\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"509",leadTitle:null,fullTitle:"Biomedical Science, Engineering and Technology",title:"Biomedical Science, Engineering and Technology",subtitle:null,reviewType:"peer-reviewed",abstract:"This innovative book integrates the disciplines of biomedical science, biomedical engineering, biotechnology, physiological engineering, and hospital management technology. Herein, Biomedical science covers topics on disease pathways, models and treatment mechanisms, and the roles of red palm oil and phytomedicinal plants in reducing HIV and diabetes complications by enhancing antioxidant activity. Biomedical engineering coves topics of biomaterials (biodegradable polymers and magnetic nanomaterials), coronary stents, contact lenses, modelling of flows through tubes of varying cross-section, heart rate variability analysis of diabetic neuropathy, and EEG analysis in brain function assessment. Biotechnology covers the topics of hydrophobic interaction chromatography, protein scaffolds engineering, liposomes for construction of vaccines, induced pluripotent stem cells to fix genetic diseases by regenerative approaches, polymeric drug conjugates for improving the efficacy of anticancer drugs, and genetic modification of animals for agricultural use. Physiological engineering deals with mathematical modelling of physiological (cardiac, lung ventilation, glucose regulation) systems and formulation of indices for medical assessment (such as cardiac contractility, lung disease status, and diabetes risk). Finally, Hospital management science and technology involves the application of both biomedical engineering and industrial engineering for cost-effective operation of a hospital.",isbn:null,printIsbn:"978-953-307-471-9",pdfIsbn:"978-953-51-4376-5",doi:"10.5772/1020",price:169,priceEur:185,priceUsd:219,slug:"biomedical-science-engineering-and-technology",numberOfPages:904,isOpenForSubmission:!1,isInWos:1,isInBkci:!0,hash:"eec1ae8717629372ed7f0c0499dee14c",bookSignature:"Dhanjoo N. 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Kye has written in the article Professor with a mission, [Dhanjoo Ghista] is a professor of professors, a world authority in biomedical engineering and physics, author or editor of several textbooks in subjects ranging from cardiovascular physics to African Rural Development and inventor of life-saving implant devices. A pioneer of research into the effect of space travel on astronauts, his work as the founder and leading exponent of the new science of societal engineering has received recognition from academics and institutions alike.\r\n\r\nAlong with having being editor-in-chief of Automedica (an international journal of high-tech medicine), Prof. Dr. Dhanjoo N. Ghista has published over 450 works in the fields of engineering science, biomedical engineering, medical science, and social sciences. 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High resolution microscopes are essential for visualizing virus particles. A transmission electron microscope (TEM) fulfils this requirement and is widely used by scientists. Unknown agents of diseases may be quickly detected by using such a microscope. A recent review on the value of electron microscopy and virus structures was presented by Zhang et al. [1].
Shortly prior to the recent recognition of mimiviruses [2], orthopoxviruses had been one of the largest virus particles, in addition to the thin and very long filoviruses. Groups of orthopoxvirus particles can be detected when inside infected cells using the highest magnification available in light microscopy. Nevertheless, an isolated virus particle of ca. 250 nm diameter remains below the resolution of standard light microscopes. With the advent of TEMs and high magnifications of over 100 000x, the structural details of virus particles could then begin to be recognized.
The first demonstration of a viral particle using a TEM was in the form of a member of the orthopoxvirus genus [3]. Following the introduction of the negative staining technique in the 1960s [4], a variety of viruses has been discovered and classified based on morphological characteristics such as symmetry, the presence or absence of the envelope or spikes and the size of these projections [5,6,7,8]. A large number of viruses of medical importance that had formerly never been described such as adenovirus, enterovirus, orthomyxovirus, reovirus and paramyxovirus were identified by TEM after isolation in cell cultures inoculated with clinical specimens [9]. Other viruses like hepatitis B and hepatitis A were detected directly by TEM in samples such as plasma and faeces, following the failure of attempting to try and isolate them in cell cultures. The initial classification of many agents was therefore based on a combination of morphology and genome structure.
Currently, more than 30 000 different viruses comprising 56 families have been identified using TEM and humans have been found to play host to 21 of the 26 families specific for vertebrates [10]. The development of other techniques, e.g., immunofluorescence, enzyme-linked immunosorbent assays (ELISA) and biological molecular methods such as polymerase chain reaction (PCR) have progressively reduced the importance of TEM in virus diagnosis and microbiology. However, compared with other diagnostic methods, TEM still benefits from its rapidity and “open view”, i.e., the capability of detecting all pathogens present in a clinical specimen [11]. Therefore, TEM should be utilized as a frontline method in infectious disease emergencies and/or in suspected cases of bioterrorism [12]. Electron microscope studies were critical in identifying the aetiologic agent of severe acute respiratory syndrome (SARS), a coronavirus, during its 2002/2003 global outbreak [13].
Several methods for specimen preparation have been developed. These can be summarized into two procedures: the negative staining of vesicular content and viral suspensions, and the ultra-thin sectioning of infected tissues and cells. Both techniques have been carried out with complementary results.
The classic processing of biological specimens observed in a TEM needs fixation, dehydration, sectioning and a selective “staining” of cell and tissue structures. “Staining”, a means of receiving coloured images, cannot be effectively used in conjunction with an electron microscope. Instead, the enhancement of structures for TEM observation is effected, usually by impregnation with heavy metal salts of plumb, tungstenium and uranium.
Some biological elements are very small and as a result, sectioning reveals aspects of its content but not about its global surface structure. The result is a bi-dimensional image. Nevertheless, when observed as a whole using the negative staining technique, these elements reveal a tri-dimensional image.
To prepare small biological specimens such as bacteria, viruses, phages, micoplasma, filaments and cell membranes, or even nucleic acids and protein filaments for TEM observation, the special technique of “negative contrast” was developed [4]. Instead of applying a more or less strong positive contrast of structures (“staining”), in this instance, contrast is not applied to the object but to its environment, using heavy metal salts. The electron beam can cross biological material easier than the surrounding space. The result resembles an inverted traditional TEM image (Figures 2, 4-7).The standard staining solution used today is an aqueous 1% phosphotungstic acid with pH 7.2.
Essentially, a fixed or unfixed drop of viral suspension is applied onto a formvar- or collodium-covered electron microscope grid for a few seconds; the liquid is absorbed by a filter paper, then a drop of the staining solution is applied and few seconds later also absorbed (Figure 1). After drying, the specimen is ready to be introduced into the electron beam.
Negative staining procedure. Forceps, grid and white filter paper are the primary tools.
Orthopoxvirus particle, Brazilian Cantagalo strain (negative staining). This virus particle was isolated from a milker\'s hand nodule, macerated using a drop of distilled water and applied onto a collodium-covered EM-copper grid, then stained using a drop of 2% phosphotungstic acid in distilled water.
