rPMS parameters in basic research on healthy subjects.
\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"7995",leadTitle:null,fullTitle:"Epigenetics",title:"Epigenetics",subtitle:null,reviewType:"peer-reviewed",abstract:"Epigenetic changes are heritable and reversible modifications that significantly affect gene expression without any change in DNA sequence. The epigenetic signature is remodelled during the lifespan as a direct consequence of both environment and lifestyle. Therefore, health or disease status strongly depends on epigenetic marks. This book summarizes the current knowledge in the field and includes chapters on epigenetics in plants and epigenetics in health and disease. It is written for a wide audience of basic and clinical scientists, teachers and students interested in gaining a better understanding of epigenetics.",isbn:"978-1-78984-088-9",printIsbn:"978-1-78984-087-2",pdfIsbn:"978-1-83881-970-5",doi:"10.5772/intechopen.77825",price:100,priceEur:109,priceUsd:129,slug:"epigenetics",numberOfPages:96,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"33c1f5868ce0c29fbde6eafdc50af702",bookSignature:"Rosaria Meccariello",publishedDate:"September 11th 2019",coverURL:"https://cdn.intechopen.com/books/images_new/7995.jpg",numberOfDownloads:5702,numberOfWosCitations:10,numberOfCrossrefCitations:15,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:24,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:49,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 12th 2018",dateEndSecondStepPublish:"October 24th 2018",dateEndThirdStepPublish:"December 23rd 2018",dateEndFourthStepPublish:"March 13th 2019",dateEndFifthStepPublish:"May 12th 2019",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"143980",title:"Prof.",name:"Rosaria",middleName:null,surname:"Meccariello",slug:"rosaria-meccariello",fullName:"Rosaria Meccariello",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:"Dr. Rosaria Meccariello obtained a degree in Biological Sciences from the University of Naples Federico II, Italy, and a PhD in Comparative Endocrinology from\r\nthe University of Padova, Italy. Currently, she is Associate Professor of Biology at\r\nthe Department of Movement and Wellness Sciences at the University of Naples\r\n'Parthenope,” Italy. She has published more than 130 papers in peer-reviewed international journals, books, proceedings and abstract books. She has experience as\r\na reviewer for international journals and has served as an editor for scientific books,\r\nspecial issues and e-books. Dr. Meccariello is an expert in biology of reproduction,\r\nspermatogenesis, the hypothalamus-pituitary-gonad axis, central and local activity\r\nof GnRH, endocannabinoid and kisspeptin systems, and epigenetics.",institutionString:"University of Naples Parthenope",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"Parthenope University of Naples",institutionURL:null,country:{name:"Italy"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"396",title:"Molecular Genetics",slug:"genomics-molecular-genetics"}],chapters:[{id:"67312",title:"Introductory Chapter: Epigenetics in Summary",doi:"10.5772/intechopen.86541",slug:"introductory-chapter-epigenetics-in-summary",totalDownloads:901,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Rosaria Meccariello",downloadPdfUrl:"/chapter/pdf-download/67312",previewPdfUrl:"/chapter/pdf-preview/67312",authors:[{id:"143980",title:"Prof.",name:"Rosaria",surname:"Meccariello",slug:"rosaria-meccariello",fullName:"Rosaria Meccariello"}],corrections:null},{id:"65601",title:"Epigenetic Modifications in Plants under Abiotic Stress",doi:"10.5772/intechopen.84455",slug:"epigenetic-modifications-in-plants-under-abiotic-stress",totalDownloads:1587,totalCrossrefCites:13,totalDimensionsCites:17,hasAltmetrics:0,abstract:"Plants face a plethora of biotic and abiotic stresses ranging from extreme temperatures to salinity, drought, nutritional deficiencies, chemical toxicity, and pathogen attacks. As a consequence, plants have acquired several sophisticated regulatory mechanisms that allow them to cope with such adverse conditions. Epigenetic regulation plays a key role in the mechanisms of plant response to the environment, without altering DNA sequences. Epigenetics refers to heritable alterations in chromatin architecture that do not involve changes in the underlying DNA sequence but alter gene expression through DNA methylation or histone modifications. The epigenetic regulation of the plant genome is a highly dynamic process that fine-tunes the expression of a pertinent set of genes under certain environmental or developmental conditions. Over the past two decades rapid advancements in the field of high throughput sequencing unveil epigenetic information at genome wide level in various plant species. In view of the adverse effects of global climatic change, utilizing epigenetic differences for developing improved crop varieties is of paramount importance.",signatures:"Garima Singroha and Pradeep Sharma",downloadPdfUrl:"/chapter/pdf-download/65601",previewPdfUrl:"/chapter/pdf-preview/65601",authors:[{id:"142882",title:"Dr.",name:"Pradeep",surname:"Sharma",slug:"pradeep-sharma",fullName:"Pradeep