Main indications for adult scoliosis bracing with frequency classification.
\\n\\n
Dr. Pletser’s experience includes 30 years of working with the European Space Agency as a Senior Physicist/Engineer and coordinating their parabolic flight campaigns, and he is the Guinness World Record holder for the most number of aircraft flown (12) in parabolas, personally logging more than 7,300 parabolas.
\\n\\nSeeing the 5,000th book published makes us at the same time proud, happy, humble, and grateful. This is a great opportunity to stop and celebrate what we have done so far, but is also an opportunity to engage even more, grow, and succeed. It wouldn't be possible to get here without the synergy of team members’ hard work and authors and editors who devote time and their expertise into Open Access book publishing with us.
\\n\\nOver these years, we have gone from pioneering the scientific Open Access book publishing field to being the world’s largest Open Access book publisher. Nonetheless, our vision has remained the same: to meet the challenges of making relevant knowledge available to the worldwide community under the Open Access model.
\\n\\nWe are excited about the present, and we look forward to sharing many more successes in the future.
\\n\\nThank you all for being part of the journey. 5,000 times thank you!
\\n\\nNow with 5,000 titles available Open Access, which one will you read next?
\\n\\nRead, share and download for free: https://www.intechopen.com/books
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'
Preparation of Space Experiments edited by international leading expert Dr. Vladimir Pletser, Director of Space Training Operations at Blue Abyss is the 5,000th Open Access book published by IntechOpen and our milestone publication!
\n\n"This book presents some of the current trends in space microgravity research. The eleven chapters introduce various facets of space research in physical sciences, human physiology and technology developed using the microgravity environment not only to improve our fundamental understanding in these domains but also to adapt this new knowledge for application on earth." says the editor. Listen what else Dr. Pletser has to say...
\n\n\n\nDr. Pletser’s experience includes 30 years of working with the European Space Agency as a Senior Physicist/Engineer and coordinating their parabolic flight campaigns, and he is the Guinness World Record holder for the most number of aircraft flown (12) in parabolas, personally logging more than 7,300 parabolas.
\n\nSeeing the 5,000th book published makes us at the same time proud, happy, humble, and grateful. This is a great opportunity to stop and celebrate what we have done so far, but is also an opportunity to engage even more, grow, and succeed. It wouldn't be possible to get here without the synergy of team members’ hard work and authors and editors who devote time and their expertise into Open Access book publishing with us.
\n\nOver these years, we have gone from pioneering the scientific Open Access book publishing field to being the world’s largest Open Access book publisher. Nonetheless, our vision has remained the same: to meet the challenges of making relevant knowledge available to the worldwide community under the Open Access model.
\n\nWe are excited about the present, and we look forward to sharing many more successes in the future.
\n\nThank you all for being part of the journey. 5,000 times thank you!
\n\nNow with 5,000 titles available Open Access, which one will you read next?
\n\nRead, share and download for free: https://www.intechopen.com/books
\n\n\n\n
\n'}],latestNews:[{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"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"6000",leadTitle:null,fullTitle:"Accounting and Corporate Reporting - Today and Tomorrow",title:"Accounting and Corporate Reporting",subtitle:"Today and Tomorrow",reviewType:"peer-reviewed",abstract:'We have spent a great deal of time on the continued development of accounting and auditing standards, which are used as a primary component of corporate reporting, to reach today\'s financial reporting framework. However, is it possible to say that, currently, financial statements provide full and prompt disclosure? Or will they still be useful as a primary element with their current structures in corporate reporting? Undoubtedly, we are deeply concerned about these issues in recent times. This volume contains chapters to discuss the today\'s and tomorrow\'s accounting and corporate reporting phenomena in a comprehensive and multidimensional way. Therefore, this book is organized into six sections: "Achieving Sustainability through Corporate Reporting", "International Standardization", "Financial Reporting Quality", "Accounting Profession and Behavioral Aspects", "Public Sector Accounting and Reporting", and "Managerial Accounting".',isbn:"978-953-51-3550-0",printIsbn:"978-953-51-3549-4",pdfIsbn:"978-953-51-4651-3",doi:"10.5772/66609",price:139,priceEur:155,priceUsd:179,slug:"accounting-and-corporate-reporting-today-and-tomorrow",numberOfPages:340,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"aa4f840bdfa861be2f1c4b982a1e2cb5",bookSignature:"Soner Gokten",publishedDate:"September 20th 2017",coverURL:"https://cdn.intechopen.com/books/images_new/6000.jpg",numberOfDownloads:39065,numberOfWosCitations:7,numberOfCrossrefCitations:21,numberOfCrossrefCitationsByBook:2,numberOfDimensionsCitations:29,numberOfDimensionsCitationsByBook:2,hasAltmetrics:1,numberOfTotalCitations:57,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 24th 2016",dateEndSecondStepPublish:"December 22nd 2016",dateEndThirdStepPublish:"March 13th 2017",dateEndFourthStepPublish:"June 11th 2017",dateEndFifthStepPublish:"August 10th 2017",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"70354",title:"Ph.D.",name:"Soner",middleName:null,surname:"Gokten",slug:"soner-gokten",fullName:"Soner Gokten",profilePictureURL:"https://mts.intechopen.com/storage/users/70354/images/2275_n.jpg",biography:"Dr. Gokten is an Assistant Professor at Department of Management - Faculty of Economics and Administrative Sciences, Baskent University, Ankara, Turkey. He received his BSBA form Faculty of Economics and Administrative Sciences-Baskent University-Ankara, Turkey, MBA Finance and Ph.D. in Accounting and Finance degrees from Graduate School of Social Sciences-Gazi University, Ankara Turkey. He has published several articles, books, book chapters and conference proceedings. He is serving as a referee for national and international journals and Dr. Gokten has investment advisory, project finance and corporate valuation experience in several national and international projects.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"Başkent University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"430",title:"Financial Reporting",slug:"financial-reporting"}],chapters:[{id:"55274",title:"Paradigm Shift in Corporate Reporting",doi:"10.5772/intechopen.68832",slug:"paradigm-shift-in-corporate-reporting",totalDownloads:2216,totalCrossrefCites:5,totalDimensionsCites:7,hasAltmetrics:0,abstract:"In this paper, we present the evolution of integrated reporting and organizations playing an active role in this process. As a result of the changes, corporate reports including only historical financial information have become insufficient. It has started to be important for the firms to be sensitive towards environment, social capital and governance. For these reasons, authorities started to search for new reporting types. Their aim was to form a report giving detailed (prospective and retrospective) information about the total performance of the firm. Sustainability reports, the starting point of integrated reporting, were established and Global Reporting Initiative (GRI) standards were formed to increase the popularization. Integrated reports aim to supply full disclosure about the firms’ strategies, goals and performances. They also respond to the demands and needs of key stakeholders. In order to actualize the financial stability and sustainability, they are necessary. Integrated reports also put related groups into play. So, decision makers become a participant instead of watching the system from outside. In addition, integrated thinking philosophy provides systematic disclosure of value creation, namely how organizations made resource allocations in the past and how they will create value in the future according to their business models.",signatures:"Pınar Okan Gökten and Beyhan Marşap",downloadPdfUrl:"/chapter/pdf-download/55274",previewPdfUrl:"/chapter/pdf-preview/55274",authors:[{id:"204188",title:"Ph.D.",name:"Pınar",surname:"Okan Gokten",slug:"pinar-okan-gokten",fullName:"Pınar Okan Gokten"},{id:"204189",title:"Prof.",name:"Beyhan",surname:"Marsap",slug:"beyhan-marsap",fullName:"Beyhan Marsap"}],corrections:null},{id:"55449",title:"Integrated Reporting: A Template for Energy Companies",doi:"10.5772/intechopen.68921",slug:"integrated-reporting-a-template-for-energy-companies",totalDownloads:2249,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Integrated reporting (IR) is an accelerated corporate reporting approach over the last few years. The idea underlying integrated reporting is to report not only on the company’s strategy, management, and financial performance, but also on its social, environmental, and economic impacts. Integrated reporting can also be defined as a holistic report aiming to present annual reports and sustainability reports in a single report, as well as short-, medium-, and long-term goals and strategies of the institution. In the integrated reporting framework prepared by the International Integrated Reporting Council (IIRC), companies aim to make company value measurable and therefore more understandable and comparable by quantifying the environmental and social implications, as well as the financial statements. In this study, firstly the conceptual framework of integrated reporting and the process of extending to integrated reporting, and then the work done in this area in Turkey were given. In the last part of this study, energy companies which are very important in the world trade and which are coming to the agenda due to environmental problems are considered. In this section, integrated reports of seven companies operating in the energy sector and publishing integrated reports are examined. Lastly, it proposes an integrated report template for the Turkish energy sector to contribute to future work.",signatures:"Gülçin Yıldırım, Tuğçe Uzun Kocamış and Figen Öker Türüdüoğlu",downloadPdfUrl:"/chapter/pdf-download/55449",previewPdfUrl:"/chapter/pdf-preview/55449",authors:[{id:"204492",title:"Prof.",name:"Figen",surname:"Öker Türüdüoğlu",slug:"figen-oker-turuduoglu",fullName:"Figen Öker Türüdüoğlu"},{id:"206372",title:"Dr.",name:"Tuğçe",surname:"Uzun Kocamiş",slug:"tugce-uzun-kocamis",fullName:"Tuğçe Uzun Kocamiş"},{id:"206373",title:"Mrs.",name:"Gülçin",surname:"Yildirim",slug:"gulcin-yildirim",fullName:"Gülçin Yildirim"}],corrections:null},{id:"54556",title:"Greening Accounting: An Inevitable Link to Help Firms Connect with Sustainability",doi:"10.5772/67936",slug:"greening-accounting-an-inevitable-link-to-help-firms-connect-with-sustainability",totalDownloads:1542,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The last decade has seen developments challenging the abilities of managerial accounting theories in supporting firms with environmental conscious decision-making that are grounded in the expanded accountability of firms toward nature and society. Critical theorists have argued that the shortcomings of the accounting theories to interpret the impacts of business activities on nature have its origin in the missing accounting standards, under-defined contractual boundaries, and the absence of a valid numéraire (monetary equivalency). In this chapter, the author posits that these shortcomings are a legacy of the economic paradigm within which the accounting frameworks operate and would remain so, unless a paradigm change evolves to handle environmental-related considerations on its own, even if it means rewriting rules to generate accounting interpretations of business activities. Instead of offering a methodological solution, this chapter ideates how having “environment” as integral to the accounting paradigm would enable firms in evaluating, accounting, and reporting environmental performance transparently and improve flow of information to help management face sustainability-related challenges better.",signatures:"Somnath Debnath",downloadPdfUrl:"/chapter/pdf-download/54556",previewPdfUrl:"/chapter/pdf-preview/54556",authors:[{id:"202694",title:"Dr.",name:"Somnath",surname:"Debnath",slug:"somnath-debnath",fullName:"Somnath Debnath"}],corrections:null},{id:"54829",title:"Greening Accounting II: Exploring Feasibility of Environmental Accounting Framework",doi:"10.5772/intechopen.68403",slug:"greening-accounting-ii-exploring-feasibility-of-environmental-accounting-framework",totalDownloads:1555,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Exploring the theme of greening accounting in the previous chapter led us to examine the challenges of managerial accounting in supporting firms with the environmentally conscious decision-making and ideate how integrating environmental viewpoint within accounting can be achieved through a new construct that would support firms in integrating ‘environmental well-being’ as a core concern. In this chapter, the argument is validated by experimenting with a real-life case study and exploring challenges to enact the proposed construct. This not only tests the feasibility of the construct from an accounting perspective, including how information generated through it could be leveraged to meet corresponding information needs of firms without sacrificing transparency and auditability, but also advances the argument of greening accounting to redefine how the concerned information needs of firms and stakeholders can be identified and perceived in relation to the micro-level application of sustainability.",signatures:"Somnath Debnath",downloadPdfUrl:"/chapter/pdf-download/54829",previewPdfUrl:"/chapter/pdf-preview/54829",authors:[{id:"202694",title:"Dr.",name:"Somnath",surname:"Debnath",slug:"somnath-debnath",fullName:"Somnath Debnath"}],corrections:null},{id:"55201",title:"Adaptation of International Accounting Standards: Case of Portugal",doi:"10.5772/intechopen.68732",slug:"adaptation-of-international-accounting-standards-case-of-portugal",totalDownloads:1664,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:1,abstract:"This chapter aims to present the results of a broad analysis about the process of accounting standardization in Portugal in order to frame the current situation and the different levels of standardization that characterize it. The methodology followed involves a broad revision of the literature and content analysis on various papers and texts as well on documents directly related with the study topic. It concludes with the identification and characterization of the current levels of accounting standardization and makes reference to the likely scenario of this regulatory framework in the short term. The objective is to understand how the evolution of accounting standards in Portugal has evolved, what the current situation is and its likely evolution in the near future. The chapter is also aimed at contributing to the understanding of the process of adaptation of international accounting standards to the Portuguese reality.",signatures:"Helena Isabel Barroso Saraiva, Maria‐Céu F.G. Alves and Vítor M.S.