Ultra-thin section of a Vero cell infected with the same strain of virus demonstrated in
Group of seven adenovirus particles and numerous small adeno-associated virus particles. A drop of clarified faeces from a patient suffering from gastroenteritis was processed as described in
A group of rotavirus particles. Clarified faeces from a patient suffering from gastroenteritis was incubated with a specific antibody prior to being submitted to the negative staining procedure and processed as described in
This unbelievably simple technique, at the outset rejected by the scientific community, eventually became a revolutionary approach for studying primarily viral morphology as emphasized by viral diagnostics [14]. Extremely detailed images were obtained and published, revealing substructures and macromolecules as viral antibodies and virus particle spines [5, 9, 15, 16, 17, 18, 19, 20].
In order to gain additional information about small structured elements, several technical steps in sample processing were developed such as immune-electron microscopy (Figure 5), solid-phase-electron microscopy, ammonium-sulphate precipitation, gradient fraction contrasting and particle concentration by diffusion in an agarose layer [21].
Contrasting solutions show a large spectrum of possibilities. Selection must be in accordance with the pH and electrical charge of the sample, of the contrasting solution and of the EM grid or support [19, 22]. Resulting precipitates and a lack of spreading of the sample are the most common inconveniences. For better spreading and adsorption of virus particles onto a formvar-carbon coated grid, polylysine (poly-L-lysine) is currently being used in our laboratory (Figures 6 to 7).
Hepatitis B antigen. One drop of a gradient virus suspension was applied directly onto an electron microscope grid and in sequence stained with 1% alcoholic uranyl acetate. Virus particles are joined together into very dark groups.
Hepatitis B antigen. One drop of the same virus suspension as shown in
An overview of the negative staining technique development and application was presented by Biel & Gelderblom [6], Harris et al. [23] and more recently, by Schramlová et al. [24]. Benefits or deception are always surprising factors when the electron beam reveals a TEM image inside a dark room.
The positive staining technique has been used since the late 50s and the early 60s for enhancing the contrast of biological samples (tissues and cell structures, viruses, etc.). Using this technique, as well as negative staining, the samples are incubated in heavy metal salt solutions that react with cellular structures. Uranyl acetate [25] and lead citrate [26] are the most commonly used salts today. Grids containing ultra-thin sections of a sample are incubated for 15 minutes in uranyl acetate; this procedure should be performed in an environment protected from light. Following on, the grids are washed in distilled water and incubated in lead citrate at four to five minutes in an environment free of CO2. NaOH tablets are used to keep the environment free from reacting with CO2 (Figure 8). At the end of the procedure the grids are washed in distilled water, air dried and observed with a TEM [27, 28].
Positive staining. The grid held with a forceps contains ultra-thin sections of a sample (arrow). In the Petri dish, there are two drops of the staining solution beside two tablets of NaOH (Barreto-Vieira et al. 2010).
Ultramicrotomy:
Dengue virus particles (arrow) isolated in the
Hepatic tissue of BALB/c mice infected with the dengue virus. Note the numerous lipidic inclusions (L) and a pyknotic nucleus (N). Positive staining emphasizes the chromatin of the hepatocyte nucleus using lead citrate and cytoplasmic proteins using uranyl acetate.
Virus diagnosis via TEM, when compared to other techniques such as immunofluorescence, PCR and ELISA have both advantages and disadvantages.
Financial support: research fellowship of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), process numbers 301525/2009-9 and 304067/2014-18 (second author).
The art and science of orthodontics have certainly come a long way from the era of treatment using removable appliances, which mainly produced tipping movements of the teeth, to the fixed appliances that bring about bodily movements of the teeth to their desired destination. But this has not been a journey without hiccups. The quest for the perfect smile or the ideal occlusion has been marred by quite a few stories of botched-up cases, which, sometimes, could be the result of unscientific methods being utilized to achieve the promised results. But it also seems to be a story of due respect not being accorded to the most important structure in the treatment process—the periodontium. This chapter discusses the relationship that the periodontium (
The force applied to the teeth during orthodontic treatment results in remodeling of the alveolar bone. The exact mechanism of how this force is converted to biological activity has not been elicited till now. Various theories try to explain this phenomenon:
Bone-bending/biological electrical
Pressure-tension
Neurogenic inflammation
Fluid-flow sheer stress
Whatever be the mechanism, it seems obvious that it is the periodontium that plays a big role in achieving the treatment goals.
The periodontium has two main functions: protection and attachment. The former function is carried out by the gingiva and the latter by its three remaining parts, namely the cementum, periodontal ligaments, and the alveolar bone. It is only the gingiva that is visible in the oral cavity, the rest being covered and protected by it.
The primary function of the gingiva is protection, as stated earlier. Orthodontic treatment tends to be associated with gingivitis in many patients. As the presence of plaque is one of the main factors in the development of gingivitis, it could be the interference of the orthodontic brackets and elastics with effective removal of dental plaque, which might be resulting in gingivitis. However, it has been shown that because of orthodontic treatment a shift in the composition and type of bacteria can occur [1]. According to J. van Gastel, et al. [2], fixed orthodontic treatment may result in localized gingivitis, which rarely progresses to periodontitis. E. Bimstein and A. Becker [3] state that, following placement of a fixed appliance, a small amount of gingival inflammation will be visible, which could be transient in nature and does not lead to attachment loss, in the majority of the patients.
Gingival recession is considered to be one of the more common complications of orthodontic tooth movement (OTM). But in a study conducted among 205 orthodontic patients, Morris JW, et al. [4] found that “orthodontic treatment is not a major risk factor for the development of gingival recession.” They further state that “although greater amounts of maxillary expansion during treatment increase the risks of post-treatment recession, the effects are minimal.”
Any treatment procedure that a human being undergoes, whether surgical or medical, can have side effects or risks involved, and orthodontic treatment is no exception. Similar to other medical procedures, the aim in orthodontics is also to minimize the risks involved in the maximum number of patients possible.
Microscopic resorption of the cementum of erupted as well as unerupted teeth is a common phenomenon. This occurs without involving the underlying dentin in the majority of cases. The resorption may be caused by local or systemic factors or can be idiopathic. Trauma from occlusion, malaligned erupting teeth, periapical as well as periodontal infections, replanted or transplanted teeth, orthodontic movement, etc. are the local factors that may result in cementum resorption. According to some authors [5, 6, 7], root resorption is the most common side effect of orthodontic treatment and occurs within 6 months of commencement of the treatment. Anja Pejicic, et al. [8] have described three degrees of severity of orthodontically induced root resorption (OIRR): the first degree wherein there is only surface resorption of the cementum which will regenerate or remodel fully. The second degree shows deep resorption with cementum and outer dentin layers involved and this is usually repaired with cementum. In this, the original shape of the root may or may not be achieved following the repair. In their third degree, there is full resorption of the apical hard tissues evidenced by shortening of the root.