Sharma"},{id:"281215",title:"Dr.",name:"Garima",surname:"Singroha",slug:"garima-singroha",fullName:"Garima Singroha"}],corrections:null},{id:"66059",title:"A Landscape of Epigenetic Regulation by MicroRNAs to the Hallmarks of Cancer and Cachexia: Implications of Physical Activity to Tumor Regression",doi:"10.5772/intechopen.84847",slug:"a-landscape-of-epigenetic-regulation-by-micrornas-to-the-hallmarks-of-cancer-and-cachexia-implicatio",totalDownloads:782,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:1,abstract:"In the last decades, there has been a remarkable advance in the treatment of most types of cancer, improving the patient’s prognosis. During cancer progression, tumor cells develop several biological changes to support initiation, proliferation, and resistance to death. Nearly 50–80% of all oncologic patients experience rapid weight loss that is related to ~20% of cancer-related deaths. Cancer cachexia is a syndrome characterized by loss of skeletal muscle mass, anorexia, and anemia. A lot of effort in scientific investigation has contributed to the understanding of cancer processes, in which epigenetic changes, as microRNAs, can influence cancer progression. Therefore, useful strategies to control the cancer-induced epigenetic changes in the tumor cells can have a key role in a clinical perspective to decrease the cancer development and aggressiveness. Physical activity has been proposed as a suitable tool to manage tumor growth and cachexia and to improve the deleterious sequelae experienced during cancer treatment. Although the molecular mechanisms involved in these responses are poorly understood, this chapter aims to discuss the role of microRNAs in the cancer-induced epigenetic changes and how physical activity could influence the epigenetic control of tumor cells and cachexia and their potential role in clinical applications for cancer.",signatures:"Gabriel Cardial Tobias, João Lucas Penteado Gomes, Ursula Paula Renó Soci, Tiago Fernandes and Edilamar Menezes de Oliveira",downloadPdfUrl:"/chapter/pdf-download/66059",previewPdfUrl:"/chapter/pdf-preview/66059",authors:[{id:"60681",title:"Dr.",name:"Edilamar Menezes",surname:"de Oliveira",slug:"edilamar-menezes-de-oliveira",fullName:"Edilamar Menezes de Oliveira"},{id:"144084",title:"Ph.D.",name:"Tiago",surname:"Fernandes",slug:"tiago-fernandes",fullName:"Tiago Fernandes"},{id:"278283",title:"MSc.",name:"João Lucas",surname:"Penteado Gomes",slug:"joao-lucas-penteado-gomes",fullName:"João Lucas Penteado Gomes"},{id:"278284",title:"Dr.",name:"Ursula Paula",surname:"Renó Soci",slug:"ursula-paula-reno-soci",fullName:"Ursula Paula Renó Soci"},{id:"291694",title:"MSc.",name:"Gabriel Cardial",surname:"Tobias",slug:"gabriel-cardial-tobias",fullName:"Gabriel Cardial Tobias"}],corrections:null},{id:"65856",title:"Consequences of Artificial Light at Night: The Linkage between Chasing Darkness Away and Epigenetic Modifications",doi:"10.5772/intechopen.84789",slug:"consequences-of-artificial-light-at-night-the-linkage-between-chasing-darkness-away-and-epigenetic-m",totalDownloads:1151,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Epigenetics is an important tool for understanding the relation between environmental exposures and cellular functions, including metabolic and proliferative responses. At our research center, we have devolved a mouse model for characterizing the relation between exposure to artificial light at night (ALAN) and both global DNA methylation (GDM) and breast cancer. Generally, the model describes a close association between ALAN and cancer responses. Cancer responses are eminent at all light spectra, with the prevalent manifestation at the shorter end of the visible spectrum. ALAN-induced pineal melatonin suppression is the principal candidate mechanism mediating the environmental exposure at the molecular level by eliciting aberrant GDM modifications. The carcinogenic potential of ALAN can be ameliorated in mice by exogenous melatonin treatment. In contrast to BALB/c mice, humans are diurnal species, and thus, it is of great interest to evaluate the ALAN-melatonin-GDM nexus also in a diurnal mouse model. The fat sand rat (Psammomys obesus) provides an appropriate model as its responses to photoperiod are comparable to humans. Interestingly, melatonin and thyroxin have opposite effects on GDM levels in P. obesus. Melatonin, GDM levels, and even thyroxin may be utilized as novel biomarkers for detection, staging, therapy, and prevention of breast cancer progression.",signatures:"Abraham Haim, Sinam Boynao and Abed Elsalam Zubidat",downloadPdfUrl:"/chapter/pdf-download/65856",previewPdfUrl:"/chapter/pdf-preview/65856",authors:[{id:"119770",title:"Dr.",name:"Abraham",surname:"Haim",slug:"abraham-haim",fullName:"Abraham Haim"},{id:"290796",title:"Dr.",name:"Abed Elsalam",surname:"Zubidat",slug:"abed-elsalam-zubidat",fullName:"Abed Elsalam Zubidat"},{id:"293515",title:"Dr.",name:"Sinam",surname:"Boynao",slug:"sinam-boynao",fullName:"Sinam Boynao"}],corrections:null},{id:"65059",title:"A Hypothesis to Explain How the DNA of Elderly People Is Prone to Damage: Genome-Wide Hypomethylation Drives