, Eduardo L. M. Naves and Alcimar B. 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1. Introduction
The world of work that is dynamic and develops in accordance with the direction of technological progress, requires workers not only to have hard skills in their respective fields, but also to have soft skills [1]. In the context of a dynamic and complex world of work, intelligence and soft skills are needed that are relevant to the world of work today and the world of work in the future [2]. These soft skills are of course in the form of adaptability, problem solving ability, analytical thinking, creativity, collaboration, and communication. The International Labor Organization (ILO) released several soft skills that are currently needed in the world of work such as analytical skills, creativity, problem solving, communication, collaboration, and entrepreneurship [3]. Some of these soft skills, such as analytical skills, creativity, and problem solving skills, are classified as critical thinking which is regulated by the ability to think reflectively or think metacognitively (metacognitive skills) [4]. Therefore, the ability to think metacognitively is very important for workers because it can help them maintain their work ethic in a very dynamic world of work with change and uncertainty.
Vocational education as an educational institution that aims to prepare a competent workforce is required to have an awareness of the demands of today’s world of work. UNESCO-UNEVOC has set one of the main priorities of vocational education in the world, namely to prepare a competent young workforce according to the demands of today’s global workforce. Vocational education or globally known as Technical and Vocational Education and Training (TVET) is required not only to equip students with hard skills but also to equip them with creativity skills, analytical thinking, problem solving, and leadership [5]. To support this, higher education should carry out various learning innovations, both in learning planning, learning processes, and learning evaluations. Digitization is one of the best choices because it is the demand of the current digital era that leads to learning 4.0 [1].
Learning 4.0 has now been promoted at various levels of education, not least at the higher education level. The use of online learning is one of the learning media used to assist the digital learning process [1]. The implications of online learning or e-learning in learning present new forms of learning and allow learners to collaborate and interact socially online [6]. In addition, online learning can increase the level of motivation of students [7] as well as helping students to access information and learning resources from anywhere and anytime [8]. The use of e-learning in vocational education has also been widely used and researched. The use of digital-based teaching materials that are integrated in e-learning can improve mathematics learning outcomes in vocational education [9]. From the aspect of users, teachers and students use mobile devices for vocational learning purposes [10]. Learning evaluation is of course also possible to do online with the help of e-learning. The advancement of internet technology and the increasing interest in online learning, issues around e-learning and its assessment methods are also getting more attention among educators [11].
Online learning evaluations carried out in the world of education today tend to measure using multiple choice-based questions [1]. Multiple choice-based questions are often used in summative and formative tests in education (online and offline or blended) [12]. In fact, to measure the higher-level cognitive of students is quite difficult, if only using the form of multiple choice questions. Because in practice, the use of multiple choice-based tests only touches low-level cognitive [13]. Therefore, it takes a form of evaluation and form of questions that allow students to explore their subjective and objective reflective and metacognitive thinking. Through this metacognitive thinking process, it is hoped that students will be able to reflect on their own learning and make adjustments so that students can achieve a deeper understanding [14]. In addition, a form of formative assessment that focuses on teaching students’ metacognitive processes is needed to evaluate their own learning and make adjustments to the learning process [15].
Several research results have examined the methods of assessing and measuring students’ metacognitive thinking through the online environment [1]. Online metacognitive thinking assessment in certain domain assignments and settings, can measure students’ metacognitive thinking abilities [16]. Researchers used measurement tools in the form of otter tasks, multiple choice questions, and open-ended questions. Another researcher conducted an assessment using an online-based group metacognitive scaffolding (GMS) to measure the metacognitive behavior of students in a small group in class [17]. The results show that GMS has a significant impact on changes in the metacognitive behavior of learners in a small group. Furthermore, Altıok et al. [18] measuring metacognitive thinking using an online environment integrated video portfolio and the results show an increase in the level of students’ metacognitive thinking in foreign language learning. The results of this study only focus on the measurement and assessment methods of learning in general education, not yet on learning in vocational education which has its own learning characteristics. In vocational education, appropriate learning models are used, namely work-based learning, project-based learning, or contextual teaching and learning so that authentic and performance-based learning assessment methods are needed [19]. The development of rubrics and assessment models uses a student-centered assessment approach where students are the subject and object of the assessment to reflect on their own learning, as well as peer assessment and teacher assessment approaches [20]. The results of the development of rubrics and metacognitive skills assessment models through blended learning MOOCs can be a reference for PjBL assessment methods that are in accordance with the characteristics of vocational education.
2. Technical and vocational education
Technical and Vocational Education and Training includes theoretical and practical learning content developed in schools, training institutions, or companies. Based on this limitation, the knowledge and skills referred to here can be understood not only as technical knowledge and skills, but also knowledge of values and identity in a complex world of work [1]. This vocational education paradigm is also not only a learning process in the school environment, but can be carried out in non-formal training environments such as training institutions and in agencies or companies [21]. The main purpose of vocational education is to prepare graduates directly for work. Vocational education should provide specialized training that is reproductive in nature and based on teacher instruction, with an emphasis on knowledge of certain industrial sectors and includes specific skills or tricks of the trade. Vocational education has played a central role in supporting the transition from school to the world of work for youth. Vocational education for productive work is considered essential for economic and social development [22]. An important emphasis of vocational education is on developing specific work-related skills or skills to prepare students for entering the workforce, while general education emphasizes on equipping students with broad knowledge and basic skills in mathematics and communication [23]. Based on these theories, it can be concluded that in general, vocational education aims to prepare graduates to work in certain sectors. The function of this education is to carry out the process of transforming work competencies, knowledge of the world of work, as well as the ability to collaborate and interact between workers.
3. Metacognitive skill
The study of metacognitive thinking has been widely associated with John Flavell as an expert in the field of cognitive development since the 1970s. The term metacognition as proposed by Flavell et al. [24] used to refer to awareness, monitoring and regulating of one’s cognitive processes. In line with this, Yusuf et al. [25] explained that metacognition refers to the principle of organizing thinking through the process of controlling one’s cognitive. The metacognitive component consists of self-awareness, as well as monitoring and evaluation. These components can improve students’ ability to solve problems.
Furthermore, Jacobs and Paris [26] explained that metacognition refers to thinking about thinking. Metacognition focuses on self-regulated thinking, namely what people know and how they apply that knowledge to certain tasks. Metacognitive theory as a systematic framework used to explain and direct cognitive processes, cognitive knowledge, and cognitive regulatory skills [27]. A fundamental distinction is made between metacognitive knowledge and metacognitive regulation. Knowledge of cognition refers to what individuals know about their own cognition or about cognition in general. It consists of declarative knowledge (knowing about things), procedural knowledge (knowing how to do things), and conditional knowledge (knowing why and when). Cognitive regulation refers to metacognitive activities that help control one’s thinking or learning. Three important skills that are widely recognized are planning (strategy selection and resource allocation), monitoring (awareness understanding and task performance), and evaluation (assessing the product and process of one’s learning arrangements) [1].
Schraw and Moshman [28] explain the classification of metacognitive knowledge and metacognitive regulation. In metacognitive knowledge, declarative knowledge includes knowledge about oneself as a learner and about what factors affect one’s performance. Procedural knowledge refers to knowledge about the implementation of procedural skills. Conditional knowledge refers to knowing when and why to apply various cognitive actions. Meanwhile, the regulation or metacognitive regulation is categorized into three domains, namely planning the cognitive process (planning), monitoring the cognitive process (monitoring), and evaluating the cognitive process (evaluation). Planning involves selecting the right strategy and allocation of resources that affect performance. Examples include making predictions before reading, sequencing strategies, and allocating time or attention selectively before starting a task. Monitoring refers to a person’s on-line awareness of task comprehension and performance. The ability to engage in periodic self-evaluations while studying is an example. Evaluation refers to the assessment of the product and process of setting one’s learning. Common examples include re-evaluating one’s goals and conclusions. In connection with some of the above definitions of metacognitive, [29] explained that metacognition can be divided into two components: metacognitive knowledge and metacognitive regulation. Metacognitive regulation is the monitoring of one’s cognition and includes planning activities, awareness of self-understanding and performance, and evaluation of the efficacy aspects of monitoring processes and strategies.
Based on the description of metacognitive above, it can be concluded that metacognitive or metacognitive thinking is an awareness of thinking about how we think, how we organize thinking strategies in order to complete certain tasks well. Metacognitive thinking can be categorized into 2 sub categories, namely metacognitive knowledge and metacognitive regulation. Metacognitive knowledge is further divided into declarative, procedural, and conditional thinking. Meanwhile, metacognitive regulation is divided into planning, monitoring, and evaluation processes.
In the context of learning in vocational education, these two categories allow to be measured and assessed. However, taking into account the performance-based and project- or product-based assessment methods in vocational education, the measurement of metacognitive regulation (planning, monitoring, and evaluation) is more likely to be measured [1]. As explained by Klerk et al. [30] that vocational education emphasizes performance-based assessment where students learn by doing. This is confirmed by Wimmers [19] that at the end of the vocational education program or professional education program, every student must achieve standardized work competence, so that in this educational program, performance-based assessment is a general method for assessing practical competence in an authentic context. Learners can measure their metacognitive thinking skills through the process of planning, monitoring, and evaluating their performance and the projects or products they make.
4. MOOCs
MOOCs cannot be separated from their early history in 2008 when George Siemens and Stephen Downes provided open enrollment for their Connectivism and Connective Knowledge course at the University of Manitoba. This course is designed as a liaison or cMOOC where students are expected to learn more about connecting with each other in online environments such as classroom learning. In 2012, prestigious educational institutions such as MIT, Harvard, and Stanford began experimenting with offering a MOOC model known as xMOOC, taking a more behavioristic approach to teaching [31]. Then in 2011, a professor of Computer Science at Stanford University, and Peter Norvig, Director of Research at Google, announced that they would offer an open online course in Artificial Intelligence. This course does not use a learning credit system, but students who complete this course will be given a certificate of acknowledgment that they have completed learning. As many as 160,000 people registered, so that the world’s attention was given to this phenomenal program and was given the term Massive Open Online Course/MOOCs [32].