Biologic as well as mechanical factors have been highlighted as probable causes of OIRR, with tooth root morphology, abnormal root shape, previous history of trauma or root resorption, genetic and systemic factors, endodontic treatment, habits and oral health, etc. likely to be the biologic factors. Mechanical factors could be the amount of apical displacement, the magnitude of force applied, duration of treatment, whether it is continuous or intermittent force, type, extent and direction of tooth movement, etc., according to Anja Pejicic, et al. There are studies [9, 10, 11, 12] that suggest that it is the trauma due to over-compression of the periodontal ligament that causes OIRR. It seems to be an accepted fact that orthodontic movements are not entirely translatory due to mechanical laws. This results in the concentration of orthodontic forces at the apical region. During OTM, hyalinization does occur because it is virtually impossible to prevent the occlusion of blood vessels totally. Because of this, root resorption might begin at the hyalinized region of the necrotic periodontal ligament. As hyalinized necrotic tissue develops in almost 100% of patients during orthodontic treatment, some authors believe that root resorption occurs in almost every orthodontic patient [13, 14]. It is believed that the aggressiveness of the resorbing cells, the vulnerability and sensitivity of the tissues involved and individual variation and susceptibility will decide the extent of resorption [8].
The use of light orthodontic force has been shown to minimize the extent of root resorption, especially with horizontal and vertical displacement. This could be because the apical third of the root is covered with cellular cementum, whereas the coronal third is covered with acellular cementum. Because of the increased proliferation activity, cells of the cellular cementum might be easily damaged, whereas the slowly dividing cells of the acellular cementum might be more resistant to those forces [15, 16, 17].
Nitric oxide (NO), the intra- and the intercellular signal molecule, is synthesized by the activity of neuronal, endothelial, and inducible isoforms of NO synthases (NOSs). The primary sensor of NO is soluble guanylate cyclase (sGC). It plays a very important part in many physiological as well as pathological processes and conditions and also in NO signaling. The enzymatic activity of sGC is boosted when NO binds to it. In inflammation, sGC is oxidized and becomes insensitive to NO. Inflammation of the periodontium induces the resorption of cementum by cementoclasts and the resorption of the alveolar bone by osteoclasts. Korkmaz Y, et al. think that if medication can be used to activate sGC in periodontal tissues of patients suffering from periodontitis in nitric oxide and heme-independent manner, it could result in a novel treatment to stop cementum resorption for such patients. They reached this conclusion after studying the α1- and β1-subunits of sGC in cementoclasts of healthy and inflamed human periodontium using double immunostaining for CD68 and cathepsin K. They compared this with those of osteoclasts from the same sections and noticed that under inflammatory conditions, cementoclasts showed a decreased staining intensity for both the subunits [18].
Yufei Xie, Ning Zhao, and Gang Shen [19] investigated the anti-resorptive mechanisms of cementocytes during orthodontic tooth movement. They concluded that under fluid-flow sheer stress, cementocytes stimulate the differentiation of osteoblasts and inhibit the activation of osteoclasts, showing greater potential for bone protection than alveolar bone osteocytes. And according to them, “cementocytes might play an important role in preventing one of the most common complications of orthodontic treatment – root resorption.”
According to Alberto Consolaro [20], teeth with OIRR do not need:
restraints, as they do not become mobile or painful. If either of these symptoms is present, he suggests that other etiological factors like recently removed orthodontic braces, trauma from occlusion, bruxism, cervical bone loss, bone loss due to periodontitis, etc. should be looked for.
endodontic treatment as the dental pulp does not undergo ischemia, infarction, or necrosis during the orthodontic movements.
replacement with dental implants, as the cervical third of the root is responsible for 60% of periodontal support.
The alveolar bone is a mineralized connective tissue and is made up of around 67% inorganic material by weight. The inorganic content is primarily calcium and phosphate, with the mineral content being typically in the form of hydroxyapatite crystals. Around 20% of the alveolar bone consists of organic material, containing both collagen and non-collagenous materials. Water constitutes the rest of the weight of the alveolar bone- ~ 15% [21]. The inner wall of the tooth socket, known as the alveolar bone proper, contains many openings through which the periodontal ligament connects with the neurovascular bundles of the cancellous bone. The interdental bone or septum is made up of cancellous supporting bone within cortical walls.
Adjacent to the PDL space is a plate of compact bone called the lamina dura, whereas the majority of alveolar bone is trabecular in nature. The alveolar bone contains many different types of cells such as adipocytes, endothelial cells, macrophages, osteoclasts, osteoblasts and osteocytes. But the crucial detail of maintaining the function as well as homeostasis of the alveolar bone is carried out by the last three types of cells. There are some differences between the osteoblasts which form bone, and the osteoclasts, which resorb bone. The former (and the osteocytes) descend from mesenchymal cells, whereas the latter originates from the monocyte or hematopoietic cells. At the same time, the osteoclasts are formed by the fusion of multiple monocytes and thus are multinucleated while the osteoblasts are mononucleated. Type I collagen, which is the most abundant protein in vertebrates, can be made by both fibroblasts and osteoblasts and it is this collagen that forms the structural and mechanical matrix of the alveolar bone. The osteoblasts contain the master switch Runx2, which helps in the differentiation of osteoblasts from the progenitor mesenchymal cells [21]. As age advances, there is a disproportion between bone deposition and resorption and this is because the number of osteoblasts decreases as we age [22]. While apposition of bone is taking place, osteoblasts get enclosed in the mineralized bone and these cells are known as the osteocytes. A lacuna can form around such an osteocyte by deposition of minerals such as calcium carbonate, hydroxyapatite and calcium phosphate, during bone formation. The lacunae connect with each other through canaliculi, which are narrow channels through which the dendrites of osteocytes correspond using gap junctions. The bone-resorbing osteoclasts express various substances such as osteoprotegerin (OPG), chloride channel 7 (ClCN7), cathepsin K, and tartrate-resistant acid phosphatase (TRAP). Bone matrix proteins such as elastin, collagen, and gelatin are catabolized by the protease cathepsin K, whereas ClCN7 maintains osteoclast neutrality by shuffling chloride ions through the cell membrane. OPG, though a member of the TNF receptor family, is secreted and acts as a cytokine.
