\r\n\tFrom practice to a mathematical and technological application, scheduling has become another form of art: an algorithmic art, declined in as many OS and hardware constraints, from embedded systems onboard an aircraft or a spacecraft to databases in all financial and Internet servers. \r\n\tThey have become ubiquitous so that a large part of our civilisational development is supported by their reliability, redundancy, and optimisation capacity. Like all of our civilisational assets, they are benefiting from scientific breakthrough in computational sciences such as evolutionary algorithms, Artificial Intelligence, and quantum computing. If not by using it, by being in need of adapting to the next generation of computing. Space development is also bringing new challenges, especially in redundancy and reliability.
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\n\t\t\t
1. Introduction
\n\t\t\t
Energy medicine (EM) is medicine based on physics instead of biochemistry. Energy medicine works with subtle forms of energy known as chi or prana that exist in and around the human body. EM treats with the understanding that all illness results from disturbances in this energy known as the human biofield. Physics does not override biochemistry, it drives it. Biology and chemistry behave according to the laws of physics. Physics is the study of energy. The human body is made of energy. It has structure (bones), plumbing (digestive tract), and electricity (nervous systems), all infused with energy. Energy is a property of all matter, therefore cells, molecules, and atoms are all made of energy. Science has begun to measure the subtle but important energy field around the human body and research is showing that when the natural flow of energy is obstructed, disordered, and depleted, the body becomes diseased [1]. Pharmaceuticals affect chemical signals in the body but EM affects electromagnetic signals in the body. EM heals using an integrated system that supervises the interaction of all the body’s systems and is not only faster, but more efficient. A continuous, uninterrupted flow of energy through the biofield plays the main role in health and healing.
\n\t\t\t
In 1989 the term energy medicine was coined by the International Society for the Study of Subtle Energy and Energy Medicine which studies the science of medical and therapeutic applications of subtle energies. Energy medicine came under government guidelines in 1992 when the National Institutes of Health (NIH) established the National Center for Complementary and Alternative Medicine [2]. According to the NIH, energy medicine is defined as a form of complementary and alternative medicine which has two distinct categories:
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\n\t\t\t\tVeritable energy medicine, which uses mechanical vibration (sound) and electromagnetic radiation (light) in order to affect health and healing. Veritable EM involves the use of specific, measurable wavelengths and frequencies to treat patients. Many of the human body electrical systems and electromagnetic fields are well known, and veritable forms of EM are being used in well established models for patients in today’s medicine. Examples of veritable forms of EM are the use of lasers and magnetic pulses which have been found to be therapeutic. Commonly used forms of veritable EM such as electrocardiogram (EKG), electroencephalogram (EEG), Computerized Tomography (CT or CAT) Scan, Magnetic Resonance Imaging (MRI) and ultrasound equipment are currently being used in traditional medical applications.
\n\t\t\t
For many years it was thought that electromagnetic field (EMF) exposure would cause only harmful effects in the body, but it is now understood that the amount of energy (field strength or amplitude), and the frequency of the field is what determines whether it is harmful, therapeutic or benign [3]. In particular, ionizing radiation has been shown to cause harmful effects by breaking the electron bonds that hold molecules like DNA together[4, 5]. Ionizing radiation includes alternating current (AC) that is produced by power lines, electrical wiring, and electrical equipment. Some epidemiological studies have suggested there is an increased risk of cancer associated with magnetic field exposure near electrical power lines [3, 6, 7]. The energy in non-ionizing radiation, however, is not strong enough to break ion bonds in atoms and molecules [8, 9]. Depending on the frequency and amplitude, the beneficial effect of non-ionizing EMF has been reported to affect natural killer cells fighting cancer and viruses [10-16], traumatic brain injury, post-operative infections, as well as bacterial and viral related inflammatory responses that are major complications in today’s medicine [17-19]. Extra low frequency electromagnetic field (ELF-EMF) in the 50 Hz range has been reported to prohibit bacterial growth and improve immune response against bacterial infection [20].
\n\t\t\t
Veritable EM treatments also include pulsed electromagnetic field (PEMF) therapy. A Pulsed Electromagnetic Field device has been approved by the US Food and Drug Administration (FDA) for bone repair, although it remains widely unused due to physician misunderstanding and lack of knowledge concerning the treatment [21]. PEMF therapeutic devices can be applied in two different ways - either by capacitive or inductive coupling. In capacitive coupling there is no contact with the body, whereas direct coupling requires the placement of opposing electrodes in direct contact with the surface of the skin of the targeted tissue [22]. Inductive coupling does not require electrodes to be in direct contact with the skin because it produces a field (see Faraday’s Law of Induction) that emanates in all directions. Research shows that therapeutic applications of PEMF at extra low frequency (ELF) levels (3-300 Hz) are beneficial to the immune system by suppressing inflammatory responses at the cell membrane level [23]. PEMF can pass through the skin and into the body’s conductive tissue [24-26], resulting in reduced pain and the onset of edema shortly after trauma. Where edema is already present, treatment exhibits significant anti-inflammatory effects [27]. In a study of the effect of PEMF therapy on arthritis, three hours of exposure to a 50-Hz magnetic field revealed that experimentally-induced inflammation in rats was significantly inhibited as a result [28]. Strong beneficial effects have also occurred using 75 Hz frequency MF treatment in patients suffering from fractures of the ankle joints [29]. PEMF treatments also promote cell activation and endothelial cell proliferation through the cell membrane. ELF levels can increase the rate of formation of epithelial cells in partially healed wounds [30] and also quicken the healing time of skin wounds [31]. Fields at 15 Hz were used to significantly accelerate wound healing in diabetic mice [32]. Skin wounds have electrical potentials that can be stimulated by ELF-EMF to aid in the healing process by dedifferentiating cells near the wound, thereby accelerating cell proliferation [23]. In a study examining the effects of whole body magnetic fields (50-165 Hz) on patients suffering from different forms of cancer, results showed the MF therapy had overall beneficial effects, particularly with respect to improved immune status and postoperative recovery [33]. Treatment consisted of 15 cycles, each 1-20 minutes in duration coupled with more traditional cancer therapies. PEMF has also been reported to reduce pain and inflammation after traumatic brain injury [34], decrease osteoarthritic inflammation [35], and reduce neuropathic pain [36], as well as control the growth of lymphocytes [37].
\n\t\t\t
EMF treatments appear to improve certain psychological conditions as well. A study of twelve patients with posttraumatic stress disorder (PTSD) and major depression underwent PEMF treatment of either 1 Hz or 5 Hz as an adjunct to antidepressant medications. Seventy-five percent of the patients had a clinically significant antidepressant response after treatment, and 50 percent had sustained that response at 2-month follow-up as compared with controls. Comparable improvements were seen in anxiety, hostility, and insomnia [38]. Low-frequency PEMF therapy at 0.1 – 64 Hz has been shown to improve mobility function, pain, and fatigue in fibromyalgia patients [39] as well. It has been firmly established that tissues such as blood, muscle, ligaments, bone and cartilage respond to biophysical input, including electrical and electromagnetic fields. Research shows that certain field strengths and frequencies of PEMF appear to be disease-modifying [Table 1].
Postoperative pain was significantly reduced for a decrease in the need for analgesic resolve
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Table 1.
Veritable EM therapies applied to various conditions. * B=magnetic field; G=Gauss; T=Tesla; Hz=Hertz; 1 mT=10 Gauss
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\n\t\t\t\tHow do veritable EMF therapies work?\n\t\t\t
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The mechanism for action of EMF on cells and tissues is based on how cells can detect and generate electromagnetic fields in general. Biological systems such as cells communicate not only with each other but also interact with their environment [61, 62]. This is done through several mechanisms at many levels depending on the type of cell tissue and nature of the information being communicated. Most known mechanisms in the literature address cell-cell interaction as chemical or electrical signaling, but intercellular interaction can also be attributed to electromagnetic fields (EMFs) [63]. Burr et al published a report on stable voltage gradients in various biological systems back in 1935 [64]. Since then researchers have discovered that these stable gradients can be altered when the whole organism undergoes biological processes such as growth, localized injury and microbial invasion. Because EMFs radiate, they behave in a wave-like manner (Figure 1).
\n\t\t\t
Figure 1.
\n\t\t\t
The biological effects of low-frequency magnetic fields have been the subject of extensive studies since they can penetrate deep into tissues [65-72]. It has been shown that low-frequency EMF can act at the cellular level affecting various cell functions, including cell proliferation and differentiation [73-76], apoptosis [77-79], DNA synthesis [80, 81], RNA transcription [82], protein expression [83], protein phosphorylation [84], re-dox mediated rises in NFkB and cell damage [85, 86], microvesicle motility [87], ATP synthesis [88], hormone production [89], antioxidant enzyme activity [90], metabolic activity [91], and the inhibition of adherence [92]. It has been proposed that the initial interaction occurs outside the plasma membrane, but could also involve interactions with transmembrane proteins [93, 94]. For example, NIH3T3 cells exposed to a 50 Hz PEMF for over 2 h significantly increased the clustering of intermembrane proteins compared with controls [95]. Investigators concluded that the signal was likely being propagated and amplified through the intracellular signal transduction pathways [96]. An example of this is when the calcium stored in the intracellular compartment prompting mitochondria to produce free radicals (which increase DNA response) [97] can be controlled by PEMF[98], providing a first order effect in preventing the onset of inflammatory responses. The impact of EMF on calcium channel protein has been reported many times [99-102]. The genes that encode ion channels are important because they produce the gradients that determine downstream cell behavior. Future advances in this work will fully integrate bioelectric cascades. Increased understanding of how these mechanisms work will lead directly to devices that stimulate cell treatment directly to the damaged region producing the bioelectromagnetic changes needed to repair and regenerate tissues.
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\n\t\t\t\tEffect of EMF on cytokine production\n\t\t\t
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It is now well established that exogenous applied EMFs affect cell signaling and cytokine production. PEMF treatment appears to be disease-modifying in a model studying osteoarthritis [103]. Since transforming growth factor beta (TGF-β) is understood to upregulate gene expression for aggrecan (a cartilage-specific core protein), downregulate matrix metalloprotease and IL-1 activity, and upregulate inhibitors of matrix metalloprotease, the stimulation of TGF-β could be considered a mechanism by which PEMF favorably affects cartilage homeostasis.
\n\t\t\t
Application of PEMF does not appear to alter the cell immunophenotype of fibroblast-like cell populations, but does appear to decrease the production of inflammatory cytokines IL-1β and TNF-α. PEMF also appears to increase anti-inflammatory cytokine IL-10 [104]. Both IL-1 and TNF-α concentration in the synovial fluid were significantly lowered while TGF-β was significantly higher compared with controls. Large bone formation was also observed one month after osteochondral graft implantation using PEMF treated grafts which favor early graft stabilation [105]. PEMF exposure at 75 Hz, 45 mT limited bone resorption in the subchondral bone while cytokine assessment in the synovial fluid indicated a more favorable articular environment for the graft.