\nGabriel",downloadPdfUrl:"/chapter/pdf-download/55201",previewPdfUrl:"/chapter/pdf-preview/55201",authors:[{id:"108390",title:"Prof.",name:"Maria",surname:"do Céu Gaspar Alves",slug:"maria-do-ceu-gaspar-alves",fullName:"Maria do Céu Gaspar Alves"},{id:"203124",title:"Prof.",name:"Helena Isabel",surname:"B. Saraiva",slug:"helena-isabel-b.-saraiva",fullName:"Helena Isabel B. Saraiva"},{id:"203126",title:"Dr.",name:"Vítor",surname:"Gabriel",slug:"vitor-gabriel",fullName:"Vítor Gabriel"}],corrections:null},{id:"55268",title:"M2M-Fair Value Accounting",doi:"10.5772/intechopen.68724",slug:"m2m-fair-value-accounting",totalDownloads:3866,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Since the past 20 years, the value relevance of financial information based on the historical cost method has been widely criticized among the academics and the preparers of financial information. The ongoing debate over the shortcomings of historical cost for ascertaining the worth of assets and liabilities and the rapid spread of fair value measurement for financial reporting has first led to the issuance of Financial Accounting Standard No. 157 Fair Value Measurements in September 2006 and then the initialization of fair value measurement project by the International Accounting Standards Board (IASB) and the Financial Accounting Standards Board in 2006 within the convergence project. On May 12, 2011, when the IASB issued IFRS 13 Fair Value Measurement, it appears that there has been substantial convergence between IFRS 13 and FASB 157. The purpose of this paper is to comprehensively explain the fair value accounting in accordance with IFRS 13 and describe the types of assets and liabilities that are subject to fair value accounting and their accompanying measurement principles with reference to other IFRSs and the Exposure Draft Conceptual Framework for Financial Reporting.",signatures:"Yıldız Özerhan and Banu Sultanoğlu",downloadPdfUrl:"/chapter/pdf-download/55268",previewPdfUrl:"/chapter/pdf-preview/55268",authors:[{id:"204283",title:"Dr.",name:"Banu",surname:"Sultanoglu",slug:"banu-sultanoglu",fullName:"Banu Sultanoglu"},{id:"204344",title:"Prof.",name:"Yildiz",surname:"Ozerhan",slug:"yildiz-ozerhan",fullName:"Yildiz Ozerhan"}],corrections:null},{id:"55448",title:"Reporting for Carbon Trading and International Accounting Standards",doi:"10.5772/intechopen.68959",slug:"reporting-for-carbon-trading-and-international-accounting-standards",totalDownloads:1772,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"During the first commitment period of the Kyoto Protocol, many developed countries were forced to restrict carbon emissions. Flexible mechanisms were initiated to reduce carbon emissions and support clean energy projects. Regulated carbon markets were established to trade carbon premiums produced by these projects by signatory countries, while carbon premiums produced by nonsignatory countries were traded in voluntary markets. Following limited participation in the Kyoto Protocol, by the leadership of European Union, 195 countries presented contributive ideas in Paris Agreement, which is the first-ever universal, legally binding global climate deal. Kyoto Protocol sets commitment targets that have legal force, while the Paris Agreement emphases on consensus building and allows for voluntary and nationally determined targets. Another key difference between Paris Agreement and the Kyoto Protocol is its scope. It does not provide a specific division between developed and developing nations. By means of these changes, trading in voluntary carbon markets is expected to increase due to the higher demand to offset unavoidable carbon emissions. There has been no authoritative guidance published on carbon accounting by the International Accounting Standards Board or the Financial Accounting Standards Board. This study proposes how to measure and report the carbon allowances and carbon credits.",signatures:"Figen Öker and Hümeyra Adıgüzel",downloadPdfUrl:"/chapter/pdf-download/55448",previewPdfUrl:"/chapter/pdf-preview/55448",authors:[{id:"204492",title:"Prof.",name:"Figen",surname:"Öker Türüdüoğlu",slug:"figen-oker-turuduoglu",fullName:"Figen Öker Türüdüoğlu"},{id:"204767",title:"Dr.",name:"Hümeyra",surname:"Adıgüzel",slug:"humeyra-adiguzel",fullName:"Hümeyra Adıgüzel"}],corrections:null},{id:"55626",title:"Accounting Choices in Corporate Financial Reporting: A Literature Review of Positive Accounting Theory",doi:"10.5772/intechopen.68962",slug:"accounting-choices-in-corporate-financial-reporting-a-literature-review-of-positive-accounting-theor",totalDownloads:5904,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"This chapter aims to put light on the positive accounting theory and related empirical studies and identify its broad contributions to the accounting research. Our objective is to provide a review of positive accounting literature in order to synthesize findings, identify areas of controversy in the literature, and evaluate critiques. Positive research in accounting started coming to prominence around the mid-1960s and had been a vector of paradigm shift within the financial accounting research in the 1970s and 1980s. The positive accounting theory is developed by Watts and Zimmerman and is based on work undertaken in economics and is heavily dependent on the efficient market hypothesis, the capital assets pricing model, and agency theory. The three key hypotheses are bonus plan hypothesis, debt hypothesis, and political cost hypothesis. Nevertheless, PAT has been subjected to severe and numerous criticisms from different perspectives, which are critiques on research methods, its theoretical foundations, its logic on economics' basis, and its reference to philosophy of science. PAT and its hypotheses will continue to be a rich field of empirical research and the basic questions that it raises are still relevant today.",signatures:"İdil Kaya",downloadPdfUrl:"/chapter/pdf-download/55626",previewPdfUrl:"/chapter/pdf-preview/55626",authors:[{id:"204387",title:"Prof.",name:"Idil",surname:"Kaya",slug:"idil-kaya",fullName:"Idil Kaya"}],corrections:null},{id:"56092",title:"Value Relevance of Accounting Data in an Emerging Market: Did Accounting Reforms Make a Difference?",doi:"10.5772/intechopen.69103",slug:"value-relevance-of-accounting-data-in-an-emerging-market-did-accounting-reforms-make-a-difference-",totalDownloads:1463,totalCrossrefCites:3,totalDimensionsCites:3,hasAltmetrics:0,abstract:"This study investigates the association of accounting earnings (NI) and book value of equity (BV) with stock prices in Istanbul Stock Exchange (ISE), currently Borsa Istanbul (BIST), during the 1992–2006 period. We also explore the effect of accounting reforms on value relevance that is measured as the strength of the association between a firm’s NI and BV and its market value. We specifically investigate the impact of the Turkish Uniform Chart of Accounts (1994), mandatory inflation accounting, consolidations and voluntary (2003–2004), and the mandatory (2005) adoption of International Financial Reporting Standards (IFRS). We hypothesize that these reforms have reduced information asymmetry and thus are expected to enhance the value relevance of accounting information. We find strong evidence that the Ohlson model is a valid model, and BV is more value relevant than NI in BIST. We also find that inflation accounting and consolidations have enhanced the value relevance of BV, while IFRS has increased the value relevance of NI, but reduced that of BV. We contribute to the debate by exploiting the unique sequence of reforms, to come up with comparative value relevance testing designs and interesting results for all major reforms, which we believe will be instructive for researchers and for all emerging and developed economies undergoing similar reforms and best practices.",signatures:"Mine Aksu, Ayse Tansel Cetin and Can Simga Mugan",downloadPdfUrl:"/chapter/pdf-download/56092",previewPdfUrl:"/chapter/pdf-preview/56092",authors:[{id:"203574",title:"Associate Prof.",name:"Mine",surname:"Aksu",slug:"mine-aksu",fullName:"Mine Aksu"},{id:"204249",title:"Prof.",name:"Can Simga",surname:"Mugan",slug:"can-simga-mugan",fullName:"Can Simga Mugan"},{id:"204250",title:"Prof.",name:"Ayse",surname:"Tansel Cetin",slug:"ayse-tansel-cetin",fullName:"Ayse Tansel Cetin"}],corrections:null},{id:"55293",title:"Associativism of Accounting Professionals",doi:"10.5772/intechopen.68711",slug:"associativism-of-accounting-professionals",totalDownloads:1952,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter aims to discuss the role of professional accounting associations and orders in relation to the current context of accounting training. It is intended, with this, to broaden the discussion about the performance of these professional entities, since they are placed as of public interest. Its work with the universities, aiming to interfere in the training process of future professionals, whether by the application of evidence of access to the profession or by direct and indirect influence in the construction of the curricular contents intended to form the accountants, must be thought openly and free of ideological load. Thus, it is considered important to analyze the aspects of the relationship between universities and such class entities, in order to know if there is a disinterested relationship or if, on the contrary, the university is influenced by professional accounting associations and orders, in percussion of their selfish interests.",signatures:"Osmar Antonio Bonzanini, Amélia Cristina Ferreira da Silva and\nTeresa Gabriela Marques Leite",downloadPdfUrl:"/chapter/pdf-download/55293",previewPdfUrl:"/chapter/pdf-preview/55293",authors:[{id:"203815",title:"Dr.",name:"Osmar Antonio",surname:"Bonzanini",slug:"osmar-antonio-bonzanini",fullName:"Osmar Antonio Bonzanini"},{id:"204399",title:"Dr.",name:"Amélia Cristina",surname:"Ferreira Da Silva",slug:"amelia-cristina-ferreira-da-silva",fullName:"Amélia Cristina Ferreira Da Silva"},{id:"204400",title:"Dr.",name:"Teresa Gabriela",surname:"Marques Leite",slug:"teresa-gabriela-marques-leite",fullName:"Teresa Gabriela Marques Leite"}],corrections:null},{id:"55289",title:"Behavioral Accounting and its Interactions",doi:"10.5772/intechopen.68972",slug:"behavioral-accounting-and-its-interactions",totalDownloads:4048,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Behavioral accounting is a branch of accounting that is related to behavior besides the accounting knowledge. It deals with the attitude and behavior of people when they are encountered with an accounting phenomenon which determines the behavior that they will show in decision‐making. This special area of accounting addresses such aspects as human information‐processing behavior, judgment quality, accounting problems that are created by users and providers of accounting information, and accounting information users’ and producers’ decision‐making skills. Behavioral research tries to find out how individuals make decisions and interact and influence other individuals, organizations, markets, and society. Behavioral accounting concept is examined under the topics of the influence of accounting information on behavior, managerial control (budget participation, nonfinancial measures, leadership, and balanced scorecard), auditing (auditor‐client negotiations, auditor’s judgment, and decision‐making), and ethics (ethical decision‐making, ethical orientation, and rationalizations on unethical behavior) in this chapter.",signatures:"Filiz Angay Kutluk",downloadPdfUrl:"/chapter/pdf-download/55289",previewPdfUrl:"/chapter/pdf-preview/55289",authors:[{id:"203083",title:"Associate Prof.",name:"Filiz",surname:"Angay Kutluk",slug:"filiz-angay-kutluk",fullName:"Filiz Angay Kutluk"}],corrections:null},{id:"55533",title:"The Future of Accounting Profession in an Era of Start-Ups",doi:"10.5772/intechopen.69264",slug:"the-future-of-accounting-profession-in-an-era-of-start-ups",totalDownloads:2054,totalCrossrefCites:6,totalDimensionsCites:8,hasAltmetrics:0,abstract:"With the help of the advancements in the field of communication and information technologies, the number of IT-based software has rapidly increased and the capabilities of high-budget enterprise resource planning (ERP) software widely used by large enterprises have begun to be offered to small and medium-sized enterprises (SMEs). In this chapter, cloud computing and other information technologies based accounting start-ups are covered, and the effects of these highly increasing start-ups on the profession of accounting have been addressed. In conclusion, it has been predicted that technology-based accounting start-ups with both accounting professionals and entrepreneurs having an expertise on information technologies will come together and will increase in the future, and cloud-based accounting initiatives will shape the future of the profession.",signatures:"Burak Özdoğan",downloadPdfUrl:"/chapter/pdf-download/55533",previewPdfUrl:"/chapter/pdf-preview/55533",authors:[{id:"203445",title:"Dr.",name:"Burak",surname:"Ozdogan",slug:"burak-ozdogan",fullName:"Burak Ozdogan"}],corrections:null},{id:"54602",title:"Graphical and Textual Presentations in Financial Reports",doi:"10.5772/68038",slug:"graphical-and-textual-presentations-in-financial-reports",totalDownloads:1429,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The use of separate graphs and texts to disclose information is a frequent occurrence in corporate annual reports. Multiple sources of information does not enhance understanding of users of financial statements. This chapter compares spatially separated text and graphs with integrated presentations that aim at bringing text and graphs as close as possible to each other. The chapter begins by illustrating the concept of split attention. Cognitive load arises when disparate sources of accounting information need to be mentally integrated by users. An experiment using separate text and diagrams is then presented to demonstrate how participants can deal with cognitive overload when reading split-attention material. Using two instructional design formats, the split-attention format and the integrated format, first-year accounting students were used as surrogates for financial report user groups such as employees and shareholders. The presence of the split-attention effect in the financial accounting material was established. Effective use of text and diagrams in integrated reporting helps integrated thinking and assists the interconnectedness of information. The findings suggest that redesigning financial reports by integrating text and diagrams may make effective use of the available cognitive resources and possibly enhance investors and other stakeholders’ decision-making process.",signatures:"Seedwell T.M. Sithole",downloadPdfUrl:"/chapter/pdf-download/54602",previewPdfUrl:"/chapter/pdf-preview/54602",authors:[{id:"203186",title:"Dr.",name:"Seedwell T.M.",surname:"Sithole",slug:"seedwell-t.m.