Genomic Instability in the Elderly by Reducing Youth-Associated Gnome-Stabilizing DNA Gaps",doi:"10.5772/intechopen.83372",slug:"a-hypothesis-to-explain-how-the-dna-of-elderly-people-is-prone-to-damage-genome-wide-hypomethylation",totalDownloads:1281,totalCrossrefCites:2,totalDimensionsCites:6,hasAltmetrics:0,abstract:"Epigenetic changes are how the DNA of elderly people is prone to damage. One role of DNA methylation is to prevent DNA damage. In the elderly and those with aging-associated noncommunicable diseases (NCDs), DNA shows reduced methylation; consequently, the aging genome is unstable and accumulates DNA damage. While the DNA damage response (DDR) of the direct intracellular machinery repairs DNA lesions, too much DDR halts cell proliferation, and promotes senescence. Therefore, genome-wide hypomethylation drives genomic instability, causing aging-associated disease phenotypes. However, the mechanism is unknown. Independent of DNA replication, the eukaryotic genome retains a certain amount of endogenous DNA double-strand breaks (EDSBs), called physiologic replication-independent EDSBs (Phy-RIND-EDSBs), that possess physiological function. Phy-RIND-EDSBs are reduced in aging yeast, and low levels of Phy-RIND-EDSBs decrease cell viability and increase DNA damage. Thus, Phy-RIND-EDSBs have a biological role as youth-associated genomic-stabilizing DNA gaps. In humans, Phy-RIND-EDSBs are located in the hypermethylated genome. Because the genomes of aging people are hypomethylated, the elderly should also have a low level of Phy-RIND-EDSBs. Based on this evidence, I hypothesize that in the human Phy-RIND-EDSBs, reduction is a molecular process that mediates the genome-wide hypomethylation driving genomic instability, which is a nidus pathogenesis mechanism of human body deterioration in aging-associated NCDs.",signatures:"Apiwat Mutirangura",downloadPdfUrl:"/chapter/pdf-download/65059",previewPdfUrl:"/chapter/pdf-preview/65059",authors:[{id:"231376",title:"Dr.",name:"Apiwat",surname:"Mutirangura",slug:"apiwat-mutirangura",fullName:"Apiwat Mutirangura"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"5222",title:"Cannabinoids in Health and Disease",subtitle:null,isOpenForSubmission:!1,hash:"d684a703afd17dc97d18480a982e5316",slug:"cannabinoids-in-health-and-disease",bookSignature:"Rosaria Meccariello and Rosanna 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Hodges",dateSubmitted:"June 21st 2018",dateReviewed:"October 22nd 2018",datePrePublished:"December 31st 2018",datePublished:"February 19th 2020",book:{id:"8295",title:"Landscape Reclamation",subtitle:"Rising From What's Left",fullTitle:"Landscape Reclamation - Rising From What's Left",slug:"landscape-reclamation-rising-from-what-s-left",publishedDate:"February 19th 2020",bookSignature:"Luis Loures",coverURL:"https://cdn.intechopen.com/books/images_new/8295.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"108118",title:"Dr.",name:"Luis",middleName:null,surname:"Loures",slug:"luis-loures",fullName:"Luis Loures"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"264298",title:"Dr.",name:"Jason",middleName:null,surname:"Gordon",fullName:"Jason Gordon",slug:"jason-gordon",email:"jason.gordon@uga.edu",position:null,institution:{name:"University of Georgia",institutionURL:null,country:{name:"United States of America"}}}]},book:{id:"8295",title:"Landscape Reclamation",subtitle:"Rising From What's Left",fullTitle:"Landscape Reclamation - Rising From What's Left",slug:"landscape-reclamation-rising-from-what-s-left",publishedDate:"February 19th 2020",bookSignature:"Luis Loures",coverURL:"https://cdn.intechopen.com/books/images_new/8295.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"108118",title:"Dr.",name:"Luis",middleName:null,surname:"Loures",slug:"luis-loures",fullName:"Luis Loures"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"12102",leadTitle:null,title:"Current Trends in Ambulatory Care",subtitle:null,reviewType:"peer-reviewed",abstract:"
\r\n\tThe goal of this book will be to introduce the current change in ambulatory care affected by the new development of medical knowledge, new technology, and social ethics. The COVID-19 pandemic plays an important role in the acceleration of the adoption of telehealth or telemedicine in medical care. Both patients and medical providers adopt it quickly. The new devices make it possible for remote measuring or monitoring vitals or other physical parameters and communication pathways that provide other tools for medical providers to change the pattern of management of different chronic diseases, like hypertension, diabetes, obesity, congestive heart failure, etc. Some techniques can switch some procedures from the hospital to the patient’s home or clinic so, which will not just make such procedures more convenient for patients but also save expense on medical care. The quality of medical care will improve once both medical providers and patients understand such changes, and cooperate proactively. Medical providers can learn how and what tools they can update and apply for caring for patients. Patients can understand and learn how to proactively engage in their health management.