\n\t\t\t
\n\t\t\t\tEMF and Inflammation\n\t\t\t
\n\t\t\t
EMF has many well documented physiological effects on cells and tissues including anti-inflammatory effects. MF therapies can provide noninvasive, safe and easy to apply methods to directly treat the source of pain, injury, inflammation and dysfunction [106]. Low-frequency EMF has a long term record of safety, backed by tissue culture, animal and clinical studies which have been conducted for over two decades [107]. Although the exact mechanism of anti-inflammatory effect is unclear, the cell membrane is most often considered the main target for EMF signals [106]. It has been reported that EMF affects membrane mediated signal transduction processes, especially the Ca2+ transport system [108]. Early events in signal transduction play a critical role in calcium influx in the lymphocyte. Because calcium is an important second messenger for a wide variety of important cellular processes such as RNA, DNA and protein synthesis; modulation of calcium signaling by electromagnetic fields has the potential to influence these cell functions [108]. Studies have demonstrated that EMF can stabilize the cell membrane by restoring membrane protein activity (Ca2+ -ATPase) and maintain intracellular Ca2+ levels [109, 110]. Biological systems in transition have been shown to be more sensitive to EMF exposure than in stationary systems. In one study immune compromised animals constituting systems in transition state were shown to be more sensitive to EMF exposure; whereas healthy animals, considered to be in relatively stable systems, exhibiting no sensitivity to the same field parameters [111]. Low-frequency, low-intensity EMF was reported to be beneficial in reducing inflammation without potential side effects indicating its value as a viable alternative for treating inflammatory responses. In living systems, from planarian flatworms to humans, mechanisms involved strongly suggest that therapeutic EMF applications stop inflammation first, then initiate healing [98].
\n\t\t
\n\t\t
\n\t\t\t
2. Veritable EM Devices
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\n\t\t\t\tPEMF Knee Device\n\t\t\t
\n\t\t\t
The PEMF knee device is an FDA-approved device consisting of a cuff that surrounds the knee. It has a coil and heating pads that send magnetic pulses and heat through injured tissue. This device combines PEMF energy and thermal therapy to increase circulation, reduce swelling, relieve chronic pain and arthritis, as well as improve range of motion. It has been reported to benefit patients with osteoarthritis [112].
Transcutaneous electrical nerve stimulation (TENS) uses electric current to stimulate nerves to induce therapeutic treatment. These devices are usually connected to the skin using electrodes. A typical TENS device is able to modulate pulse width, frequency, and intensity of the electrical field it uses. TENS applied at frequencies above 50 Hz uses intensity below motor contraction (sensory intensity). TENS applied at frequencies below 10 Hz, use an intensity that produces motor contractions [113]. Studies show that TENS stimulates nerves in order to reduce both acute and chronic pain [114, 115].
\n\t\t\t
\n\t\t\t\tPEMF Mats\n\t\t\t
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PEMF mats produce a therapeutic pulsed electromagnetic field (PEMF) that surrounds the entire body. PEMF whole-body mats are promoted in many countries for a wide range of therapeutic applications. Randomized, sham-controlled, double-blind trials focusing on osteoarthritis of the knee (3 trials) or the cervical spine (1 trial), fibromyalgia (1 trial), pain perception (2 trials), skin ulcer healing (1 trial), multiple sclerosis-related fatigue (2 trials), or heart rate variability and well-being (1 trial) have been performed, with outcomes varying between improvement and ineffective [116]. PEMF mats are primarily advertised and distributed over the internet, and are often used without medical supervision. More research is needed to repeat outcomes. As of 2012 they have not been approved by the US Food and Drug Administration (FDA).
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The second type of energy medicine is known as putative energy medicine.
\n\t\t\t
\n\t\t\t\tPutative energy medicine is based on the idea that human beings are able to influence subtle forms of energy with their hands, intentions, or meditation. By focusing on these subtle energies, EM practitioners are able to feel vibrational frequencies with their hands and align the biofield through healing treatments [117]. Putative energy medicine is an all-inclusive term used for practices that include, but are not limited to Acupuncture, Alexander Technique, Bowen Technique, Chakra Balancing, Craniosacral Therapy, Eden Energy Medicine, Energy Psychology, Feldenkrais, Healing Touch (HT), Nambudripad\'s Allergy Elimination Techniques (NAET), Polarity Therapy (PT), Reiki, Rolfing, Therapeutic Touch (TT), Traditional Chinese Medicine (TCM), Trager Approach and yoga.
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Putative EM is based on the understanding that a therapist instead of a device is able to facilitate healing by balancing disturbances in a patients’ energy field. Practitioners are able to generate sub extremely low frequency (sub ELF) fields (0.3-30 Hz) from their hands through meditation and intention [118, 119]. This subtle energy entrains the biofield of the patient and initiates a healing effect. Instruction on body movement is also used to shift energy imbalances. Treatments are carried out in an integrative and holistic manner. The concept of holism in medicine dates back to 460 B.C. with Hippocrates, the father of medicine, positing the idea that every aspect of our body and mind are interrelated to every other aspect of our being [120]. Manipulation of the holistic field allows for healing throughout the entire being – body, mind and spirit.
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\n\t\t\t\tHow Putative EM Techniques work\n\t\t\t
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The hands of EM practitioners produce coherent electromagnetic fields that affect the human biofield in many ways. A measuring device called the Superconducting Quantum Interference Device (SQUID) is a magnetometer used to detect very weak biomagnetic fields. SQUID has detected frequencies coming from the hands of practitioners in the sub extra low frequency electromagnetic field (sub ELF-EMF) range of 0.3 to 30 Hz [121]. The signal emitted by a practitioner is not steady or constant, but moves through the range of sub ELF-EMFs with an average range around 7 – 8 Hz. EM techniques are capable of producing healing results because they directly affect mechanical vibrations in the membrane and the cytoskeleton of human cells as well as the biofield in general. Many research studies have detected the frequency limit of cell oscillations to be only 30 Hz [122-126], which is the same frequency range coming from the hands of EM practitioners. This suggests a subtle resonance involved in the healing process. An interesting characteristic of energy emission from any living organism is that it stays somewhat organized in its fields. It has a tendency to remain stable and does not randomly dissipate [127]. Biofield vibrations are like tuning forks, acting as both transmitters and receivers of vibration coming from their environment. They resonate at specific harmonic pitches when we are healthy. When we are not healthy a non-coherent type noise vibrates from our cells and our biofield. Valerie Hunt, PhD, Professor Emeritus in the UCLA Department of Physiological Sciences has been conducting research in this field for over 40 years. She was the first to research the relationship between changes in bioenergy fields and human health. In mapping bioenergy fields, Hunt has found that each individual has a unique resting pattern she calls the Signature Field. “The Signature Field of a healthy human being is composed of balanced, coherent energy patterns running the full spectrum of frequencies (4 – 20 microns in wavelength [128]). This coherency shows up on a graph as smooth, gentle, shallow waves evenly distributed throughout the frequency spectrum”. There are two types of patterns in the Signature Fields of people who have (or are soon going to develop) disease: deficiency patterns, and hyperactive patterns. They appear in graphs as thick, jagged waves concentrated in the high- or low-frequency bands (Figure 2).
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Figure 2.
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Deficiency diseases like cancer and chronic fatigue syndrome have what Hunt calls “anti-coherent” patterns in the high frequency ranges, with almost no energy at all in the lower frequencies. Hyperactive conditions like colitis, hypertension, and skin problems show anti-coherent patterns in the low frequencies, with absent vibrations in the high frequencies [129]. The sub ELF-EMF frequency emitted from the hands of EM practitioners is capable of retraining the incoherent frequencies back to a healthy state. Gentle changes in body movement exhibited in EM therapies such as Alexander Technique, Feldenkrais and yoga retrain the cells and biofield back to a healthy vibrational state as well. The application of energy medicine, whether from a medical device or from the hands of a practitioner, is a viable alternative or complement to conventional medicine. Free flowing energy throughout the body eliminates physical health problems attributed to pain, disease and structural dysfunction [130]. EM significantly increases energy levels even if no specific problem exists [131]. It is used as both a preventative as well as a healing treatment.
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\n\t\t\t\tEnergy Medicine Therapies\n\t\t\t
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More people are turning to energy medicine because of its holistic approach that includes not just the physiological, but mental, emotional and spiritual aspects of disease. Being diagnosed with a life threatening illness is very emotionally and psychologically disruptive; EM helps the patient find solace despite challenge. It also eases or counteracts the side effects of conventional therapies [131]. When it comes to selecting an EM therapy there are a variety of options. The following EM treatments are substantiated by peer reviewed published research:
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\n\t\t\t\tAcupuncture uses meridians of Eastern medicine traditions which form a continuous, semiconducting network. This Chinese medical procedure uses the stimulation of specific points on the body where the insertion of needles through the skin removes blockages in the flow of chi through the body’s meridians to reinstate health. Acupuncture needles are metallic, solid, and hair-thin. Experienced differently, most people feel little or minimal pain while the needles are inserted. Some feel energized by treatment, others feel relaxed. Acupuncture has been shown to improve treatment related pain in cancer patients [132], pain management for women in labor [133], treatment of temporomandibular (TMJ) disorders [134], treat infertility, improve symptoms of menopause [135], improve insomnia [136], and improve chances of successful in vitro fertilization [137]. Relatively few complications have been reported from the use of acupuncture; however, acupuncture can cause potentially serious side effects if not delivered properly by a qualified practitioner. Make sure the practitioner is a certified Licensed Acupuncturist (L.Ac.).
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\n\t\t\t\tAlexander Technique improves physical postural habits, particularly those that have become ingrained or are conditioned responses. The technique has been purported to improve athletic performance, self observation and impulse control, as well as relieve chronic stiffness, tension and stress. It changes movement habits in everyday activities, improving ease and freedom of movement, balance, support and coordination, teaching the use of appropriate amount of effort for a particular activity, increasing energy. It is not a series of treatments or exercises, but rather a reeducation of the mind and body. It can be applied to sitting, lying down, standing, walking, lifting, and other daily activities. Strong evidence exists for the effectiveness of Alexander Technique lessons for chronic back pain and moderate evidence in Parkinson\'s-associated disability [138].
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\n\t\t\t\tBowen is a gentle technique involving a series of moves held for several seconds and then released. The therapist gently pulls the skin on the back of the neck, knees, or affected body part away from the muscle or tendon beneath it and applies light pressure following a specific pattern. Bowen relieves both physical and psychosocial problems, including pain, sports injuries [139], shoulder problems [140], postpartum symptoms [141], fatigue, anger and depression [142].
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\n\t\t\t\tChakra balancing based on the seven energy centers along the center of the human body starting from the base of the spine to the top of the head. Chakras are responsible for keeping vital energy flowing through the biofield. They create openings for life energy to flow into and out of the aura. Their function is to vitalize the physical body and to bring about the development of our self-consciousness. They are associated with physical, mental and emotional interactions. An energy worker trained in chakra balancing will determine which chakras are functioning poorly and which chakras are over stressed in order to keep the body’s energy balanced. When one or two chakras are performing at a reduced level, the remaining chakras have to work harder. Having a non-functioning or closed chakra can cause another chakra to blow, creating havoc in the biofield [143]. Blown chakras cause pain and initiate disease. Chakra balancing reprograms the chakra system to flow as nature intended.