-sithole",fullName:"Seedwell T.M. Sithole"}],corrections:null},{id:"55587",title:"Historical Development of Government Accounting",doi:"10.5772/intechopen.69121",slug:"historical-development-of-government-accounting",totalDownloads:2796,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Government accounting aims at preventing waste in government services and establishing a balance between optimal expenditure and services by managing government assets and government sources in the most efficient way. This balance can be established only by obtaining complete and accurate information from government accounting system on time. Since the users have a low level of knowledge needs in government accounting system, it has been recorded for long years in a cash basis manner. However, as the government’s area of operation expanded and the needs increased, it became obvious that cash basis system had lacking parts. So it started to focus on recording financial transactions and financial reporting. These lacking parts in the accounting system tried to be overcome through a new regulation by focusing on the areas where cash basis accounting system was insufficient; and a change was experienced with regard to applying the accrual basis in the areas of government accounting and financial reporting. This study aims to explain the historical development of government accounting by applications in countries and especially by detailed expressions for Turkey. As a result of the literature review and the examination of countries’ government accounting practices, it has been determined that the government accounting practice has made the correct transition from cash basis to accrual basis.",signatures:"Mihriban Coşkun Arslan",downloadPdfUrl:"/chapter/pdf-download/55587",previewPdfUrl:"/chapter/pdf-preview/55587",authors:[{id:"203724",title:"Dr.",name:"Mihriban",surname:"Coşkun Arslan",slug:"mihriban-coskun-arslan",fullName:"Mihriban Coşkun Arslan"}],corrections:null},{id:"55385",title:"Public Accounting Reform from Institutional Theory Perspectives: Case of Turkey",doi:"10.5772/intechopen.68778",slug:"public-accounting-reform-from-institutional-theory-perspectives-case-of-turkey",totalDownloads:1726,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:0,abstract:"In the literature, it is often found that institutional theory is used as the theoretical framework to explain the development and application of accounting. By means of these studies, it becomes easier to understand accounting as a social and political activity within itself and thus to be able to understand the economic, institutional, political and social environment of the turnover of the practices. In this regard, the main aim of this study is to explain the development of the public accounting system in Turkey with the help of institutional theory. Thus, it is aimed to explain all the dynamics that provide the institutionalization of state account in the national sense, together with the economic, political and social processes of the period in question. It is revealed that the regulatory arrangements directly contribute to the institutionalization of a field, and as a result, how the public organizations directly contribute to the institutionalization process.",signatures:"Ceray Aldemir and Tuğba Uçma Uysal",downloadPdfUrl:"/chapter/pdf-download/55385",previewPdfUrl:"/chapter/pdf-preview/55385",authors:[{id:"204342",title:"Dr.",name:"Ceray",surname:"Aldemir",slug:"ceray-aldemir",fullName:"Ceray Aldemir"},{id:"204348",title:"Dr.",name:"Tugba",surname:"Ucma Uysal",slug:"tugba-ucma-uysal",fullName:"Tugba Ucma Uysal"}],corrections:null},{id:"55750",title:"The Factors Used to Create Performance-Based Budgeting: A Research on Turkey",doi:"10.5772/intechopen.68920",slug:"the-factors-used-to-create-performance-based-budgeting-a-research-on-turkey",totalDownloads:1705,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Performance-based budgeting (PBB) is the practice of developing flexible financial management tools to increase the efficiency and productivity of public institutions both in developed and developing countries such as Turkey. It can be seen from international literature gathered as a result of researches that developing countries have come a long way in developing performance-based budgeting activities. In developed economies, successful international institutions such as Organization for Economic Cooperation and Development (OECD) and International Monetary Fund (IMF) promote the implementation of performance-based budgeting for a developing world. Fiscal transparency, medium-term expenditure framework, and other institutional arrangements are factors effective in developing performance-based budgeting. Budget experts regard these factors as important factors, and the view that it is difficult to implement these prevails. Within the context of this theory, the main purpose of this study is to determine the preparation and implementation of performance-based budgeting in public institutions of developing countries such as Turkey, which has an important economy in the world, and to measure the perception levels of employees working in these institutions. As a result of the confirmatory factor analysis (CFA) based on the main findings of the study, goodness-of-fit values of the measurement model were found to be sufficient. Independent t test and one-way ANOVA analyses were conducted to find out the perception levels of the participants in the study. As a result of the analyses, significant differences were found between demographic features and perception levels.",signatures:"Hakan Vahit Erkutlu, Şükran Güngör Tanç and Seyhan Çil Koçyiğit",downloadPdfUrl:"/chapter/pdf-download/55750",previewPdfUrl:"/chapter/pdf-preview/55750",authors:[{id:"204390",title:"Dr.",name:"Şükran",surname:"Güngör Tanç",slug:"sukran-gungor-tanc",fullName:"Şükran Güngör Tanç"},{id:"204391",title:"Prof.",name:"Hakan Vahit",surname:"Erkutlu",slug:"hakan-vahit-erkutlu",fullName:"Hakan Vahit Erkutlu"},{id:"204395",title:"Prof.",name:"Seyhan Çil",surname:"Koçyiğit",slug:"seyhan-cil-kocyigit",fullName:"Seyhan Çil Koçyiğit"}],corrections:null},{id:"54188",title:"The Managerial Perspective and Systems of Accountability in Judicial Offices",doi:"10.5772/67555",slug:"the-managerial-perspective-and-systems-of-accountability-in-judicial-offices",totalDownloads:1127,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In Italy, the machinery of justice has been, on more than one occasion, the subject of criticism. For the most part, the criticism has been relative to the slowness of trials and the inadequacy of the judicial system, deemed not capable of confronting the request for continuously evolving justice in an exhaustive manner, whose characteristics change in time based on the emerging needs of society. The analysis of the justice system was, in fact, generally not subject to enquiries on offices’ productivity and to evaluation of the management of resources invested in the sector. The same centres of data elaboration and the related departments at the Ministry of Justice, for example, have not gone much further than collecting the statistical data and creating the generic indicators of service quality. Such parameters, though, are often revealed to be too bureaucratic and of little use in proposing ameliorative solutions of the service offered to citizens, who desire levels of protection that are more responsive to their expectations. In this sense, the application of the system of accountability within the judicial system can contribute to the managerialization of the service.",signatures:"Ubaldo Comite",downloadPdfUrl:"/chapter/pdf-download/54188",previewPdfUrl:"/chapter/pdf-preview/54188",authors:[{id:"195399",title:"Prof.",name:"Ubaldo",surname:"Comite",slug:"ubaldo-comite",fullName:"Ubaldo Comite"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"6051",title:"Financial Management from an Emerging Market Perspective",subtitle:null,isOpenForSubmission:!1,hash:"48fd9d56d82da76c785db97e23ae398e",slug:"financial-management-from-an-emerging-market-perspective",bookSignature:"Guray Kucukkocaoglu and Soner Gokten",coverURL:"https://cdn.intechopen.com/books/images_new/6051.jpg",editedByType:"Edited by",editors:[{id:"70354",title:"Ph.D.",name:"Soner",surname:"Gokten",slug:"soner-gokten",fullName:"Soner Gokten"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6490",title:"Energy Management for Sustainable Development",subtitle:null,isOpenForSubmission:!1,hash:"a5e77ab7a4bfed7a2a1d524b8a3d6a90",slug:"energy-management-for-sustainable-development",bookSignature:"Soner Gokten and Guray Kucukkocaoglu",coverURL:"https://cdn.intechopen.com/books/images_new/6490.jpg",editedByType:"Edited by",editors:[{id:"70354",title:"Ph.D.",name:"Soner",surname:"Gokten",slug:"soner-gokten",fullName:"Soner Gokten"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6823",title:"Sustainability Assessment and Reporting",subtitle:null,isOpenForSubmission:!1,hash:"4db72204a34eff9b5143955463b293cf",slug:"sustainability-assessment-and-reporting",bookSignature:"Soner Gokten and Pinar Okan Gokten",coverURL:"https://cdn.intechopen.com/books/images_new/6823.jpg",editedByType:"Edited by",editors:[{id:"70354",title:"Ph.D.",name:"Soner",surname:"Gokten",slug:"soner-gokten",fullName:"Soner Gokten"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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Bifurcations, solitons and fractals are some of these ubiquitous structures that can be indistinctively identified in many models with the most diverse applications, from microtubules with an essential role in the maintenance and the shaping of cells, to the nano/microscale structure in disordered systems determined with small-angle scattering techniques. This book collects several works in this direction, giving an overview of some models and theories, which are useful for the study and analysis of complex biological and physical systems. It can provide a good guidance for physicists with interest in biology, applied research scientists and postgraduate students.",isbn:"978-1-78923-051-2",printIsbn:"978-1-78923-050-5",pdfIsbn:"978-1-83881-342-0",doi:"10.5772/intechopen.68687",price:119,priceEur:129,priceUsd:155,slug:"complexity-in-biological-and-physical-systems-bifurcations-solitons-and-fractals",numberOfPages:202,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"c511a26efc1b9c0638c8f9244240cb93",bookSignature:"Ricardo López-Ruiz",publishedDate:"May 2nd 2018",coverURL:"https://cdn.intechopen.com/books/images_new/6216.jpg",keywords:null,numberOfDownloads:10522,numberOfWosCitations:8,numberOfCrossrefCitations:8,numberOfDimensionsCitations:21,numberOfTotalCitations:37,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 20th 2017",dateEndSecondStepPublish:"May 11th 2017",dateEndThirdStepPublish:"August 7th 2017",dateEndFourthStepPublish:"November 5th 2017",dateEndFifthStepPublish:"January 4th 2018",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"5 years",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:"Edited by",kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"9849",title:"Prof.",name:"Ricardo",middleName:null,surname:"López-Ruiz",slug:"ricardo-lopez-ruiz",fullName:"Ricardo López-Ruiz",profilePictureURL:"https://mts.intechopen.com/storage/users/9849/images/system/9849.jpeg",biography:"Ricardo López-Ruiz, MS, Ph.D., is an associate professor in the Department of Computer Science and Systems Engineering, Faculty of Science, University of Zaragoza, Spain. He is also an associate researcher in Complex Systems at the School of Mathematics, University of Zaragoza. Previously, he worked as a lecturer at the University of Navarra, the Public University of Navarra, and UNED Calatayud, all in Spain. He completed his postdoc with Prof. Yves Pomeau at the École Normale Supérieure, Paris, France, and with Prof. Gabriel Mindlin at the University of Buenos Aires, Argentina. His areas of interest include statistical complexity and nonlinear models, chaotic maps and applications, multiagent systems, econophysics, big data, and artificial intelligence techniques.",institutionString:"University of Zaragoza",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"6",institution:{name:"University of Zaragoza",institutionURL:null,country:{name:"Spain"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"966",title:"Dynamical Systems Theory",slug:"dynamical-systems-theory"}],chapters:[{id:"58685",title:"Mechanical Models of Microtubules",slug:"mechanical-models-of-microtubules",totalDownloads:1050,totalCrossrefCites:1,authors:[{id:"210601",title:"Dr.",name:"Slobodan",surname:"Zdravkovic",slug:"slobodan-zdravkovic",fullName:"Slobodan Zdravkovic"}]},{id:"57291",title:"The Dynamics Analysis of Two Delayed Epidemic Spreading Models with Latent Period on Heterogeneous Network",slug:"the-dynamics-analysis-of-two-delayed-epidemic-spreading-models-with-latent-period-on-heterogeneous-n",totalDownloads:895,totalCrossrefCites:0,authors:[{id:"209856",title:"Dr.",name:"Qiming",surname:"Liu",slug:"qiming-liu",fullName:"Qiming Liu"},{id:"213889",title:"Mrs.",name:"Shihua",surname:"Zhang",slug:"shihua-zhang",fullName:"Shihua Zhang"},{id:"213890",title:"Mrs.",name:"Meici",surname:"Sun",slug:"meici-sun",fullName:"Meici Sun"}]},{id:"57947",title:"Stability and Hopf Bifurcation Analysis of a Simple Nutrient- Prey-Predator Model with Intratrophic Predation in Chemostat",slug:"stability-and-hopf-bifurcation-analysis-of-a-simple-nutrient-prey-predator-model-with-intratrophic-p",totalDownloads:1087,totalCrossrefCites:0,authors:[{id:"208713",title:"Associate Prof.",name:"Zabidin",surname:"Salleh",slug:"zabidin-salleh",fullName:"Zabidin Salleh"},{id:"209618",title:"BSc.",name:"Liyana",surname:"Abd. 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Lyon has always had a great tradition of orthopedic, and Charles Gabriel Pravaz was not only the inventor of the syringe, but he also created in Lyon a great orthopedic institute to treat scoliosis 200 years ago. The first Lyon brace, which was made of leather and steel, was created by Stagnara 70 years ago. It undergone a first change with the replacement of leather by polymethacrylate. This brace was used in adults in addition to surgery while waiting for the graft fusion, at a time when osteosynthesis did not have the current quality. In 2013, the use of adult ARTbrace in Europlex’O in polyamide and asymmetry allowed to avoid the plaster cast which has always been the characteristic of the Lyon management. The use of polyamide and digital allows treatment of thoracic and double major curves.