\r\n\r\n\tThe quest to ensure a perfect patient safety record is at the heart of the decades-long quest to improve quality, enhance value, and increase trust in our healthcare delivery systems. Beginning with the landmark report, To Err Is Human, the Institute of Medicine set an ambitious agenda for the medical community to reduce the number of patients harmed by healthcare-related errors and preventable adverse events. As a result, large-scale initiatives were initiated, including electronic medical records, trainee work hours restrictions, and the advent of evidence-based care bundles. To help support the effort, various governmental and non-governmental agencies established funding for patient safety research and actively fostered the development of well-defined Patient Safety Goals via the National Quality Forum. Parallel to targeted efforts aimed at reducing human and systemic errors leading to patient harm, legislative efforts resulted in bills intended to increase public reporting of medical errors and a paradigm shift allowing public support of the concept that most patient injuries are a result of system failures and not provider errors. This book will intend to provide the reader with a comprehensive overview of the current state-of-the-art in patient safety, featuring an easy-to-follow, vignette-based format that focuses on the most important evidence-based developments in this critically important area.
",isbn:"978-1-83768-192-1",printIsbn:"978-1-83768-191-4",pdfIsbn:"978-1-83768-193-8",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"fa37d79f81893fd0a9ab346ae1c3e4a9",bookSignature:"Dr. Xin-Nong Li",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/12102.jpg",keywords:"Pandemic, Telehealth, Communication, High Technology, Chronic Disease, Remote, Monitor, Quality, Diabetes, Hypertension, Digital Device, Cardiovascular Disease",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 26th 2022",dateEndSecondStepPublish:"July 28th 2022",dateEndThirdStepPublish:"September 26th 2022",dateEndFourthStepPublish:"December 15th 2022",dateEndFifthStepPublish:"February 13th 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"11 days",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Dr. Li, MD, graduated from Sun Yat-Sen University of Medical Sciences as an Outstanding Student. He later retrained as a resident in the department of internal medicine at the University of Pittsburgh Medical Center. He gained rich professional experience by working at Basel University, Switzerland, the University of Alabama at Birmingham, USA, and Medical School, the University of California at Davis. He is a Fellow of the American College of Physicians and a member of the American Medical Association.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"345917",title:"Dr.",name:"Xin-Nong",middleName:null,surname:"Li",slug:"xin-nong-li",fullName:"Xin-Nong Li",profilePictureURL:"https://mts.intechopen.com/storage/users/345917/images/system/345917.jpg",biography:"Dr. Xin-Nong Li, MD is an internal medicine specialist in Fair Oaks, CA. Dr. Li completed a residency at U Pittsburgh MC Shadyside. He currently practices at Xin-Nong Li, MD, and is affiliated with Mercy San Juan Medical Center. He accepts multiple insurance plans. Dr. Li is board-certified in Internal Medicine.\r\n\r\nEducation:\r\nU Pittsburgh MC Shadyside, Residency Hospital — 1999\r\nU Pittsburgh MC Shadyside, Internship Hospital — 1997\r\nSun Yat Sen University Med Sci, Medical School — 1982",institutionString:"Sutter Health",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Sutter Health",institutionURL:null,country:{name:"United States of America"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"466997",firstName:"Patricia",lastName:"Kerep",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/466997/images/21565_n.jpg",email:"patricia@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully"}},relatedBooks:[{type:"book",id:"6550",title:"Cohort Studies in Health Sciences",subtitle:null,isOpenForSubmission:!1,hash:"01df5aba4fff1a84b37a2fdafa809660",slug:"cohort-studies-in-health-sciences",bookSignature:"R. Mauricio Barría",coverURL:"https://cdn.intechopen.com/books/images_new/6550.jpg",editedByType:"Edited by",editors:[{id:"88861",title:"Dr.",name:"R. Mauricio",surname:"Barría",slug:"r.-mauricio-barria",fullName:"R. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],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"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"117",title:"Artificial Neural Networks",subtitle:"Methodological Advances and Biomedical Applications",isOpenForSubmission:!1,hash:null,slug:"artificial-neural-networks-methodological-advances-and-biomedical-applications",bookSignature:"Kenji Suzuki",coverURL:"https://cdn.intechopen.com/books/images_new/117.jpg",editedByType:"Edited by",editors:[{id:"3095",title:"Prof.",name:"Kenji",surname:"Suzuki",slug:"kenji-suzuki",fullName:"Kenji Suzuki"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3828",title:"Application of Nanotechnology in Drug Delivery",subtitle:null,isOpenForSubmission:!1,hash:"51a27e7adbfafcfedb6e9683f209cba4",slug:"application-of-nanotechnology-in-drug-delivery",bookSignature:"Ali Demir Sezer",coverURL:"https://cdn.intechopen.com/books/images_new/3828.jpg",editedByType:"Edited by",editors:[{id:"62389",title:"PhD.",name:"Ali Demir",surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"71988",title:"Introductory Chapter: Safety and Health for Workers - Theory and Applications",doi:"10.5772/intechopen.92196",slug:"introductory-chapter-safety-and-health-for-workers-theory-and-applications",body:'According to 2017 estimates of accidents and work-related diseases and deaths report released by the International Labor Organization (ILO), each year 2.78 million workers die from occupational accidents of which 2.4 million are disease related, approximately 86.3% of the total estimated deaths. The work-related mortality accounted for 5% of the global total deaths (based on the Global Burden of Disease Study 2015) and fatal accidents accounted for the remaining 13.7% [1]. Likewise, for 2017, BLS reported 282,750 MSD cases resulting in days away from work in the private sector, a continued decrease from the previous year (285,950) [2]. Work-related musculoskeletal disorders (WMSDs) accounted for 31.2% of all injuries and illnesses involving days away from work and remain the largest source of injury and illness cases [2]. Therefore, work-related issues have led to the explosion of research on safety and health for workers in the ergonomics and human factors, medical, psychological, engineering, science, nursing, and environmental literature for over two decades. The health and safety hazards address both acute and chronic hazards workers are exposed to at workplaces daily. These days health hazards at workplaces attract more attention because of the potential harm associated with the employee’s exposure and the monetary cost attributed to a single cause. Thus, everyone wants a safe and healthy workplace for proper operation and productivity of the employees. Therefore, health and safety at work is aimed at creating conditions, capabilities, and habits that enable the worker and the organization to operate efficiently and in a way that avoids events that could cause them harm [3].
To reduce the rate of accidents reported every year at work, the United State (US) enacted a law to oversee the safety and health of workers at various workplaces in 1970, known as Occupational Safety and Health Act (OSHA). The act was enacted purposely to ensure that employers provide safe working environment for all employees. The importance of human safety and good health cannot be overemphasized or overestimated. Before the existence of OSHA, the National Environmental Protection Policy Act of 1969 became the basis of the environmental protection in the US. This chapter provides the overview of the book on safety and health for workers from research and practical application perspectives.
Everyone is exposed to at least one hazard daily and constantly interacts with different hazards on daily basis. The hazards concern with safety and health hazards, include biological, botanical, mechanical, chemical, physical, etc. Human beings cannot escape inhalation, egestion, injection, and absorption processes, even if they refuse to engage in daily work activities. Thus, it is imperative to study in depth the processes and the methods to control and manage the everyday hazards humans are constantly exposed to. Furthermore, to complicate issues, human typically operates under different constraints including inability to survive without interaction with one another, environments, materials, and equipment on daily basis to function as human. Given these constraints, human beings are forced to maintain good health while performing their daily tasks by using good judgment during decision-making. Exposure to hazardous materials is inevitable but human errors, time of exposure, concentration, and the dose of the hazardous materials determine the effect on safety and health of the workers. To reduce the likelihood of making errors, human beings must first understand the theory behind each operating process of any activity before engaging in it. Therefore, identification and recognition of hazards relating to the theory and the applications of the principles of handling the hazards are the significant ways for protecting human safety and health at work.
In a cafeteria in the northwest region of United State (US), a teenager rushed out from a restroom and everyone seated immediately perceived unpleasant odor. At once, everyone choruses what is this? The sister of the teenager boy asked her brother “did you wash your hands? The boy responded oh NO, I forgot.” Immediately, debate on why and how started in the room that inspired other customers to join the discussion.