Among all the periodontal tissues, alveolar bone is the least stable because it is in a constant state of flux. Local factors that cause internal remodeling include age-related changes as well as functional requirements on the tooth. Mechanical strains caused by orthodontic movements are thought to be resulting in physiologic bone adaptation together with minor injuries to the periodontium, which are reversible [23]. The pressure-tension theory of tooth movement proposes that a tooth moves in the periodontal space by creating a pressure and tension side. According to this theory, the tooth shifts its position within the periodontal ligament (PDL) space, resulting in PDL compression in some areas and PDL tension in others within a few seconds of force loading and this is brought about by chemical, rather than electric, signals as the stimulus for cellular differentiation and ultimately tooth movement. Bone resorption occurs at the compression side and bone formation at the tension side, with blood flow being decreased on the compression side and is maintained or increased on the tension side. Within minutes of force being applied, the alteration in blood flow changes the oxygen tension and the chemical environment by releasing biologically active agents such as prostaglandins and cytokines [24]. This happens especially if there is sustained force. This alteration results in less oxygen levels on the pressure side due to compression of the periodontal ligament and vice versa. It has been observed that low oxygen tension causes decreased adenosine triphosphate (ATP) activity [25]. These changes act on cellular differentiation and activity, bringing about bone resorption at the compression side and bone formation at the tension side. Schwarz (1932) correlated the tissue response to the magnitude of force, with capillary blood pressure. If the force exceeds the pressure of ~20–25 g/cm2 of the root surface, tissue necrosis can occur due to the strangulated periodontium [26]. It has been shown that with the application of heavy force, blood flow tends to be cut off resulting in cell death under compression. According to Al Ansari et al., these cell deaths also include some osteocytes and osteoblasts in the adjacent alveolar bone. This causes acute inflammatory response with the release of chemokines that could attract other inflammatory and precursor cells into the extravascular space from the blood vessels. According to Taddei et al., during orthodontic movement, the chemokines known as monocyte chemo-attractant protein-1 (MCP-1) is released attracting the monocytes. These monocytes become either macrophages or osteoclasts once they exit the bloodstream and enter into the tissue. The release of other inflammatory mediators is also seen within the first few hours of tooth movement.
If the cessation of blood flow occurs because of heavy orthodontic force being applied, a delayed differentiation or recruitment of osteoclasts from adjacent bone marrow space also may occur resulting in “undermining resorption” that removes the lamina dura next to the compressed PDL. This is because no osteoclast differentiation occurs within the compressed PDL space. Under such a condition, tooth movement will take place only after this “undermining resorption” is completed, meaning only after a week or two. This also explains why tooth movement occurs within 2 to 3 days when light force is applied, because the light force will only reduce the blood flow permitting the quick recruitment of osteoclasts either from within the periodontal ligament space or from blood. This will result in the removal of the lamina dura by the process of “frontal resorption.” At the same time, it is a fact that tooth movement is a result of a combination of “undermining” as well as “frontal” resorption. This is because some degree of hyalinization almost always occurs as it is virtually impossible to clinically prevent the occlusion of blood vessels completely [24].
Yes, the force applied by the orthodontic appliance provides the impetus for the tooth to move. But without the PDL it would be impossible for the teeth to move through the bone and reach their intended destination, in an orderly manner. The PDL, like all ligaments in the body, connects the hard tissue structures, either the cementum of adjacent teeth to each other or the cementum of the tooth to the alveolar bone.
The PDL also connects with the neurovascular bundles of the cancellous bone through the alveolar bone proper
Some of the more frequent complications of orthodontic treatment are dehiscence or fenestration of the alveolar bone. These can result in root exposure, gingival recession, and relapse of the condition.
As discussed earlier, tooth loading, physiologic or otherwise, causes areas of compression and tension on the soft tissues surrounding the teeth also—the PDL, nerves, blood vessels, etc. In the PDL, there is an intimate relationship of the nerve endings with the blood vessels. Neurotransmitters such as calcitonin gene-related peptide (CGRP) and substance P are released when the nerve endings get distorted and these cause vasodilation and increased permeability of the blood vessels resulting in plasma leakage [23, 26]. OTM is achieved by the remodeling of the PDL and alveolar bone. These remodeling activities and the movement of the teeth result in an aseptic inflammatory process with the consequent increase in mediators such as prostaglandins (PGs), interleukins (ILs. IL-6, IL-7 & IL-17), the tumor necrosis factor (TNF)-α superfamily, and the receptor activator of nuclear factor (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG).
Current scientific literature suggests that arachidonic acid (AA) pathway plays a very important role in many human diseases such as cardiovascular problems, carcinogenesis as well as inflammatory conditions such as asthma, arthritis. Periodontists have been exploring the role of AA in periodontitis for some time, it being an inflammatory condition. AA can be metabolized by three specific enzyme systems, that is, cyclooxygenases, lipoxygenases, and cytochrome P450 (CYP) enzymes. One of the derivatives of the AA cascade—the prostaglandins (PGs) are produced within seconds of cell injury. PGE2 is the most abundantly seen PG in various tissues and is known for its all-around physiologic and pathological actions. It increases vascular permeability and chemotactic actions by acting as a vasodilator and at the same time, it increases bone resorption and osteoclast formation. An increase in PGs levels in the PDL and alveolar bone has been reported by Ngan, et al. [27], during orthodontic treatment. PGE2 levels in the gingival crevicular fluid (GCF) increased during OTM, according to Shetty et al. [28]. Leiker et al. [29] demonstrated that exogenous prostaglandins enhanced the rate of OTM in rats. The administration of PGE or prostaglandin receptor EP4 also enhanced the rate of tooth movement [30, 31]. It has also been demonstrated that indomethacin, a specific inhibitor of prostaglandin synthesis, reduces the rate of OTM in rats [31, 32]. As mentioned earlier, the cytokines also increase during OTM. IL-β in particular is involved with inflammation and stimulates bone resorption. It has been reported that IL-1β is produced by both macrophages and neutrophils, and is increased in inflamed gingival tissues. IL-6 is a multifunctional cytokine produced by immune cells and induces osteoclastic bone resorption. IL-17 is an inflammatory cytokine that is produced by activated T cells and it has been reported that IL-17 induces osteoclastogenesis from monocytes.
RANK ligand (RANKL) and its receptor RANK are present on osteoblasts and precursor osteoclasts, respectively. They are considered to be the key factors that stimulate osteoclast formation and osteoclastogenesis. RANKL is required for osteoclast formation with macrophage-colony-stimulating factor (MCSF) from precursor monocyte/macrophages. Osteoprotegerin (OPG) inhibits RANK–RANKL interactions [24]. It binds to RANKL and prevents RANK–RANKL ligation. Therefore, OPG prevents osteoclast differentiation and activation. Kanzaki et al. demonstrated that compression forces upregulate RANKL expression through induction of COX-2 in human PDL cells
All these studies suggest that these and other inflammatory cytokines may be intricately entwined with one another during OTM, and may play important roles in bone remodeling. But studies on OIRR seem to suggest that these mediators might also be the cause for the most common complication in orthodontics-root resorption.
A systematic review of prospective studies on the duration of orthodontic treatment suggests that the duration of orthodontic treatment varies widely but takes less than 2 years to complete, on average [34]. Most patients would like their treatment to be done in a much shorter period and in addition, longer treatment periods might increase the chances of root resorption, decalcification, etc. This has resulted in orthodontists as well as manufacturers trying to shorten the duration by using various methods to accelerate OTM (AOTM). Some of the techniques advocated in this quest to accelerate OTM are as follows:
Limited orthodontic treatment.
