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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
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Catto-Smith",coverURL:"https://cdn.intechopen.com/books/images_new/1057.jpg",editedByType:"Edited by",editors:[{id:"76906",title:"Dr.",name:"Anthony G.",surname:"Catto-Smith",slug:"anthony-g.-catto-smith",fullName:"Anthony G. Catto-Smith"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},onlineFirst:{chapter:{type:"chapter",id:"79498",title:"Oral Aspects and Dental Management of Special Needs Patient",doi:"10.5772/intechopen.101067",slug:"oral-aspects-and-dental-management-of-special-needs-patient",body:'According to the WHO World report on disability 2011, About 15% of the world’s population lives with some form of disability, of whom 2–4% experience significant difficulties in functioning. The global disability prevalence is higher than previous WHO estimates, which date from the 1970s and suggested a figure of around 10%. This global estimate for disability is on the rise due to population aging and the rapid spread of chronic diseases, as well as improvements in the methodologies used to measure disability.
Individuals with disabilities have generally poorer health, lower education, fewer economic opportunities, and higher rates of poverty than people without disabilities. This is mainly due to the obstacles they face in their daily lives and the lack of services available to them. Regarding oral health and access to dental care, the same obstacles are of concern. Oral health is mostly ignored, oral hygiene is neglected, and dental treatments are postponed after other health issues. As a result, individuals with special needs present more dental caries, periodontal problems, orthodontic anomalies, and are more prone to dental diseases compared with the healthy population.
Cerebral palsy is a non-progressive movement, posture, and tone disorder characterized by the impairment of motor activities in the developing fetal or infant brain. Motor disorders are often accompanied by sensory, perception, communication, and behavioral disorders, epilepsy, and musculoskeletal problems [1]. In these patients, muscle weakness or paralysis, unbalanced and irregular gait, uncoordinated movements, sudden seizures, mental retardation, emotional disorders, learning, speech communication disorders, and weakness of swallowing, and coughing reflexes are seen. Because brain development continues during the first 2 years of life, cerebral palsy may develop as a result of brain damage occurring in the prenatal, perinatal, or postnatal periods [2]. However, more than 80% of cases are due to problems in the prenatal period.
Etiologically, in the prenatal period; maternal diseases, trauma, genetics, drug use, bleeding, consanguineous marriage, radiation, in the natal period; premature/late birth, birth trauma due to inappropriate position, low/high birth weight, cord entanglement, lack of oxygen, multiple pregnancies, difficult birth, birth trauma, in the postnatal period; febrile diseases, trauma, hyperbilirubinemia, hypoglycemia, seizure, and cerebral hemorrhage are risk factors for cerebral palsy [3].
It has been reported that the rate of drooling in children with cerebral palsy is 10–58% [4]. Although drooling is normal in infants and young children, it is considered pathological after 4 years of age. Most children with cerebral palsy, who are drooling, are unable to swallow normal saliva due to oral-motor dysfunction, although not much saliva is produced. Perioral eczema, infection, and dehydration occur as a result of drooling out of the mouth [5].
Bruxism, especially in the “Spastic” type, is commonly observed in individuals with cerebral palsy [6]. It has been reported that 36.9–51% of children with cerebral palsy have bruxism. In addition to bruxism, the presence of parafunctional habits such as pacifier-finger sucking, biting objects have also been detected [7].
Periodontal diseases occur more often in children with cerebral palsy due to physical inadequacies, malocclusions, poor oral hygiene, chewing, swallowing difficulties, and consumption of soft food with high carbohydrate content. Besides, the use of phenytoin for seizure control causes gingival hyperplasia [8].
Caries formation is observed at a high rate in children with cerebral palsy. The most important reason for this situation is poor oral hygiene. Other risk factors for caries formation are mouth breathing, the effect of drugs used, and enamel hypoplasia [8]. Differences in food form, increased duration of food consumption, difficult cooperation, and structural defects in the teeth cause an increase in the prevalence of dental caries in children with cerebral palsy, and it has been reported that there are more extracted and untreated teeth compared with healthy children [9].