Vanderpool et al. [1] shows that the frequency of scoliosis in adults increases steadily with age, from 6% of scoliosis after the patient reaches 40 years until it reaches 10% of the population at age 65. The sex ratio was 2 females to 1 male. It is women who have the most painful instabilities and imbalances. Their bone mass is lower than that of men with a vertebral fracture threshold at age 65. Pregnancy and menopause could be also aggravating factors [2].
Akbarnia et al. [3] described the key features as curve stiffness, degeneration of the discs, osteoporosis, spinal imbalance both coronal and sagittal, rotary subluxation, spinal stenosis, and higher rate of complications (pulmonary, etc.). The esthetic aspect is not negligible, and even surgery performed during adolescence does not solve everything. Edgar and Mehta [4] has shown that self-image representation and social life is different after surgery in adolescence. 82% of adult scoliosis without surgery was married compared to 60% of scoliosis operated in adolescence. O’Brien [5] analyzes the consequences of scoliosis in adulthood. He noted that for adult scoliosis abnormal physical appearance and diminished self-esteem may always be present, but breathing limitations, inability to function, and other quality of life issues generally become the driving forces for clinical examination, diagnosis, and treatment.
The complications were analyzed by many authors. For Baron and Albert [6] the incidence of medical complications ranges between 40 and 86%. Local complications include infection, pseudarthrosis or failure of instrumentation, and neurological and adjacent-level degeneration or instability. Common medical complications include pneumonia, atelectasis, ileus, delirium, and cerebrovascular incidents. Smith et al. [7] studied the incidence of complications according to age. His conclusions were the following: the oldest age group (65–85 years) has nearly four times the number of minor complications and nearly five times the number of major complications when compared with the youngest age group (25–44 years). As invasive surgical therapy needs a perfect understanding of risk/benefit, Ogilvie [8] suggests that the decision to proceed with surgical treatment even if justified in many cases must be based on a thorough understanding of the anticipated benefits from surgical treatment and the risk of serious complications. These potential complications lead to multiple surgeries with results that can be less desirable than the original condition. The results of conservative orthopedic treatment are more difficult to assess. Kluba et al. [9] compares surgical and conservative treatment for degenerative lumbar scoliosis. He finds a significantly higher rate of spinal stenosis and degenerative spondylolisthesis in the group of patients with surgery. However no significant difference was evident between the two groups in terms of lumbar back pain after 4 years, respectively.
Everett and Patel [10] conducted a systematic review of non-operative treatment. There is indeterminate, level III/IV evidence on the effectiveness of any conservative option; level IV evidence on the role of physical therapy, chiropractic care, and bracing; and level III evidence for injections in the conservative treatment of adult deformity. The use of rigid or hard bracing in adult scoliosis is generally not recommended. This is due to the risk of muscle weakening effects from hard bracing and the fact that this could accelerate the degenerative process in some cases. Chuah et al. [11] notes that bracing may sometimes help the symptoms, but it has no effect on curve progression.
Pain is not synonymous with deformity progression. Some stable scoliosis patient report pain, and others evolve without pain. It will be necessary to try to make the difference between the “physical” pain and the “emotional” suffering when the patient does not support his deformation anymore.
Thoracolumbar pain often corresponds to minor joint instability.
The pain of convexity is of muscular origin.
The pain of the concavity is posterior: facet syndrome.
The lumbosacral pain is of ligament origin.
These pains respond perfectly to physiotherapy.
When scoliosis progresses, it is either (1) the evolution in adulthood of an adolescent idiopathic scoliosis, (2) a de novo scoliosis usually of discal origin, or (3) a camptocormia of muscular origin. In all cases, there may be a disc disease with sometimes rotatory dislocation, postural impairment with imbalance, extrapyramidal muscle involvement, and bone involvement (osteoporosis). In these progressive cases of instability, bracing or surgery may be necessary.
From 20 to 30 years old, the main problem is the anatomical pain.
From 30 to 50 years old, the main problem is the discal decompensation.
After 50 years old, there are two main problems: degenerative scoliosis very rigid with arthrosis and camptocormia reducible with paravertebral muscular atrophy.
Early works on scoliosis progression in adulthood were pessimistic [12], but at this time, idiopathic scoliosis, especially rachitic infantile, is mixed with neurological poliomyelitis that no longer exists.
In 2003 Weinstein published the spontaneous evolution of 117 idiopathic scolioses over more than 50 years [13]. Thoracic curves of more than 50 degrees at skeletal maturity progressed with an average of 29.4 degrees. Thoracolumbar curves between 50 and 75 degrees increased with an average of 22.3 degrees. Lumbar curves had the most progression, especially when the L5 vertebra was not well seated and when the apical rotation was greater than 33%. He does not observe a functional respiratory or painful repercussion below 70°. This angulation could be currently the functional surgical Cobb limit. Pregnancy does not change the progression of scoliosis in adulthood, except in cases of twin pregnancy.
In 2007 Marty-Poumarat [14] describes two specific adult scoliosis entities: adolescent scoliosis in adult (ASA) and degenerative de novo scoliosis (DDS).
Group A (ASA) = adult progression of AIS > 40° with first dislocation at 45 years. The progression can be sometimes regular, sometimes chaotic.
Group B (DDS) = de novo scoliosis with low Cobb after 50°, first dislocation at 52 years after menopause. DDS is more progressive than AIS. Because DDS is a result of degenerative disc instability, it is almost always progressive. Lumbar and thoracolumbar are the most progressive degenerative curves. Duval-Beaupere and Dubousset [15] have first described the mechanism of rotatory subluxation. Following their work, many authors have insisted on the importance of the lumbo-pelvic parameters [16, 17, 18].
The radiological risk factors for instability are (1) rotatory dislocation with lateral olisthesis (Figure 1), (2) L3–L4 inclination, (3) hypolordosis, and (4) increased thoracolumbar kyphosis [19, 20].
De novo scoliosis with constitution of a rotatory dislocation in 2 years, then scoliosis worsening by osteoporotic cuneiformization.
The physical activity and fracture rate of adult scoliosis is identical to that of the general population, except for operated patients who have less physical activity [21]. Unlike adolescence, when bracing is systematic when scoliosis progresses, the corrective bracing indication in adults is less related to Cobb angulation but more to the instability which results in pain, abnormal angular evolution, or imbalances (Figure 2).
Clinical imbalances in the frontal and the sagittal planes.
From a database started in 1998, we selected all adult scoliosis in which conservative orthopedic treatment has been proposed to, even if the treatment had not been achieved by the patient. Scoliosis treated during adolescence and monitored in adulthood were excluded [22]. In this case series study, we analyzed 779 patients referred for nonsurgical treatment, and we correlated three parameters: the etiology, age, and Cobb angulation (Table 1).
Indications ARTbrace adult (n = 779) | Rate % | Mean age | Mean angulation |
---|---|---|---|
Rotatory dislocation (n = 361) | 46.5% | 59.73 y ± 13.50 | 39.08° ± 16.56 |
Segmental instability (n = 150) | 19% | 46.03 y ± 15.49 | 25.29° ± 12.29 |
Instability post-surgery (n = 86) | 11% | 53.09 y ± 12.91 | 40.49° ± 15.38 |
Camptocormia (n = 68) | 9% | 69.78 y ± 12.19 | 38.09° ± 14.23 |
Kyphosis (thoracolumbar) (n = 62) | 8% | 60.73 y ± 15.51 | 43.34° ± 21.48 |
Disabling pain (n = 33) | 4% | 48.36 y ± 13.73 | 36.45° ± 21.48 |
Spondylolisthesis and spinal stenosis (n = 19) | 2.5% |
Main indications for adult scoliosis bracing with frequency classification.
The rate of dropout patients not wearing the brace is 17% which is not excessive, especially since the plaster cast at that time was made before the brace discouraged patients.
A tentative classification according to etiology, age, and angulation is proposed (Figure 3).
Indications of nonsurgical treatment by etiology (n = 739).
More than half of the indications concern the rotational dislocation, which is the specific complication of adult scoliosis. The rotary dislocation is visible on the CT scan with subluxation and joint narrowing on the sliding side and widening of the articular space on the opposite side.
One-fourth of the indications concern disc instability, which can be considered as the early stage of rotational dislocation.
The other etiologies are less frequent: lumbar-pelvic-femoral kyphosis, secondary instability under arthrodesis, root pain, and rarely spinal stenosis which requires neurosurgery. Camptocormia is linked to weakness of the deep posterior musculature [23]. The patient increases kyphosis gradually to tighten his weak paravertebral muscles. There is often an extrapyramidal context of Parkinson’s disease [23]. MRI cross sections highlight the fatty degeneration. Some authors have mentioned paravertebral myopathy [24].