Self-ligating and varying bracket designs
Customized appliances
Medications such as corticosteroids, vitamin D3, parathyroid hormone, thyroxin, prostaglandins, platelet-rich plasma.
Micro-vibration
Low-intensity Laser
Photobiomodulation aka low-level light therapy
Electromagnetic fields
Direct electrical current
Micro-osteoperforations
Piezocision
Corticotomies
Osteotomies/PDL distraction
Surgery first
Miles P [35] reviewed the studies involving the aforesaid techniques and was of the opinion that the technique of photobiomodulation may be of benefit but suggested that since there is limited evidence to support it, more studies will be needed before it can be applied routinely. With regard to the use of corticotomy, also he says that only low-level evidence is available and he concludes his review by suggesting that rigorous, well-designed randomized controlled trials with longer follow-up periods are necessary for all the techniques before they can be recommended.
The effects of most of the above AOTM procedures on the periodontium do not seem to have been studied in detail. The more commonly performed and studied one seems to be the corticotomies,
In 2001, Wilcko, et al. [36] introduced the “periodontally accelerated osteogenic orthodontics” (PAOO) technique that they claimed shortened the duration of orthodontic treatment. This involved flap design, selective decortication, alveolar augmentation, membrane coverage, and closure using sutures. They radiographically assessed the presence of transient demineralization followed by remineralization at the corticotomy level. According to them, reversible osteopenia occurs both within the alveolar bone proper and on the surface and with this, the collagenous bony matrix also moves with the root in the same direction as the OTM. Once the OTM is completed and the teeth are retained in their predetermined position, remineralization of the matrix takes place. They claim that this demineralization-remineralization is complete in adolescents but not so much in adults and termed it the “regional acceleratory phenomenon” (RAP) of bone remodeling. They thought that this “bone matrix transportation” had made it possible to design a surgical approach, which permits extraction space closure in 3 to 4 weeks. The duration of RAP is claimed to last for 3–4 months by these authors and the amount of tooth movement during this period was double around 1 mm/month, in animal studies conducted by Iino S, et al. [37].
The use of techniques to speed up orthodontic tooth movement by utilizing alveolar surgery has a history dating back to more than a century. But it is Heinrich Kole [38] who has been credited with refining the process. He proposed the idea of accelerating orthodontic movements by displacing bone blocks, more than 6 decades ago. He hypothesized that it was the cortical bone that slowed the orthodontic movement of teeth and so why not weaken it by osteotomizing it? He advocated buccal and lingual interdental corticotomies together with supra-apical horizontal osteotomies connecting the two vertical cuts. Though accelerated orthodontic movements were achieved, he encountered quite a few complications like the non-vitality of teeth. It should be noted that Kole achieved the tooth movements using removable appliances fitted with adjustable screws. Others tried to build on this technique with Duker in 1975 [39] sparing the crestal bone in his corticotomies and Suya [40] replacing the supra-apical osteotomy with a corticotomy in 1991.
According to T. Gellee, et al. [41], PAOO also allows larger tooth displacements, a reduction in the risk of root resorption, and a gain in stability after the removal of orthodontic devices.
According to the American Association of Orthodontists, one in four orthodontic patients is an adult. Some studies suggest that almost 40% of the patients are adults. As more and more adult patients seek orthodontic treatment for various reasons, it can be challenging for the orthodontist to tailor his/her techniques to the specific patient. Many of these patients might have underlying periodontal problems that can affect the treatment process as well as its outcome. The periodontist can play an active role in ensuring the success of the orthodontic treatment—in adult patients or adolescents. This role can be before, during, or after the orthodontic treatment.
A thorough periodontal examination/charting is of utmost importance for every orthodontic patient, especially if skeletal growth has been completed. This is to identify and manage active conditions such as gingivitis and periodontitis as well as conditions that result in deficiency of soft or hard tissues or both. In ideal conditions, and with good oral hygiene, gingival health can be maintained with as little as 1–2 mm of keratinized gingiva. But soft tissue grafting might be indicated under the following circumstances:
when the buccal displacement of the roots is planned during the treatment or when treatment might result in thinning of the gingiva.
chronically inflamed areas of keratinized gingiva or no area of keratinized gingiva where the alveolar mucosa prevents optimal plaque control.
minimal areas of attached gingiva compromised by a shallow vestibule or frenum pull.
advancing gingival recession.
The techniques that are available to correct these conditions include the following:
Laterally or coronally advanced pedicle grafts.
Coronally advanced flaps alone or in conjunction with barrier membranes or enamel matrix proteins.
Free gingival grafts.
Subepithelial connective tissue autografts.
Allografts.
Every patient should undergo professional plaque removal and root debridement before the start of the treatment. Oral hygiene instructions should be reinforced because it has been shown that orthodontic bands, elastics, etc., tend to retain plaque, resulting in gingivitis, which may then proceed to periodontitis. Orthodontically induced remodeling process may have a positive effect on bone, so extensive osseous surgery is usually not indicated at this time. But sometimes osseous surgery might be indicated in the following conditions:
The American Academy of Periodontology’s systematic review on whether periodontal phenotype modification therapy (PhMT) involving hard tissue augmentation (PhMT-b) or soft tissue augmentation (PhMT-s) has clinical benefits for patients undergoing orthodontic treatment concluded that PhMT
The maintenance of oral hygiene during treatment is of paramount importance. During each visit reinforcement of oral hygiene instructions have to be carried out along with motivating the patient to do so. Periodontal evaluation every 6 months and radiographic examination once in a year would be ideal. Procedures like frenectomy might have to be carried out during the treatment period if the orthodontist feels that diastema closure, etc. are being hampered by an aberrant frenum.
Regular periodontal charting should be carried out in patients who have completed their treatment. Depending on the case, circumferential supracrestal fiberotomy (CSF) may have to be carried out during the end part of the treatment or after the treatment is over. This is expected to release the tension on the supra-alveolar fibers following tooth de-rotation, thereby reducing the relapse risk. Reham Al-Jasser, et al. [43] in their study found that “post-treatment rotational relapse of anterior teeth subjected to CSF was minimal and statistically insignificant after 1 year of follow-up.”
Most orthodontists may be worried about carrying out orthodontic treatment in periodontally compromised patients and with good reason. At the same time, studies show that a large percentage (~65%) of patients with moderate to severe periodontitis are interested in such treatment for esthetic and functional changes caused by pathologic tooth migration [44].
Many questions need to be answered in these periodontally compromised patients who opt for orthodontic treatment. Some of the findings of a comprehensive search on PubMed focusing on “ortho-perio treatments” are as follows [45]:
Best time to start orthodontic treatment following periodontal therapy.
According to the authors, in periodontally compromised cases that have undergone periodontal therapy, it is better to start orthodontic treatment as follows:
3 to 6 months after non-surgical/surgical periodontal treatment and
9 to 12 months after regenerative surgical procedures.