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\n\t\t\t\tCraniosacral therapy (CST) is a manipulation technique involving light touch to the cranium (skull) and sacrum (tailbone). It is based on the theory that the movement of bones within the skull and the lower back, as well as the rhythmic flow of cerebrospinal fluid (in and around the spinal cord), play a central role in the body’s overall function. Obstruction of this flow of spinal fluid contributes to problems in the brain, spine and endocrine system. Research shows statistically significant improvements in the treatment of migraine headache using CST [144].
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\n\t\t\t\tEden Energy Medicine activates the body’s natural healing ability by restoring weak or disturbed energy. Eden EM utilizes techniques from acupuncture, yoga, kinesiology, and qi gong. Energy is brought back into balance by tapping, massaging, pinching, twisting, or connecting specific energy points (acupoints) on the skin; by tracing or swirling the hand over the skin along specific energy pathways; through exercises or postures designed for specific energetic effects; by focused use of the mind to move specific energies; and/or by surrounding an area with healing energies. There is qualitative evidence that Eden EM relieves pain; stimulates immune function, relieves headaches, releases stress, improves memory, enhances digestion, relieve arthritis, neck, shoulder, and low back pain [145].
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\n\t\t\t\tEnergy Psychology (EP) addresses the relationship of energy systems to emotion, cognitive behavior and health [146]. Energy psychology uses imagery, narrative, and hyperarousal associated with traumatic memory or threatening situations to resolve traumatic memory [147]. When the brain reprocesses traumatic memory, the new association is retained by reducing it to hyperarousal. This leads to treatment outcomes that involve less time with fewer repetitions and higher impact. These techniques show less chance of retraumatization [147]. During EP treatments, mental/emotional/spiritual problems are healed through the biofield. The biofield is connected through the consciousness, thought processes and spirit, and includes the electrical activity of the nervous system, heart, meridians, biophotons (energy field particles), and chakras.
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\n\t\t\t\tFeldenkrais Method uses gentle movement and directed attention to improve range of motion and enhance human functioning. Based on principles of physics, biomechanics and an empirical understanding of learning and human development, Feldenkrais exercises have been reported to be an effective way to improve balance and mobility, flexibility and coordination, helping to offset age-related declines in mobility and reduce the risk of falling among community-dwelling older adults [148].
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\n\t\t\t\tHealing Touch (HT) is an energy medicine practice involving the relationship between the practitioner, the patient, intention, and the power of touch to facilitate healing. Like most EM treatments the patient is lying on a massage-type table, where the practitioner applies different forms of touch in order to assess the patient’s biofield imbalances. HT is widely used to help ease pain, stress and anxiety [149]. Patients receiving music, imagery and touch therapy during angiograms or other cardiac procedures were 65 percent less likely to die in the following six months than patients who received no such intervention [150]. Other research shows that HT lowers blood pressure, heart and breathing rates, fatigue, mood disturbances, and pain in patients receiving chemotherapy [151]. HT is endorsed by the American Holistic Nurses’ Association.
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\n\t\t\t\tNambudripad\'s Allergy Elimination Techniques (NAET®) is an EM treatment designed to alleviate allergies using a combination of energy balancing, testing and treatment procedures from acupuncture/acupressure, allopathy, chiropractic, nutritional, and kinesiological disciplines of medicine. Research suggests it is effective in treating allergies to milk, sugar, egg whites, pork meat and other foods causing eczema and dyspnea [152].
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\n\t\t\t\tPolarity Therapy (PT) uses touch, verbal interaction, exercise, and nutrition [153] to balance and restore the natural flow of energy in the biofield. Blocked and stagnant energy is responsible for both emotional and physical pain as well as disease. Energy medicine treatments are patient-practitioner oriented, where both the giver and receiver of the energy treatment work in tandem to facilitate treatment. The practitioner grounds and centers his/her body, meaning all thoughts, emotions and physical sensations are neutralized through intention. This mindset begins the healing process for both the practitioner and the client. PT balances the subtle energy of the biofield which can be detected and manipulated by movements of the practitioner’s hands. The practitioner provides the resonating template for the patient’s biofield to follow. Change occurs on a spiritual or unconscious level, and most people do not feel much other than becoming very relaxed. This mind-body state is optimal for healing and cell regeneration. After effects of the treatment last from hours to days with feelings of calm, focus, peace and serenity. PT bases its philosophy in the traditional system of Ayurvedic medicine, which defines patterns of health as energy moving through the Five Elements of Life – Ether, Air, Fire, Water and Earth. The practice of PT focuses on the balance of these elements as the foundation of good health. It integrates philosophies of Ayurvedic medicine, hermetic or ancient Egyptian medicine, Traditional Chinese Medicine (TCM), chakra balancing and the balance of yin and yang. PT understands that energy flows through the body along five pathways, enabled by positive and negative poles of the body. Five energy centers along the body represent the five elements of Ayurvedic tradition relating to different organs and functions in the body. Practitioners aim to correct disturbances and enable optimal physical, emotional as well as spiritual healing. Along with energy balancing sessions, cleansing diet and energy exercises are part of the therapy. PT has been shown to reduce cancer related fatigue [154], and improve the quality of life for caregivers of dementia and Alzheimer’s patients [155] as well as improved stress reduction in burned out oncology professionals [131].
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\n\t\t\t\tReiki is an ancient Tibetan Buddhist practice in which practitioners serve as facilitators for life force energy (chi). Reiki is used to reduce stress, improve health and quality of life, and promote mental clarity. Practitioners use 12 – 15 specific hand positions each held for a few minutes on the patient’s clothed body. Sessions last 30-90 minutes and the number of treatments may vary. Like other EM therapies, Reiki practitioners assert treatments can be effective over long distances. Formal scientific evidence has shown that Reiki can increase quality of life and reduce pain when used with standard medications [156]. Reiki has also been reported to relieve stress and improve psychological well being in patients with heart rate variability [157], and pain management issues [158].
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\n\t\t\t\tRolfing focuses on fascia tissue that connects all internal structures within the human frame. Connective tissue unites the structure of the body and divides it into individual functioning parts. Fascia is constantly changing and adapting in response to demands placed on the body. It reacts to trauma to a joint for instance by producing extra tissue to enhance stability and support; however, it can produce more than is necessary. In time, rather than stabilizing movement it can actually reduce mobility, leading to a changed posture and altered patterns of movement. After completing ten sessions a client can expect greater ease of movement and all over range of motion, along with better posture. Rolfing has been shown to significantly decrease pain and increase range of motion in adults who have cervical spine dysfunction [159].
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\n\t\t\t\tTherapeutic Touch (TT) is similar to PT and HT, except practitioners usually do not actually touch the patient, but hold their hands 4-8 inches (10-18 cm) from the body in order to detect energy imbalances and correct them. TT has been shown to significantly reduce pain and increase the quality of life in fibromyalgia patients [160], significantly decrease pain and improve function in patients with osteoarthritis [161], produce significant reductions in behavioral symptoms of dementia [162], and chemical dependency in pregnant women who suffer from anxiety [163]. TT is mainly practiced by nurses.
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\n\t\t\t\tTraditional Chinese Medicine (TCM) suggests that the basis for disease results from the disruption in the flow of subtle energy known as qi or chi. TCM works with imbalance in the forces of yin (feminine principle) and yang (masculine principle). Practices such as Chinese herbs, meditation, massage and acupuncture aid healing by restoring yin-yang and Qi to homeostasis. This same subtle energy is known as ki in the Japanese Kamp system.
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\n\t\t\t\tTrager Approach is a combination of massage, meditation and movement education. The head, torso, arms and legs are manipulated with rhythmic pull and rotation techniques in order to release tension, increase mobility and clear the mind. Movement awareness is emphasized to promote relaxation and ease neuromuscular pain. The Trager Approach has been shown to reduce symptoms of chronic headache along with reduction of headache medication [164].
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\n\t\t\t\tYoga is an ancient Indian practice uniting the spirit, the body and mind accomplished through physical postures, controlled breathing exercises, and meditation, often accompanied by healthy lifestyle and search for higher consciousness. Yoga is not a religion but a philosophy and way of life. Hatha yoga is most commonly practiced in North America and Europe, using a sequence of postures or asanas held statically or moved through dynamically in sequence, using the breath and hand positions for balance. Ashtanga yoga builds strength, stamina and flexibility, more commonly known in the United States as power yoga. Bikram yoga is practiced in rooms heated to 100 °F (39 °C). Profuse sweating loosens muscles and tendons while promoting inner cleansing. This type of yoga should only be practiced after consulting with a physician. Research has shown the practice of yoga can reduce pain, and increase energy, flexibility, and function during physical activity, as well as relieve stress and anxiety in breast cancer survivors[165]. It has also been shown to reduce pain associated disability [166], reduce stress [167], and as a complementary therapy for major psychiatric disorders [168].
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As with pharmaceuticals, the effectiveness of these treatments varies with each patient. It is important to speak with a practitioner before scheduling an appointment to discuss your needs and ask questions about what to expect during your visit. Most of these therapies are practiced with the patient fully clothed except for shoes, socks and jewelry. Although human biofields have as yet been proved measurable with conventional scientific equipment, medical journals have published articles suggesting the existence of such fields [169-171]. Please consult with a physician to determine any health issues (recent surgeries or trauma) which may not allow for physical manipulation. Many EM treatments are not recommended for people who have multi-personality disorder or schizophrenia as manipulation of the biofield can sometimes exacerbate delusion, hallucination and bring out multiple personalities at once.
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\n\t\t\t\tIn Summary\n\t\t\t
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The growth and maintenance of correct vibrational patterning of tissues and organs is the hallmark of good health. Current biomedical interventions ultimately attempt to restore the body’s optimal vibrational patterns. In order to accomplish this goal it is imperative to understand the key aspects of immune response with respect to cellular communication, as well as biochemical, bioelectrical, and bioelectromagnetic processes; and to develop technologies to facilitate the body’s use of this information during the repair and regeneration process.