MOOCs have attracted the attention of researchers, learning experts, and even governments who have raised various opinions and assumptions regarding the features offered and their advantages and disadvantages. Despite this heterogeneity, dozens of MOOC options emerge every day and thousands of people sign up for the courses available. Besides being free, their motivation is because the course content comes from prestigious universities including Harvard, Massachusetts Institute of Technology, Stanford, University of California, and so on. In addition, research teams from various scientific backgrounds from universities around the world focus daily on finding new alternatives in terms of content access and distribution in MOOCs. It is solely aimed at providing a more engaging learning experience for MOOCs users.
MOOCs have great potential in the world of educational technology so that their use becomes a challenge in itself from the massive aspect, open access, and connectivity which of course must be developed through a multidisciplinary approach. Cyber-socialecology MOOCs can provide a collaborative approach not only among students, but also between educational institutions so that students can adapt their learning models, preferences, and learning needs to MOOCs from different institutions. Another important thing in collaboration between educational institutions is the formalization or recognition of learning in MOOCs. In this way, formal MOOCs can become part of an educational institution’s curriculum or tailor a course of study to earn an online diploma. An example of this scenario has been done on the “Mobile Cloud Computing with Android” specialization provided by Coursera [31].
MOOCs can support competency-based education [33]. In addition, MOOCs need to improve the quality and personalization of the student learning experience to further increase the effectiveness of education in general. As well as, Rosé et al. [34] emphasized the need to explore the possibilities of new features, such as collaboration features that encourage collaborative online activities such as structured brainstorming, whole group feedback, group reflections, and other collaborative activities. This activity aims to foster and maintain connectivity support, direction, and a more positive experience for students.
One of the advantages of online courses such as MOOCs is that it is easy to be able to engage in classes from any geographic location at any time you want. Having students spread all over the world in different time zones does not pose much of a problem while studying. This is because it facilitates the delivery of learning asynchronously and synchronously. However, the lack of face-to-face engagement can lead to a sense of isolation and result in students feeling separated from their peers in the classroom [35]. As a result, students in online environments tend to feel like they are taking on independent study rather than being active members of a study group [36]. One way to minimize this sense of alienation is through the use of technology and more interactive content that can enhance collaboration and knowledge construction.
In the learning system through MOOCs, students learn content knowledge by utilizing information and multimedia systems based on the development of learning models and methods. In other words, through learning systems and technology MOOCs require students to use metacognitive skills to manage their own learning pace (metacognitive skills). Students must be active learners in encouraging and sustaining their own learning progress. For example, they should assess the extent to which their learning strategies are effective in facilitating their learning progress, and identify which content has been optimal in terms of helping them achieve their desired learning goals [37]. Tsai et al. [38] conducted research with the aim of proposing an integrated model that integrates aspects of metacognition and interest in learning to investigate student learning motivation through MOOCs. The results of this study revealed that the increase in metacognitive skills was also accompanied by an increase in student enjoyment and encouragement regarding learning in the setting and organization of MOOCs. The findings show that metacognitive aspects can explain whether learners are motivated to learn through MOOCs because of the consequences of cognitive aspects mediated by interest in learning. In the use of MOOCs, the term blended is known which combines learning in terms of the implementation of learning (online or face to face), the delivery of learning content (synchronous or asynchronous).
5. Blended learning practice
Blended learning is a combination of various modalities (on-site, self-directed and web-based learning), delivery media (internet, lectures, powerpoint presentations, textbooks); teaching methods (face-to-face or technology-based/online sessions) and web-based technologies (wikis, chat rooms, blogs, textbooks, online courses) [1]. The combination (hybrid) is carried out depending on criteria such as learning objectives, course content, lecturer experience and teaching style, student characteristics, and others [39]. While, Kaur [40] define blended/hybrid learning from multiple perspectives:
Holistic perspective: delivery of learning using various media formats, including integration of learning media into traditional classrooms (f2f) or into online learning environments regardless of the combination of synchronous or asynchronous media
Educational perspective: a lecture that integrates f2f lecture activities with online pedagogical content. Some f2f lectures are replaced by online activities, especially in terms of synchronous, and online-asynchronous classes.
Pragmatic perspective: lectures are taught both in the classroom and remotely using different pedagogic combination strategies.
Corporate training perspective: the use of various learning media formats to deliver a curriculum or course.
CLO-Chief learning officer perspective: a learning strategy that integrates several communication modalities (both synchronous and asynchronous).
The success of blended learning depends not only on the quality of the courses and the virtual/online environment, but also on the degree to which faculty and students are prepared to work in a virtual learning environment. It also really depends on the preparation of learning materials and activities by the lecturers and the technical abilities of lecturers and students [1]. In particular, to use all the tools/features offered by the Learning Management System (LMS)-MOOCs, such as related to metacognitive assignments and quiz-essays.
6. Project-based learning (PjBL)
Project-based learning (PjBL) is an approach to teaching science and technology that focuses on investigating questions and problems that students find meaningful and interesting, as well as sparking curiosity about something [41]. By investigating these questions and problems, students are involved in understanding phenomena, recurring natural events, or finding solutions to problems using disciplinary core ideas, scientific and engineering practice, and cross-disciplinary concepts. PjBL involves students and lecturers in finding solutions to questions about the environment around them. Investigating real-world questions in which students investigate meaningfulness has long been touted as a viable learning method. Thus, PjBL triggers the curiosity and active involvement of students to find out what is going on in their environment [41]. The George Lucas Educational Foundation [42, 43], recommend 6 steps of PjBL, namely:
Essential questions: provide essential questions related to the focus or scope of the project that is related to the real world and is relevant to students.
Designing plans for projects: planning the rules of the game, tools, materials, and selection of activities that can support and answer the important questions of the project focus.
Create a schedule: create a timeline and determine project completion deadlines.
Monitor students and project progress: Monitor student progress and activities during the project completion process. Monitoring uses a rubric that can record all important activities.
Assessing the results: evaluating project progress, providing feedback on the level of understanding students have achieved, assisting lecturers in developing further learning strategies.
Evaluate the experience: Lecturers and students reflect on activities and results.
Figure 1 presents a procedural map of the use of metacognitive rubrics in PjBL.
Figure 1.
Procedural map of the use of metacognitive rubrics in PjBL.
PjBL is a model that organizes learning around projects. Projects are complex tasks, based on challenging questions or problems that involve students in design, problem solving, decision making, or investigative activities, and provide students with the opportunity to work independently guided over a long period of time, culminating in on the final product or presentation. As a learning strategy, PjBL involves students in authentic learning through working on a project. This approach varies greatly from the traditional teacher-centered classroom and provides an interdisciplinary, student-centered activity for students that is integrated with real-world problems and practices, and usually lasts over a long period of time [44].
PjBL, sometimes referred to as project work, can be seen as an extensive problem-based learning activity in which students need to find ways to verify a phenomenon or solve a problem. Thus, aspects of skills are determined to be relevant to aspects of attitudes and abilities needed by students, including abilities such as critical thinking, creative thinking, time management skills and the ability to work cooperatively with others [45]. PjBL is centered on generating questions or inquiries that lead students to see concepts and principles related to their learning. Work on this project requires a long period of time, involving students to generate new knowledge to build on the premise of student inquiry and understanding [46]. Furthermore, Netto-Shek explains that project work, when executed properly, gives students autonomy to make decisions and to work independently and collaboratively in producing solutions for situations that were not previously planned. Netto-Shek argues that in the process of project work by students, monitoring by lecturers provides guidance and advice if needed. As such, project work embeds authentic real-world challenges in student learning experiences.
PjBL allows students to hone and develop skills through knowledge reconstruction when students work together to develop their projects and overcome problems, thereby forcing them to maximize cognitive aspects and overall theoretical understanding and identify theoretical knowledge gaps [47]. This is a more authentic approach to the student learning experience compared to the traditional approach. In keeping with current trends, the Israel Institute of Technology, in 2014 launched an online course on nanotechnology and nanosensors in the MOOCs format, which continues to this day. This course was developed by Prof. Hossam Haick, from the School of Chemical Engineering, is a leading researcher in the field of nanotechnology. The nanotechnology and nanosensors course is the world’s first MOOCs in this field, and the first to be presented simultaneously in two languages: English and Arabic. Their purpose is twofold. First, it reaches everyone around the world, even those who live in countries that do not have diplomatic relations with Israel. Second, provide a model for promoting sociocultural learning in the context of technical education, by integrating project-based learning, multicultural teamwork, and peer assessment into a curriculum [48].
Following previous developments on project-based learning in higher education [49], assignments on nanotechnology and nanosensor learning in MOOCs involving features related to the use of authentic questions, inquiry communities, and the use of cognitive aspect support technologies. PjBL involves students in authentic inquiry directly [41, 49]. In order for an activity to be considered as PjBL, it is necessary to involve the construction of knowledge through the development of new ideas, understanding, and/or skills on the part of students. This raises questions about the role of project-based MOOCs in the process of knowledge construction and learning motivation among science and engineering students. More specifically, how to assess the appropriate knowledge construction project for blended MOOCs learning according to the characteristics of vocational education.
7. The development of PjBL metacognitive assessment models
The development of the metacognitive assessment model presented is the result of the author’s research, which uses Research and Development steps [1]. Metacognitive instruments and rubrics were developed based on the theory of [28] and Lai [29] previously reviewed, where metacognitive regulation covers 3 aspects, namely: the planning process, the monitoring process, and the evaluation process of the project undertaken.
7.1 Metacognitive scoring rubric for PjBL
Assessment models and rubrics are based on the previously studied metacognitive thinking theory. The results of this study use the theory of metacognitive regulation which is divided into planning, monitoring, and evaluation processes. Table 1 is a complete rubric that has been compiled based on the theoretical indicators that have been described previously.
Metacognitive aspect
Indicator
Score 1
Score 2
Score 3
Score 4
1. Planning (planning their learning activities according to their ability to understand the material)
The plan contains the ultimate learning objectives they expect in project work.
The plan contains indicators of the achievement of the final objectives of learning that can be measured well.
The plan contains the prerequisites for the initial knowledge needed in the project work.