Acceptable periodontal status for orthodontic treatment
It is important to achieve low rates of full-mouth plaque and bleeding on probing after active periodontal treatment with scores <25% of previous ones. They recommend that these low scores (i.e., optimal plaque control without clinical gingival inflammation) be reached and maintained during the entire phase of orthodontic therapy and they think that without these conditions, orthodontic tooth movement should be discontinued.
Biologic efficacy of orthodontic treatment
A combined periodontist-orthodontist diagnostic and treatment endeavor in periodontally compromised patients can result in improved masticatory efficiency by a more balanced occlusion brought about by a realignment of the migrated teeth. The realignment may also result in the periodontal structures being better able to carry out their assigned functions.
According to Lindhe J and Ericsson I [46], a healthy periodontium with reduced height has a capacity similar to that of a normal periodontium to adapt to traumatizing occlusal forces. Wennström JL, et al. [47] state that sites with the horizontal bone loss after periodontal therapy will not be negatively influenced by the type of tooth movement once the individualized orthodontic mechanics are established (i.e., an appropriate ratio force/% remaining periodontal support). According to Polson A, et al., if teeth are moved through or into vertical bone defects, it can increase the rate of destruction of these periodontal structures. At the same time, if the OTM into infrabony pockets is done after successful elimination of subgingival infection, it will not result in adverse effects. They concluded that this movement/treatment will not bring about changes in the periodontal ligament attachment level; instead, the formation of a long junctional epithelium is what will be achieved [48].
According to Melsen B, et al. [49], “orthodontic intrusion at healthy sites can lead to new cementum formation and new collagen attachment, whereas for sites lacking proper oral hygiene, results vary from a moderate new attachment development to a worsening of the alveolar bone loss.” And in a subsequent study, Melsen B [50] recommends that “the intrusion movement should be carefully planned as it can increase the risk of other adverse effects not desired in patients with a reduced periodontium, such as alveolar process reduction and root resorption.”
Cassio Volponi Carvalho, et al. [51] studied the effects of orthodontic movement in the periodontal tissues of 10 adult patients with aggressive periodontitis and compared them with 10 patients with healthy periodontium. They evaluated the probing pocket depth, clinical attachment level, bleeding on probing, and dental plaque index before, during and 4 months after orthodontic treatment. They found improvement in all the above parameters, 4 months after orthodontic treatment.
Despite advances in therapeutics as well as our increased knowledge of the biological effects of orthodontic treatment, it might be better to avoid OTM in conditions such as uncontrolled infection/inflammation, inadequate anchorage, conditions where periodontal health might not improve despite periodontal therapy.
This chapter has attempted to portray the roles the periodontium, inflammation, and periodontal therapy play during the planning and execution of orthodontic treatment as well as once it is completed. It also discusses orthodontics in the periodontally compromised patient. There is a huge void in our knowledge about various aspects of the orthodontic movement of teeth and their effects on the periodontium. It is also evident that for the long-term success of orthodontic treatment, especially in the periodontally compromised patient, joining forces of the orthodontist and the periodontist would benefit patients as well as both the specialties.
The authors declare no conflict of interest.
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Taiar",coverURL:"https://cdn.intechopen.com/books/images_new/7543.jpg",editedByType:"Edited by",editors:[{id:"157376",title:"Prof.",name:"Mario",middleName:null,surname:"Bernardo-Filho",slug:"mario-bernardo-filho",fullName:"Mario Bernardo-Filho"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6772",title:"Occupational Therapy",subtitle:"Therapeutic and Creative Use of Activity",isOpenForSubmission:!1,hash:"0f6de90c02282919494d6254e473defe",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",bookSignature:"Meral Huri",coverURL:"https://cdn.intechopen.com/books/images_new/6772.jpg",editedByType:"Edited by",editors:[{id:"171525",title:"Dr.",name:"Meral",middleName:null,surname:"Huri",slug:"meral-huri",fullName:"Meral Huri"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5711",title:"Occupational Therapy",subtitle:"Occupation Focused Holistic Practice in Rehabilitation",isOpenForSubmission:!1,hash:"38180e287b6cb09b8002b7ab485de2c2",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",bookSignature:"Meral Huri",coverURL:"https://cdn.intechopen.com/books/images_new/5711.jpg",editedByType:"Edited by",editors:[{id:"171525",title:"Dr.",name:"Meral",middleName:null,surname:"Huri",slug:"meral-huri",fullName:"Meral Huri"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:3,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"55163",doi:"10.5772/intechopen.68799",title:"Virtual Reality and Occupational Therapy",slug:"virtual-reality-and-occupational-therapy",totalDownloads:2642,totalCrossrefCites:4,totalDimensionsCites:6,abstract:"Virtual reality is three dimensional, interactive and fun way in rehabilitation. Its first known use in rehabilitation published by Max North named as “Virtual Environments and Psychological Disorders” (1994). Virtual reality uses special programmed computers, visual devices and artificial environments for the clients’ rehabilitation. Throughout technological improvements, virtual reality devices changed from therapeutic gloves to augmented reality environments. Virtual reality was being used in different rehabilitation professions such as occupational therapy, physical therapy, psychology and so on. In spite of common virtual reality approach of different professions, each profession aims different outcomes in rehabilitation. Virtual reality in occupational therapy generally focuses on hand and upper extremity functioning, cognitive rehabilitation, mental disorders, etc. Positive effects of virtual reality were mentioned in different studies, which are higher motivation than non‐simulated environments, active participation of the participants, supporting motor learning, fun environment and risk‐free environment. Additionally, virtual reality was told to be used as assessment. This chapter will focus on usage of virtual reality in occupational therapy, history and recent developments, types of virtual reality technologic equipment, pros and cons, usage for pediatric, adult and geriatric people and recent research and articles.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Orkun Tahir Aran, Sedef Şahin, Berkan Torpil, Tarık Demirok and\nHülya Kayıhan",authors:[{id:"172938",title:"Prof.",name:"Hulya",middleName:null,surname:"Kayihan",slug:"hulya-kayihan",fullName:"Hulya Kayihan"},{id:"183079",title:"Ph.D.",name:"Sedef",middleName:null,surname:"Şahin",slug:"sedef-sahin",fullName:"Sedef Şahin"},{id:"196848",title:"M.Sc.",name:"Orkun Tahir",middleName:null,surname:"Aran",slug:"orkun-tahir-aran",fullName:"Orkun Tahir Aran"},{id:"197159",title:"Mr.",name:"Tarık",middleName:null,surname:"Demirok",slug:"tarik-demirok",fullName:"Tarık Demirok"},{id:"197312",title:"M.Sc.",name:"Berkan",middleName:null,surname:"Torpil",slug:"berkan-torpil",fullName:"Berkan Torpil"}]},{id:"61806",doi:"10.5772/intechopen.78312",title:"Executive Functions and Neurology in Children and Adolescents",slug:"executive-functions-and-neurology-in-children-and-adolescents",totalDownloads:1759,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"This chapter discusses the theoretical and methodological issues of creating a developmental perspective on executive function (EF) in childhood and adolescence. Focusing on school periods, this section outlines the development of the basic components of EF—inhibition, working memory, and attention. Cognitive and neurophysiological evaluations show that despite the emergence of EF in the first few years of life, it continues to grow significantly in childhood and adolescence. The components vary slightly according to their developmental sequence. The chapter links findings to long-standing developmental issues (i.e. developmental sequences and processes) and suggests the necessary research to establish a developmental framework covering early childhood throughout adolescence.