Likewise, Wickens et al. [4] document a situation in the Midwestern factory in US on an assembly-line worker. In the scenario, the assembly-line worker had to reach to an awkward location and position a heavy component for assembly. Toward the end of a shift, after grabbing the component, he felt a twinge of pain in his lower back. A trip to the doctor revealed that the worker had suffered a ruptured disc, and he missed several days of work. He filed a lawsuit against the company requiring physical action that endangered the lower back.
A young lady who graduated with GPA of 4.0 from one of the ivy league Universities in US, pick up a supervisory role position in a multi-million construction company and having worked for 5 years in this position, she realized that her health has been deteriorated. She visited the doctor and discovered she suffered from cardiovascular damage, gastrointestinal problems that has led as ulcers and irritable bowel syndrome, and decreased fertility. She requested for damage compensation from the company.
This book is designed to address the theory of safety and health for workers and the practical applications to solving issues associated with hand hygiene, social support, ergonomics-spine deformity, workplace conditions, health equality, etc. at workplaces.
Many workers and employers constantly face one or more of the episodes described in the introduction. The episodes illustrate the role of ergonomics and human factors, industrial hygienist and safety specialist in workplace design. The umbrella for human safety and health at workplaces is known as the ergonomics and human factors. Various definitions exist for ergonomics and human factors from different sources such as scientific literature, professional organizations, governmental agencies, scholars etc. Ergonomics as defined by scientists is the science and practice of designing jobs and workplaces to match the capabilities and limitations of the human body. In 2018, it was precisely defined as fitting the job, workplaces, products to users’ capability to enhance safety and good health of the users [5]. CETENA (The Italian Ship Research Company) defined ergonomics as the study of human performance and its application to the design of technological systems [6]. The author further stated that the goal of ergonomic is to enhance productivity, safety, convenience, and quality of life. It is a fact that ergonomics is derived from the Greek words ergo (work) and norms (law), which denotes the science of work. Therefore, the principles of ergonomics are not limited to traditional occupational environment as stated in Pamela McCauley-Bush textbook [7].
Hand hygiene is the act of cleaning hands for removing soil, dirt, and microorganisms. Proper hand hygiene had saved thousands of humans from death, chronic diseases, and incurable sickness. In the mid of eighteen century, Dr. Ignazz Philip Semmelwies proposed hand washing to reduce child mortality in the nation, before the discovery of microbial in the late eighteen century. At the time Dr. Semmlwies proposed the method, baby mortality was at 15–20%, and after implementing the proposed procedure, mortality rate reduced significantly to 0.85% in the hospitals where he worked while in other hospitals it remained at 10–15% of mortality rate [8]. Hand hygiene has been taken as the practice mostly needed for the medical practitioners. However, it should be considered necessary and important for everyone, as no one is exempted from sickness or diseases. Absolutely, people have forgotten that cleanliness is next to godliness as the saying goes. Therefore, complete hand hygiene is what is required in our workplaces today, even as many diseases spring up every day. Not long ago, Ebola disease took over the entire world, SARS also, and now it is Corona virus; so, who can tell what the disease will be tomorrow. Nearly, all the new outbreaks are traced to poor hygiene. Nevertheless, the importance of hand hygiene in the workplaces cannot be underemphasized therefore, the earlier the intervention, the better to preventing the spreading of any disease outbreak. In 2017, the findings of the study conducted by Prasad et al. [9] concluded that most patients and nurses interviewed reported hand hygiene as an important aspect of everyday life in preventing infection in the hospital setting. Many researchers have also suggested that hand hygiene is one of the main strategies to preventing infections that affect hundreds of millions of individuals worldwide and are constantly leading to chronic diseases, illnesses, and prolonged hospital stays, which sometime added burden to patients’ financial stand and later cause instability within families [10, 11, 12]. There are many chemicals, substances, and materials human beings interact with on a regular basis at workplaces and homes, which have high potential of contaminating hands. Sometimes, people forget that their hands are dirty and pick food straight into their mouth without washing their hands, while many scratch their eyes 100 times daily and are found constantly touching their nose and seeping fingers in their mouth. Thus, educating people on the importance of hand hygiene is a crucial aspect of life to preventing unplanned sickness, diseases, and transfer of similar dangerous germs.