According to age, there is no Cobb angle difference between patients aged 39 and 80 years old, even if we notice a slight worsening between patients aged 80 and 90 years old. It can be concluded that after 40 years, for the same angulation, the risk of decompensation does not depend on age [22].
If we examine in more detail the distribution of patients according to Cobb angle, we find that Cobb angle is not a discriminating factor like aging.
One of the bracing eligibility tests especially for camptocormia is self-correction by using the hands on the thighs, even if this self-correction does not last long in time. The second test of reducibility is carried out in supine position. The occipital patient must rely on the plane of the examination table. The placement of the ARTbrace is performed by the patient who stabilizes the brace at the pelvic level then unrolls the spine using the rigidity of the posterior bar and finally blocks the upper part. As for children, the “mayonnaise tube” effect of the two lateral hemi-valves completes the correction in the sagittal plane.
Adult scoliosis bracing is performed only in technically equipped medical clinics. Hospitalization is not essential because the use of the brace must be integrated into the patient’s environment. On the other hand, physiotherapy scoliosis-specific exercises (PSSE) is mandatory.
The brace wearing time protocol is a total time of 24 hours a day during 3 weeks with a plaster cast (or digital cast) to adjust the length of the ligaments with plastic deformation and, then, at least 4 hours per day for a minimum of 6 months, including systematically for 2 hours after the practice of sports activity (Table 2).
Management | Wearing time | Particularity | Follow-up examination |
---|---|---|---|
First 3 weeks | Total time 24/24 | Only 10′ for shower, no work interruption | At the end of total time without X-ray |
First 6 months | 4 hours/24 | Systematically for 2 hours after physical activity | At 6 months with X-ray |
6 m to 2 years | On demand and 2 hours after sport | In case of pain, in prevention before major efforts | At 2 years with X-ray |
After 2 years | No specific indication | Brace is kept for safety | AT 5 years with X-ray, then every 5 years |
Adult bracing management (Lyon ARTbrace).
Wearing the brace for a “total time” allows the patient to relearn all the gestures of daily living in a good posture, for example, the sitting writing posture with feet behind the chair and buttocks in front of the seat. The lower part of the chest touches the anterior edge of the table, and the forearms rest on the desktop.
The digital cast is made in three blocks according to the deviations as in the teenager, but in deep inspiration. In many cases, only a scan in maximum corrective posture perfectly balanced is performed. The corrective posture is derived from Schroth. The sagittal plane and the frontal plane are simultaneously corrected, ensuring the overall balance of the spine. The spine is placed in maximum extension to promote lumbar lordosis and reduce thoracic hyperkyphosis. The convex hand is placed on the vertical support, the concave hand is placed on the head, and the operator supports the patient’s elbow (Figure 4).
Digital cast with simultaneous correction in the frontal and in the sagittal planes.
The thickness of Europlex’O used in adults is 3 mm. The digital cast is made in blocks according to the deviations as in the teenager, but in deep inspiration. The advantages are manifold: (1) The patient can maintain the maximum corrected position for a few seconds while standing; (2) breathing is controlled, and the patient can be asked to perform maximum inspiration; and (3) the accuracy of the eight structure sensors is less than 1 mm. The 3 mm Europlex’O with very high rigidity can be used instead of polyethylene. It is possible to work bare skin, but the thin optical vest in jersey allows the use of landmarks for the superposition of the three blocks. The processing with a specific software allows the creation of a positive which will be milled by a digital milling machine. The CPO has all the tools to rework on the captured shapes. After a period of 3 weeks of “total time,” the brace is worn for a minimum of 4 hours/24 for 6 months, then on demand.
Instability pain management is obtained by:
A skin contact of the brace like a massage.
A discharge of the lumbar discs and vertebral body by the “composite beam effect.” The discharge of 30% is provided by the waist grip in the frontal plane, while the sagittal plane is free to prevent an excessive abdominal pressure.
A rebalancing spine in the frontal and sagittal plane.
A limitation of extreme postures.
The rigid brace is an active brace. The patient spontaneously tends to contract the paravertebral musculature in the sense of self-active axial elongation. Associated physiotherapy is however essential.
The brace can reshape the waist. It can also symmetrize the body for the largest scoliotic curves by the adjunction of a foam cushion in the concavity.
The lock automatically performed by the brace facilitates motion and strengthens the musculature of the lower limbs. There is also a better mobility of shoulder girdle because of the stabilization of shoulder blades in a more physiological position.
The wearing of a rigid brace is obligatorily supplemented by physiotherapy scoliosis-specific exercises. The ideal is to act when the spine begins to disrupt or becomes painful, indicating instability. The therapeutic progression is usual:
Analgesia.
Preventing muscle atrophy lumbo-abdominal strengthening in isometric and improving paravertebral deep muscles (Figure 5).
Promoting more flexible self-active axial elongation (Figure 6).
Correcting 3D spine balance: in the frontal plane, rebalance of the occipital axis; in the sagittal plane, restoration of sagittal lumbar and pelvic curvatures (pelvic anteversion and lumbar lordosis (strengthening of the iliopsoas)); and in the horizontal plane, dissociation of pelvic and shoulder girdles.
Developing compensation at the lower and upper limbs: relaxation under pelvic extension (hamstring stretching) (Figure 7).
Stimulating the mechanisms of postural correction with reharmonization of the paravertebral tensions (muscular chains) (Figure 8).
Isometric strengthening of the deep front line with correction of thoracolumbar kyphosis.
Self-active axial elongation in closed kinetic chain (hands/espalier).
Posture of stretching posterior chains of the lower limbs.
Reharmonization of paravertebral tensions with mirror control.
The main differences between adolescent and adult scoliosis are demonstrated in Table 3.
Physiology and biomechanics | Adolescent | Adult |
---|---|---|
No specific pain in adolescents. Painful instability in adults | No pain relief techniques | Pain relief techniques, massage, and others |
Flat back in the teenager. Loss of lordosis and hyperkyphosis in adults | Restoration of physiological sagittal curves (arms projected forward) | Physiotherapy in lumbar lordosis (hands crossed in the back) |
The brace aims to stiffen the spine (rust the spring). Spine mobilization in adults can lead to curve progression | Spine mobilization during cast and brace in all the amplitudes | No spine mobilization beyond the corrected posture |
Strengthening muscle fibers (adult sarcopenia) | Reinforcement of the reticulospinal system (aerobic) | Reinforcement of voluntary musculature in anaerobic metabolism. |
Translation along the vertical axis | Active axial self-elongation in standing position (grand porter) Open kinetic chain | Active axial self-elongation trunk bent at 90°, hands resting on the espalier. Closed kinetic chain |
Lumbo-pelvic region | Opening the iliolumbar angle | Anterior lumbo-pelvic strengthening (iliopsoas, abdo, quad) |
Lower limbs | No specific stretching. Global training without excessive resistance | Stretching of the posterior chain at the level of the lower limbs |
One-third of the thorax volume develops after the end of the stature growth | Resistance breathing exercises (inflating a balloon) | Breathing exercises in forced expiration |
Main differences between adolescent and adult scoliosis Lyon method physiotherapy.
First week. Physiotherapy is for analgesic purposes and is performed in the supine position by soft traction and a muscular work with irradiation of the short external rotators. Breathing is controlled because of the limitation of the abdominal expansion. The thoracic breathing is facilitated by the mobilization of the intercostal muscles.
Second week. The iliolumbar angle is mobilized to adjust tension at the iliolumbar level. The hump can be modeled with progressive closure of the ratcheting buckle. Physiotherapy is performed in sitting position.
Third week. Physiotherapy is more global, more general, more tonic, and stronger. The lever arm of shoulder and pelvic girdles is used. The sessions are made in standing position.
We first determine the sagittal direction of muscular work, usually lordosis for lumbar and thoracolumbar scoliosis. For each session there is a progression from supine to sitting and standing position.
In case of major disc degeneration, physiotherapy will be conducted in physiological lordosis, rather than in a standing position.
In case of major facet joint degeneration, physiotherapy will be conducted in physiological lordosis in prone position, legs bent or in a sitting position.
In case of leg length discrepancy, the feet imbalances adjustment with a shoe lift of 5 mm if it improves both pelvic and spine alignment.
In the sagittal plane, one can use small high heel stubs from 3 to 5 cm to reduce a lumbar kyphosis.
The food control helps to reduce overweight.
The postural control concerns mainly the workstation.
The regular practice of physical activity outside is essential. It is necessary to insist on the strict brace wearing during 2 hours after the sports activity.
Excessive mobilization of passive structures may lead to a progression of scoliosis, so the hyper flexibility is avoided and a position closest to that of the brace is better.
High thoracic breathing is less efficient than the usual abdominal breathing, and we must insist on improving the vital capacity for thoracic or double major curves. If lumbar scoliosis is treated, the risk of an increase of scoliosis during inspiration is low; however, breathlessness is to be avoided.
As the brace can be asymmetrical in the direction of the rebalancing of the spine, it will, however, always ensure the balance of the shoulder girdle.
When the body is fully developed, we advise high-impact sports such as running and dance, to favor the fixation of the calcium on the bone and the constitution of an important bony mass.
In a specific way when ribs are asymmetric, we recommend avoiding deep and quick inhalation which favors the vertebral rotation and therefore the breathlessness during the practice of sports.
For lumbar curves, we advise, as well, against the quick flexions of the trunk forward or the position extending with an anterior flexion of the trunk.
During the period of maximal tensegrity up to 40 years, all sports can be performed at a high level as long as the spine is straight.
After 40 years, decreased intervertebral disc height and sarcopenia reduce the body’s performance.
After 65 years, osteoarthritis is predominant. Swimming avoids overloading the lower limbs and helps maintain lumbar lordosis (Table 4).
Age (girls) | Physiology | Activity (example) |
---|---|---|
15–21 years | Before complete bone mass | Jogging and running Axial impact and spiral chains |
21–40 years | Before sarcopenia and osteopenia (tensegrity) | Fitness, sports reinforcing spiral chains |
40 to retirement | Before extrapyramidal weakness (postural system) | Nordic walking, cycling |
Retirement | Osteoarthritis, Pisa syndrome | Swimming |
Sports activity according to the age.
Immobilization braces made of polyethylene have been used for more than 50 years in case of mechanical pain. They complement classical physiotherapy by reducing load by 30% at the lumbar spine. We specifically studied the 158 patients with 5-year follow-up from our prospective database [25].
The principle of bracing is completely different from that of adolescent scoliosis. Indeed, we try to:
Decompress the discs with the “sandglass effect” lifting the trunk under the ribs and transferring the load on the pelvis.
Rebalance the spine in both the frontal plane and in the sagittal planes, mostly by recreating lumbar lordosis.
Relieve pain by the analgesic effect of rigid low back brace.
A specific frame is used to stabilize the patient in the most corrective posture in the frontal and the sagittal plane.
For those patients who had a progressive scoliosis, Cobb angle is stabilized or improved by more than 5° in 80% of cases, and only 20% of scoliosis remain candidates for surgery [25].
The frontal and horizontal clinical parameters are improved, but not the sagittal parameters with the forward trunk projection (Figure 9).
Insufficient correction in the sagittal plane.
The sternoclavicular support is poorly tolerated, and due to reduced dexterity in the older person, lateral closure is a handicap for elderly patients, even if adaptations are possible, that is why we currently use the 3 mm Europlex’O.
Instability in adulthood is frequent, and surgery is the most frequently offered solution despite the high rate of complications, as there was no alternative to date for thoracic and thoracolumbar curves. Only overlapped bivalve polyethylene braces were used for lumbar scoliosis with good frontal stabilization but no control in the sagittal plane (Figure 9). The ARTbrace in Europlex’O which allows an average reduction of 70% for the children has been used since 2015 in the adult for all the deviations.
The results of a consecutive series of 62 patients (6.2% of all ARTbrace patients) were treated between 2015 and 2016, as an alternative to surgery.
Nine patients (15%) which constitute the dropout were not seen at 6 months, which is very little considering the general condition and age of patients. The percentage of dropouts is identical to the previous series of lumbar curves treatments. Despite the very high rigidity, Europlex’O which needs a precision of 1 mm is therefore as well tolerated as polyethylene.