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Gokcen Akyurek",authors:[{id:"197265",title:"Dr.",name:"Gokcen",middleName:null,surname:"Akyurek",slug:"gokcen-akyurek",fullName:"Gokcen Akyurek"}]},{id:"55024",doi:"10.5772/intechopen.68463",title:"Occupational Therapy in Oncology and Palliative Care",slug:"occupational-therapy-in-oncology-and-palliative-care",totalDownloads:2699,totalCrossrefCites:1,totalDimensionsCites:4,abstract:"Cancer is a chronic disease that may occur in both children and adults. Occupational therapy focuses on the activity limitations and participation problems in their life. Oncology rehabilitation involves in helping an individual with cancer to regain maximum physical, psychological, cognitive, social, and vocational functioning with the limits up to disease and its treatments in an interdisciplinary team concept. These treatment options are associated with the risk of some side effects, including fatigue, pain, cognitive problems, decrease in bone density and muscle endurance, weight loss, and stress- or anxiety-related psychosocial problems. Occupational therapy approaches are a holistic view in a client center and use training in activities of daily living, assistive technology, education of energy conservation techniques, and management of treatment-related problems, such as pain, fatigue, and nausea. In palliative and hospice care, occupational therapists support clients with cancer by minimizing the secondary symptoms related to cancer and its treatments. At the end of life, occupational therapy offers to identify the roles and activities that are meaningful and purposeful to the client with cancer and try to determine the barriers that limit their performance. Clients with cancer who have childhood cancer or adult cancer can face problems about body structure and functions, activity, and participation, which may limit their participation to their daily life.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Sedef Şahin, Semin Akel and Meral Zarif",authors:[{id:"183079",title:"Ph.D.",name:"Sedef",middleName:null,surname:"Şahin",slug:"sedef-sahin",fullName:"Sedef Şahin"},{id:"183078",title:"Dr.",name:"Burcu Semin",middleName:null,surname:"Akel",slug:"burcu-semin-akel",fullName:"Burcu Semin Akel"},{id:"198859",title:"Dr.",name:"Meral",middleName:null,surname:"Zarif",slug:"meral-zarif",fullName:"Meral Zarif"}]},{id:"56049",doi:"10.5772/intechopen.69101",title:"Measurement of Participation: The Role Checklist Version 3: Satisfaction and Performance",slug:"measurement-of-participation-the-role-checklist-version-3-satisfaction-and-performance",totalDownloads:2823,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Participation in society is an area of interest to both clinicians and population researchers. Measurement of participation is therefore important, yet differences in definition, in terms of both content and scope, have made general agreement on one instrument tool elusive. What is recognized is the need for a theoretically based tool that captures both the insider and the outsider perspective. The outsider perspective, inclusive of the generally held views of a society, supports the utility for aggregating population data, whereas the insider perspective provides the internally held views of an individual needed for client-centered treatment planning. The Role Checklist Version 3 modifies one of the most commonly used assessment tools in occupational therapy practice, has good preliminary psychometric properties, and is theoretically consistent with both the ICF and the Model of Human Occupation. The Model of Human Occupation is the most widely used theoretical model in occupational therapy. This chapter provides an overview of the theoretical development, empirical testing, and implications for use of this participation measure by occupational therapists along with implications for population researchers.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Patricia J. Scott, Kelsey McKinney, Jeff Perron, Emily Ruff and Jessica\nSmiley",authors:[{id:"195495",title:"Dr.",name:"Patricia J",middleName:null,surname:"Scott",slug:"patricia-j-scott",fullName:"Patricia J Scott"},{id:"208801",title:"Dr.",name:"Kelsey G.",middleName:null,surname:"McKinney",slug:"kelsey-g.-mckinney",fullName:"Kelsey G. McKinney"},{id:"208802",title:"Mr.",name:"Jeffrey M.",middleName:null,surname:"Perron",slug:"jeffrey-m.-perron",fullName:"Jeffrey M. Perron"},{id:"208803",title:"Dr.",name:"Emily G.",middleName:null,surname:"Ruff",slug:"emily-g.-ruff",fullName:"Emily G. Ruff"},{id:"208804",title:"Dr.",name:"Jessica L.",middleName:null,surname:"Smiley",slug:"jessica-l.-smiley",fullName:"Jessica L. Smiley"}]},{id:"55018",doi:"10.5772/intechopen.68315",title:"Psychomotor Therapy for Patients with Severe Mental Health Disorders",slug:"psychomotor-therapy-for-patients-with-severe-mental-health-disorders",totalDownloads:2274,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"Psychomotor therapy is defined as a method of treatment based on a holistic view of the human being that is derived from the unity of body and mind. Assessments (observation and/or evaluation) are essential to achieving concrete psychosocial objectives methodically. Psychomotor therapy uses movement, body awareness and a wide range of movement activities to optimize movement behaviour as well as the cognitive, affective and relational aspects of psychomotor functioning (i.e. the relationships between physical movements and cognitive and social-affective aspects). Consequently, the approach to this type of therapy integrates the physical, cognitive and emotional aspects of functioning in relation to the capacity of being and acting in a psychosocial context in order to achieve clearly defined goals in consultation with the patients. Psychomotor therapy framework consists of three different approaches: a health-related approach, a psychosocial approach and a psychotherapeutic approach, which can be embedded in several psychotherapeutic approaches. Through the implementation of both systematically planned evaluations and individually targeted interventions in group, the psychomotor therapist strives to broaden the general action competences and specific skills and to stimulate a positive self-image and personal well-being in balanced social relationships. Today, there is sufficient evidence that psychomotor therapy has a major contribution to both well-being and mental health of patients with severe psychiatric problems. In Flemish psychiatric hospitals, psychomotor therapy is imbedded in different treatment programmes. In this chapter, the theory behind this approach and some practical examples will be provided.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Michel Probst",authors:[{id:"196227",title:"Prof.",name:"Michel",middleName:null,surname:"Probst",slug:"michel-probst",fullName:"Michel Probst"}]}],mostDownloadedChaptersLast30Days:[{id:"55080",title:"Life Skills in Occupational Therapy",slug:"life-skills-in-occupational-therapy",totalDownloads:6076,totalCrossrefCites:4,totalDimensionsCites:1,abstract:"Occupational therapy is a health profession that uses the purposeful activities to achieve multiple and complex rehabilitation aims. The main goals of the occupational therapy are to support the reintegration of individuals in daily living skills as well as to increase their independence and autonomy. Interventions of occupational therapists have primarily focused on self-care, productivity, and leisure time activities. Since the life skills includes a wide range of abilities that enable a person to perform personal care and more complicated tasks such as traveling, shopping, community participation etc., occupational therapists provide life skills training programs to meet the needs of the clients. This chapter aims to contribute to the current understanding and practices of life skills from an occupational therapy perspective. The chapter starts with a brief discussion of the importance of life skills in occupational therapy. After this introduction, the first part takes a look at the definition of life skills and identifies core components of life skills. The second part describes assessment and interventions of life skills. The third one gives an overview about school life skills programs for children and adolescents. Finally, the last part explains some life skills programs in people with disadvantages.