The plan contains learning activities that will be carried out in completing the project.
The plan contains the ultimate learning goals they expect in project work.
The plan contains the ultimate learning objectives they expect in project work.
The plan contains indicators of the achievement of the final objectives of learning that can be measured well.
The plan contains the ultimate learning objectives they expect in project work.
The plan contains indicators of the achievement of the final objectives of learning that can be measured well.
The plan contains the prerequisites for the initial knowledge needed in project work.
The plan contains the ultimate learning objectives they expect in project work.
The plan contains indicators of the achievement of the final objectives of learning that can be measured well.
The plan contains the prerequisites for the initial knowledge needed in the project work.
The plan contains learning activities that will be carried out in completing the project.
2. Monitoring (self-monitoring of learning activities)
The learning monitoring report contains the completeness of learning activities in the form of checklist items.
The learning monitoring report contains the obstacles faced in carrying out learning activities during the project work process.
The learning monitoring report contains things that have helped them complete each learning activity that has been carried out.
The learning monitoring report contains strategies that will be carried out in minimizing the constraints that have been written previously.
The learning monitoring report contains the completeness of learning activities in the form of checklist items.
The learning monitoring report contains the completeness of learning activities in the form of checklist items.
The learning monitoring report contains the obstacles faced in carrying out learning activities during the project work process.
The learning monitoring report contains the completeness of learning activities in the form of checklist items.
The learning monitoring report contains the obstacles faced in carrying out learning activities during the project work process.
The learning monitoring report contains things that have helped them complete each learning activity that has been carried out.
The learning monitoring report contains the completeness of learning activities in the form of checklist items.
The learning monitoring report contains the obstacles faced in carrying out learning activities during the project work process.
The learning monitoring report contains things that have helped them complete each learning activity that has been carried out.
The learning monitoring report contains strategies that will be carried out in minimizing the constraints that have been written previously.
3. Evaluation (evaluating the results of his work)
The report contains clear, coherent, and complete information.
Reports are presented by including the appropriate images.
The report states that all project work processes are carried out in accordance with the stages.
The report writes a good conclusion that summarizes the final goal of working on a previously written project.
The report contains clear, coherent, and complete information.
The report contains clear, coherent, and complete information.
Reports are presented by including the appropriate images.
The report contains clear, coherent, and complete information.
Reports are presented by including the appropriate images.
The report states that all project work processes are carried out according to the stages.
The report contains clear, coherent, and complete information.
Reports are presented by including the appropriate images.
The report states that all project work processes are carried out in accordance with the stages.
The report writes a good conclusion that summarizes the final goal of working on a previously written project.
The rubrics in Table 1 are then integrated into the LMS-MOOCs. The following is a metacognitive rubric display on planning aspects that have been integrated into the LMS.
Figure 2 shows a metacognitive rubric consisting of 4 rating scales where each scale contains several assessment criteria from the planning aspect of project work which is one of the metacognitive aspects. Students and teaching staff directly choose one of the points in accordance with the contents of the student project project planning report being assessed.
Figure 2.
Metacognitive rubric integrated in LMS. (Source: [1]).
7.2 Implementation of PjBL metacognitive assessment rubric through blended learning MOOCs
This learning process applies the Blended learning method that combines two learning cycles, namely online-based and face-to-face. The online-based learning cycle is used to strengthen basic materials or theories before students work on projects directly in the laboratory [1]. In addition, online methods are also used to integrate metacognitive assessment instruments and rubrics. The following is a display of the results of Peer, Self, and Teacher Assessment from students (Figure 3).
Figure 3.
Peer, self, and teacher assessment.
The picture above shows the results of peer assessment (Grades received), self-assessment (Grades given), and teacher assessment (Grade for Submission and Grade for Assessment). Each student gave a score to 3 other students and received a score from 3 students based on the assessment rubric. After that, the teacher also gives a score based on the same assessment rubric. These scores are then downloaded in an excel file format for further processing by assigning a weight to each score. The score from the self-assessment is given a weight of 20, the score from the peer assessment is given a weight of 30, and the score from the teacher assessment is given a weight of 50 so that the maximum score is 100. The following is the final score from the results of measuring students’ overall metacognitive thinking in project work (Figure 4).
Figure 4.
Results of measuring students’ metacognitive thinking. (Source: [1]).
The graph above shows the scores of the three aspects of metacognitive thinking, namely planning, monitoring, and project evaluation. The score comes from three sources, namely peer, self, and teacher assessment. In the planning aspect, the peer assessment score (24.19) is categorized as high because it is close to the maximum score (30). Likewise, the self score (18.38) and teacher assessment (36.29) were also categorized as high because they were close to the maximum scores of 20 and 50. Scores on the metacognitive aspects of monitoring and evaluation also showed high scores from peer, self, and teacher assessment.
The scores in the graph can also be seen that the peer assessment scores from the planning, monitoring, and evaluation aspects are not much different. Likewise, the self and teacher assessment scores do not differ much from the three metacognitive aspects. This means that the metacognitive thinking rubric is effectively used as an assessment guide by students and lecturers in vocational education. These scores have shown the level of students’ metacognitive thinking that is in accordance with the characteristics of assessment methods in vocational education based on performance-based assessment and project-based learning models.
8. Metacognitive assessment model for PjBL through blended learning MOOCs
The results of the research on assessment models, instruments, and rubrics that have been integrated with LMS through blended learning practice MOOCs have successfully measured students’ metacognitive thinking skills [1]. This is because this assessment model provides opportunities for students to assess their own answers (self-assessment) and provides opportunities for students to assess the answers of their peers (peer-assessment). Students are involved in assessing and evaluating answers based on the assessment rubric given in BLEMS. This encourages students to be more proactive in evaluating their own metacognitive thinking skills so as to support the development of their metacognitive skills. This is in line with the results of Vaughan’s research that applies the Triad Approach Assessment (self, peer, teacher assessment) in blended learning where this assessment approach can support the development of students’ metacognitive skills [20]. In addition, the results of this study are also in accordance with the theory that has been described previously, namely metacognitive thinking or metacognitive thinking is an awareness of thinking about how we think, how we organize thinking strategies in order to complete certain tasks well. Metacognitive thinking can be categorized into 2 sub categories, namely metacognitive knowledge and metacognitive regulation. Metacognitive knowledge is further divided into declarative, procedural, and conditional thinking. Meanwhile, metacognitive regulation is divided into planning, monitoring, and evaluation processes.
In the context of learning in vocational education, these two categories allow to be measured and assessed. However, considering the performance-based and project- or product-based assessment methods in vocational education, the measurement of metacognitive regulation (planning, monitoring, and evaluation) is more likely to be measured. As explained by Klerk et al. [30] that the vocational education emphasizes performance-based assessment where students learn by doing. This is confirmed by Wimmers [19] that at the end of the vocational education program or professional education program, every student must achieve standardized work competence, so that in this educational program, performance-based assessment is a general method for assessing practical competence in an authentic context. In addition, PjBL is an alternative learning model in vocational education where students can plan, design, and reflect on their learning through projects [50]. PjBL is a student-centered learning model in which students work on a project, make a project report, and communicate the report to their peers and teaching staff [51]. Therefore, students can measure their metacognitive thinking skills through the process of planning, monitoring, and evaluating their performance and the projects or products they make.
In addition, the application of blended learning methods (online and face to face) in project-based learning is able to optimize the learning process carried out. The online method is carried out to strengthen basic theory before students work on projects directly (face to face) in the laboratory so that students are able to optimize the three metacognitive aspects, namely planning, monitoring, and evaluating project work. The following is a metacognitive assessment model that combines self, peer, and teacher assessment in a blended learning environment using a project-based learning model (Figure 5).
The picture above shows an assessment model that combines self, peer, and teacher assessment integrated in LMS-MOOCs with a project-based learning model. Blended learning consists of online learning and face to face in the laboratory. The online method is used to assess the three metacognitive aspects, namely planning, monitoring, and evaluation based on metacognitive rubrics that have been integrated in the online environment. While the face to face method is carried out in the laboratory for project work for students. In addition, face to face also allows educators to conduct authentic assessments of the three metacognitive aspects (planning, monitoring, evaluation). The final result of the implementation of this assessment model is the metacognitive thinking score of students in vocational education.
Learning evaluation methods are generally only teacher-centered, not involving students in assessing and reflecting on their own evaluation results. Their answers from carrying out activities at LMS-MOOCs were only judged by one side by the educator. Students only see the score or final score of each test they pass so they cannot see which aspect they lack. However, through this assessment model (self-assessment and peer-assessment), students are actively involved in assessing their higher order thinking skills, namely metacognitive thinking.
9. Conclusions
The assessment rubric aims to determine students’ metacognitive thinking skills in project-based learning in vocational education. The assessment rubric was developed for 3 activities, namely planning, monitoring, and evaluation, then integrated into the LMS-MOOCs blended learning practice method. This study also produces a metacognitive assessment model for blended learning models in vocational education. The resulting model is an integration of three activities with self-assessment, peer-assessment, and teacher-assessment assessments for the PjBL learning model [1]. The metacognitive assessment model can be an assessment method to measure students’ metacognitive thinking skills, especially in project/work-based learning in vocational education.