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\n\t\n',keywords:null,chapterPDFUrl:"https://cdn.intechopen.com/pdfs/40433.pdf",chapterXML:"https://mts.intechopen.com/source/xml/40433.xml",downloadPdfUrl:"/chapter/pdf-download/40433",previewPdfUrl:"/chapter/pdf-preview/40433",totalDownloads:3990,totalViews:293,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:1,impactScore:0,impactScorePercentile:1,impactScoreQuartile:1,hasAltmetrics:1,dateSubmitted:"April 26th 2012",dateReviewed:"August 28th 2012",datePrePublished:null,datePublished:"December 18th 2012",dateFinished:"October 23rd 2012",readingETA:"0",abstract:null,reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/40433",risUrl:"/chapter/ris/40433",book:{id:"3369",slug:"alternative-medicine"},signatures:"Christina L. Ross",authors:[{id:"156977",title:"Dr.",name:"Christina",middleName:"L.",surname:"Ross",fullName:"Christina Ross",slug:"christina-ross",email:"chrross@wakehealth.edu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Wake Forest University",institutionURL:null,country:{name:"United States of America"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Veritable EM Devices",level:"1"}],chapterReferences:[{id:"B1",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tOschman\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2000\n\t\t\t\t\tEnergy Medicine: The Scientific Basis.Churchill Livingstone,. Edinburgh\n\t\t\t'},{id:"B2",body:'\n\t\t\t\t\n\t\t\t\t\tNCCAM,\n\t\t\t\t\t2010\n\t\t\t\t\thttp://nccam.nih.gov/health/whatiscam/\n\t\t\t\t\n\t\t\t'},{id:"B3",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tAdministration\n\t\t\t\t\t\t\tO.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tS.a\n\t\t\t\t\t\t\tH.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2012\n\t\t\t\t\tExtremely Low Frequency (ELF) Radiation.\n\t\t\t\t\thttp://www.osha.gov/SLTC/elfradiationretrieved February 15\n\t\t\t'},{id:"B4",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBuonanno\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tToledo\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tAzzam\n\t\t\t\t\t\t\tE.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2011\n\t\t\t\t\tIncreased frequency of spontaneous neoplastic transformation in progeny of bystander cells from cultures exposed to densely ionizing radiationPloS One. 6\n\t\t\t\t\t6\n\t\t\t\t\te21540\n\t\t\t\t\n\t\t\t'},{id:"B5",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMobbs\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMuirhead\n\t\t\t\t\t\t\tC.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHarrison\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2011\n\t\t\t\t\tRisks from ionising radiation: an HPA viewpoint paper for SafegroundsJ Radiol Prot 31\n\t\t\t\t\t3\n\t\t\t\t\t289\n\t\t\t\t\t307\n\t\t\t\t\n\t\t\t'},{id:"B6",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tOrganization\n\t\t\t\t\t\t\tW. 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36\n\t\t\t\t\t3\n\t\t\t\t\t187\n\t\t\t\t\t229\n\t\t\t\t\n\t\t\t'},{id:"B70",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tVolpe\n\t\t\t\t\t\t\tP.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2003\n\t\t\t\t\tInteractions of zero-frequency and oscillating magnetic fields with biostructures and biosystemsPhotochemical and Photobiological Sciences2\n\t\t\t\t\t6\n\t\t\t\t\t637\n\t\t\t\t\t648\n\t\t\t\t\n\t\t\t'},{id:"B71",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFunk\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMonsees\n\t\t\t\t\t\t\tT.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2006\n\t\t\t\t\tEffects of electromagnetic fields on cells: physiological and therapeutical approaches and moleclular mechanisms of interaction.\n\t\t\t\t\tCell Tissues 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informative medicine.Electromag Biol Med28\n\t\t\t\t\t1\n\t\t\t\t\t71\n\t\t\t\t\t79\n\t\t\t\t\n\t\t\t'},{id:"B74",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLisi\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFoletti\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLedda\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRosola\n\t\t\t\t\t\t\tE.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGiuliani\n\t\t\t\t\t\t\tL.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tD’Emilia\n\t\t\t\t\t\t\tE.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGrimaldi\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2006\n\t\t\t\t\tExtremely low frequency 7 Hz 100 uT electromagnetic radiation promotes differentiation in the human peithelial cell line HaCaT.\n\t\t\t\t\tElectromag Biol Med\n\t\t\t\t\t25\n\t\t\t\t\t4\n\t\t\t\t\t269\n\t\t\t\t\t280\n\t\t\t\t\n\t\t\t'},{id:"B75",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tVentura\n\t\t\t\t\t\t\tC.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMaioli\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tAsara\n\t\t\t\t\t\t\tY.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tsantoni\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMesirca\n\t\t\t\t\t\t\tP.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRemondini\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBersani\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2005\n\t\t\t\t\tTurning on stem cell cardiogenesis with extremely low frequency magnetic fields.FASB J19\n\t\t\t\t\t155\n\t\t\t\t\t7\n\t\t\t\t\n\t\t\t'},{id:"B76",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRoss\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2005\n\t\t\t\t\tCombined DC and ELF magnetif fields can alter cell proliferation.\n\t\t\t\t\tBioelectromagnetics\n\t\t\t\t\t11\n\t\t\t\t\t1\n\t\t\t\t\t27\n\t\t\t\t\t36\n\t\t\t\t\n\t\t\t'},{id:"B77",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTian\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tNakahara\n\t\t\t\t\t\t\tT.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tYoshida\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHonda\n\t\t\t\t\t\t\tN.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHirose\n\t\t\t\t\t\t\tH.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMiyakoshi\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2002\n\t\t\t\t\tExposure to power frequency magnetic fields suppresses X-ray induced apoptosis transiently in Ku80-deficient xrs5 cellsBiochem Biophys Res Commun292\n\t\t\t\t\t2\n\t\t\t\t\t355\n\t\t\t\t\t361\n\t\t\t\t\n\t\t\t'},{id:"B78",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTofani\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBarone\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCintorino\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tDe Santi\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFerrara\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tOrlassino\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tOssola\n\t\t\t\t\t\t\tP.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPeroglio\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRolfo\n\t\t\t\t\t\t\tK.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRonchetto\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2001\n\t\t\t\t\tStatic and elf magnetic fields induce tumor inhibition and apoptosis.\n\t\t\t\t\tBioelectromagnetics\n\t\t\t\t\t22\n\t\t\t\t\t6\n\t\t\t\t\t419\n\t\t\t\t\t428\n\t\t\t\t\n\t\t\t'},{id:"B79",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSantini\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFerrante\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRainaldi\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tIndovina\n\t\t\t\t\t\t\tP.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tIndovina\n\t\t\t\t\t\t\tP.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2005\n\t\t\t\t\tExtremely low frequency (ELF) magnetic fields andapoptosis: a review.\n\t\t\t\t\tInternat J Rad Biol\n\t\t\t\t\t81\n\t\t\t\t\t1\n\t\t\t\t\t1\n\t\t\t\t\t11\n\t\t\t\t\n\t\t\t'},{id:"B80",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTakahashi\n\t\t\t\t\t\t\tK.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKaneki\n\t\t\t\t\t\t\tI.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tDate\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFukada\n\t\t\t\t\t\t\tE.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1986\n\t\t\t\t\tEffect of pulsing electromagnetic fields on DNA synthesis in mammalian cells in culture.Cellular and Molecular Life Sciences42\n\t\t\t\t\t2\n\t\t\t\t\t185\n\t\t\t\t\t186\n\t\t\t\t\n\t\t\t'},{id:"B81",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLitovitz\n\t\t\t\t\t\t\tT.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKrause\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMontrose\n\t\t\t\t\t\t\tC.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMullins\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1994\n\t\t\t\t\tTemporally incoherent magnetic fields mitigate the response of biological systems to temporally cohreent magnetic fields.\n\t\t\t\t\tbioelectromagnetics\n\t\t\t\t\t15\n\t\t\t\t\t5\n\t\t\t\t\t399\n\t\t\t\t\t410\n\t\t\t\t\n\t\t\t'},{id:"B82",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGoodman\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBassett\n\t\t\t\t\t\t\tC.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHenderson\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1983\n\t\t\t\t\tPulsing electromagnetic fields induce cellular transcription.Science220\n\t\t\t\t\t4603\n\t\t\t\t\t1283\n\t\t\t\t\n\t\t\t'},{id:"B83",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGoodman\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHenderson\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1988\n\t\t\t\t\tExposure of salivary gland cells to low-frequency electromagnetic fields alters polypeptide synthesisProceed Nat Acad Sci USA85\n\t\t\t\t\t11\n\t\t\t\t\t3928\n\t\t\t\t\n\t\t\t'},{id:"B84",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSun\n\t\t\t\t\t\t\tW.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tChiang\n\t\t\t\t\t\t\tH.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFu\n\t\t\t\t\t\t\tY.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tYu\n\t\t\t\t\t\t\tY.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tXie\n\t\t\t\t\t\t\tH.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLu\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2001\n\t\t\t\t\tExposure to 50 Hz electromagnetic field induces the phosphorylation and activity of stress-activated protein kinase in cultures cells.Electromag Biol Med20\n\t\t\t\t\t3\n\t\t\t\t\t415\n\t\t\t\t\t423\n\t\t\t\t\n\t\t\t'},{id:"B85",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tWolf\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTorsello\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTedesco\n\t\t\t\t\t\t\tB.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFasanella\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBoninsegna\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tD’Ascenzo\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGrassi\n\t\t\t\t\t\t\tC.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tAzzena\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCittadini\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2005\n\t\t\t\t\t50-Hz extremely low frequency electromagnetic fields enhance cell proliferation and DNA damage; possible involvement of redox mechanism.\n\t\t\t\t\tBiochimica et Biophysica Acta (BBA) Molecular Cell Research\n\t\t\t\t\t1743\n\t\t\t\t\t1-2\n\t\t\t\t\t120\n\t\t\t\t\t129\n\t\t\t\t\n\t\t\t'},{id:"B86",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRegoli\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGorbi\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMachella\n\t\t\t\t\t\t\tN.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTedesco\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBenedetti\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBocchetti\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tNotti\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGattorini\n\t\t\t\t\t\t\tD.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPiva\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPrincipato\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2005\n\t\t\t\t\tPro-oxidant effects of extremely low frequency electromagnetic fields in the land snail Helix aspersa.Free Radical biol and med39\n\t\t\t\t\t12\n\t\t\t\t\t1620\n\t\t\t\t\t1628\n\t\t\t\t\n\t\t\t'},{id:"B87",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGolfert\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHofer\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tThummler\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBauer\n\t\t\t\t\t\t\tH.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFunk\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2001\n\t\t\t\t\tExtremely low frequency electromagnetic fields and heat shock can increase microvesicle motility in astrocytes.\n\t\t\t\t\tBioelectromagnetics\n\t\t\t\t\t71\n\t\t\t\t\t78\n\t\t\t\t\n\t\t\t'},{id:"B88",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tZrimec\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tJerman\n\t\t\t\t\t\t\tI.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLahajnar\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2002\n\t\t\t\t\tAlternating electric fields stimulate ATP synthesis in Escherichia coli\n\t\t\t\t\tCell Mol Biol Letters\n\t\t\t\t\t7\n\t\t\t\t\t1\n\t\t\t\t\t172\n\t\t\t\t\t175\n\t\t\t\t\n\t\t\t'},{id:"B89",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPaksy\n\t\t\t\t\t\t\tK.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tThuroczy\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tForgacs\n\t\t\t\t\t\t\tZ.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLazar\n\t\t\t\t\t\t\tP.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGaati\n\t\t\t\t\t\t\tI.