Malocclusions are observed two times more when compared with healthy individuals, and these patients have unilateral crossbite with excessive overbite and overjet. It has been reported that patients with cerebral palsy have a higher prevalence of malocclusion than healthy individuals, but the severity of malocclusion varies according to the degree of neurological disorder. In these individuals, musculoskeletal anomalies, altered cranial base relationships, premature tooth eruption, mouth breathing, and inadequate lip closure, as well as increased overjet and overbite, can be observed [10, 11].
It has been reported that cerebral palsy is not an etiological factor for erosion, but an increase in erosion since gastro-esophageal reflux is frequently observed in these individuals [12]. It has been reported that in children with cerebral palsy accompanied by gastro-esophageal reflux, especially in the quadriplegia type, the risk of dental erosion is considerably increased and the incidence of oral diseases is quite high [13].
Neuromuscular problems specific to cerebral palsy affect oral health in different ways. Changes in the orofacial region cause nutritional problems as well as the development of parafunctional habits and difficulties in maintaining oral hygiene [14]. In addition, dyskinetic movements cause pathological oral reflexes such as sudden biting or nausea. Gastric reflux associated with a blended diet, often rich in sugar, further puts these patients’ oral health at risk. Neuromuscular problems also prevent the patient from brushing their teeth correctly [15]. Patients with cerebral palsy have difficulty in chewing and swallowing due to changes in tongue, cheek, and lip motility. In these patients, there is an imbalance in the oral microbiota, which favors the proliferation of acidogenic bacterial species, which initiate the caries process [15].
Treatment sessions should be kept brief for patients with cerebral palsy. Patients may need to be moved from a wheelchair to a dental chair. The patient should be placed in the middle of the dental chair with arms and legs as close to the body as possible. After the patient is placed properly in a dental chair, the patient should be checked whether he/she is comfortable and the position of the extremities is correct. To keep the airway open, the patient should be seated at a 45-degree angle, but not in the supine position. The dental chair should be moved slowly, and the light reflector should be turned on slowly to prevent spastic muscle movements and to eliminate the risk of seizure. Myorelaxant agents should be used when necessary.
During dental treatment procedures, it is crucial to balance the patient’s head at all stages. Various mouthguards should be used to control involuntary jaw movements and accidental bites. The airway should be controlled, and frequent breaks should be given to allow the patient to relax and breathe normally. To minimize the startle reflex, the patient should be warned at every stage. The use of stimuli such as sudden movements, sounds, and lights should be avoided. Efficient, fast treatment should be done, and chair time should be minimized to reduce muscle fatigue. In patients with more complex situations, sedation or general anesthesia may be an option [15, 16, 17].
Down syndrome, defined by Down in 1866, is an autosomal anomaly associated with the trisomy of the 21st chromosome pair. Its incidence in the population is 1/800, and it is the most common chromosomal change. There is an extra 21st chromosome (trisomy) in 95% of cases. In some cases, there are 46 normal chromosomes, but the 21st chromosome has been replaced with another chromosome [18, 19]. Mosaic Down syndrome, on the other hand, is caused by the inability of chromosomes to fully divide during cell division in the embryonic period. Some cells of the mosaic type have 47 chromosomes, while others have 46 chromosomes [19]. Individuals with Down syndrome represent learning difficulties, neuropsychiatric disorders, and behavioral problems as well as congenital cardiac anomalies, thyroid problems, seizures, visual and hearing disorders, early-onset dementia, and frequent infections. Also, some individuals with Down syndrome are hepatitis B carriers, and leukemia can be seen in patients with Down syndrome [20].
The only factor known to cause Down syndrome is the age of the mother during pregnancy, the risk increases in pregnancies over the age of 35. However, because young women, in general, have more babies, 75–80% of children with Down syndrome are babies of young mothers. There is no difference between country, nationality, or socioeconomic status [21].
Craniofacial features of individuals with Down syndrome include brachycephaly, broad and short neck, maxillary hypoplasia, sloping palpebral fissures, short ears, midface hypoplasia, curved eyes, narrow, flat nose [22].