\n',keywords:"metacognitive skills, blended learning, PjBL, MOOCs, vocational education",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/78635.pdf",chapterXML:"https://mts.intechopen.com/source/xml/78635.xml",downloadPdfUrl:"/chapter/pdf-download/78635",previewPdfUrl:"/chapter/pdf-preview/78635",totalDownloads:179,totalViews:0,totalCrossrefCites:0,dateSubmitted:"June 15th 2021",dateReviewed:"June 21st 2021",datePrePublished:"September 17th 2021",datePublished:"June 23rd 2022",dateFinished:"September 17th 2021",readingETA:"0",abstract:"Online or blended learning assessments through LMS-MOOCs carried out in the world of education today tend to be multiple-choice assessments that are only based on low-level cognitive. In fact, to measure the metacognitive of students is quite difficult, if only using the form of multiple choice questions. Therefore, it takes the form of questions and assessments that allow students to explore their reflective and metacognitive thinking according to the characteristics of the education they are attending. Vocational education tends to apply a project-based learning (PjBL) model that requires authentic and performance-based learning assessment methods. Therefore, it is necessary to develop an appropriate blended metacognitive skill assessment rubric instrument for vocational education. Metacognitive assessment was developed using research and development procedures, with students as subjects in vocational education in Makassar, Indonesia. The integration between elements of metacognitive skills: planning, monitoring, and evaluation with self-peer-teacher assessment can be an assessment method to measure students’ metacognitive thinking skills in PjBL. Especially metacognitive assessment through blended learning practice MOOCs that are in accordance with the characteristics of vocational education and can be adopted by general education.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/78635",risUrl:"/chapter/ris/78635",signatures:"Ridwan Daud Mahande, Fitrah Asma Darmawan and Jasruddin Daud Malago",book:{id:"10858",type:"book",title:"MOOC (Massive Open Online Courses)",subtitle:null,fullTitle:"MOOC (Massive Open Online Courses)",slug:"mooc-massive-open-online-courses-",publishedDate:"June 23rd 2022",bookSignature:"Dragan Cvetković",coverURL:"https://cdn.intechopen.com/books/images_new/10858.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-1-83969-738-8",printIsbn:"978-1-83969-737-1",pdfIsbn:"978-1-83969-739-5",isAvailableForWebshopOrdering:!0,editors:[{id:"101330",title:"Dr.",name:"Dragan",middleName:"Mladen",surname:"Cvetković",slug:"dragan-cvetkovic",fullName:"Dragan Cvetković"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"357204",title:"Dr.",name:"Ridwan",middleName:null,surname:"Daud Mahande",fullName:"Ridwan Daud Mahande",slug:"ridwan-daud-mahande",email:"ridwandm@unm.ac.id",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"357205",title:"Mr.",name:"Fitrah",middleName:null,surname:"Asma Darmawan",fullName:"Fitrah Asma Darmawan",slug:"fitrah-asma-darmawan",email:"fitrahdarmawan@unm.ac.id",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"357206",title:"Prof.",name:"Jasruddin",middleName:null,surname:"Daud Malago",fullName:"Jasruddin Daud Malago",slug:"jasruddin-daud-malago",email:"jasruddin@unm.ac.id",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Technical and vocational education",level:"1"},{id:"sec_3",title:"3. Metacognitive skill",level:"1"},{id:"sec_4",title:"4. MOOCs",level:"1"},{id:"sec_5",title:"5. Blended learning practice",level:"1"},{id:"sec_6",title:"6. Project-based learning (PjBL)",level:"1"},{id:"sec_7",title:"7. The development of PjBL metacognitive assessment models",level:"1"},{id:"sec_7_2",title:"7.1 Metacognitive scoring rubric for PjBL",level:"2"},{id:"sec_8_2",title:"7.2 Implementation of PjBL metacognitive assessment rubric through blended learning MOOCs",level:"2"},{id:"sec_10",title:"8. Metacognitive assessment model for PjBL through blended learning MOOCs",level:"1"},{id:"sec_11",title:"9. Conclusions",level:"1"}],chapterReferences:[{id:"B1",body:'Mahande, R. D., Darmawan, F. A., and Malago, J. D. (2021). Metacognitive skill assessment model through the blended learning management system in vocational education. Jurnal Pendidikan Vokasi, 11(1), 1-13. DOI: 10.21831/jpv.v11i1.36912'},{id:"B2",body:'Mane, F., and Corbella, T. (2017). Developing and running an establishment skills survey—Guide to anticipating and matching skills and jobs Vol. 5 Skills for Employment (Vol. 5). Publications Office of the European Union. DOI: 10.2816/413514'},{id:"B3",body:'International Labour Office (2019). A Skilled Workforce for Strong, Sustainable and Balanced Growth (1st ed., Issue November). International Labour Organization.'},{id:"B4",body:'Gotoh, Y. (2016). Development of Critical Thinking with Metacognitive Regulation. International Conference on Cognition and Exploratory Learning in Digital Age, Celda, 353-356.'},{id:"B5",body:'Peter Ganter, J. (2019). The Trends Mapping Study on Innovation in Technical and Vocational Education and Training (TVET). the UNESCO-UNEVOC International Centre for Technical and Vocational Education and Training.'},{id:"B6",body:'Mhouti, A. El, and Nasseh, A. (2017). Enhancing collaborative learning in Web 2.0-based e-learning systems: A design framework for building collaborative e-learning contents. Education and Information Technologies, 22, 2351-2364. DOI: 10.1007/s10639-016-9545-2'},{id:"B7",body:'Kew, S. N., and Petsangsri, S. (2018). Examining the motivation level of students in e-learning in higher education institution in Thailand: A case study. Education and Information Technologies, 23, 2947-2967.'},{id:"B8",body:'Al-araibi, A. A. M., and Naz, M. (2018). Technological aspect factors of E-learning readiness in higher education institutions: Delphi technique. Education and Information Technologies, 24, 567-590.'},{id:"B9",body:'Zwart, D. P., Luit, J. E. H. Van, Noroozi, O., Goei, S. L., Zwart, D. P., Luit, J. E. H. Van, Noroozi, O., Goei, S. L., Zwart, D. P., Luit, J. E. H. Van, Noroozi, O., and Goei, S. L. (2017). The effects of digital learning material on students’ mathematics learning in vocational education The effects of digital learning material on students’ mathematics learning in vocational education. Cogent Education, 29(1). DOI: 10.1080/2331186X.2017.1313581'},{id:"B10",body:'Mahande, R. D., Susanto, A., & Surjono, H. D. (2017). The Dynamics of Mobile Learning Utilization in Vocational Education: Frame Model Perspective Review. Turkish Online Journal of Educational Technology, 16(4), 65-76.'},{id:"B11",body:'Hsu, C. M., Yeh, Y. C., and Yen, J. (2009). Development of design criteria and evaluation scale for web-based learning platforms. International Journal of Industrial Ergonomics, 39(1), 90-95. DOI: 10.1016/j.ergon.2008.08.006'},{id:"B12",body:'Costello, E., Holland, J., and Kirwan, C. (2018). The future of online testing and assessment: Question quality in MOOCs. International Journal of Educational Technology in Higher Education, 15(42), 1-14.'},{id:"B13",body:'Xiong, Y., and Suen, H. K. (2018). Possibilities, challenges and future directions. International Review of Education, 64, 241-263. DOI: 10.1007/s11159-018-9710-5'},{id:"B14",body:'Earl, L., Katz, S., and WNCP. (2006). Rethinking Classroom Assessment with Purpose in Mind. In: Learning. DOI: 10.4135/9781446214695'},{id:"B15",body:'Johnson, R. (2004). Peer Assessments in Physical Education. Journal of Physical Education, Recreation and Dance, 75(8), 33-40. DOI: 10.1080/07303084.2004.10607287'},{id:"B16",body:'Veenman, M. V. J., Bavelaar, L., Wolf, L. De, and Haaren, M. G. P. Van. (2014). The on-line assessment of metacognitive skills in a computerized learning environment. Learning and Individual Differences, 29, 123-130. DOI: 10.1016/j.lindif.2013.01.003'},{id:"B17",body:'Zheng, L., Li, X., Zhang, X., and Sun, W. (2019). The e ff ects of group metacognitive sca ff olding on group metacognitive behaviors, group performance, and cognitive load in computer-supported collaborative learning. The Internet and Higher Education, 42(19), 13-24. DOI: 10.1016/j.iheduc.2019.03.002'},{id:"B18",body:'Altıok, S., Başer, Z., and Yükseltürk, E. (2019). Enhancing metacognitive awareness of undergraduates through using an e-educational video environment. Computers and Education, 139(May), 129-145. DOI: 10.1016/j.compedu.2019.05.010'},{id:"B19",body:'Wimmers, P. F. (2016). Innovation and Change in Professional Education 13 Assessing Competence in Professional Performance across Disciplines and Professions (M. Mentkowski, Ed.; 1st ed.). Springer. DOI: 10.1007/978-3-319-30064-1'},{id:"B20",body:'Koc, S., Liu, X., and Wachira, P. (2015). Assessment in Online and Blended Learning Environment. Information Age Publishing.'},{id:"B21",body:'Sudira, P. (2017). TVET Abad XXI (Hartono, Ed.; 2nd ed.). UNY Press.'},{id:"B22",body:'Jung, S., Chul, J., and Nam, S. (2019). Impact of vocational education and training on adult skills and employment: An applied multilevel analysis. International Journal of Educational Development, 66(September 2018), 129-138. DOI: 10.1016/j.ijedudev.2018.09.007'},{id:"B23",body:'Hampf, F., and Woessmann, L. (2017). Vocational vs. General Education and Employment over the Life-Cycle: New Evidence from PIAAC. NBER Working Papers Series, 5(10298), 1-17.'},{id:"B24",body:'Flavell, J. H., Miller, P. H., and Miller, S. A. (1979). Cognitive Development (L. Pearson, Ed.; 4th ed.). Prentice Hall.'},{id:"B25",body:'Yusuf, Y., Rodding, R., Awang, H., and Mukhtar, I. (2017). Metacognitive Strategies in Promoting the Development of Generic Competences in High TVE in Malaysia. Pertanika Journal of Social Science and Humanities, 25, 247-256.'},{id:"B26",body:'Jacobs, J. E., and Paris, S. G. (1987). Children’s Metacognition About Reading: Issues in Definition, Measurement, and Instruction Children’s Metacognition About Reading: Issues in Definition, Measurement, and Instruction. Educational Psychologist, 22(3), 37-41. DOI: 10.1080/00461520.1987.9653052'},{id:"B27",body:'Moshman, D. (2017). Metacognitive Theories Revisited. Educational Psychology Review. DOI: 10.1007/s10648-017-9413-7'},{id:"B28",body:'Schraw, G., and Moshman, D. (1995). Metacognitive Theories. 7(4), 351-371.'},{id:"B29",body:'Lai, E. R. (2011). Metacognition: A Literature Review Research Report. Pearson’s Research Reports, April.'},{id:"B30",body:'Klerk, S., De Veldkamp, B. P., and Eggen, T. J. H. M. (2018). A framework for designing and developing multimedia-based performance assessment in vocational education. Educational Technology Research and Development, 66(1), 147-171. DOI: 10.1007/s11423-017-9559-5'},{id:"B31",body:'Mendoza, R., and González. (2016). User-centered Design Strategies for Massive Open Online Courses (MOOCs). In User-Centered Design Strategies for Massive Open Online Courses (MOOCs) (1st ed.). Information Science Reference. DOI: 10.4018/978-1-4666-9743-0'},{id:"B32",body:'Haber, J. (2014). MOOCs. In Angewandte Chemie International Edition, 6(11), 951-952. (1st ed.). MIT Press.'