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2000\n\t\t\t\t\tInfluence of sinusoidal 50-Hz magnetic field on cultured human ovarian granulosa cellsElectromag Biol Med19\n\t\t\t\t\t1\n\t\t\t\t\t91\n\t\t\t\t\t97\n\t\t\t\t\n\t\t\t'},{id:"B90",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKula\n\t\t\t\t\t\t\tB.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSobczak\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKuska\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2000\n\t\t\t\t\tEffects of static and ELF magnetic fields on free-radical processes in rat liver and kidneyElectromag Biol Med19\n\t\t\t\t\t1\n\t\t\t\t\t99\n\t\t\t\t\t105\n\t\t\t\t\n\t\t\t'},{id:"B91",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMilani\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBallerini\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFerraro\n\t\t\t\t\t\t\tL.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tZabeo\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBarberis\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCannone\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFaleri\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2001\n\t\t\t\t\tMagnetic field effects on human lumphocytes.\n\t\t\t\t\tElectromag Biol Med\n\t\t\t\t\t20\n\t\t\t\t\t1\n\t\t\t\t\t81\n\t\t\t\t\t106\n\t\t\t\t\n\t\t\t'},{id:"B92",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tJandova\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHurych\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tPokorny\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCoeek\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tTrojan\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tNedbalova\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tDohnalova\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2001\n\t\t\t\t\tEffects of sinusoidal magnetic field on adherence inbition of leukocytes.\n\t\t\t\t\tElectromag Biol Med\n\t\t\t\t\t20\n\t\t\t\t\t3\n\t\t\t\t\t397\n\t\t\t\t\t413\n\t\t\t\t\n\t\t\t'},{id:"B93",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMc Leod\n\t\t\t\t\t\t\tK.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRubin\n\t\t\t\t\t\t\tC. T.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tDonahue\n\t\t\t\t\t\t\tH. J.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1995\n\t\t\t\t\tElectromagnetic fields in bone repair and adaptationRadio Sci30\n\t\t\t\t\t233\n\t\t\t\t\t244\n\t\t\t\t\n\t\t\t'},{id:"B94",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tOtter\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMc Leod\n\t\t\t\t\t\t\tK. J.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRubin\n\t\t\t\t\t\t\tC. T.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t1998\n\t\t\t\t\tEffects of electromagnetic fields in experimental fracture repair.Clin Orthop355\n\t\t\t\t\tS90\n\t\t\t\t\t104\n\t\t\t\t\n\t\t\t'},{id:"B95",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBersani\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMarinelli\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tOgnibene\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMatteucci\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCecchi\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSanti\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSquarzoni\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMaraldi\n\t\t\t\t\t\t\tN. 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H.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMinakuchi\n\t\t\t\t\t\t\tK.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKashimoto\n\t\t\t\t\t\t\tH.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKitamura\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tKinouchi\n\t\t\t\t\t\t\tY.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tYoshizaki\n\t\t\t\t\t\t\tK.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMiyamoto\n\t\t\t\t\t\t\tH.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2005\n\t\t\t\t\tEffects of a time-varying strong magnetic field on transient increase in Ca2+ release induced by cytosolic Ca2+ in cultured pheochromocytoma cellsBiochim Biophys Acta1724\n\t\t\t\t\t8\n\t\t\t\t\t16\n\t\t\t\t\n\t\t\t'},{id:"B99",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLieb\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tRegelson\n\t\t\t\t\t\t\tW.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tWest\n\t\t\t\t\t\t\tB.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tJordan\n\t\t\t\t\t\t\tR. 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K.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tWang\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSimon\n\t\t\t\t\t\t\tB.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2003\n\t\t\t\t\tModification of osteoarthritis by pulsed electromagnetic field--a morphological study.Osteoarthritis Cartilage11\n\t\t\t\t\t6\n\t\t\t\t\t455\n\t\t\t\t\t462\n\t\t\t\t\n\t\t\t'},{id:"B104",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGómez-Ochoa\n\t\t\t\t\t\t\tI.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGómez-Ochoa\n\t\t\t\t\t\t\tP.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGómez-Casal\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCativiela\n\t\t\t\t\t\t\tE.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLarrad-Mur\n\t\t\t\t\t\t\tL.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2011\n\t\t\t\t\tPulsed electromagnetic fields decrease proinflammatory cytokine secretion (IL-1β and TNF-α) on human fibroblast-like cell culture.\n\t\t\t\t\tRheumatol Int\n\t\t\t\t\t31\n\t\t\t\t\t10\n\t\t\t\t\t1283\n\t\t\t\t\t1289\n\t\t\t\t\n\t\t\t'},{id:"B105",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBenazzo\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCadossi\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCavani\n\t\t\t\t\t\t\tF.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tFini\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGiavaresi\n\t\t\t\t\t\t\tG.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tSetti\n\t\t\t\t\t\t\tS.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tCadossi\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGiardino\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2008\n\t\t\t\t\tCartilage repair with osteochondral autografts in sheep: effect of biophysical stimulation with pulsed electromagnetic fieldsJ Orthop Res26\n\t\t\t\t\t5\n\t\t\t\t\t631\n\t\t\t\t\t642\n\t\t\t\t\n\t\t\t'},{id:"B106",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMarkov\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tColbert\n\t\t\t\t\t\t\tA. 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Med\n\t\t\t\t\t10\n\t\t\t\t\t5\n\t\t\t\t\t40\n\t\t\t\t\t46\n\t\t\t\t\n\t\t\t'},{id:"B165",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGalantino\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tGreene\n\t\t\t\t\t\t\tL.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tArchetto\n\t\t\t\t\t\t\tB.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBaumgartner\n\t\t\t\t\t\t\tM.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tHassall\n\t\t\t\t\t\t\tP.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMurphy\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tUmstetter\n\t\t\t\t\t\t\tJ.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tDesai\n\t\t\t\t\t\t\tK.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2012\n\t\t\t\t\tA qualitative exploration of the impact of yoga on breast cancer survivors with aromatase inhibitor-associated arthralgiasExplore8\n\t\t\t\t\t1\n\t\t\t\t\t40\n\t\t\t\t\t47\n\t\t\t\t\n\t\t\t'},{id:"B166",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tBüssing\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tOstermann\n\t\t\t\t\t\t\tT.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tLüdtke\n\t\t\t\t\t\t\tR.\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tMichalsen\n\t\t\t\t\t\t\tA.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2012\n\t\t\t\t\tEffects of yoga interventions on pain and pain-associated disability: a meta-analysisJ Pain13\n\t\t\t\t\t1\n\t\t\t\t\t1\n\t\t\t\t\t9\n\t\t\t\t\n\t\t\t'},{id:"B167",body:'\n\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\tWhite\n\t\t\t\t\t\t\tL.\n\t\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t2012\n\t\t\t\t\tReducing stress in school-age girls through mindful yogaJ Pediatr Health 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Ross",address:" chrross@wakehealth.edu",affiliation:'
Department of Energy Medicine, Akamai University, U. S. A.
Research Fellow, Wake Forest Institute for Regenerative Medicine, School of Medicine, Winston-Salem, U. S. A.
'}],corrections:null},book:{id:"3369",type:"book",title:"Alternative Medicine",subtitle:null,fullTitle:"Alternative Medicine",slug:"alternative-medicine",publishedDate:"December 18th 2012",bookSignature:"Hiroshi Sakagami",coverURL:"https://cdn.intechopen.com/books/images_new/3369.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:null,printIsbn:"978-953-51-0903-7",pdfIsbn:"978-953-51-7054-9",reviewType:"peer-reviewed",numberOfWosCitations:29,isAvailableForWebshopOrdering:!0,editors:[{id:"82603",title:"Prof.",name:"Hiroshi",middleName:null,surname:"Sakagami",slug:"hiroshi-sakagami",fullName:"Hiroshi Sakagami"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1127"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},chapters:[{id:"41480",type:"chapter",title:"Cancer and Its Treatment in Main Ancient Books of Islamic 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1. Introduction
The Lautenbach procedure involves debridement, intramedullary reaming, and the insertion of double-lumen tubes to establish both a local antibiotic delivery system and cavity analysis for volume and culture. The end-point of treatment is when the irrigation fluid produces three consecutive clear cultures with improvement in the blood indices and obliteration of the cavity volume [1, 2].
In theater, the patient’s affected limb is debrided, and sequestra are removed and cleaned. After that holes will be made (Reaming) on the bone. These holes will be enough to insert an irrigation tube, which is a double-lumen tube that means the tube has a smaller tube inside. There is one big tube (perforated) which drains the irrigation fluid from the patient and an intra-catheter inside that administers an antibiotic to the bone and its bone marrow. These tubes will stay with the patient from two weeks upwards or until the patient is cleared of infection.
2. Irrigation system contents
An administration set that almost looks like an intravenous infusion line which is attached to a 50 ml sodium chloride bag. This line, which carries the antibiotic connects to the perforated tube through a Y-connection and the same administration set connects to a three-way stopcock and it delivers the antibiotic through the intra-catheter (a smaller tube that goes inside the bigger tube)
A bellow that looks like a portable vacuum drain (portovac) drain but cannot be opened to maintain continuous negative suction.
A drainage bag that looks like a urine bag, but it has a tube permanently connected to the bellow.
Courtesy of ward 369 Charlotte Maxeke Johannesburg Academic Hospital, South Africa.
3. Nursing management
On arrival in the ward from the recovery room, the nurse in charge of a patient post insertion of the Lautenbach irrigation system should do the following:-.
Postoperative vital data monitoring must be done as per hospital protocol. This includes checking of temperature, pulse, respiration, blood pressure, and oxygen saturation, which should be between 94 and 100% on room air. If the patient desaturates; 40% oxygen via face mask should be administered and the orthopedic surgeon on call should be informed to do arterial blood gases and also to take blood for post-operative full blood count and urea and electrolyte. As this is a major orthopedic procedure these patients bleed a lot and might need an intra-operative blood transfusion or postoperative blood transfusion depending on the condition of the patient. The patient may come back from the theatre with one, two, or even three irrigation tubes. These should be labeled, especially if there is more than one irrigation tube as follows; proximal tube, medial tube, and distal tube or tube 1, tube 2, and tube 3. The tube closest to the midline of the body of the patient would be labeled as a proximal tube and the tube that is situated further away from the body is labeled distal tube or tube 3 respectively.
The operated site should be checked as soon as possible so that the patient can be dressed with a pressure bandage to contain the bleeding. Whilst repacking the dressing; another nurse should open the red and yellow clips and let the irrigations drain regardless of time. This means for example; if the patient came back from the theater at around 16 h05 the drains should be drained from approximately 16 h10 till 18 h00, whilst monitoring the drainage. If the drainage is above 250 ml post operatively the irrigation system; (both yellow and red clips) should be closed and the orthopedic surgeon should be informed. That much drainage is concerning.
The gold standard antibiotic that is used postoperatively is gentamicin 80 mg in 50 ml of sodium chloride 0.9%. Sometimes in theater, the nursing staff will add 320 mg of gentamicin in 200 ml of sodium chloride 0.9%. This is not totally wrong but it is not ideal in a ward situation. This should be changed from 80 mg to 50 ml of sodium chloride 0.9% as soon as the patient is stabilized in the ward. Gentamicin mixed with sodium chloride will only last for two days at room temperature. So mixing 320 mg with 200 ml of saline is actually wasteful in nature and might as well prolong the patient’s hospital stay because what if it is not changed at due time because 200 ml is seemingly enough to run for a few weeks.