Although individuals with Down syndrome have usually a cooperative personality, providing sufficient oral hygiene depends on the family’s knowledge and education level. Down syndrome children might also experience anxiety or fear of dental visits and parents are usually not aware of the dental problems of their children. Also, Down syndrome children using medical agents suffering from seizures experience dry mouth due to a decrease in the salivary flow rate, which may lead to xerostomia preparing a suitable environment for caries and periodontal problems [29, 30]. In addition, high levels of tooth wear are observed in these patients. This is mainly due to bruxism and the acidic oral environment (reflux and vomiting) [22].
The behavior management skills of the dental professional are the key factor in a child’s acceptance of dental treatment [19]. Before determining the right approach to the Down syndrome child, the dentist should consider the level of the mental, emotional, and social development of the child [31]. Most Down syndrome children are affectionate and cooperative for their dental treatment and can be treated easily with the tell-show-do technique [32].
When treating Down Syndrome children, the need for prophylaxis of subacute bacterial endocarditis and the patient’s compliance level should be considered [22]. During treatment, the gag reflex can be reduced by behavioral management techniques, as comforting and distracting patients. It can also be reduced by intraoral massage and pharmacological or non-pharmacological interventions [33]. The recalls should be planned frequently, and preventive dental treatments should be included in the treatment plan. The education of caregivers is crucial for sufficient oral hygiene provision and follow-ups. Mild sedation may be used in children with moderate anxiety. Extremely resistant patients may require general anesthesia [17].
Autism was first described in 1943 by an American child psychiatrist, Leo Kanner. Autism spectrum disorder (ASD) is a neurodevelopmental disorder, characterized by difficulties in communication, social relationships, and limited and repetitive behaviors [34, 35].
Individuals with ASD have characteristics such as stereotypical or repetitive motor behavior (flapping, rocking back and forth), repetitive use of objects (turning coins, putting objects in order), or making repetitive speeches. Many patients adhere to rigid routines in their lives and may have a more rigid thinking pattern. They react negatively to even minor changes or transitions [36].
No specific etiology has been identified for ASD. However, studies indicate a combination of genetical and environmental factors before and after birth, such as parental age, fetal environment (e.g., sex steroids, maternal infections/immune activation, obesity, diabetes, hypertension, or ultrasound examinations), perinatal and obstetric events (e.g., hypoxia), medication (valproate, selective serotonin reuptake inhibitors), smoking and alcohol use, nutrition (e.g., short inter-pregnancy intervals, e.g., vitamin D, iron, zinc, and copper), vaccination, and toxic exposures (air pollution, heavy metals, pesticides, organic pollutants) and low birth weight [37, 38].
In addition, problems such as tongue thrusting, erosion, hyperactive gag reflex, and some malocclusions such as anterior open bite and maxillary retrognathia were also reported in these individuals [42, 43].
Clinical conditions that ASD children present, such as sensorimotor and attention deficits, anxiety and related emotion regulation, comprehensive difficulties, and general speech disorders, create various difficulties for families, educators, and dentists in the provision of oral health care of these children [44]. Besides, parents face difficulties in brushing the teeth of the ASD children due to the sensory sensitivities of their children and the unpredictable or aggressive behavior that may require physical restraints.
In the literature, the caries experience of ASD individuals is controversial. Research reports state that ASD children are more prone to dental caries due to the consumption of sugar-containing food [45, 46, 47]. Besides, insufficient chewing and prolonged time of food staying in the mouth also increase caries formation [48]. The fact that autistic individuals are more difficult to accept oral and dental health care than healthy individuals and that their hand skills are not sufficiently developed and that they cannot perform adequate and effective tooth brushing is also effective in the formation of caries [49].
The impaired behavioral activities and complicated medical conditions make the dental management of patients with ASD challenges. Children with ASD have remarkable difficulties in establishing relationships with other people, understanding and the following information, and dentists may be insufficient in providing cooperation during the dental treatment process [40]. Furthermore, the invasive nature of dental treatment procedures along with the hypersensitivity of children with ASD to sensory stimulation (sound, touch, and light) may trigger undesired responses during dental treatment.
In the dental treatment of autistic individuals, many basic behavior management techniques such as tell-show-do, desensitization, and voice control behavior management can be successfully applied [50].
The dental treatment sessions of autistic individuals should be kept short and the sensory stimulation should be minimized. However, it has been reported that in many cases it may be necessary to use advanced behavior management techniques including sedation and general anesthesia [51, 52]. Also, a dental office filled with unpleasant smells, sounds, and colors can be an overstimulating environment for patients with autism [53].