},{id:"B33",body:'Dasarathy, B., Sullivan, K., Schmidt, D., and Porter, A. (2018). P212-Dasarathy. Future of Software Engineering Proceedings, 212-224. DOI: 10.1145/2593882.2593897'},{id:"B34",body:'Rosé, C. P., Ferschke, O., Tomar, G., Yang, D., Howley, I., Aleven, V., Siemens, G., Crosslin, M., Gasevic, D., and Baker, R. (2015). Challenges and opportunities of dual-layer MOOCs: Reflections from an edX deployment study. Computer-Supported Collaborative Learning Conference, CSCL, 2, 848-851.'},{id:"B35",body:'Willging, P. A., and Johnson, S. D. (2019). Factors that influence students’ decision to dropout of online courses. Journal of Asynchronous Learning Network, 13(3), 115-127. DOI: 10.24059/olj.v8i4.1814'},{id:"B36",body:'Lave, J., and Wenger, E. (1991). Situated Learning: Legitimate Peripheral Participation (E. Wenger, Ed.). Cambridge University Press.'},{id:"B37",body:'Ackerman, R., Parush, A., Nassar, F., and Shtub, A. (2016). Metacognition and system usability: Incorporating metacognitive research paradigm into usability testing. Computers in Human Behavior, 54, 101-113. DOI: 10.1016/j.chb.2015.07.041'},{id:"B38",body:'Tsai Y., Hsun, Lin, C. Hung, Hong, J. Chao, and Tai K. Hsin. (2018). The Effects of Metacognition on Online Learning Interest and Continuance to Learn with MOOCs. Computers and Education, 121, 18-29. DOI: 10.1016/j.compedu.2018.02.011'},{id:"B39",body:'Koſar, Gülten. 2016. “A Study of EFL Instructors’ Perceptions of Blended Learning.” Procedia - Social and Behavioral Sciences 232:736-44. DOI: 10.1016/j.sbspro.2016.10.100.'},{id:"B40",body:'Kaur, Manjot. 2013. “Blended Learning-Its Challenges and Future.” Procedia - Social and Behavioral Sciences 93:612-17. DOI: 10.1016/j.sbspro.2013.09.248.'},{id:"B41",body:'S. Krajcik and M. Czerniak (2014). Teaching Science in Elementary and Middle School: A Project-Based Approach. In Interdisciplinary Journal of Problem-Based Learning (5th ed., Vol. 8, Issue 1). Routledge. DOI: 10.7771/1541-5015.1489'},{id:"B42",body:'Husamah, H., and Pantiwati, Y. (2014). Cooperative learning STAD-PjBL: Motivation, thinking skills, and learning outcomes of biology department students. International Journal of Education Learning and Development, 2(1), 68-85.'},{id:"B43",body:'Sukamti, E. U., Putra, A. P., and Devi, A. C. (2019). Innovation of Project Base Learning (PjBL) on Outdoor Study for PGSD’s Student Activity on Education Diffusion. Int. J. Innov. Creat. Chang, 5(5), 546-561.'},{id:"B44",body:'Joseph, C. T., and Chapman, A. (2016). Project-Based Learning for Academically-Able Student (1, Ed.). Sense Publisher.'},{id:"B45",body:'Ngeow, K., and Kong, Y.-S. (2001). Learning To Learn: Preparing Teachers and Students for Learning To Learn: Preparing Teachers and Students for Problem-Based Learning. ERIC. ERIC Digest, 20, 1-6.'},{id:"B46",body:'Netto-Shek, Ho, T. B., and Chang, A. S. (2014). Making Projects Work: Structuring Learning. Managing Project work in Schools: Issues and Innovative Practices. Singapore (1st ed.). Prentice Hall.'},{id:"B47",body:'Helle, L., Tynjälä, P., and Olkinuora. (2016). Project-Based Learning in Post-Secondary Education – Theory, Practice and Rubber Sling Shots. Higher Education, 51, 287-314. DOI: 10.1007/s10734-004-6386-5'},{id:"B48",body:'Barak, M., and Watted, A. (2017). Project-based MOOC: Enhancing knowledge construction and motivation to learn. In: B. Berenfeld and J. Ginestie (Eds.), Digital Tools and Solution for Inquiry-Based STEM Learning (p. 26). IGI Global. DOI: 10.4018/978-1-5225-2525-7'},{id:"B49",body:'Barak, M., and Dori, Y. J. (2005). Enhancing undergraduate students’ chemistry understanding through project-based learning in an IT environment. Science Education, 89(1), 117-139. DOI: 10.1002/sce.20027'},{id:"B50",body:'Doppelt, Y. (2005). Assessment of Project-Based Learning in a MECHATRONICS Context. 16(2).'},{id:"B51",body:'Marx, R. W., Blumenfeld, P. C., Krajcik, J. S., and Soloway, E. (1997). Enacting Project-Based Science. The Elementary School Journal, 97(4), 342-358.'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Ridwan Daud Mahande",address:"ridwandm@unm.ac.id",affiliation:'
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The company was founded in Vienna in 2004 by Alex Lazinica and Vedran Kordic, two PhD students researching robotics. While completing our PhDs, we found it difficult to access the research we needed. So, we decided to create a new Open Access publisher. A better one, where researchers like us could find the information they needed easily. The result is IntechOpen, an Open Access publisher that puts the academic needs of the researchers before the business interests of publishers.
",metaTitle:"Our story",metaDescription:"The company was founded in Vienna in 2004 by Alex Lazinica and Vedran Kordic, two PhD students researching robotics. While completing our PhDs, we found it difficult to access the research we needed. So, we decided to create a new Open Access publisher. A better one, where researchers like us could find the information they needed easily. The result is IntechOpen, an Open Access publisher that puts the academic needs of the researchers before the business interests of publishers.",metaKeywords:null,canonicalURL:"/page/our-story",contentRaw:'[{"type":"htmlEditorComponent","content":"
We started by publishing journals and books from the fields of science we were most familiar with - AI, robotics, manufacturing and operations research. Through our growing network of institutions and authors, we soon expanded into related fields like environmental engineering, nanotechnology, computer science, renewable energy and electrical engineering, Today, we are the world’s largest Open Access publisher of scientific research, with over 4,200 books and 54,000 scientific works including peer-reviewed content from more than 116,000 scientists spanning 161 countries. Our authors range from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery.
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In the same year that IntechOpen was founded, we launched what was at the time the first ever Open Access, peer-reviewed journal in its field: the International Journal of Advanced Robotic Systems (IJARS).
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The IntechOpen timeline
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2004
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Intech Open is founded in Vienna, Austria, by Alex Lazinica and Vedran Kordic, two PhD students, and their first Open Access journals and books are published.
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Alex and Vedran launch the first Open Access, peer-reviewed robotics journal and IntechOpen’s flagship publication, the International Journal of Advanced Robotic Systems (IJARS).
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2005
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IntechOpen publishes its first Open Access book: Cutting Edge Robotics.
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2006
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IntechOpen publishes a special issue of IJARS, featuring contributions from NASA scientists regarding the Mars Exploration Rover missions.
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2008
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Downloads milestone: 200,000 downloads reached
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2009
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Publishing milestone: the first 100 Open Access STM books are published
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2010
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Downloads milestone: one million downloads reached
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IntechOpen expands its book publishing into a new field: medicine.
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2011
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Publishing milestone: More than five million downloads reached
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IntechOpen publishes 1996 Nobel Prize in Chemistry winner Harold W. Kroto’s “Strategies to Successfully Cross-Link Carbon Nanotubes”. Find it here.
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IntechOpen and TBI collaborate on a project to explore the changing needs of researchers and the evolving ways that they discover, publish and exchange information. The result is the survey “Author Attitudes Towards Open Access Publishing: A Market Research Program”.
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IntechOpen hosts SHOW - Share Open Access Worldwide; a series of lectures, debates, round-tables and events to bring people together in discussion of open source principles, intellectual property, content licensing innovations, remixed and shared culture and free knowledge.
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2012
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Publishing milestone: 10 million downloads reached
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IntechOpen holds Interact2012, a free series of workshops held by figureheads of the scientific community including Professor Hiroshi Ishiguro, director of the Intelligent Robotics Laboratory, who took the audience through some of the most impressive human-robot interactions observed in his lab.
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2013
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IntechOpen joins the Committee on Publication Ethics (COPE) as part of a commitment to guaranteeing the highest standards of publishing.
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2014
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IntechOpen turns 10, with more than 30 million downloads to date.
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IntechOpen appoints its first Regional Representatives - members of the team situated around the world dedicated to increasing the visibility of our authors’ published work within their local scientific communities.
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2015
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Downloads milestone: More than 70 million downloads reached, more than doubling since the previous year.
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Publishing milestone: IntechOpen publishes its 2,500th book and 40,000th Open Access chapter, reaching 20,000 citations in Thomson Reuters ISI Web of Science.
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40 IntechOpen authors are included in the top one per cent of the world’s most-cited researchers.
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Thomson Reuters’ ISI Web of Science Book Citation Index begins indexing IntechOpen’s books in its database.
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2016
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IntechOpen is identified as a world leader in Simba Information’s Open Access Book Publishing 2016-2020 report and forecast. IntechOpen came in as the world’s largest Open Access book publisher by title count.