Check for any leakage or oozing from the wound site. Do not remove dressings from the theater if oozing is noted. Dressings from the theater will only be removed on the day of removal of the irrigation system as a whole. Apply orthopedic wool and crepe bandage and monitor bleeding. In an ideal situation there should not be any bleeding at all, more often than not the report from the surgeon postoperatively would be space was left on the wound for various reasons, that would make exudate escape from the tubes to the dressing itself.
4. Protocol for irrigation maintenance
09H30-10H00
Open yellow clip and red clip. Let it drain for thirty minutes.
10H00
Close yellow clip and red clip. Administer 20 drops of an antibiotic.
13H30-14H00
Open yellow and red clip. Let it drain for thirty minutes.
14H00
Close yellow clip and red clip. Administer 20 drops of an antibiotic.
17H30-18H00
Open yellow and red clip. Let it drain for thirty minutes.
18H00
Close yellow clip and red clip. Administer 20 drops of an antibiotic.
21H30-22H00
Open yellow and red clip. Let it drain for thirty minutes.
22H00
Close yellow clip and red clip. Administer 20 drops of an antibiotic.
01H30-02H00
Open yellow and red clip. Let it drain for thirty minutes.
02H00
Close yellow clip and red clip. Administer 20 drops of an antibiotic.
These yellow, red, blue, or white clips are also called pinch clamps.
This is a very easy procedure to do as it is repeated every four hours. Even a patient can be taught how to do it without any issues. The disadvantage to this is that the patients are often in a hurry to get discharged and they would assume that administering more than 20 drops of antibiotics at a go will help them get better sooner than expected, which is never the case. They will be overdosing on the tissues. Instead; the irrigation system will start leaking from the wound site.
5. Specimen collection
The specimens are collected three times a week, that is, Monday, Wednesday, and Friday. Before collecting a specimen, the nurse responsible for the patient should prepare a trolley. Aseptic technique should be maintained at all times to avoid contaminating the specimen. The trolley should be cleaned with a disinfectant using an S shape. A sterile green cloth should be put on top of the trolley. Two 20 ml sterile syringes should be opened from their packaging and thrown on the sterile cloth. A packet of sterile gloves should also be put on the sterile cloth. An alcohol swab should be put on the bottom of the trolley with specimen bottle. If the alcohol swabs are not available, sterile cotton wool swabs drenched in a disinfectant should be used. A nurse who is taking a specimen should have another nurse who will open an alcohol swab for her, so sterile cotton swabs are better if there is no one to open the readymade alcohol swabs.
The nurse must then wash her hands and don gloves. After wearing gloves, would look for the port (Also called suction valve) between the yellow and red pinch clamp. This port should be cleaned thoroughly with an alcohol swab before opening it. The nurse must remove the cap connect the 20 ml syringe and then open the yellow pinch clamp. The red pinch clamp must not be touched at all during the collection of the specimen. The nurse must withdraw the first specimen and close the yellow pinch clamp. That specimen must be discarded and a second 20 ml syringe must be connected to the port so as to get a fresh new specimen directly from the wound site. The first specimen must have been sitting there in the tube for a long time and it might give a wrong result, also; using two syringes assists in unblocking of the irrigation system if this is the case . Once enough specimen is collected the yellow pinch clamp must be closed and the port must be closed. It is advisable to clean the cap with the disinfectant before putting it back on the port.
If the patient has more than one tube the same procedure should be repeated on another tube making sure that new gloves and syringes are used. The specimens should be labeled accordingly. The laboratory form should be filled with a patient’s name, hospital number, doctor who is in charge of the patient’s details, ward number, date and time the specimen was collected, and the diagnosis of the patient. The wound site should also be included in the laboratory form, for example, the right tibia, left humerus, right femur, etc. The specimen type should be marked as Irrigation Fluid, not blood even though it looks like blood a few days postoperatively. The investigation required should be indicated as Microscopy/Culture/Sensitivity in the laboratory form. After that, the specimen should be sent to the laboratory and it would take 24 to 48 hours for the results to come out, depending on the laboratory. If the patient has more than one irrigation tube, a separate laboratory form should be used for each specimen collected on each tube.
A nurse should make a note on the progress notes for doctors that a specimen has been collected. A lab sticker with a reference number for the laboratory should be stuck underneath the signature of the nurse who took the specimen so that it becomes easier for the medical personnel to trace the results for the patient.
Once results are received by the ward a professional nurse can read them and act accordingly. For example, if the patient cultured Staphylococcus Aureas, which is sensitive to Cloxacillin the professional nurse should put 1 g of cloxacillin in 50 ml sodium chloride and remove the one that has gentamycin in it. The doctor should be made aware of this development but there is no need to wait for further instructions to change antibiotics as the protocol allows the nursing staff to do so. Precaution should be taken with penicillin drugs and the patient’s allergy should be considered. If the patient has MRSA the irrigations should be changed to vancomycin and the patient should be isolated in a private room or placed next to a window in hospitals where there are no isolation rooms. Universal precautions should be abided by at all times. With patients who have cultured MRSA, the surgeon would prescribe vancomycin to be administered intravenously for a week as well. A nurse is not allowed to administer intravenous antibiotics without a prescription. So, the intravenous antibiotics will be initiated after the prescription has been obtained. The patient might be put on Vancomycin 1 g daily or 1 g twice daily taking into consideration the renal function of the patient. If the patient has some renal dysfunction, the nephrologist will be involved to suggest and give guidance on an appropriate renal dose. Vancomycin is not combined with rifampicin as irrigations are not put on a patient with an implant. The Implants are removed before a DRI procedure is done on a patient. Microbiologists and Infectious Diseases physicians are also involved once a patient cultures and is started on antibiotics.
For a patient to be considered cleared of infection; they should have three consecutive negative culture results. If a patient has two negative specimen results and a third one is positive, the third one will cancel the first two negative ones and the patient will continue with irrigation treatment until they receive uninterrupted three negative specimen results.
6. Unblocking the irrigation system
At any given time, the irrigation system can be blocked. This can be observed during drainage times. When the yellow clip is opened there will be no movement of the fluid from the patient to the bellow. A bellow is supposed to provide a continuous negative suction pressure at all times but this would be disturbed due to various reasons. Those reasons might be after physiotherapy, after mobilizing to the bathroom without taking precaution in the handling of irrigation system or a blood cloth or fat debris from the bone marrow caught between the outside tube (the tube that drains the irrigation fluid from the patient) and the intra-catheter (the inner tube that administers antibiotic to the wound site).
Before trying to unblock the tubes, the system should be checked if it is still in situ, as the system is only held by one stitch around the insertion area, it is easy for tubes to come out. Once the tubes are out, the whole system must be removed. They must never be pushed back inside the patient as this is a sterile procedure done in theater, so pushing the irrigation system in the patient’s wound would be introducing infection to the patient as those tubes would already have been exposed to the unsterile environment.
Another thing that a nurse can do to maintain the continuous negative suction is to open a blue or white clip between the bellow and a drain bag (That looks like a urine bag but without the volume markings) and then put pressure on the bellow until all the contents of the bellow have been drained to the drain bag. If the drain bag is full of air from the bellow, the air can be released without contaminating the system. If the bag is full of fluid drainage it can be emptied and discarded. There is no need to measure the contents of the bag.
If putting pressure on the bellow is not working a 20 ml syringe can be used as the same procedure of taking a specimen to try and provide manual suction. This can be done several times if the patient is complaining of pain. The clot; unless it is not big might come and may be seen in the syringe after being caught. The port must be closed and then the two pinch clamps (the red and yellow one) must be open to check if there is any drainage. If the clot was properly removed, the system might be seen running properly at this moment.
If those two avenues have been exhausted it could mean there is a clot somewhere that could not be removed with a mere 20 ml syringe. A 50 mg of Actilyse (alteplase) should be mixed with 50 ml of sterile water for injections. After that 2 ml of that solution should be added to an already prepared new solution of 50 ml sodium chloride and a relevant antibiotic. The 2 ml of alteplase solution should not be added to an already running antibiotic. A new solution must be prepared and an old one must be discarded so that 2 mg of actilyse is added into 50 ml of sodium chloride with for example 1.2 g of Augmentin.
Streptokinase 1,500,000 international units is another drug of choice in the unblocking of irrigation systems depending on the hospital pharmacy availability. It also should be added in 50 ml water for injection and 2 ml withdrawn and added into the antibiotics.
Two cycles of irrigation procedure should be enough to clear any clot and the solution should be removed unless the problem is persistent. The patient should also be monitored for any bleeding on the wound site. The solution should be discontinued if the bleeding is concerning or if it is disproportionate to the amount of antibiotic solution administered.
Sometimes the irrigation system will stop running and restart during the next cycle on its own without any interference from the nursing staff. The assumption is that there might be nothing to drain from inside especially after taking a specimen. Remember +/− 40 ml is taken during specimen collection and during the administration of antibiotics only 20 drops are administered, which is not a lot by any account.
7. Discussion
Patients are discouraged from mobilizing unnecessary to prevent pulling out of irrigation tubes. If a patient wants to go to the bathroom a plastic bag can be used to put the tubes, bellow, and drain bag in and the patient can carry it with the hand that is on the side of the limb with irrigations, for example, if the irrigations are on the left leg, the plastic bag should be carried on the left hand. The irrigation system should not be made to move across to the other side.
The patient is encouraged to reduce smoking; though this is a difficult thing to do the patient should be made aware that smoking will delay the process of wound healing.
If possible; the patient should not sleep on his own pajamas or blankets. They should use hospital linen, which can be changed daily so that the patient is nursed on a clean environment at all times. As the world has been engulfed by COVID-19 pandemic, most hospitals have changed their rules as far as visiting relatives are concerned, so it might be impossible for the family to bring clean pajamas every day for their relatives. The patient is also encouraged to take high protein foods to promote wound healing.