Workplace conditions have been proved to have both positive and negative effects on employees’ health status likewise on their productivity. The more the employee is satisfied with workplace conditions the faster the organization success, which makes workplace condition a major concern for organizations today. In 2019, Sorensen et al.’s study revealed that workplace condition significantly affects workers’ health as well as their well-being [13]. Additionally, it is a proven fact that safe working conditions influence the habits of workers, which in turn impacts on efficiency [14]. Accidents at workplaces are mainly attributed to workplace condition or workers’ acts. Workplace conditions refers to the working environment and all existing circumstances affecting labor in the workplace, including working time (hours of work, rest periods, and work schedules) to remuneration, legal rights and leaders’ responsibilities as well as the physical conditions and mental demands that exist in the workplace. In other words, workplace condition deals with the organization leadership structure and floor layout or equipment setting. International Labor Organization (ILO) has consistently demanded for workers’ work-life balance. Therefore, critical attention is required for worker schedule, leadership skills of the authority, and good workplace layout for proper flow to ensure workers’ well-being and better productivity. Research findings on job redesign at call centers significantly improved employee well-being, psychological contract fulfillment, and supervisor-rated job performance [15], mental health [16]. Likewise, research has revealed that work systems design may have effects on physical health, mental health, and longevity of life [17]; therefore, continuous attention to health and safety of the employees is important because ill-health and injuries caused by the systems of work or working conditions cause suffering and loss to individuals and their dependents [18]. As simple as workplace condition might sounds, the fear created through improper workplace conditions such as violent, abuse, segmental judgment, gender biases, etc. are factors, which could prevent employee from taking goal-directed action toward safety. Although, the psychologically, flexible people are less emotionally disturbed in such environments as argued in Hayes et al.’s [19] findings. Nevertheless, adequate consideration should be given to workplace condition to ensure workers’ well-being and safety at workplace.
Employees’ act is another important aspect to be considered at workplaces, to reduce or eliminate accidents that might result in illnesses, diseases, injuries, and death at workplaces. Certainly, no environment is free from all hazards, but workers’ behavior toward handling the hazards is a crucial aspect of preventing accidents from occurring at workplaces. Undoubtedly, safety and health specialists need to have general knowledge of the impacts of any hazardous materials to the human body and train all employees on ways of preventing such effects, but because of human nature, how many adhere to the totality of this principle? Employees’ safety responsibilities were acknowledged in 1999 by Bratton and Gold [20] that employee is to behave in a manner that safeguards his or her own health and safety and that of his/her co-workers. Furthermore, Jonathan and Mbogo documented the findings from the research carried out at The Research Centre Design and Technology of the Saxion University of Applied sciences on “Safety at work,” which acknowledged that personal safety, a safe environment, and safe behavior were important components that employers need to ensure their availability within their organizations for proper productivity and safety of the employees. Liao et al. [21] acknowledged in their study that almost all accidents and injuries occurring at workplace are attributed to workers’ unsafe acts, which are also a reflection of system deficiency and unsafe work condition. Dodoo and Al-Samarraie [22] concluded in their study that lack of adequate knowledge on safety and health, violation of safety rules, work pressure, stress, and non-use of protective equipment were the unsafe acts perpetrated by the workers sampled. Researcher has also referred unsafe act as a deliberate omission or deviation from the recommended safety standards Mason [23]. The same researcher described an unsafe act as an individual’s likelihood of not following standard safety rules, procedures, instructions, and specified criteria for work imposed by the organization management. Since the contributions of worker’s unsafe acts to the workplace accidents is undeniable worldwide, research aimed at reducing this factor should be considered a discipline of great interest for society in general.
The physical and chemical properties of raw material use and produce are other essential factors that need attention to properly monitor the health and safety of workers at workplaces. To do this, detailed attention must be given to workplace Material Safety Data Sheet (MSDS). The importance of MSDS in handling worker exposure to hazardous materials in every workplace cannot be substituted for another record keeping data sheet for the purpose of workers’ health and safety. According to Translink online website, MSDS is a document that contains information on the potential health effects of exposure to chemicals, or other potentially dangerous substances, and on safe working procedure when handling chemical products. It is an essential starting point for the development of a complete health and safety program. MSDS contains hazard evaluations on the use, storage, handling, disposal information, and emergency procedures related to that material. Therefore, it is imperative to consider the use of MSDS in every workplace to ensure better control of hazardous materials effect on the employees.
This book highlights significant factors contributing to workers’ poor health and safety at work, which could result in injury, chronic diseases, and death. Both theories and practical applications are discussed in this book for easy understanding of the readers.
Magnetic stimulation is the application of “electrode-free electrical stimulation” using induced current from a pulsed magnetic field. The magnetic field generated by the stimulation coil induces an electromagnetic-induced overcurrent in the body that resultantly depolarizes nerves and muscles’ cell membranes, thereby stimulating the brain, nerves, and muscles. Repetitive peripheral magnetic stimulation (rPMS) is applied as a treatment method that noninvasively delivers repetitive magnetic stimulation to peripheral nerves and muscles. It has attracted attention as a new means of rehabilitation, especially for sensory and motor disorders [1].