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2017
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Downloads milestone: IntechOpen reaches more than 100 million downloads
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Publishing milestone: IntechOpen publishes its 3,000th Open Access book, making it the largest Open Access book collection in the world
We started by publishing journals and books from the fields of science we were most familiar with - AI, robotics, manufacturing and operations research. Through our growing network of institutions and authors, we soon expanded into related fields like environmental engineering, nanotechnology, computer science, renewable energy and electrical engineering, Today, we are the world’s largest Open Access publisher of scientific research, with over 4,200 books and 54,000 scientific works including peer-reviewed content from more than 116,000 scientists spanning 161 countries. Our authors range from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery.
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In the same year that IntechOpen was founded, we launched what was at the time the first ever Open Access, peer-reviewed journal in its field: the International Journal of Advanced Robotic Systems (IJARS).
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The IntechOpen timeline
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2004
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Intech Open is founded in Vienna, Austria, by Alex Lazinica and Vedran Kordic, two PhD students, and their first Open Access journals and books are published.
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Alex and Vedran launch the first Open Access, peer-reviewed robotics journal and IntechOpen’s flagship publication, the International Journal of Advanced Robotic Systems (IJARS).
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2005
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IntechOpen publishes its first Open Access book: Cutting Edge Robotics.
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2006
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IntechOpen publishes a special issue of IJARS, featuring contributions from NASA scientists regarding the Mars Exploration Rover missions.
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2008
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Downloads milestone: 200,000 downloads reached
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2009
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Publishing milestone: the first 100 Open Access STM books are published
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2010
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Downloads milestone: one million downloads reached
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IntechOpen expands its book publishing into a new field: medicine.
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2011
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Publishing milestone: More than five million downloads reached
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IntechOpen publishes 1996 Nobel Prize in Chemistry winner Harold W. Kroto’s “Strategies to Successfully Cross-Link Carbon Nanotubes”. Find it here.
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IntechOpen and TBI collaborate on a project to explore the changing needs of researchers and the evolving ways that they discover, publish and exchange information. The result is the survey “Author Attitudes Towards Open Access Publishing: A Market Research Program”.
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IntechOpen hosts SHOW - Share Open Access Worldwide; a series of lectures, debates, round-tables and events to bring people together in discussion of open source principles, intellectual property, content licensing innovations, remixed and shared culture and free knowledge.
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2012
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Publishing milestone: 10 million downloads reached
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IntechOpen holds Interact2012, a free series of workshops held by figureheads of the scientific community including Professor Hiroshi Ishiguro, director of the Intelligent Robotics Laboratory, who took the audience through some of the most impressive human-robot interactions observed in his lab.
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2013
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IntechOpen joins the Committee on Publication Ethics (COPE) as part of a commitment to guaranteeing the highest standards of publishing.
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2014
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IntechOpen turns 10, with more than 30 million downloads to date.
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IntechOpen appoints its first Regional Representatives - members of the team situated around the world dedicated to increasing the visibility of our authors’ published work within their local scientific communities.
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2015
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Downloads milestone: More than 70 million downloads reached, more than doubling since the previous year.
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Publishing milestone: IntechOpen publishes its 2,500th book and 40,000th Open Access chapter, reaching 20,000 citations in Thomson Reuters ISI Web of Science.
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40 IntechOpen authors are included in the top one per cent of the world’s most-cited researchers.
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Thomson Reuters’ ISI Web of Science Book Citation Index begins indexing IntechOpen’s books in its database.
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2016
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IntechOpen is identified as a world leader in Simba Information’s Open Access Book Publishing 2016-2020 report and forecast. IntechOpen came in as the world’s largest Open Access book publisher by title count.
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2017
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Downloads milestone: IntechOpen reaches more than 100 million downloads
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Publishing milestone: IntechOpen publishes its 3,000th Open Access book, making it the largest Open Access book collection in the world
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Larramendy and Sonia Soloneski",coverURL:"https://cdn.intechopen.com/books/images_new/5184.jpg",editedByType:"Edited by",editors:[{id:"14764",title:"Dr.",name:"Marcelo L.",middleName:null,surname:"Larramendy",slug:"marcelo-l.-larramendy",fullName:"Marcelo L. Larramendy"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:1,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"50482",doi:"10.5772/63094",title:"Pesticides, Environmental Pollution, and Health",slug:"pesticides-environmental-pollution-and-health",totalDownloads:6971,totalCrossrefCites:53,totalDimensionsCites:122,abstract:"In recent years, people have been exposed to several types of substances with broad spectrum due to the rapidly evolving technology. One of these chemical substance groups are pesticides. Pesticides have been an essential part of agriculture to protect crops and livestock from pest infestations and yield reduction for many decades. Despite their usefulness, pesticides could pose potential risks to food safety, the environment, and all living things. Concern about the environmental impact of repeated pesticide use has prompted research into the environmental fate of these agents, which can emigrate from treated fields to air, other land, and water bodies. The importance of agricultural pesticides for developing countries is undeniable. However, the issue of human health and environmental risks has emerged as a key problem for these countries in accordance to a number of studies. In the last five decades, pesticide usages increased the quantity and improved the quality of food. However, with the increasing amounts of their usage, concern about their adverse effects on nontarget organisms, including human beings, has also grown. The purpose of this publication is to explain the nature of pesticides and their history, classification, risks, and effects on health and the environment.",book:{id:"5184",slug:"environmental-health-risk-hazardous-factors-to-living-species",title:"Environmental Health Risk",fullTitle:"Environmental Health Risk - Hazardous Factors to Living Species"},signatures:"Arzu Özkara, Dilek Akyıl and Muhsin Konuk",authors:[{id:"5974",title:"Prof.",name:"Muhsin",middleName:null,surname:"Konuk",slug:"muhsin-konuk",fullName:"Muhsin Konuk"},{id:"179732",title:"Dr.",name:"Dilek",middleName:null,surname:"Akyıl",slug:"dilek-akyil",fullName:"Dilek Akyıl"},{id:"179733",title:"Dr.",name:"Arzu",middleName:null,surname:"Özkara",slug:"arzu-ozkara",fullName:"Arzu Özkara"}]},{id:"49818",doi:"10.5772/62049",title:"Amoxicillin in the Aquatic Environment, Its Fate and Environmental Risk",slug:"amoxicillin-in-the-aquatic-environment-its-fate-and-environmental-risk",totalDownloads:3171,totalCrossrefCites:14,totalDimensionsCites:36,abstract:"Amoxicillin is a broad-spectrum antibiotic widely used for treating both human and animal diseases, and it belongs to a group that are excreted unchanged within urine and faeces; therefore, it is possible to find traces of this drug or its degradation products in environmental water bodies. In water, it is rapidly degraded by biotic and abiotic factors, yielding different intermediate products; these are suspected of being more resistant to degradation, and potentially more toxic, than the parent compound. In the water bodies, these compounds may produce toxic effects on the aquatic organisms from different trophic levels and produce an ecological imbalance. Amoxicillin may bioaccumulate in fish muscle tissues, with the possibility of the occurrence of these drugs in food, leading to a passive consumption of this antibiotic resulting in undesirable effects on consumer health such as immunoallergic responses. However, the main problem related with the presence of this antimicrobial compounds in fish tissues is the possibility of inducing bacterial resistance genes. At present, the available scientific knowledge is less than what is needed to fully assess the risks that amoxicillin pose to the environment, and it is still necessary to conduct large amount of research works before a thorough understanding of this severe environmental issue.",book:{id:"5184",slug:"environmental-health-risk-hazardous-factors-to-living-species",title:"Environmental Health Risk",fullTitle:"Environmental Health Risk - Hazardous Factors to Living Species"},signatures:"Armando Elizalde-Velázquez, Leobardo Manuel Gómez-Oliván,\nMarcela Galar-Martínez, Hariz Islas-Flores, Octavio Dublán-García and Nely SanJuan-Reyes",authors:[{id:"179818",title:"Dr.",name:"Leobardo Manuel",middleName:null,surname:"Gómez-Oliván",slug:"leobardo-manuel-gomez-olivan",fullName:"Leobardo Manuel Gómez-Oliván"}]},{id:"50234",doi:"10.5772/62455",title:"Environmental Effects of Endocrine-Disrupting Chemicals: A Special Focus on Phthalates and Bisphenol A",slug:"environmental-effects-of-endocrine-disrupting-chemicals-a-special-focus-on-phthalates-and-bisphenol-",totalDownloads:2838,totalCrossrefCites:3,totalDimensionsCites:13,abstract:"Several environmental chemicals are classified as endocrine-disrupting chemicals (EDCs). Many of them have an impact on reproductive functions and sex hormones because of their estrogenic and/or antiandrogenic properties. Phthalates and bisphenol A (BPA) are two well-known EDCs. They are abundant in the environment. Phthalates are usually classified as