\n',keywords:"infection, chronic osteomyelitis, Lautenbach irrigation system, D.R.I, antibiotics",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/82299.pdf",chapterXML:"https://mts.intechopen.com/source/xml/82299.xml",downloadPdfUrl:"/chapter/pdf-download/82299",previewPdfUrl:"/chapter/pdf-preview/82299",totalDownloads:7,totalViews:0,totalCrossrefCites:0,dateSubmitted:"January 23rd 2022",dateReviewed:"February 7th 2022",datePrePublished:"June 18th 2022",datePublished:null,dateFinished:"June 18th 2022",readingETA:"0",abstract:"Osteomyelitis is an infection of the bone and frequently seeds in trabecular areas affecting both bone and bone marrow. Bone infection differs from the soft-tissue infection since bone consists of a collection of rigid compartments. Bone is thus more susceptible than soft tissues to vascular damage and cell death due to pressure in acute inflammation. Unless it is rapidly suppressed, bone infection will inevitably lead to necrosis. Chronic infection is seldom eradicated by antibiotics alone. Yet bactericidal drugs are important to suppress the infection and prevent its spread to healthy bones and control acute flares. The choice of antibiotic depends on microbiological studies, but the drug must be capable of penetrating sclerotic bone and should be nontoxic with long-term use. A different technique is the Lautenbach approach, involving radical excision of all avascular and infected tissue followed by closed irrigation and suction drainage, and an appropriate antibiotic solution in high concentration to allow the “dead space” to be filled by vascular granulation tissue.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/82299",risUrl:"/chapter/ris/82299",signatures:"Princess Busisiwe Siphiwe Mbatha",book:{id:"11222",type:"book",title:"Nursing",subtitle:null,fullTitle:"Nursing",slug:null,publishedDate:null,bookSignature:"Prof. Victor Chaban",coverURL:"https://cdn.intechopen.com/books/images_new/11222.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80355-517-1",printIsbn:"978-1-80355-516-4",pdfIsbn:"978-1-80355-518-8",isAvailableForWebshopOrdering:!0,editors:[{id:"83427",title:"Prof.",name:"Victor",middleName:null,surname:"Chaban",slug:"victor-chaban",fullName:"Victor Chaban"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Irrigation system contents",level:"1"},{id:"sec_3",title:"3. Nursing management",level:"1"},{id:"sec_4",title:"4. Protocol for irrigation maintenance",level:"1"},{id:"sec_5",title:"5. Specimen collection",level:"1"},{id:"sec_6",title:"6. Unblocking the irrigation system",level:"1"},{id:"sec_7",title:"7. Discussion",level:"1"}],chapterReferences:[{id:"B1",body:'Blom A, Warwick D, Michael Whitehouse. Apley and Solomon’s System of Orthopaedics and Trauma. 2018. pp. 31-43'},{id:"B2",body:'Hashmi MA, Norman P, Saleh M. The management of chronic osteomyelitis using the Lautenbach method. Journal of Bone and Joint Surgery. British Volume (London). 2004;86(2):269-275. DOI: 10.1302/0301-620x.86b2.14011 PMID: 15046445'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Princess Busisiwe Siphiwe Mbatha",address:"bathaphiwe@gmail.com",affiliation:'
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After graduation, Dr. El Rifai joined the Clemenceau Medical Center as a surgical fellow.\nDr. El Rifai is currently serving as a medical advisor for Johnson and Johnson in the Middle East. Her interest is in colorectal and oncology surgery with a focus on innovation, technology, and shaping healthcare and policy in the region.",institutionString:"American University of Beirut",institution:{name:"American University of Beirut",institutionURL:null,country:{name:"Lebanon"}}},{id:"327116",title:"M.D.",name:"Andrea",surname:"Sanna",slug:"andrea-sanna",fullName:"Andrea Sanna",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/327116/images/system/327116.png",biography:"Andrea Sanna, MD, is a Chief of General Surgery at Adria Hospital, Padua, Italy. He graduated in General Surgery from Ferrara University, Italy. His main clinical interests include minimally invasive techniques for the treatment of gastrointestinal cancer, abdominal wall reconstruction, and thyroid surgery. His areas of surgical specialty include laparoscopic colonic and gastric cancer; laparoscopic primary and incisional abdominal wall repair; extended-view, totally extraperitoneal primary and incisional abdominal wall hernia reconstruction; minimally invasive video-assisted thyroidectomy (MIVAT); and Desarda’s groin hernia repair technique. Dr. Sanna has published several articles in peer-reviewed journals and authored several book chapters in general surgery. He is a member of several surgical associations including Associazione dei Chirurghi Ospedalieri Italiani (ACOI), European Hernia Society, and Società Italiana di Endocrinochriurgia (SIUEC).",institutionString:"“Mother Teresa of Calcutta” Hospital",institution:null},{id:"333588",title:"Dr.",name:"Luca",surname:"Felicioni",slug:"luca-felicioni",fullName:"Luca Felicioni",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ospedale Misericordia di Grosseto",institutionURL:null,country:{name:"Italy"}}},{id:"339967",title:"Prof.",name:"Alpha Oumar",surname:"Toure",slug:"alpha-oumar-toure",fullName:"Alpha Oumar Toure",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"348826",title:"Dr.",name:"Ousmane",surname:"Thiam",slug:"ousmane-thiam",fullName:"Ousmane Thiam",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"348828",title:"Dr.",name:"Mamadou",surname:"Seck",slug:"mamadou-seck",fullName:"Mamadou Seck",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"357486",title:"Dr.",name:"Carmen Aurelia",surname:"Mogoanta",slug:"carmen-aurelia-mogoanta",fullName:"Carmen Aurelia Mogoanta",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"357487",title:"Dr.",name:"Stefan",surname:"Paitici",slug:"stefan-paitici",fullName:"Stefan Paitici",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null}]},generic:{page:{slug:"OA-publishing-fees",title:"Open Access Publishing Fees",intro:"
The Open Access model is applied to all of our publications and is designed to eliminate subscriptions and pay-per-view fees. This approach ensures free, immediate access to full text versions of your research.
As a gold Open Access publisher, an Open Access Publishing Fee is payable on acceptance following peer review of the manuscript. In return, we provide high quality publishing services and exclusive benefits for all contributors. IntechOpen is the trusted publishing partner of over 140,000 international scientists and researchers.
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Permanent and unrestricted online access to your work
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To explore funding opportunities and learn more about how you can finance your IntechOpen publication, go to our Open Access Funding page. IntechOpen offers expert assistance to all of its Authors. We can support you in approaching funding bodies and institutions in relation to publishing fees by providing information about compliance with the Open Access policies of your funder or institution. We can also assist with communicating the benefits of Open Access in order to support and strengthen your funding request and provide personal guidance through your application process. You can contact us at funders@intechopen.com for further details or assistance.
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Choosing to publish with IntechOpen ensures the following benefits:
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As a gold Open Access publisher, an Open Access Publishing Fee is payable on acceptance following peer review of the manuscript. In return, we provide high quality publishing services and exclusive benefits for all contributors. IntechOpen is the trusted publishing partner of over 140,000 international scientists and researchers.
\n\n
The Open Access Publishing Fee (OAPF) is payable only after your book chapter, monograph or journal article is accepted for publication.
\n\n
OAPF Publishing Options
\n\n
\n\t
1,400 GBP Chapter - Edited Volume
\n\t
850 GBP Chapter - Book Series Topic (Annual Volume)
\n\t
10,000 GBP Monograph - Long Form
\n\t
4,000 GBP Compacts Monograph - Short Form
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850 GBP Journal Article (Across Portfolio)
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During the launching phase journals do not charge an APC, rather they will be funded by IntechOpen.
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*These prices do not include Value-Added Tax (VAT). Residents of European Union countries need to add VAT based on the specific rate in their country of residence. Institutions and companies registered as VAT taxable entities in their own EU member state will not pay VAT as long as provision of the VAT registration number is made during the application process. This is made possible by the EU reverse charge method.
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Services included are:
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An online manuscript tracking system to facilitate your work
\n\t
Personal contact and support throughout the publishing process from your dedicated Author Service Manager
\n\t
Assurance that your manuscript meets the highest publishing standards
\n\t
English language copyediting and proofreading, including the correction of grammatical, spelling, and other common errors
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XML Typesetting and pagination - web (PDF, HTML) and print files preparation
\n\t
Discoverability - electronic citation and linking via DOI
\n\t
Permanent and unrestricted online access to your work
\n
\n\n
What isn't covered by the Open Access Publishing Fee?
\n\n
If your manuscript:
\n\n
\n\t
Exceeds the number of pages defined by the publishing guidelines, an additional fee per page may be required
\n\t
If a manuscript requires Heavy Editing or Language Polishing, this will incur additional fees.
\n
\n\n
Your Author Service Manager will inform you of any items not covered by the OAPF and provide exact information regarding those additional costs before proceeding.
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To explore funding opportunities and learn more about how you can finance your IntechOpen publication, go to our Open Access Funding page. IntechOpen offers expert assistance to all of its Authors. We can support you in approaching funding bodies and institutions in relation to publishing fees by providing information about compliance with the Open Access policies of your funder or institution. We can also assist with communicating the benefits of Open Access in order to support and strengthen your funding request and provide personal guidance through your application process. You can contact us at funders@intechopen.com for further details or assistance.
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Added Value of Publishing with IntechOpen
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Choosing to publish with IntechOpen ensures the following benefits:
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Indexing and listing across major repositories, see details ...