To minimize anxiety and uncooperative behavior pattern, soothing light, rhythmic music with or without headphones, and having minimal visual stimuli on the walls should be considered. It may also be beneficial to improve cooperation by having the same dental professional in the same operating room at all sessions [54].
If traumatic ulcers or lesions are observed on oral mucosa or gingiva, a mouth guard may be prescribed for patients who have problems with self-injurious behavior or bruxism.
The term intellectual disability (ID) is generally used to describe mental retardation. The most widely used current definition of disability is the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF), which incorporates the complex interactions between health conditions, environmental factors, and personal factors. Regarding a person with an ID, this definition would consider how their factors, health condition, and environment affect their lives (WHO 2001). Three elements are common for people with ID:
Significant impairment of intelligence,
A resultant significant reduction in adaptive behavior/social functioning and
The development of the condition (which persists throughout life) before the age of 18 years.
Mental retardation is a developmental disorder that occurs before the age of 18. In addition to having significant retardation in normal functions, there is an inadequacy in the adaptive skills necessary to maintain daily life. Adaptive skills cover skill areas such as self-care skills such as feeding, dressing, bathing, home life skills such as housekeeping, speaking and understanding language, as well as communication skills, social skills, social usefulness, and professional skills [55].
Intellectual disability may be caused by a problem that starts any time before a child turns 18 years old—even before birth. It can be caused by injury, disease, or a problem in the brain. For many children, the cause of their intellectual disability is not known. Some of the most common known causes of intellectual disability—such as Down syndrome, fetal alcohol syndrome, fragile X syndrome, genetic conditions, birth defects, and infections—occur before birth. Others occur during or soon after birth. Besides, other reasons for intellectual disability do not occur until a child is older; these include serious head injury, stroke, or certain infections [56].
Patients with intellectual disability associated with a syndrome may present typical facial appearance; e.g., in these individuals, the tongue is placed in a protruding position due to macroglossia with micrognathia. Malocclusion, enamel defects, short conical roots, delayed eruption of teeth, congenital tooth agenesis, and tooth malformation are other common intraoral findings [57]. Due to certain genetic conditions or a history of high fever, children with disabilities may have their enamel defects or malformation and thus be more prone to dental caries.
These individuals also have inadequate lip closure, impaired tongue movement, and destabilization of the chewing muscles [55]. Salivary flow rate alterations due to the use of multiple medications along with poor oral hygiene may increase dental plaque and calculus formation, which may lead to dental and periodontal disease and halitosis.
Due to early loss of teeth, speech disorders may also be observed in these individuals [58]. Individuals with intellectual disabilities often consume a cariogenic and soft diet. Besides, individuals consuming daily medicine in the form of syrup constantly have a high risk of caries due to the high sugar content.
It has been shown that individuals with MR (mental retardation) aged 4–18 present significantly higher mean DMFT and dental erosion scores than healthy individuals [59].
Individuals with severe intellectual disability present impaired oral motor functions and weakened muscles, which cause chewing and swallowing problems. These patients often consume a soft diet including puree or semi-solid foods. In addition, individuals with an intellectual disability usually need the help of their caregivers to consume liquids and do not benefit enough from the washing and cleansing effect of liquids because they consume less liquid than healthy individuals. Oral hygiene procedures such as tooth brushing, which require manual dexterity, may not be performed adequately due to varying degrees of motor dysfunction as well as cognitive deficiencies in mentally retarded individuals [55].
Medical history is quite essential to assess the degree and type of ID and associated medical problems [60]. Complete information should be obtained from the parents/caregivers about the medical background, the medicine consumption, the level of communication of the child, the daily functions she/he can perform individually, and if there are behavior problems at home/institution [61].
It may be helpful to familiarize patients and/or caregivers with the clinical environment without any treatment at the first appointment. Dental office and instruments should be introduced patiently, and the tell-show-do method may be also introduced.
In the next session, the dental instruments that may cause anxiety are introduced, and then treatment may start. It is essential to keep the sessions short. The treatment session should begin with the easy-to-tolerate procedures and no pain stimulus should be created during the first procedure.