antiandrogens, whereas BPA is considered as estrogen-like EDC and xenoestrogen. Other than their endocrine-disrupting effects, these two chemicals are also known to have genotoxic and epigenetic effects. Besides, they are hepatotoxic and have substantial effects on other organs/systems (thyroid, kidney, neuroendocrine system, immune system, etc.). In this chapter, we will mainly focus on the toxic effects of different phthalate esters and BPA by discussing their availability in the environment, mechanism and mode of actions, their biotransformation and reproductive effects, and their effects on other systems (hepatic, renal, etc.). Besides, we discuss epidemiological studies that are conducted to reveal their effects on the reproductive and endocrine systems. This chapter provides the readers a compact piece of knowledge on these abundant substances and helps them to understand the action of these substances at the molecular and cellular levels.",book:{id:"5184",slug:"environmental-health-risk-hazardous-factors-to-living-species",title:"Environmental Health Risk",fullTitle:"Environmental Health Risk - Hazardous Factors to Living Species"},signatures:"Pinar Erkekoglu and Belma Kocer-Gumusel",authors:[{id:"109978",title:"Prof.",name:"Pınar",middleName:null,surname:"Erkekoğlu",slug:"pinar-erkekoglu",fullName:"Pınar Erkekoğlu"},{id:"185037",title:"Dr.",name:"Belma",middleName:null,surname:"Kocer-Gumusel",slug:"belma-kocer-gumusel",fullName:"Belma Kocer-Gumusel"}]},{id:"50341",doi:"10.5772/62456",title:"Soil Contamination Health Risks in Czech Proposal of Soil Protection Legislation",slug:"soil-contamination-health-risks-in-czech-proposal-of-soil-protection-legislation",totalDownloads:1522,totalCrossrefCites:6,totalDimensionsCites:9,abstract:"A new system of soil contamination limit values proposed for Czech legislation is described. The system is based on the hierarchical limit values system with two levels. The first one—prevention limit—defined background values of risk elements (REs) and persistent organic pollutants (POPs) in Czech agricultural soils supported by the data from soil monitoring system. The second one—indication limit—is defined for human health protection by two principles, the protection of food chain and the protection of direct human health risks by inhalation, dermal and oral intake of RE and POPs in soil particles on the field. The practical application of limit values proposal was applied in the project focused on soil contamination influence on health and environmental risks in fluvial zones of Czech important river basins. The floodplain soils belong to the most contaminated soils in Europe generally and the project defined the potential fluvial areas with increased human health risks.",book:{id:"5184",slug:"environmental-health-risk-hazardous-factors-to-living-species",title:"Environmental Health Risk",fullTitle:"Environmental Health Risk - Hazardous Factors to Living Species"},signatures:"Radim Vácha, Milan Sáňka, Jan Skála, Jarmila Čechmánková and\nViera Horváthová",authors:[{id:"85483",title:"Associate Prof.",name:"Radim",middleName:null,surname:"Vacha",slug:"radim-vacha",fullName:"Radim Vacha"}]},{id:"50264",doi:"10.5772/62486",title:"Occupational Exposure to Coal, Genotoxicity, and Cancer Risk",slug:"occupational-exposure-to-coal-genotoxicity-and-cancer-risk",totalDownloads:1953,totalCrossrefCites:4,totalDimensionsCites:7,abstract:"Coal is a heterogeneous mixture containing large quantities of organic and inorganic matter, including carbon, hydrogen, oxygen, sulfur, nitrogen, and organometallic forms. The presence of mineral matter in coal may result in a number of environmental and human health problems related to its mining, preparation, and combustion. During coal mining activities, large quantities of coal dust, ashes, polycyclic aromatic hydrocarbons (PAHs), and heavy metals are released into the environment, forming a complex mixture. This mixture becomes one of the most important occupational risks for the health and safety of workers due to its synergistic, additive, and enhancing effects. Once inside the organism, this cocktail-like mixture can interact with cellular mechanisms related to the production of reactive oxygen species (ROS) and can cause damage in important macromolecules such as DNA, lipids, and proteins. In this review, human populations exposed to coal and coal burning were analyzed. Data from different studies were evaluated in relation to the effect of complex mixture exposure on DNA damage and mechanisms, and the background factors, such as gender, age, or smoking habit. The high temperatures that occur in combustion processes affect the characteristics of the resulting particles. The coal fly ash is released by combustion and its composition varies depending on the coal type and the method of collection used such as electrostatic precipitators. Compounds such as PAHs once activated by the organisms have been shown to have mutagenic and carcinogenic activity due to its ability to form adducts with purines. Moreover, metals that commonly are evaporated during the cooling process increase its toxicity. The particles when inhaled can pass from the alveoli into the bloodstream and affect extrapulmonary organs. Several studies have described the inflammatory cascade that triggers exposure to coal and coal fly ash particles; they have a complex composition capable of generating a persistent inflammatory process, resulting in diseases widely described as emphysema, bronchitis, pneumoconiosis, asthma, and cancer. Several human biomonitoring studies have been conducted evaluating the inflammatory process and the release of cytokines, polymorphisms involved in detoxification mechanisms, different biomarkers associated with occupational exposure, DNA damage, and the influence of oxidative stress in disease development. The relationship between chronic exposure to coal and coal ash particles and cancer is still widely debated. This review gave us a broad assessment about the associated mechanisms between cancer and exposure to coal and different findings around the world.",book:{id:"5184",slug:"environmental-health-risk-hazardous-factors-to-living-species",title:"Environmental Health Risk",fullTitle:"Environmental Health Risk - Hazardous Factors to Living Species"},signatures:"Grethel León-Mejía , Milton Quintana Sosa , Paula Rohr , Katia\nKvitko, João Antonio Pêgas Henriques and Juliana da Silva",authors:[{id:"170192",title:"Dr.",name:"Katia",middleName:null,surname:"Kvitko",slug:"katia-kvitko",fullName:"Katia Kvitko"},{id:"170193",title:"Dr.",name:"Juliana",middleName:null,surname:"Da Silva",slug:"juliana-da-silva",fullName:"Juliana Da Silva"},{id:"180743",title:"MSc.",name:"Grethel",middleName:null,surname:"Leon-Mejia",slug:"grethel-leon-mejia",fullName:"Grethel Leon-Mejia"},{id:"180880",title:"Dr.",name:"Milton",middleName:null,surname:"Quintana",slug:"milton-quintana",fullName:"Milton Quintana"},{id:"181198",title:"Dr.",name:"Paula",middleName:null,surname:"Rohr",slug:"paula-rohr",fullName:"Paula Rohr"},{id:"181199",title:"Dr.",name:"Jose Antonio",middleName:null,surname:"Pegas Henriques",slug:"jose-antonio-pegas-henriques",fullName:"Jose Antonio Pegas Henriques"}]}],mostDownloadedChaptersLast30Days:[{id:"50482",title:"Pesticides, Environmental Pollution, and Health",slug:"pesticides-environmental-pollution-and-health",totalDownloads:6971,totalCrossrefCites:53,totalDimensionsCites:122,abstract:"In recent years, people have been exposed to several types of substances with broad spectrum due to the rapidly evolving technology. One of these chemical substance groups are pesticides. Pesticides have been an essential part of agriculture to protect crops and livestock from pest infestations and yield reduction for many decades. Despite their usefulness, pesticides could pose potential risks to food safety, the environment, and all living things. Concern about the environmental impact of repeated pesticide use has prompted research into the environmental fate of these agents, which can emigrate from treated fields to air, other land, and water bodies. The importance of agricultural pesticides for developing countries is undeniable. However, the issue of human health and environmental risks has emerged as a key problem for these countries in accordance to a number of studies. In the last five decades, pesticide usages increased the quantity and improved the quality of food. However, with the increasing amounts of their usage, concern about their adverse effects on nontarget organisms, including human beings, has also grown. The purpose of this publication is to explain the nature of pesticides and their history, classification, risks, and effects on health and the environment.",book:{id:"5184",slug:"environmental-health-risk-hazardous-factors-to-living-species",title:"Environmental Health Risk",fullTitle:"Environmental Health Risk - Hazardous Factors to Living Species"},signatures:"Arzu Özkara, Dilek Akyıl and Muhsin Konuk",authors:[{id:"5974",title:"Prof.",name:"Muhsin",middleName:null,surname:"Konuk",slug:"muhsin-konuk",fullName:"Muhsin Konuk"},{id:"179732",title:"Dr.",name:"Dilek",middleName:null,surname:"Akyıl",slug:"dilek-akyil",fullName:"Dilek Akyıl"},{id:"179733",title:"Dr.",name:"Arzu",middleName:null,surname:"Özkara",slug:"arzu-ozkara",fullName:"Arzu Özkara"}]},{id:"50298",title:"Environmental Factors in Causation of Diabetes Mellitus",slug:"environmental-factors-in-causation-of-diabetes-mellitus",totalDownloads:2396,totalCrossrefCites:4,totalDimensionsCites:5,abstract:"Environmental factors play a role in etiopathogenesis of diabetes. Environmental factors include polluted water, soil, unhealthy diet, stress, lack of physical activity, vitamin D deficiency, exposure to enteroviruses, and damage to immune cells.",book:{id:"5184",slug:"environmental-health-risk-hazardous-factors-to-living-species",title:"Environmental Health Risk",fullTitle:"Environmental Health Risk - Hazardous Factors to Living Species"},signatures:"P.G. Raman",authors:[{id:"179146",title:"Dr.",name:"Poondy Gopalratnam",middleName:null,surname:"Raman",slug:"poondy-gopalratnam-raman",fullName:"Poondy Gopalratnam Raman"}]},{id:"50234",title:"Environmental Effects of Endocrine-Disrupting Chemicals: A Special Focus on Phthalates and Bisphenol A",slug:"environmental-effects-of-endocrine-disrupting-chemicals-a-special-focus-on-phthalates-and-bisphenol-",totalDownloads:2838,totalCrossrefCites:3,totalDimensionsCites:13,abstract:"Several environmental chemicals are classified as endocrine-disrupting chemicals (EDCs). Many of them have an impact on reproductive functions and sex hormones because of their estrogenic and/or antiandrogenic properties. Phthalates and bisphenol A (BPA) are two well-known EDCs. They are abundant in the environment. Phthalates are usually classified as antiandrogens, whereas BPA is considered as estrogen-like EDC and xenoestrogen. Other than their endocrine-disrupting effects, these two chemicals are also known to have genotoxic and epigenetic effects. Besides, they are hepatotoxic and have substantial effects on other organs/systems (thyroid, kidney, neuroendocrine system, immune system, etc.). In this chapter, we will mainly focus on the toxic effects of different phthalate esters and BPA by discussing their availability in the environment, mechanism and mode of actions, their biotransformation and reproductive effects, and their effects on other systems (hepatic, renal, etc.). Besides, we discuss epidemiological studies that are conducted to reveal their effects on the reproductive and endocrine systems. This chapter provides the readers a compact piece of knowledge on these abundant substances and helps them to understand the action of these substances at the molecular and cellular levels.",book:{id:"5184",slug:"environmental-health-risk-hazardous-factors-to-living-species",title:"Environmental Health Risk",fullTitle:"Environmental