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Long-term archiving
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Visibility on the world's strongest OA platform
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Live Performance Metrics to track readership and the impact of your chapter
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Dissemination and Promotion
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Benefits of Publishing with IntechOpen
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Proven world leader in Open Access book publishing with over 10 years experience
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+5,700 OA books published
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Most competitive prices in the market
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Fully compliant with OA funding requirements
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Optimized processes that assure your research is made available to the scientific community without delay
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Personal support during every step of the publication process
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+184,650 citations in Web of Science databases
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Currently strongest OA platform with over 175 million downloads
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This spectral index provides relevance and is updated for each scene, evidences about the biomass and soil productivity, and vegetation density cover or vegetation stress (e.g., forest fires, droughts). Modeled output maps are suitable for temporal change analysis, which allows the identification of the effect of land management practices, soil and vegetation regeneration, or climate effects.",book:{id:"5883",slug:"modern-fuzzy-control-systems-and-its-applications",title:"Modern Fuzzy Control Systems and Its Applications",fullTitle:"Modern Fuzzy Control Systems and Its Applications"},signatures:"Ignacio Meléndez-Pastor, Jose Navarro Pedreño, Ignacio Gómez\nLucas and Antonis A. 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However, the underlying rule sets for OBIA are usually too complex to be directly applied on a variety of image data without any adaptations or human interactions. Thus, recent research projects investigate the potential for integrating the agent-based paradigm with OBIA. Agent-based systems are highly adaptive and therefore robust, even under varying environmental conditions. In the context of image analysis, this means that even if the image data to be analyzed varies slightly (e.g., due to seasonal effects, different locations, atmospheric conditions, or even a slightly different sensor), agent-based methods allow to autonomously adapt existing analysis rules or segmentation results according to changing imaging situations. The basis for individual software agents’ behavior is a so-called believe-desire-intention (BDI) model. Basically, the BDI describes for each individual agent its goal(s), its assumed current situation, and some action rules potentially supporting each agent to achieve its goals. The chapter introduces a believe-desire-intention (BDI) model based on fuzzy rules in the context of agent-based image analysis, which extends the classic OBIA paradigm by the agent-based paradigm.",book:{id:"5883",slug:"modern-fuzzy-control-systems-and-its-applications",title:"Modern Fuzzy Control Systems and Its Applications",fullTitle:"Modern Fuzzy Control Systems and Its Applications"},signatures:"Peter Hofmann",authors:[{id:"199778",title:"Dr.",name:"Peter",middleName:null,surname:"Hofmann",slug:"peter-hofmann",fullName:"Peter Hofmann"}]},{id:"56033",doi:"10.5772/68126",title:"A Fuzzy Logic Approach for Separation Assurance and Collision Avoidance for Unmanned Aerial Systems",slug:"a-fuzzy-logic-approach-for-separation-assurance-and-collision-avoidance-for-unmanned-aerial-systems",totalDownloads:1401,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"In the coming years, operations in low altitude airspace will vastly increase as the capabilities and applications of small unmanned aerial systems (sUAS) continue to multiply. Therefore, finding solutions to managing sUAS in highly congested airspace will facilitate sUAS operations. In this study, a fuzzy logic-based approach was used to help mitigate the risk of collisions between aircraft using separation assurance and collision avoidance techniques. The system was evaluated for its effectiveness at mitigating the risk of mid-air collisions between aircraft. This system utilizes only current state information and can resolve potential conflicts without knowledge of intruder intent. The avoidance logic was verified using formal methods and shown to select the correct action in all instances. Additionally, the fuzzy logic controllers were shown to always turn the vehicles in the correct direction. Numerical testing demonstrated that the avoidance system was able to prevent a mid-air collision between two sUAS in all tested cases. Simulations were also performed in a three-dimensional environment with a heterogeneous fleet of sUAS performing a variety of realistic missions. Simulations showed that the system was 99.98% effective at preventing mid-air collisions when separation assurance was disabled (unmitigated case) and 100% effective when enabled (mitigated case).",book:{id:"5883",slug:"modern-fuzzy-control-systems-and-its-applications",title:"Modern Fuzzy Control Systems and Its Applications",fullTitle:"Modern Fuzzy Control Systems and Its Applications"},signatures:"Brandon Cook, Tim Arnett and Kelly Cohen",authors:[{id:"200830",title:"Mr.",name:"Brandon",middleName:"Matthew",surname:"Cook",slug:"brandon-cook",fullName:"Brandon Cook"},{id:"200833",title:"Mr.",name:"Timothy",middleName:null,surname:"Arnett",slug:"timothy-arnett",fullName:"Timothy Arnett"},{id:"200834",title:"Dr.",name:"Kelly",middleName:null,surname:"Cohen",slug:"kelly-cohen",fullName:"Kelly Cohen"}]}],mostDownloadedChaptersLast30Days:[{id:"54537",title:"Fuzzy Logic Application, Control and Monitoring of Critical Machine Parameters in a Processing Company",slug:"fuzzy-logic-application-control-and-monitoring-of-critical-machine-parameters-in-a-processing-compan",totalDownloads:1846,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The processing company under study found out that the boiler was the key machine and needs artificial intelligence monitoring and control. It was simulated under Matlab software and oil level, and pressure and temperature were to be modelled and controlled using the programmable logic controller (PLC) with a fuzzy logic controller as the main brain of control. The company is for processing of fruits to produce juice.",book:{id:"5883",slug:"modern-fuzzy-control-systems-and-its-applications",title:"Modern Fuzzy Control Systems and Its Applications",fullTitle:"Modern Fuzzy Control Systems and Its Applications"},signatures:"Tawanda Mushiri",authors:[{id:"198749",title:"Dr.",name:"Tawanda",middleName:null,surname:"Mushiri",slug:"tawanda-mushiri",fullName:"Tawanda Mushiri"}]},{id:"65167",title:"Functional Safety of FPGA Fuzzy Logic Controller",slug:"functional-safety-of-fpga-fuzzy-logic-controller",totalDownloads:799,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"In this paper we describe a methodology to implement a fuzzy logic controller in FPGA. The implementation of fuzzy logic controller (FLC) in FPGA requires a qualitative and a quantitative analysis to define the system safety integrity level (SIL). This level can be defined by the quantification of the probability of failure on demand (PFDavg). We propose to analyze the implementation advance safety architecture of fuzzy logic controllers with 1-out-of-2 controllers (1oo2) in FPGA using the reliability block diagram (RBD) and the Markov model. 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Dr. Şentürk currently works as an professor of Biochemistry in the Department of Basic Pharmacy Sciences, Faculty of Pharmacy, Ağri Ibrahim Cecen University, Turkey. \nDr. Şentürk published over 120 scientific papers, reviews, and book chapters and presented several conferences to scientists. \nHis research interests span enzyme inhibitor or activator, protein expression, purification and characterization, drug design and synthesis, toxicology, and pharmacology. \nHis research work has focused on neurodegenerative diseases and cancer treatment. 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Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. 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. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"July 5th, 2022",hasOnlineFirst:!0,numberOfOpenTopics:4,numberOfPublishedChapters:319,numberOfPublishedBooks:32,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. 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"}}},subseries:[{id:"14",title:"Cell and Molecular Biology",keywords:"Omics (Transcriptomics; Proteomics; Metabolomics), Molecular Biology, Cell Biology, Signal Transduction and Regulation, Cell Growth and Differentiation, Apoptosis, Necroptosis, Ferroptosis, Autophagy, Cell Cycle, Macromolecules and Complexes, Gene Expression",scope:"The Cell and Molecular Biology topic within the IntechOpen Biochemistry Series aims to rapidly publish contributions on all aspects of cell and molecular biology, including aspects related to biochemical and genetic research (not only in humans but all living beings). We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics include, but are not limited to: Advanced techniques of cellular and molecular biology (Molecular methodologies, imaging techniques, and bioinformatics); Biological activities at the molecular level; Biological processes of cell functions, cell division, senescence, maintenance, and cell death; Biomolecules interactions; Cancer; Cell biology; Chemical biology; Computational biology; Cytochemistry; Developmental biology; Disease mechanisms and therapeutics; DNA, and RNA metabolism; Gene functions, genetics, and genomics; Genetics; Immunology; Medical microbiology; Molecular biology; Molecular genetics; Molecular processes of cell and organelle dynamics; Neuroscience; Protein biosynthesis, degradation, and functions; Regulation of molecular interactions in a cell; Signalling networks and system biology; Structural biology; Virology and microbiology.",annualVolume:11410,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"79367",title:"Dr.",name:"Ana Isabel",middleName:null,surname:"Flores",fullName:"Ana Isabel Flores",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRpIOQA0/Profile_Picture_1632418099564",institutionString:null,institution:{name:"Hospital Universitario 12 De Octubre",institutionURL:null,country:{name:"Spain"}}},{id:"328234",title:"Ph.D.",name:"Christian",middleName:null,surname:"Palavecino",fullName:"Christian Palavecino",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000030DhEhQAK/Profile_Picture_1628835318625",institutionString:null,institution:{name:"Central University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",fullName:"Francisco Javier Martin-Romero",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",institutionString:null,institution:{name:"University of Extremadura",institutionURL:null,country:{name:"Spain"}}}]},{id:"15",title:"Chemical Biology",keywords:"Phenolic Compounds, Essential Oils, Modification of Biomolecules, Glycobiology, Combinatorial Chemistry, Therapeutic peptides, Enzyme Inhibitors",scope:"Chemical biology spans the fields of chemistry and biology involving the application of biological and chemical molecules and techniques. In recent years, the application of chemistry to biological molecules has gained significant interest in medicinal and pharmacological studies. This topic will be devoted to understanding the interplay between biomolecules and chemical compounds, their structure and function, and their potential applications in related fields. Being a part of the biochemistry discipline, the ideas and concepts that have emerged from Chemical Biology have affected other related areas. This topic will closely deal with all emerging trends in this discipline.",annualVolume:11411,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null,editorialBoard:[{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",fullName:"Abdulsamed Kükürt",profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",institutionString:null,institution:{name:"Kafkas University",institutionURL:null,country:{name:"Turkey"}}},{id:"241413",title:"Dr.",name:"Azhar",middleName:null,surname:"Rasul",fullName:"Azhar Rasul",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRT1oQAG/Profile_Picture_1635251978933",institutionString:null,institution:{name:"Government College University, Faisalabad",institutionURL:null,country:{name:"Pakistan"}}},{id:"178316",title:"Ph.D.",name:"Sergey",middleName:null,surname:"Sedykh",fullName:"Sergey Sedykh",profilePictureURL:"https://mts.intechopen.com/storage/users/178316/images/system/178316.jfif",institutionString:null,institution:{name:"Novosibirsk State University",institutionURL:null,country:{name:"Russia"}}}]},{id:"17",title:"Metabolism",keywords:"Biomolecules Metabolism, Energy Metabolism, Metabolic Pathways, Key Metabolic Enzymes, Metabolic Adaptation",scope:"Metabolism is frequently defined in biochemistry textbooks as the overall process that allows living systems to acquire and use the free energy they need for their vital functions or the chemical processes that occur within a living organism to maintain life. Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. Thus all studies on metabolism will be considered for publication.",annualVolume:11413,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",institutionString:null,institution:{name:"Artois University",institutionURL:null,country:{name:"France"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",fullName:"Anca Pantea Stoian",profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"203824",title:"Dr.",name:"Attilio",middleName:null,surname:"Rigotti",fullName:"Attilio Rigotti",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institutionString:null,institution:{name:"Pontifical Catholic University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"300470",title:"Dr.",name:"Yanfei (Jacob)",middleName:null,surname:"Qi",fullName:"Yanfei (Jacob) Qi",profilePictureURL:"https://mts.intechopen.com/storage/users/300470/images/system/300470.jpg",institutionString:null,institution:{name:"Centenary Institute of Cancer Medicine and Cell Biology",institutionURL:null,country:{name:"Australia"}}}]},{id:"18",title:"Proteomics",keywords:"Mono- and Two-Dimensional Gel Electrophoresis (1-and 2-DE), Liquid Chromatography (LC), Mass Spectrometry/Tandem Mass Spectrometry (MS; MS/MS), Proteins",scope:"With the recognition that the human genome cannot provide answers to the etiology of a disorder, changes in the proteins expressed by a genome became a focus in research. Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. The Proteomics topic aims to attract contributions on all aspects of MS-based proteomics that, by pushing the boundaries of MS capabilities, may address biological problems that have not been resolved yet.",annualVolume:11414,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null,editorialBoard:[{id:"72288",title:"Dr.",name:"Arli Aditya",middleName:null,surname:"Parikesit",fullName:"Arli Aditya Parikesit",profilePictureURL:"https://mts.intechopen.com/storage/users/72288/images/system/72288.jpg",institutionString:null,institution:{name:"Indonesia International Institute for Life Sciences",institutionURL:null,country:{name:"Indonesia"}}},{id:"40928",title:"Dr.",name:"Cesar",middleName:null,surname:"Lopez-Camarillo",fullName:"Cesar Lopez-Camarillo",profilePictureURL:"https://mts.intechopen.com/storage/users/40928/images/3884_n.png",institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",institutionURL:null,country:{name:"Mexico"}}},{id:"81926",title:"Dr.",name:"Shymaa",middleName:null,surname:"Enany",fullName:"Shymaa Enany",profilePictureURL:"https://mts.intechopen.com/storage/users/81926/images/system/81926.png",institutionString:"Suez Canal University",institution:{name:"Suez Canal University",institutionURL:null,country:{name:"Egypt"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/40433",hash:"",query:{},params:{id:"40433"},fullPath:"/chapters/40433",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var t;(t=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(t)}()