In the frontal plane, the average in-brace reduction is 27%, slightly higher for lumbar and thoracolumbar curvatures. The reduction to 2 years without brace is 15%, and especially the symptomatology of instability disappears. It is now possible to stabilize all thoracolumbar, thoracic, and double major scoliosis (Figure 10).
Reduction in the frontal plane after decompensation upon arthrodesis.
In the sagittal plane, the average in-brace reduction is 32% and at 2 years without brace of 25% (Figure 11).
Correction of kyphosis in the sagittal plane.
In the horizontal plane, some characteristic case study with EOS 3D confirms that adult ARTbrace is indeed, as in the child, a detorsion brace. Adult ARTbrace is the only brace to correct kyphosis and thus compensate for the insufficiency of polyethylene whose sternoclavicular support was not tolerated (Figure 12).
EOS 3D confirms thoracolumbar spine detorsion in ARTbrace.
Adult deformity is a major demographic health issue in the geriatric population. Surgeons are often very conservative in the treatment of adult scoliosis because of the complication rates associated with the surgeries and the marginal bone quality endemic to this population. Medical complications are a major concern in adult spinal deformity surgery [26]. The incidence ranges between 40% and 86%, but there is indeterminate level III/IV evidence on the effectiveness of any usual conservative care option. There is currently a lack of consensus on the most efficacious conservative treatments for adult deformity.
Very few results have been published concerning scoliosis adult bracing. Most of them only concern low back pain [27, 28]. Pain is the usual reason of medical consultation. Pain means instability when combined with the following clinical signs:
Frontal and sagittal Imbalance. The lumbar kyphoscoliosis is due to pelvic retroversion. The hips are extended under a retroverted pelvis, femurs were oriented downward and forward, and knees and ankles compensate with flexion deformity. Pelvic retroversion is limited by osteoarthritis of the hip, flexion deformity of the knee is poorly tolerated, and the patient will use a walking stick to walk. The thorax can enter in conflict with the pelvis at the concavity level pushing the viscera down. The patient suffers from breathing difficulty; digestive disorders are common and promote abdominal hypertension and sphincter disorders. The loss of lumbar lordosis has multiple causes: a decrease in the anterior height of the disc, hypertrophy of the facet joints and spinous process increasing the posterior height, and loss of extensors muscle strength [29].
In the horizontal plane, there is a rotation of the shoulder girdle as if the patient looks on the concave side of thoracic scoliosis. The pelvis is drawn by lumbar scoliosis. The convex hemi-pelvis moves back, and the hip is placed in internal rotation, while the concave hemi-pelvis moves forward, and the hip is placed in external rotation.
On each occasion when examining a patient at least every 5 years, verification X-ray is necessary in order to define a progression while being aware that in many cases the progression is chaotic.
The most characteristic sign of decompensating is the disc height loss that can sometimes exceed 10 mm. The disc corruption results in loss of physiological lordosis and ligament instability by hypermobility.
The losses of the gluteal muscles are very distinct when we make the plaster cast. It explains in part the pelvic retroversion; the spine tends to relocate along the line of gravity.
Muscular atrophy is a common criticism for rigid braces. In fact, the conservative orthopedic treatment does not suffer approximation. Its teamwork incorporates a specific physical therapy, the continuation of normal activity, and the practice of regular physical activity. No patient is wearing the brace for pleasure. The risk of overtreatment is zero.
Usually the total time bracing relieves pain, and the partial time bracing extends the improvement obtained. When the patient is not relieved, we can discuss the surgery with better arguments. The nonsurgical treatment treats the cause of lumbar instability mainly by discharging the pressure in the disc and stabilizing the lumbar area in lordosis to restore the tensegrity of the spine.
The esthetic improvement of the rib hump and asymmetrical waist is logical; the orthopedic brace is the best way to remodel a trunk. The cosmetic result continues 5 years after starting the treatment, with improvement of the rib hump measured with the plumb line and the Bunnel angle of trunk rotation (Figure 9).
The nonsurgical treatment can fit into a therapeutic progression. The indications may be progressive: observation, physiotherapy, medicine, conservative orthopedic Treatment, and surgery.
The good surgical indications concern the degenerative scoliosis not relieved by bracing, or relieved by total time, but insufficiently by partial time and especially if there is a spinal stenosis. It can also be used to complete surgery if remaining instability.
The Greek study [30] associating Schroth and Chêneau brace shows that patients have great difficulty to follow the protocol. For the quarter of patients following the protocol, the results are correct on pain and posture, but in 39% of patients, Cobb angle continues to increase.
Josette Bettany [31] confirms that for adult scoliosis, there are only a few studies on the effectiveness of PSSEs and a conclusion cannot yet be drawn. Recently a RCT proves the effectiveness of a motor and cognitive rehabilitation [32].
The motivation of the patient is fundamental. The brace should be designed as a tool to facilitate physiotherapy.
The use of an instantaneous and accurate CAD/CAM is better because the adult patient can only maintain the corrected position for a few seconds.
The scan is made in deep inspiration to not limit the vital capacity.
The management is 4 hours a day including systematically for 2 hours after any physical activity. Physiotherapy is even more important than during adolescence [33].
The frequency of adult scoliosis makes it a public health problem. The new digital technologies have changed the adult scoliosis bracing, and conservative care in general may be a helpful option for adult deformity, but evidence for this decision was lacking. Lyon nonsurgical treatment is effective and offers new perspectives to adult scoliosis bracing. Not only does the brace relieve pain and support the spine, but for the first time, it corrects deviations in the frontal, sagittal, and horizontal planes. Immobilization braces in polyethylene allow a treatment of the cause of pain without side effects. Worn a few hours in the day, they complement physiotherapy. The first results confirm the excellent tolerance of Europlex’O adult ARTbrace with its ease of implementation and corrections unmatched to date in adults. These corrections make it possible to restore stability of the deviations without surgery. Adult scoliosis bracing as an alternative to surgery could be possible. Initially reserved for the most severe cases, this management deserves to be more widely used for adult scoliosis. The increasing number of CPO using the most modern CAD/CAM technologies should facilitate research in the field of very high rigidity.
Thanks to my daughter Agnès Thornton de Mauroy, for proofreading in English.
asymmetrical rigid torsion brace
adolescent scoliosis in adult
computer-aided design/computer-aided manufacturing
certified prosthetist/orthotist
computed tomography scan
degenerative de novo scoliosis
low-dose X-ray imaging
magnetic resonance imaging
physiotherapy scoliosis-specific exercises
randomized controlled trial
Chronic pain is classified as pain that lasts longer than three to 6 months. Besides medical treatment, it consists of many other issues, such as social, economic and psychological. The treatment of chronic pain is a chronic problem for many specialities; it is generally based on an approach with antidepressants, anti-epileptics and opioids as drugs of first choice. Still, there is no right choice for these patients and 60–70% remains untreated [1, 2].
Chronic pain management is arguably at its most effective when a multidisciplinary approach is used. Ketamine can optimise other (non-opioid) medications by reducing opioid requirements [3].
The socioeconomic burden due to chronic pain is another problematic issue and cannot be overestimated. In Europe, the reported burden of chronic pain is nearly equally steep, with the point prevalence estimated to be 25–30% [4].
Ketamine has been on the market as an alternative to phencyclidine since 1960s. In 1965, it is used as an anaesthetic. Ketamine produces dissociative anaesthesia as well as analgesia and amnesia. Because of its side effects like, the induction of a psychedelic state causing agitation, hallucinations and panic attacks, ketamine has limited use in contemporary anaesthesia.
Ketamine is a phenylpiperidine derivative structurally related to phencyclidine with 2(2-chlorophenyl)-2-(methylamino)-cyclohexanone as its chemical structure. There are two different forms of ketamine: the racemic mixture (Ketalar®, Pfizer Inc., available in the US since 1966) and the S(+) enantiomer (S-ketamine or Ketanest-S®, Pfizer Inc.).
Ketamine is a potent N-Methyl-D-aspartate (NMDA) antagonist and is generally used in the treatment of acute and chronic pain, sedation, induction and maintenance of anaesthesia and ICU sedation [5]. It exerts its NMDA antagonism by binding to the phencyclidine receptor site when the channel is open. Its property to inhibit these receptors, it is postulated that ketamine can help treat chronic neuropathic pain [6]. Also, ketamine can be used as an antidepressant, making it useful in the concomitant treatment of pain and depression [7].
Ketamine is known to prevent central sensitization, so infusions of ketamine started intraoperatively and continued into the early postoperative period might prevent chronic postoperative pain, which is a problem impacting approximately 20% of surgical patients [8]. Ketamine, by inhibition of the N-Methyl-D-aspartate receptor (NMDAR), causes strong analgesia in neuropathic pain. Also, NMDAR is involved in the process of chronification of pain [9].
Ketamine also interacts with other receptors such as opioidergic, muscarinic and mono aminergic receptors. But still, little is known about the contributions of these receptor systems to the various effects of ketamine [10].
There are many routes that ketamine can be given; IV, IM, SC, oral, rectal, nasal, transdermal, epidural, or intrathecal [11]. Orally administered ketamine undergoes extensive first-pass metabolism, primarily via N-demethylation, resulting in small ketamine concentrations and large nor-ketamine concentrations in blood and tissue [12].
One of the challenging concepts about chronic pain patients should be treated in an inpatient setting. When outpatient treatment is planned, other issues must be considered like lack of monitoring, increased risk of toxicity and abuse. Smart dosing regimens, patient (and doctor) training, frequent contact and close monitoring of drug are needed for home treatment of ketamine [13].
The multimodal approach is the most effective treatment of chronic pain. Ketamine is often administered together with opioid analgesics, post-operatively and in the treatment of chronic cancer pain.
Ketamine has been studied for central pain after spinal cord injury. Oral and parenteral ketamine was found to be effective. It reduced continuous and evoked pain in these patients, and it is related to only mild side effects [14]. Ketamine showed an analgesic effect in a case with neuropathic pain after cauda equina trauma [15]. Ketamine was found effective in a patient with central poststroke pain after subarachnoid haemorrhage, besides providing analgesia, ketamine also helped the opioids and anticonvulsants to be tapered and discontinued [16]. The authors used midazolam for premedication and used iv incremental dose. With 50 mg oral dosing nightly, increasing to 50 mg 3 times a day resulted in relief of allodynia and hyperalgesia.
Complex regional pain syndrome is a chronic pain condition having both autonomic and inflammatory features. It occurs acutely in about 7% of patients who have limb fractures, limb surgery, or other injuries. Only a small percentage of it turns into a chronic form. This transition is often paralleled by a change from ‘warm complex regional pain syndrome,’ with inflammatory characteristics dominant, to ‘cold complex regional pain syndrome’ in which autonomic features dominate. Many complex mechanisms take role in this period. This may include peripheral and central sensitization, autonomic changes and sympatho-afferent coupling, inflammatory and immune alterations, brain changes, and genetic and psychological factor. Effective management of the chronic form of the syndrome is often challenging. There are reports about epidural use of ketamine in patients with complex regional pain syndromes and refractory to other treatments [16, 17]. Dose for epidural ketamine suggested was 0.3 mg/kg followed by 25 mcg/kg/h with only transient side effects like headache and nausea.
Fibromyalgia is a disorder characterised by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Fibromyalgia is thought to amplify painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals. Symptoms usually appear after physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.
In patients with fibromyalgia, ketamine which is given 0.3 mg/kg iv, showed an increase in endurance and reduction in pain intensity, tenderness at trigger points, referred pain, temporal summation, muscular hyperalgesia, and muscle pain at rest. It is suggested that ketamine by reducing central sensitization, is effective in fibromyalgia.
Peripheral vascular disease is a common reason of limb pain-causing considerable suffering. In its early stages, it can present as intermittent claudication, but with multiple levels of occlusion rest pain can develop. Patients presenting with critical limb ischemia face a 13% risk of primary amputation. The pain often responds poorly to different treatment strategies including opioids.
As ischemic pain of arteriosclerosis may consist of both nociceptive and neuropathic components, it is generally poorly responsive to opioids. When compared with ketamine with a potent dose dependent analgesic effect (0.15, 0.3, o.45 mg/kg iv) in clinical ischemic pain but with a narrow therapeutic window, ketamine may show better analgesia in these patients [18]. Also dose dependent side effect such as disturbed cognition and perception recorded for these patients.