Behavior management with positive direction and distraction with movies or music may be applied. Perception difficulties are observed in patients with MR. In these patients, directions and explanations should be short and simple and the instructions should be repeated. General anesthesia or sedation should be considered in patients who do not comply and cannot cooperate [55].
Visual impairment was defined as visual acuity less than 20/40 in the better eye. Hearing impairment was defined as the pure-tone average air-conduction hearing threshold worse than 25-dB hearing level (dB HL) in the better ear, averaged over four frequencies: 500, 1000, 2000, and 4000 Hz. [62] Hearing loss can be mild, moderate, moderate, severe, or profound and can affect one or both ears.
Major causes of hearing loss include congenital or early-onset childhood hearing loss due to various chronic middle ear infections, noise-induced hearing loss, age-related hearing loss, and ototoxic drugs that damage the inner ear [62]. Hereditary hearing loss can be conductive, sensorineural, or mixed and is sometimes the result of a genetic trait passed down from a parent.
Children with hearing loss experience social isolation, loneliness, and frustration, and delayed language development due to the loss of ability to communicate with others [62].
Visual impairment is usually defined as a best-corrected visual acuity worse than 20/40 or 20/60 [63]. Visual impairment, or vision loss, is a degree of reduced vision that causes problems that cannot be corrected by general methods, such as with glasses [64]. The term blindness is used for complete or near-complete loss of vision. Physical injury risks such as falling, hitting, and traumatic injuries are reported higher in visually impaired children. Besides, their conceptual development and cognitive skills may be delayed, and they have challenges especially in skills that require abstract thinking [65].
The most common causes of visual impairment are globally uncorrected refractive error (43%), cataracts (33%), and glaucoma (2%). Refractive errors include myopia, hypermetropia, presbyopia, and astigmatism. Cataracts are the most common cause of blindness [66]. Other disorders that may cause visual problems include age-related macular degeneration, diabetic retinopathy, corneal clouding, childhood blindness, and several infections [67]. Visual impairment can also be caused by problems in the brain due to stroke, premature birth, or trauma, among others [68].
Visual impairment may have a negative impact on an individual’s oral hygiene. As a result of the inability to remove the microbial dental plaque appropriately, visually impaired individuals experience more dental caries, calculus, and gingivitis compared with healthy individuals [69]. Reluctance to consume solid foods due to prolonged infantile swallowing patterns and poor oral hygiene may be the main reason for the oral health problems. Besides, enamel hypomineralization has been identified as a possible oral manifestation in visually impaired children.
Visually impaired children are more prone to traumatic dental injuries, especially in the anterior teeth is also a predisposing factor. Visually impaired people generally require a high level of orthodontic treatment due to the increasing prevalence and severity of malocclusions [70].
Hard tissue anomalies such as enamel hypoplasia and higher rates of demineralization in the teeth are seen in patients with hearing impairment. Also, a high incidence of bruxism is one of the problems that occur especially when the individual has both hearing loss and visual impairment [71].
Due to the difficulties of providing oral hygiene, diet type, and problems of accessibility to the routine dental check-ups, dental caries are quite often seen in patients with hearing impairment [72]. The prevalence of gingivitis is also higher in these individuals due to poor oral hygiene and mouth breathing, and they are more prone to develop periodontitis early in life [73, 74].
Visually impaired individuals experience difficulties maintaining oral hygiene since they cannot visualize plaque on the tooth surface and adequately assess whether dental plaque is removed effectively. This leads to the progression of dental caries and also to oral inflammatory diseases [74].
Compared with healthy children, individuals with hearing impairment may have a higher risk of experiencing oral diseases, including dental caries or periodontal disease, as they have difficulties maintaining good oral hygiene [75].
Individuals with hearing impairment should be informed about the procedures to be performed at the first appointment, and an individual method should be developed for the communication during treatment sessions.
The degree of hearing loss should be noted in the patient’s medical history. In the first appointment, it is necessary to avoid exaggerated facial movements and mimics when communicating with the patient, not to cause difficulty to read lips. Comforting the child patient and increasing the sense of trust by smiling will help to establish confidence and healthy communication with the dental professional.