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Hatice Abaoğlu, Özge Buket Cesim, Sinem Kars and Zeynep Çelik",authors:[{id:"197551",title:"Dr.",name:"Hatice",middleName:null,surname:"Abaoğlu",slug:"hatice-abaoglu",fullName:"Hatice Abaoğlu"},{id:"205199",title:"Dr.",name:"Sinem",middleName:null,surname:"Kars",slug:"sinem-kars",fullName:"Sinem Kars"},{id:"205200",title:"Dr.",name:"Zeynep",middleName:null,surname:"Celik",slug:"zeynep-celik",fullName:"Zeynep Celik"},{id:"205203",title:"Ms.",name:"Özge Buket",middleName:null,surname:"Cesim",slug:"ozge-buket-cesim",fullName:"Özge Buket Cesim"}]},{id:"62493",title:"Occupational Therapy in Forensic Settings",slug:"occupational-therapy-in-forensic-settings",totalDownloads:2543,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"It is necessary for a person to comply with the expectations of society and the rules of law to which these expectations are secured. Offenders turn back to the community after the penalty was executed by isolating from society and some occupations. An occupational imbalance is seen in the individuals, during this penalty period and afterward, because of limited occupational participation. As an occupational being, this affects their physical, mental and psychological well-being. Imprisonment is an important practice in criminal law to punish criminals. This may be necessary for the protection of society from criminals, but successful integration into a community after exiting the prison is the most important factor in preventing recidivism. Occupational therapy focuses on health and well-being by using meaningful and purposeful occupations. Occupation involves any activity that people perform or participate in, such as giving care to themselves or others, working, learning, playing games, and interacting with others. From this perspective, the role of occupational therapists in forensic settings is to determine the abilities of these individuals to congregate their deprived freedoms and use them to train them for an independent and autonomous life; to provide a professional orientation, career counseling, and self-esteem; to gain some habits for physical, spiritual and moral life and to reinforce.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Esma Ozkan, Sümeyye Belhan, Mahmut Yaran and Meral Zarif",authors:null},{id:"70122",title:"Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives",slug:"parkinson-s-disease-rehabilitation-effectiveness-approaches-and-new-perspectives",totalDownloads:2083,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"Parkinson’s disease has been considered one of the most important and common neurodegenerative diseases in the world. Its motor and nonmotor signs determine a huge functional loss, leading the individuals to lose their independence. Although the treatment requires a pharmacological approach, physical therapy has confirmed its importance in this process. Today, neurorehabilitation is indispensable to increase many of the cardinal signs of the disease. Using traditional or technological approaches, physical therapy has reached good results in improving motor and nonmotor functions, as well as the quality of life of Parkinsonians. 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Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. 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Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"436430",title:"Associate Prof.",name:"Mesut",middleName:null,surname:"Işık",slug:"mesut-isik",fullName:"Mesut Işık",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/436430/images/19686_n.jpg",biography:null,institutionString:null,institution:{name:"Bilecik University",country:{name:"Turkey"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329248",title:"Dr.",name:"Md. Faheem",middleName:null,surname:"Haider",slug:"md.-faheem-haider",fullName:"Md. Faheem Haider",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329248/images/system/329248.jpg",biography:"Dr. Md. Faheem Haider completed his BPharm in 2012 at Integral University, Lucknow, India. In 2014, he completed his MPharm with specialization in Pharmaceutics at Babasaheb Bhimrao Ambedkar University, Lucknow, India. He received his Ph.D. degree from Jamia Hamdard University, New Delhi, India, in 2018. He was selected for the GPAT six times and his best All India Rank was 34. Currently, he is an assistant professor at Integral University. Previously he was an assistant professor at IIMT University, Meerut, India. He has experience teaching DPharm, Pharm.D, BPharm, and MPharm students. He has more than five publications in reputed journals to his credit. Dr. Faheem’s research area is the development and characterization of nanoformulation for the delivery of drugs to various organs.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/system/329795.png",biography:"Dr. Mohd Aftab Siddiqui is an assistant professor in the Faculty of Pharmacy, Integral University, Lucknow, India, where he obtained a Ph.D. in Pharmacology in 2020. He also obtained a BPharm and MPharm from the same university in 2013 and 2015, respectively. His area of research is the pharmacological screening of herbal drugs/natural products in liver cancer and cardiac diseases. He is a member of many professional bodies and has guided many MPharm and PharmD research projects. Dr. Siddiqui has many national and international publications and one German patent to his credit.",institutionString:"Integral University",institution:null}]}},subseries:{item:{id:"12",type:"subseries",title:"Human Physiology",keywords:"Anatomy, Cells, Organs, Systems, Homeostasis, Functions",scope:"Human physiology is the scientific exploration of the various functions (physical, biochemical, and mechanical properties) of humans, their organs, and their constituent cells. The endocrine and nervous systems play important roles in maintaining homeostasis in the human body. Integration, which is the biological basis of physiology, is achieved through communication between the many overlapping functions of the human body's systems, which takes place through electrical and chemical means. Much of the basis of our knowledge of human physiology has been provided by animal experiments. Because of the close relationship between structure and function, studies in human physiology and anatomy seek to understand the mechanisms that help the human body function. The series on human physiology deals with the various mechanisms of interaction between the various organs, nerves, and cells in the human body.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",hasOnlineFirst:!1,hasPublishedBooks:!0,annualVolume:11408,editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. 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We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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Valarmathi",profilePictureURL:"https://mts.intechopen.com/storage/users/69697/images/system/69697.jpg",institutionString:"Religen Inc. | A Life Science Company, United States of America",institution:null},{id:"205081",title:"Dr.",name:"Marco",middleName:"Vinícius",surname:"Chaud",fullName:"Marco Chaud",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDGeQAO/Profile_Picture_1622624307737",institutionString:null,institution:{name:"Universidade de Sorocaba",institutionURL:null,country:{name:"Brazil"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/48639",hash:"",query:{},params:{id:"48639"},fullPath:"/chapters/48639",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()