Health Risk - Hazardous Factors to Living Species"},signatures:"Pinar Erkekoglu and Belma Kocer-Gumusel",authors:[{id:"109978",title:"Prof.",name:"Pınar",middleName:null,surname:"Erkekoğlu",slug:"pinar-erkekoglu",fullName:"Pınar Erkekoğlu"},{id:"185037",title:"Dr.",name:"Belma",middleName:null,surname:"Kocer-Gumusel",slug:"belma-kocer-gumusel",fullName:"Belma Kocer-Gumusel"}]},{id:"50193",title:"Risks of Environmental Genotoxicants",slug:"risks-of-environmental-genotoxicants",totalDownloads:1699,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"Humans have throughout their development been exposed to various environmental genotoxicants through food, air, water, and soil. Environmental exposure to genotoxic compounds may induce damage to human health and thereby increase risks of human cancers and other diseases. Environmental genotoxic chemicals have the ability to induce mutations. Such mutations can give rise to cancer in somatic cells. However, when germ cells are affected, the damage can also have an effect on the next and successive generations. Because of the potential health hazard represented by exposure to genotoxic chemicals, it is important that all chemicals for which there is possible human exposure be screened for genotoxic activity. If genotoxic hazard is detected, then the risks of exposure can be assessed and the use of the chemical controlled and when appropriate eliminated from the market and the environment. In this chapter, a general overview of the genotoxicity and the genotoxicity of some environmental genotoxicants are discussed. This is followed by a description of the genotoxic properties of some environmental genotoxicants such as bisphenols and mycotoxins, which are prominent environmental contaminates, and is believed to be genotoxic agents that contribute to the high incidence of carcinogenicity among populations.",book:{id:"5184",slug:"environmental-health-risk-hazardous-factors-to-living-species",title:"Environmental Health Risk",fullTitle:"Environmental Health Risk - Hazardous Factors to Living Species"},signatures:"Sabry M. Attia and Gamaleldin I. Harisa",authors:[{id:"178995",title:"Prof.",name:"Sabry",middleName:null,surname:"Attia",slug:"sabry-attia",fullName:"Sabry Attia"},{id:"180300",title:"Prof.",name:"Gamaleldin",middleName:null,surname:"Harisa",slug:"gamaleldin-harisa",fullName:"Gamaleldin Harisa"},{id:"190926",title:"Prof.",name:"M. Abd Allah",middleName:null,surname:"Gamil",slug:"m.-abd-allah-gamil",fullName:"M. Abd Allah Gamil"}]},{id:"50769",title:"Assessment of DNA Damage by Comet Assay in Buccal Epithelial Cells: Problems, Achievement, Perspectives",slug:"assessment-of-dna-damage-by-comet-assay-in-buccal-epithelial-cells-problems-achievement-perspectives",totalDownloads:1925,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"DNA damage risk assessment in comet assay by the use of buccal mucosa cells has great advantages in comparison with other cell type sample due to more safely, easier, cheaper, and non-invasive method for in vivo studies. According to the OECD Guidelines, the in vivo mammalian alkaline comet assay is well-established and validated method for measuring DNA strand breaks in single eukaryotic cells. Considering exposure to xenobiotics and endogenous damage inductors, buccal mucosa cells are the first to be in direct contact after exposure and this makes them an ideal biomatrices in evaluation of the level of individual genotoxicity to several compounds already mentioned. Their clinical diagnostic applicability confers a potential use in patients across time. However, the number of publications referring to the human buccal comet assay is low in the last two decades. This low growing interest may be explained by several factors, including its relative technical problems. Different procedures have been used in collecting and processing the samples. In order to have widespread acceptance and credibility in human population studies, the comet assay in buccal cells requires standardization of the protocol, of parameters analyzed, and a better knowledge of critical features affecting the assay outcomes, including the definition of the values of spontaneous DNA damage. There is a need for further collaborative work as in the HUMN (micronucleus assay on lymphocytes) and HUMNxL (micronucleus assay on buccal cells) collaborative projects. The creation of a network of laboratories will allow more focused validation studies, including the design of a classic, historic, prospective cohort study in order to explore the link between measures of genetic instability in the buccal mucosa and the risk of cancer and other chronic-degenerative diseases. One such network connection will start in 2016 as a COST project under the name “hCOMET—The comet assay as a human biomonitoring tool” launched by Prof. Andrew Collins.",book:{id:"5184",slug:"environmental-health-risk-hazardous-factors-to-living-species",title:"Environmental Health Risk",fullTitle:"Environmental Health Risk - Hazardous Factors to Living Species"},signatures:"J. Sánchez-Alarcón, M. Milić, S. Gómez-Arroyo, J. M. R. Montiel-González and R. 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A dynamic career research platform which is based on the thematic areas of comparative vertebrate physiology, stress endocrinology, reproductive endocrinology, animal health and welfare, and conservation biology. \nEdward has supervised 40 research students and published over 60 peer reviewed research.",institutionString:null,institution:{name:"University of Queensland",institutionURL:null,country:{name:"Australia"}}},editorTwo:null,editorThree:null},{id:"20",title:"Animal Nutrition",coverUrl:"https://cdn.intechopen.com/series_topics/covers/20.jpg",isOpenForSubmission:!0,editor:{id:"175967",title:"Dr.",name:"Manuel",middleName:null,surname:"Gonzalez Ronquillo",slug:"manuel-gonzalez-ronquillo",fullName:"Manuel Gonzalez Ronquillo",profilePictureURL:"https://mts.intechopen.com/storage/users/175967/images/system/175967.png",biography:"Dr. Manuel González Ronquillo obtained his doctorate degree from the University of Zaragoza, Spain, in 2001. He is a research professor at the Faculty of Veterinary Medicine and Animal Husbandry, Autonomous University of the State of Mexico. He is also a level-2 researcher. He received a Fulbright-Garcia Robles fellowship for a postdoctoral stay at the US Dairy Forage Research Center, Madison, Wisconsin, USA in 2008–2009. He received grants from Alianza del Pacifico for a stay at the University of Magallanes, Chile, in 2014, and from Consejo Nacional de Ciencia y Tecnología (CONACyT) to work in the Food and Agriculture Organization’s Animal Production and Health Division (AGA), Rome, Italy, in 2014–2015. He has collaborated with researchers from different countries and published ninety-eight journal articles. He teaches various degree courses in zootechnics, sheep production, and agricultural sciences and natural resources.\n\nDr. Ronquillo’s research focuses on the evaluation of sustainable animal diets (StAnD), using native resources of the region, decreasing carbon footprint, and applying meta-analysis and mathematical models for a better understanding of animal production.",institutionString:null,institution:{name:"Universidad Autónoma del Estado de México",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null},{id:"28",title:"Animal Reproductive Biology and Technology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/28.jpg",isOpenForSubmission:!0,editor:{id:"177225",title:"Prof.",name:"Rosa Maria Lino Neto",middleName:null,surname:"Pereira",slug:"rosa-maria-lino-neto-pereira",fullName:"Rosa Maria Lino Neto Pereira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9wkQAC/Profile_Picture_1624519982291",biography:"Rosa Maria Lino Neto Pereira (DVM, MsC, PhD and) is currently a researcher at the Genetic Resources and Biotechnology Unit of the National Institute of Agrarian and Veterinarian Research (INIAV, Portugal). She is the head of the Reproduction and Embryology Laboratories and was lecturer of Reproduction and Reproductive Biotechnologies at Veterinary Medicine Faculty. She has over 25 years of experience working in reproductive biology and biotechnology areas with a special emphasis on embryo and gamete cryopreservation, for research and animal genetic resources conservation, leading research projects with several peer-reviewed papers. Rosa Pereira is member of the ERFP-FAO Ex situ Working Group and of the Management Commission of the Portuguese Animal Germplasm Bank.",institutionString:"The National Institute for Agricultural and Veterinary Research. Portugal",institution:null},editorTwo:null,editorThree:null}]},overviewPageOFChapters:{paginationCount:14,paginationItems:[{id:"82457",title:"Canine Hearing Management",doi:"10.5772/intechopen.105515",signatures:"Peter M. 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She obtained her Ph.D. in Veterinary Sciences from the University of Trás-os-Montes e Alto Douro, Portugal. After almost 32 years of teaching at the University of Trás-os-Montes and Alto Douro, she recently moved to the University of Évora, Department of Veterinary Medicine, where she teaches in the field of Animal Reproduction and Clinics. Her primary research areas include the molecular markers of the endometrial cycle and the embryo–maternal interaction, including oxidative stress and the reproductive physiology and disorders of sexual development, besides the molecular determinants of male and female fertility. She often supervises students preparing their master's or doctoral theses. 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He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. 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He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}},{id:"338856",title:"Mrs.",name:"Nur Alvira",middleName:null,surname:"Pascawati",slug:"nur-alvira-pascawati",fullName:"Nur Alvira Pascawati",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universitas Respati Yogyakarta",country:{name:"Indonesia"}}},{id:"441116",title:"Dr.",name:"Jovanka M.",middleName:null,surname:"Voyich",slug:"jovanka-m.-voyich",fullName:"Jovanka M. Voyich",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Montana State University",country:{name:"United States of America"}}},{id:"330412",title:"Dr.",name:"Muhammad",middleName:null,surname:"Farhab",slug:"muhammad-farhab",fullName:"Muhammad Farhab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"349495",title:"Dr.",name:"Muhammad",middleName:null,surname:"Ijaz",slug:"muhammad-ijaz",fullName:"Muhammad Ijaz",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Veterinary and Animal Sciences",country:{name:"Pakistan"}}}]}},subseries:{item:{id:"23",type:"subseries",title:"Computational Neuroscience",keywords:"Single-Neuron Modeling, Sensory Processing, Motor Control, Memory and Synaptic Pasticity, Attention, Identification, Categorization, Discrimination, Learning, Development, Axonal Patterning and Guidance, Neural Architecture, Behaviours and Dynamics of Networks, Cognition and the Neuroscientific Basis of Consciousness",scope:"Computational neuroscience focuses on biologically realistic abstractions and models validated and solved through computational simulations to understand principles for the development, structure, physiology, and ability of the nervous system. This topic is dedicated to biologically plausible descriptions and computational models - at various abstraction levels - of neurons and neural systems. This includes, but is not limited to: single-neuron modeling, sensory processing, motor control, memory, and synaptic plasticity, attention, identification, categorization, discrimination, learning, development, axonal patterning, guidance, neural architecture, behaviors, and dynamics of networks, cognition and the neuroscientific basis of consciousness. 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