Before starting the dental treatment session, the instruments should be introduced using the show-tell-do method. If the hearing-impaired patient feels that she/he is unable to understand directions, she/he may show fear or aggression. For this reason, communication should be facilitated by reducing external sounds such as high-speed air turbines, dental aspirator, and radio or TV as much as possible. Mirrors, models, pictures, and written information should be used to establish communication [71].
In visually impaired individuals, treatment should be explained using the senses of touch, taste, and smell instead of the tell-show-do technique. The environment should be introduced, and necessary definitions should be made before each treatment. The dental professional should speak to the patient in a clear, warm tone of voice and should use a descriptive manner to explain the procedures. Also, patients should be informed about how the equipment may feel and sound and how the procedures will be performed before the instruments are inserted into the mouth.
The dental restorative materials should be placed in small pieces as the sharp taste may irritate the patient. Since such patients cannot see and remove dental plaque, tooth brushing should be explained by the dentist by holding the brush together with the patient. Oral hygiene education and motivation should be given by the doctor to whom he is accustomed to the treatment of the patient [70, 75].
Special healthcare need patients are literally special patients who need special attention by means of healthcare provision including dental care. The major challenges they have with their overall health may create barriers to access to proper oral healthcare. Oral healthcare for this special group is often neglected or down the list, and as a result, they often attend to dental clinics with emergency.
Individuals with special needs are the most underserved regarding healthcare needs in almost all populations. Due to the challenges of nutrition and insufficient oral hygiene provision, this population is usually more prone to dental caries, periodontal disease, and orthodontic problems. Besides, they face more difficulties accessing professional dental care than other segments of the population.
The field of special care dentistry is attracting more interest of pediatric dentists and general dental practitioners. The inclusion of the specialty programs in the dentistry faculty curriculum may initiate the ideal treatment procedures and regular recalls of these special patients, which may facilitate the access to sufficient dental care provision and regular check-ups for this special group.
Though many countries developed community-based systems to improve oral health for people with special needs, providing good oral health mainly depends on the effort of the families. Therefore the education of the caregiver about oral hygiene provision is also critical for the special needs patient to enjoy a lifetime of oral health the same as other members of the society.
The author declares no conflict of interest.
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Here we focus on the role of key pro-inflammatory and anti-inflammatory cytokines. Several experimental interventions have been found to modulate cytokine production and brain injury after AIS or TBI. Here minocycline, biological response modifiers, hormonal therapies, omega-3 fatty acids, N-acetylcysteine, and cannabinoids will be discussed. In addition, the role of cytokine-induced inflammasomes in both TBI and AIS will be addressed and followed by discussion of pro-inflammatory cytokines (e.g., TNF-α, IL-1β, IL-18, and IFN-γ). Finally, the main anti-inflammatory cytokines, IL-33, IL-10, IL-6, and IL-4, will be discussed in the context of both TBI and AIS. 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In particular, Alzheimer's disease (AD) models have been designed to test the hypothesis that certain lesions are associated with functional and morphological changes beginning with memory loss and impairment in activities of daily life. This review compares and evaluates the phenotypes of different AD animal models, on the basis of the specific objectives of each study, with the purpose of encompassing their contributions to the comprehension of the AD signs and symptoms in humans. All these models contribute to the comprehension of the human AD mechanisms regarding the heterogeneity of AD phenotypes: the overlap between AD and age‐related changes, the variability of AD onset (early or late), the probable reactiveness of amyloid‐β and tau proteins, the scarcity of senile plaques and/or neurofibrillary tangles in some AD cases, the spatial correlation of the pathology and cerebral blood vessels, and the immunological responses (microglial aging) and synaptopathy. 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Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. 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Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"38",title:"Pollution",coverUrl:"https://cdn.intechopen.com/series_topics/covers/38.jpg",isOpenForSubmission:!0,editor:{id:"110740",title:"Dr.",name:"Ismail M.M.",middleName:null,surname:"Rahman",slug:"ismail-m.m.