According to aetiology, neuropathic pain syndromes are heterogeneous; in clinical aspect, they have many similarities. Pain, dysesthesias and hyperalgesia are the main features of neuropathic pain syndromes. Unfortunately, standard pharmacologic therapies are generally insufficient.
Current interest in ketamine focuses on its ability to alleviate chronic pain, especially when chronic pain has a neuropathic component. Chronic neuropathic pain is the most widely investigated indication for IV ketamine. Different doses have been tried between 0.25 and 0.75 mg/kg iv. Most side effects are observed with high doses. Neuropathic pain results from lesions of the somatosensory nervous system causing alterations in structure and function so that pain occurs spontaneously and responses to noxious and innocuous stimuli are amplified [19].
Another condition that generally manifests with neuropathic pain is chronic diabetes. In mice, this can be modelled with high-dose injection of streptozotocin which selectively kills pancreatic beta cells through DNA alkalization. Ketamine when given systemic infusion at 20 mg/kg/day for 5 days showed to reduce heat and mechanical hyperalgesia for several weeks following treatment.
Ketamine is frequently used for managing acute episodes of refractory neuropathic pain. In these situations, generally, large doses of opioids are used which leads to development of severe hyperalgesia. The mechanism of opioid induced hyperalgesia is not certain, one of the leading theories is overactivation and stimulation of the NMDA-receptor, so this proposed mechanism would explain why NMDA receptor modulators such as ketamine are effective in treating the condition. Ketamine with 10 mg/h iv suggested for opioid hyperalgesia. Also, subcutaneous administration can be a good alternative for these patients to get time for finding iv access.
Neuropathic pain related to ‘nerve damage in the trigeminal region’ is one of the chronic pain topics, which generally needs many interventions for pain relief. Ketamine can be an alternative for these kinds of pain issues. NMDA receptor inhibition by ketamine might change the sensitization, so ketamine causes pain relief even after ketamine has been eliminated from the body. The optimal dose suggested as 60 mg per oral, 6 times a day found [20]. Some side effects like dizziness and fatigue were well tolerated.
After amputation of a limb, most amputees suffer from stump and phantom limb pain. Many medical and surgical therapies have been tried, but only a few treatments have been found to be effective. Both peripheral and spinal mechanisms have been accused of underlying mechanism. Studies show that C-fibre input may induce a central hyperexcitability in dorsal horn neurons. There is evidence that this hyperexcitability in part is mediated by excitatory amino acids acting at NMDA receptor sites and that excitatory amino acid receptor antagonists may block this central hyperexcitability and its clinical manifestations.
Case series and case reports support ketamine use in stump and phantom pain. Ketamine showed a significant increase in pressure thresholds and reduced hyperpathia. Especially for patients who did not benefit from conventional treatments, iv ketamine was very effective. Doses such as 0.1 mg/kg iv over 5 min then infusion of 7 g/kg/min for 45 min and 0.125–0.3 mg/kg iv then continuous sc infusion 0.125–0.2 mg/kg/h for maintenance showed effective results. Also, other papers support the use of oral ketamine to control phantom pain (50 mg/6 hr) [21].
Nerve injury may lead to persistent pathological pain with hyperalgesia and pain evoked by non-noxious stimuli. Long-lasting hyperexcitability in nociceptive neurons initiated by increased activity in primary afferents may play a role in the pathogenesis of nerve injury pain. In particular, the N-methyl-o-aspartic acid receptors may be important for the development of long-lasting changes in neuronal excitability. NMDA receptor blockers inhibit the progressive increase in action potential discharge (wind-up) and neuronal hyperexcitability produced by repeated stimulation of small-diameter primary. NMDA receptor blockers also inhibit nociceptive behaviour in animals caused by nerve injury.
Ketamine is effective for pain relief in postherpetic neuralgia. Ketamine produces significant pain relief and also reduces allodynia and hyperpathia [22]. Relief of continuous pain was observed at the smallest dose but was most marked at the largest (0.05, 0.075, 0.1, 0.15 mg/kg/h. sc). The number and severity of spontaneous pain attacks are also reduced. Ketamine administration showed even complete resolution of ophthalmic postherpetic neuralgia [23].
Patients with refractory chronic migraine suffer from continuous pain and nonpainful symptoms, substantial disability, and have generally failed treatments with multiple medications. Patients with severe pain have often failed typically inpatient or outpatient infusion treatment, so few options remain for them.
Ketamine use for headaches has demonstrated benefits. Subcutaneous ketamine of 80 μg/kg was associated with an approximately 50% reduction in acute migraine-related pain and an approximate 75% reduction in chronic migraine-related pain [24].
Unfortunately, there was weak or no evidence supporting ketamine infusions for immediate improvements in pain management of mixed neuropathic pain, PLP, PHN, fibromyalgia, cancer pain, ischemic pain, migraine headache and low-back pain. Evidence only supports ketamine infusions for intermediate or long-term improvements in pain management of CRPS [25].
Some reports suggest that ketamine decreases the rate of chronic postoperative pain when administered as a pre-incisional dose (0.15–1 mg/kg iv) followed by an intraoperative infusion, and intravenous ketamine has been shown to significantly reduce chronic pain incidence following certain types of surgeries [26].
Multimodal approach to chronic pain is found to be the most effective treatment. In general, ketamine is administered with opioids, post-operatively and in the treatment of chronic cancer pain. A Cochrane review showed that ketamine is effective in reducing morphine consumption, and is related to less pain and less nausea and vomiting [27]. Also, ketamine positively affect opioid treatment in cancer pain [28]. The ability of ketamine to reduce the incidence (and severity) of opioid side effects is important as side effects reduce patient compliance. So, an opioid-ketamine combination may be useful in non-neuropathic pain states (e.g., in the palliative setting) or in mixed nociceptive/neuropathic pain states (e.g., in cancer pain).
Studies show that ketamine has also anti-depressant effects [29]. In fact, clinical studies showed that a subanaesthetic dose of ketamine produces antidepressant effects Ketamine has a positive effect on depressive symptoms in otherwise therapy-resistant patients. Because depression and chronic pain share common mechanistic pathways, Most chronic pain patients face depression or depression-like symptoms.
In fact, the treatment of chronic pain may serve two purposes, treating the pain and ameliorating the depressive symptoms. When the pain is treated and the depression simultaneously resolves, or the reverse is true.
Some experimental reports conclude that ketamine has also anti-inflammatory, neuroprotective and anti-tumour effects [30].
Intravenous ketamine infusions have the advantages of avoiding first-pass metabolism and also controlling the way of administration. But this requires inpatient settings allowing the healthcare team to monitor for adverse conditions and track treatment efficacy.
A meta-analysis including seven different studies examining both neuropathic and non-neuropathic pain conditions showed a significant analgesic effect for intravenous ketamine infusions. The median ketamine dose of 0.35 mg/kg was reached after 5 h. In these studies, maximum analgesic effect was observed between 48 h and 2 weeks post-infusion. The studies showed no efficacy difference between ketamine as a sole agent or adjuvant therapy [31]. This meta-analysis reported that ketamine shows significant promise for the treatment of a wide variety of chronic pain conditions, including neuropathic and non-neuropathic. Due to the long-acting nature of ketamine’s analgesia, outpatients treatments could be effective with visits required as frequently as infusions are needed.
Ketamine can be used as a third-line agent in intractable cancer pain. In a case study of cancer patients with intractable pain, ketamine infusions at a rate of 1.5 mg/kg/day reduced total daily morphine use by 50% after patients were sent home with ketamine/morphine pain pumps [32].
Oral and nasal formulations generally do not need are direct physician supervision in contrast to infusions, so oral and nasal formulations are more desirable for management of long-term pain conditions. Despite requiring higher doses due to extensive metabolism, oral administrations have also been found to be effective in providing analgesia.
A study with a daily dose of 2 mg/kg, ketamine showed reduction in pain in two-thirds of patients while one-half of patients reported some adverse event [33].
Intranasal ketamine, although now mostly taken part in the treatment of depression, has also been tried for management of cancer pain. Intranasal ketamine was found to be successful in 65% of breakthrough cancer pain patients and achieved a Numerical Pain Intensity Scale (NPIS) score that was at least 40% lower than pre-treatment levels [34].
Ketamine as a topical agent may be preferred for patients in whom systemic ketamine administration via oral or IV routes is not desirable administration. Topical application provides the benefit of keeping plasma concentrations and therefore potential side effects at a minimum.
Topical ketamine has been tried in chronic regional pain syndrome, studies reported effective reduction in pain measures, tactile allodynia and Visual Analog Scale pain score. Besides being a good alternative in pain management, still, there is concern about the systemic levels of ketamine [35].
Ketamine besides being an anaesthetic is used to treat various chronic pain syndromes, especially those that have a neuropathic component. Inhibition of the N-methyl-D-aspartate receptor and probably some other mechanisms like enhancement of descending inhibition and anti-inflammatory effects at central sites results in strong analgesia even with low doses.
The side effects of ketamine noted in clinical studies include psychedelic symptoms (hallucinations, memory defects, panic attacks), nausea/vomiting, somnolence, cardiovascular stimulation and hepatoxicity. There are also risks ranging from the bladder and renal complications to persistent psychological behaviour and memory defects by the increase in ketamine usage. Also, abuse is another problem.
Cognitive side effects of ketamine frequently limit its use. Since its discovery, ketamine was known to produce dissociative and psychomimetic effects. These effects are also responsible for the continued abuse of ketamine [36].
Studies showed that ketamine produces structural and physiological changes in the brain, even a decrease in grey and white matter volumes in the pre-frontal cortex and white matter degeneration in the left temporoparietal lobe has been reported [37].
Regardless of the mechanism of these cognitive disorders, many research has been done to find out what drugs may be able to prevent them. Several of these studies have demonstrated that benzodiazepines, specifically midazolam and haloperidol, reduced undesired psychotic side effects and nausea associated with ketamine administration [38].
Cystitis related to ketamine use is another problem, especially for long term users. The increase in neurotrophin in bladder tissue accused to cause the chronic inflammation of the bladder and urinary tract in ketamine cystitis [39].
Elevation of serum liver enzymes has been reported in patients receiving ketamine infusions, but these levels decreased back to baseline within 10–14 days following treatment [40].
Due to ketamine’s central inhibition effect of norepinephrine reuptake in adrenergic nerves, an increase in cardiac output via elevations in heart rate, systolic blood pressure, and diastolic blood pressure can be observed. Also, ketamine acts as a sympathomimetic on the cardiovascular system [41].
Because of dissociative and hallucinogenic effects of ketamine, it has been abused. Even therapeutic doses are generally less than street-use doses, ketamine still maintains addictive potential.
In clinical settings, ketamine is generally well tolerated, especially when benzodiazepines are used to suppress the psychotropic side effects. Patients receiving ketamine should be monitored closely, especially for CNS, haemodynamic, renal and hepatic symptoms as well as abuse. Until definite proof is obtained ketamine administration should be restricted to patients with therapy-resistant severe neuropathic pain.
Ketamine as an analgesic can be used for several indications and in many ways. It may be used most effectively to reduce the symptoms of allodynia, hyperalgesia and hyperpathia rather than acting as a traditional analgesic. This could be consistent with NMDA receptor blockade limiting or reducing central sensitization, although the ability of ketamine to interact with such a wide variety of receptors means that this is currently only speculative.
There are various dose regimens for different application ways for ketamine. Most of the data is based on case reports. Still, there are also concerns about side effects and with different premedication like lorazepam or midazolam, most of the side effects may resolve.
The data provides encouraging suggestions about ketamine for chronic pain situations. To talk about pros of ketamine for chronic pain management:
Ketamine is tried for many types of pain and found most useful
Pain related to neuropathies can be relieved by ketamine
Ketamine can be effective for pain where opioids are ineffective, and hyperalgesia occurred cause of opioids.
Ketamine can be used during the perioperative period both for acute analgesia management and for preventing chronic pain.
Ketamine can be applied by many routes; epidural, subcutaneous, intravenous.