-rahman",fullName:"Ismail M.M. Rahman",profilePictureURL:"https://mts.intechopen.com/storage/users/110740/images/2319_n.jpg",biography:"Ismail Md. Mofizur Rahman (Ismail M. M. Rahman) assumed his current responsibilities as an Associate Professor at the Institute of Environmental Radioactivity, Fukushima University, Japan, in Oct 2015. He also has an honorary appointment to serve as a Collaborative Professor at Kanazawa University, Japan, from Mar 2015 to the present. \nFormerly, Dr. Rahman was a faculty member of the University of Chittagong, Bangladesh, affiliated with the Department of Chemistry (Oct 2002 to Mar 2012) and the Department of Applied Chemistry and Chemical Engineering (Mar 2012 to Sep 2015). Dr. Rahman was also adjunctly attached with Kanazawa University, Japan (Visiting Research Professor, Dec 2014 to Mar 2015; JSPS Postdoctoral Research Fellow, Apr 2012 to Mar 2014), and Tokyo Institute of Technology, Japan (TokyoTech-UNESCO Research Fellow, Oct 2004–Sep 2005). \nHe received his Ph.D. degree in Environmental Analytical Chemistry from Kanazawa University, Japan (2011). He also achieved a Diploma in Environment from the Tokyo Institute of Technology, Japan (2005). 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is a Professor of Statistics and Dean of the School of Mathematics and Statistics, Yunnan University, China. He was elected a Yangtze River Scholars Distinguished Professor in 2013, a member of the International Statistical Institute (ISI) in 2016, a member of the board of the International Chinese Statistical Association (ICSA) in 2018, and a fellow of the Institute of Mathematical Statistics (IMS) in 2021. He received the ICSA Outstanding Service Award in 2018 and the National Science Foundation for Distinguished Young Scholars of China in 2012. He serves as a member of the editorial board of Statistics and Its Interface and Journal of Systems Science and Complexity. He is also a field editor for Communications in Mathematics and Statistics. His research interests include biostatistics, empirical likelihood, missing data analysis, variable selection, high-dimensional data analysis, Bayesian statistics, and data science. He has published more than 190 research papers and authored five books.",institutionString:"Yunnan University",institution:{name:"Yunnan University",country:{name:"China"}}},{id:"1177",title:"Prof.",name:"António",middleName:"J. R.",surname:"José Ribeiro Neves",slug:"antonio-jose-ribeiro-neves",fullName:"António José Ribeiro Neves",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1177/images/system/1177.jpg",biography:"Prof. António J. R. Neves received a Ph.D. in Electrical Engineering from the University of Aveiro, Portugal, in 2007. Since 2002, he has been a researcher at the Institute of Electronics and Informatics Engineering of Aveiro. Since 2007, he has been an assistant professor in the Department of Electronics, Telecommunications, and Informatics, University of Aveiro. He is the director of the undergraduate course on Electrical and Computers Engineering and the vice-director of the master’s degree in Electronics and Telecommunications Engineering. He is an IEEE Senior Member and a member of several other research organizations worldwide. His main research interests are computer vision, intelligent systems, robotics, and image and video processing. He has participated in or coordinated several research projects and received more than thirty-five awards. He has 161 publications to his credit, including books, book chapters, journal articles, and conference papers. He has vast experience as a reviewer of several journals and conferences. As a professor, Dr. Neves has supervised several Ph.D. and master’s students and was involved in more than twenty-five different courses.",institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"11317",title:"Dr.",name:"Francisco",middleName:null,surname:"Javier Gallegos-Funes",slug:"francisco-javier-gallegos-funes",fullName:"Francisco Javier Gallegos-Funes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/11317/images/system/11317.png",biography:"Francisco J. Gallegos-Funes received his Ph.D. in Communications and Electronics from the Instituto Politécnico Nacional de México (National Polytechnic Institute of Mexico) in 2003. He is currently an associate professor in the Escuela Superior de Ingeniería Mecánica y Eléctrica (Mechanical and Electrical Engineering Higher School) at the same institute. His areas of scientific interest are signal and image processing, filtering, steganography, segmentation, pattern recognition, biomedical signal processing, sensors, and real-time applications.",institutionString:"Instituto Politécnico Nacional",institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"428449",title:"Dr.",name:"Ronaldo",middleName:null,surname:"Ferreira",slug:"ronaldo-ferreira",fullName:"Ronaldo Ferreira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428449/images/21449_n.png",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. 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