Ketamine has an antidepressant effect, which plays an important role in the management of chronic pain.
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There are 91 (33) TCs and 113 (50) cases with CE identified in the WNP (ATL). Three CE structural change types are classified as follows: a CE with the inner eyewall dissipated in an eyewall replacement cycle (ERC, 51 and 56% in the WNP and ATL), a CE with the outer eyewall dissipated first and the no eyewall replacement cycle (NRC, 27 and 29% in the WNP and ATL), and a CE structure that is maintained for an extended period (CEM, 23 and 15% in the WNP and ATL). The moat size and outer eyewall width in the WNP (ATL) basin are approximately 20–50% (15–25%) larger in the CEM cases than that in the ERC and NRC cases. Our analysis suggests that the ERC cases are more likely dominated by the internal dynamics, whereas the NRC cases are heavily influenced by the environment condition, and both the internal and environmental conditions are important in the CEM cases. A good correlation of the annual CE TC number and the Oceanic Niño index is found (0.77) in WNP basin, with most of the CE TCs occurring in the warm episodes. In contrast, the El Niño/Southern Oscillation (ENSO) may not influence on the CE formation in the ATL basin. After the CE formation, however, the unfavorable environment that is created by ENSO may reduce the TC intensity quickly during warm episode. The variabilities of structural changes in the WNP basin are larger than that in the ATL basin.",book:{id:"5180",slug:"recent-developments-in-tropical-cyclone-dynamics-prediction-and-detection",title:"Tropical Cyclone Dynamics, Prediction, and Detection",fullTitle:"Recent Developments in Tropical Cyclone Dynamics, Prediction, and Detection"},signatures:"Yi-Ting Yang, Hung-Chi Kuo, Eric A. Hendricks and Melinda S. Peng",authors:[{id:"24152",title:"Dr.",name:"Melinda",middleName:null,surname:"Peng",slug:"melinda-peng",fullName:"Melinda Peng"},{id:"24153",title:"Prof.",name:"Hung-Chi",middleName:null,surname:"Kuo",slug:"hung-chi-kuo",fullName:"Hung-Chi Kuo"},{id:"179607",title:"Dr.",name:"Yi-Ting",middleName:null,surname:"Yang",slug:"yi-ting-yang",fullName:"Yi-Ting Yang"},{id:"180632",title:"Prof.",name:"Eric",middleName:null,surname:"Hendricks",slug:"eric-hendricks",fullName:"Eric Hendricks"}]},{id:"60010",title:"Influence of Climate Regime Shift on the Abrupt Change of Tropical Cyclone Activity in Various Genesis Regions",slug:"influence-of-climate-regime-shift-on-the-abrupt-change-of-tropical-cyclone-activity-in-various-genes",totalDownloads:1192,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"In this chapter, we reported the effect of basin-scale climate regime shift (CRS) on the abrupt change of tropical cyclone (TC) activity in various genesis basins, including the Pacific, Atlantic, and Indian Oceans. An analysis of regime shift index reveals that the worldwide TC activity experienced four significant abrupt changes during 1960–2014, including (i) an abrupt increase/decrease in the eastern North Pacific (ENP)/western North Pacific (WNP) in the early 1970s, (ii) an abrupt increase in the ENP and WNP in the early 1980s, (iii) an abrupt increase in the North Atlantic and ENP in the middle 1990s, and (iv) an abrupt decrease in the WNP and western South Pacific in the late 1990s. Three of them are identified concurrent with a significant CRS. The possible influence of a CRS on the abrupt change of TC activity in various genesis regions is addressed. We demonstrate that a CRS induced time mean state shift results in a rapid change in the large-scale dynamic and thermodynamic conditions, which substantially contributes to the abrupt change of TC activity in various genesis regions. In addition the CRS, the effect of interdecadal variability, such as the interdecadal Pacific Oscillation and Atlantic Multidecadal Oscillation, on the abrupt change of TC activity was discussed.",book:{id:"6701",slug:"extreme-weather",title:"Extreme Weather",fullTitle:"Extreme Weather"},signatures:"Chi-Cherng Hong and Yi-Kai Wu",authors:[{id:"236396",title:"Prof.",name:"Chi-Cherng",middleName:null,surname:"Hong",slug:"chi-cherng-hong",fullName:"Chi-Cherng Hong"},{id:"242960",title:"Mr.",name:"Yi-Kai",middleName:null,surname:"Wu",slug:"yi-kai-wu",fullName:"Yi-Kai Wu"}]},{id:"60156",title:"Heat Waves: Health Effects, Observed Trends and Climate Change",slug:"heat-waves-health-effects-observed-trends-and-climate-change",totalDownloads:1254,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"According to climate change scenarios, the average annual temperature will increase by around 4°C if current trends continue. Maximum temperatures, however, have already registered higher values in different regions of the world, increasing the number, duration and intensity of heat waves. With the increase of maximum temperatures and the increase of significance of heat wave events, reports of mortality episodes due to heat effects have been increasing. According to the information from the Centre for Research on Epidemiology of Disasters (CRED), 5 of the 20 deadliest disasters between 1996 and 2015 were heat wave events. This chapter analyzes heat wave events, the criteria for determining dangerous temperature thresholds, as well as trends already observed, and those expected due to climate change. 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Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. 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Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. 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Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"79367",title:"Dr.",name:"Ana Isabel",middleName:null,surname:"Flores",slug:"ana-isabel-flores",fullName:"Ana Isabel Flores",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRpIOQA0/Profile_Picture_1632418099564",institutionString:null,institution:{name:"Hospital Universitario 12 De Octubre",institutionURL:null,country:{name:"Spain"}}},{id:"328234",title:"Ph.D.",name:"Christian",middleName:null,surname:"Palavecino",slug:"christian-palavecino",fullName:"Christian Palavecino",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000030DhEhQAK/Profile_Picture_1628835318625",institutionString:null,institution:{name:"Central University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",slug:"francisco-javier-martin-romero",fullName:"Francisco Javier Martin-Romero",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",institutionString:null,institution:{name:"University of Extremadura",institutionURL:null,country:{name:"Spain"}}}]},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. 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He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. 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More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. He is a Consultant Reviewer for several journals, including the Journal of Chromatography A, Journal of Chromatography B, Plos ONE, Proteomes, International Journal of Molecular Science, Biotech, Electrophoresis, and others. 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She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. 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For 20 years, he has studied the analysis and processing of biomedical images, emphasizing the full automation of measurement for a large inter-individual variability of patients. Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. 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His fields of interest are anterior segment disease, keratoconus, glaucoma, corneal dystrophies, and cataracts. His research topics include\nintraocular lens power calculation, eye modification induced by refractive surgery, glaucoma progression, and validation of new diagnostic devices in ophthalmology. \nHe has published more than 100 papers in international and Italian scientific journals, more than 60 in journals with impact factors, and chapters in international and Italian books. He has also edited two international books and authored more than 150 communications or posters for the most important international and Italian ophthalmology conferences.",institutionString:'University of Campania "Luigi Vanvitelli"',institution:{name:'University of Campania "Luigi Vanvitelli"',institutionURL:null,country:{name:"Italy"}}}]},{type:"book",id:"7560",title:"Non-Invasive Diagnostic Methods",subtitle:"Image Processing",coverURL:"https://cdn.intechopen.com/books/images_new/7560.jpg",slug:"non-invasive-diagnostic-methods-image-processing",publishedDate:"December 19th 2018",editedByType:"Edited by",bookSignature:"Mariusz Marzec and Robert Koprowski",hash:"d92fd8cf5a90a47f2b8a310837a5600e",volumeInSeries:3,fullTitle:"Non-Invasive Diagnostic Methods - Image Processing",editors:[{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. 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Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:null},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:"Polytechnic University of Timişoara",institution:{name:"Polytechnic University of Timişoara",country:{name:"Romania"}}},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:null},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"414880",title:"Dr.",name:"Maryam",middleName:null,surname:"Vatankhah",slug:"maryam-vatankhah",fullName:"Maryam Vatankhah",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Borough of Manhattan Community College",country:{name:"United States of America"}}},{id:"414879",title:"Prof.",name:"Mohammad-Reza",middleName:null,surname:"Akbarzadeh-Totonchi",slug:"mohammad-reza-akbarzadeh-totonchi",fullName:"Mohammad-Reza Akbarzadeh-Totonchi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ferdowsi University of Mashhad",country:{name:"Iran"}}},{id:"414878",title:"Prof.",name:"Reza",middleName:null,surname:"Fazel-Rezai",slug:"reza-fazel-rezai",fullName:"Reza Fazel-Rezai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"American Public University System",country:{name:"United States of America"}}},{id:"302698",title:"Dr.",name:"Yao",middleName:null,surname:"Shan",slug:"yao-shan",fullName:"Yao Shan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Dalian University of Technology",country:{name:"China"}}},{id:"125911",title:"Prof.",name:"Jia-Ching",middleName:null,surname:"Wang",slug:"jia-ching-wang",fullName:"Jia-Ching Wang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Central University",country:{name:"Taiwan"}}},{id:"357085",title:"Mr.",name:"P. Mohan",middleName:null,surname:"Anand",slug:"p.-mohan-anand",fullName:"P. Mohan Anand",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"356696",title:"Ph.D. Student",name:"P.V.",middleName:null,surname:"Sai Charan",slug:"p.v.-sai-charan",fullName:"P.V. Sai Charan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"357086",title:"Prof.",name:"Sandeep K.",middleName:null,surname:"Shukla",slug:"sandeep-k.-shukla",fullName:"Sandeep K. Shukla",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"356823",title:"MSc.",name:"Seonghee",middleName:null,surname:"Min",slug:"seonghee-min",fullName:"Seonghee Min",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Daegu University",country:{name:"Korea, South"}}},{id:"353307",title:"Prof.",name:"Yoosoo",middleName:null,surname:"Oh",slug:"yoosoo-oh",fullName:"Yoosoo Oh",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:"Yoosoo Oh received his Bachelor's degree in the Department of Electronics and Engineering from Kyungpook National University in 2002. He obtained his Master’s degree in the Department of Information and Communications from Gwangju Institute of Science and Technology (GIST) in 2003. In 2010, he received his Ph.D. degree in the School of Information and Mechatronics from GIST. In the meantime, he was an executed team leader at Culture Technology Institute, GIST, 2010-2012. In 2011, he worked at Lancaster University, the UK as a visiting scholar. In September 2012, he joined Daegu University, where he is currently an associate professor in the School of ICT Conver, Daegu University. Also, he served as the Board of Directors of KSIIS since 2019, and HCI Korea since 2016. From 2017~2019, he worked as a center director of the Mixed Reality Convergence Research Center at Daegu University. From 2015-2017, He worked as a director in the Enterprise Supporting Office of LINC Project Group, Daegu University. His research interests include Activity Fusion & Reasoning, Machine Learning, Context-aware Middleware, Human-Computer Interaction, etc.",institutionString:null,institution:{name:"Daegu Gyeongbuk Institute of Science and Technology",country:{name:"Korea, South"}}},{id:"262719",title:"Dr.",name:"Esma",middleName:null,surname:"Ergüner Özkoç",slug:"esma-erguner-ozkoc",fullName:"Esma Ergüner Özkoç",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Başkent University",country:{name:"Turkey"}}},{id:"346530",title:"Dr.",name:"Ibrahim",middleName:null,surname:"Kaya",slug:"ibrahim-kaya",fullName:"Ibrahim Kaya",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"419199",title:"Dr.",name:"Qun",middleName:null,surname:"Yang",slug:"qun-yang",fullName:"Qun Yang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Auckland",country:{name:"New Zealand"}}}]}},subseries:{item:{id:"9",type:"subseries",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. 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.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11405,editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",slug:"luis-villarreal-gomez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",biography:"Dr. Luis Villarreal is a research professor from the Facultad de Ciencias de la Ingeniería y Tecnología, Universidad Autónoma de Baja California, Tijuana, Baja California, México. Dr. Villarreal is the editor in chief and founder of the Revista de Ciencias Tecnológicas (RECIT) (https://recit.uabc.mx/) and is a member of several editorial and reviewer boards for numerous international journals. He has published more than thirty international papers and reviewed more than ninety-two manuscripts. 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