To date, neuromuscular electrical stimulation (NMES) has been widely used as a similar tool. NMES is an electrical stimulation therapy primarily performed to improve motor function, such as suppressing muscle hypertonia associated with upper-motor neuron damage, preventing and improving muscle atrophy associated with peripheral neuropathy, and increasing muscle strength. However, this therapy is associated with pain and discomfort caused by electrical stimulation. Compared with NMES, rPMS does not cause discomfort due to pain and can stimulate deep muscles [2]. NMES evokes cutaneous receptors and may generate noisy signals, whereas rPMS generates intrinsic receptive information during muscle contraction that affects brain reversibility [3].
Furthermore, rPMS does not require the application of electrodes and can be stimulated over clothing. Similar to NMES, however, rPMS is contraindicated for pacemakers and implantable medical devices. In addition, rPMS is larger in size and more expensive than NMES, making its widespread use a challenge. However, rPMS is expected to improve functional recovery in stroke patients because of its ability to safely stimulate deeper layers and improve muscle areas without pain [4].
rPMS can improve motor function in central nervous system (CNS) diseases. How, then, would the induction of CNS plasticity be altered by the parameters of rPMS? Nito et al. [5] studied the effects of rPMS on wrist extensor muscles in terms of neuroplasticity and motor performance in 26 healthy subjects (HS). Motor-evoked potential (MEP), intracortical inhibition (ICI), intracortical facilitation (ICF), M-wave, and Hoffman reflex were measured before and after the application of rPMS, and the effects of rPMS on wrist extensor movements were examined.
First, rPMS was applied to the wrist extensor muscles at different frequencies (50, 25, and 10 Hz), with the total number of stimuli set constant to examine the physical effects of stimulus frequency. MEPs of the wrist extensors increased significantly with rPMS at 50 and 25 Hz but remained unchanged at 10 Hz. In the next experiment, in which the number of stimuli was increased and the time required to induce plasticity was examined, at least 15 minutes of rPMS were required for 50- and 25-Hz rPMS. Based on these parameters, the sustained effect of 50- or 25-Hz rPMS was evaluated after 15 minutes of rPMS. Significant increases in MEP were observed up to 60 minutes after 50- and 25-Hz rPMS were administered. Similarly, attenuation of ICI and enhancement of ICF were also observed.
In addition, the maximal M-wave and Hoffman reflex were unchanged, suggesting that the imposition of rPMS does not directly stimulate the centrifugal nerves and excite the muscles but that the increase in MEP is caused by the plastic changes in the motor cortex. In addition, an increase in force and EMG during wrist extension movements was observed after the application of rPMS at 50 and 25 Hz. These results suggest that the application of rPMS at 25 Hz or higher for 15 minutes can increase cortical excitability at the irradiated site and improve motor output from the motor cortex, rather than changing the excitability of the spinal cord circuitry.
Recent studies have also reported the effects of rPMS in combination with noninvasive brain stimulation techniques and on regions other than the periphery. Kumru et al. [6] examined the effects of paired associative stimulation (PAS), in which paired stimuli of repetitive transcranial magnetic stimulation (rTMS) and rPMS are repeatedly applied. PAS is an effective method to induce plasticity in the human motor cortex. Three stimulus conditions were applied to 11 HS for 10 minutes each. In the rPMS alone condition, rPMS at 10 Hz was applied to the extensor carpi radialis (ECR) five times every 10 seconds for 60 trials. In the rTMS alone condition, rTMS was applied to the contralateral primary motor cortex region of the ECR at a frequency of 0.1 Hz (60 stimuli) and an intensity of 120% of the ECR threshold. In the PAS condition, rPMS and rTMS described above were performed with paired stimuli. The results showed that the PAS condition increased MEP amplitude and decreased ICI in the ECR. This suggests that PAS stimulation effectively increases corticospinal tract excitability and decreases ICI. Krause et al. [7] studied the effects of repetitive magnetic stimulation (rMS) to the right cervical nerve root (C7/C8) on corticospinal excitability in HS. The right cervical nerve root (C7/C8) innervating the test muscle, the right first dorsal interosseous muscle, was stimulated at a frequency of 20 Hz for 10 seconds with an intensity of 120% of resting motor threshold for a total of 10 trials. The results showed that rMS caused a significantly longer cortical silent period, increased ICI, and increased MEP amplitude. These changes were not confirmed contralaterally. This study confirmed that rMS increased MEP amplitude in the right first dorsal interosseous muscle without altering the left dorsal interosseous muscle. These results indicate that rMS affects motor cortex excitability similar to electrical stimulation; this suggests that rMS is applicable in spastic and central paraplegia rehabilitation.
As described above, physiological changes in rPMS have been reported in HS, and based on these studies, various clinical application studies have been conducted in the recent years.
Motor imagery (MI) is the simulation of movement in the brain without actual movement and is widely used in clinical practice as a tool for evaluation and treatment. Recently, the combined effects of MI and rPMS have been reported.
Asao et al. [8] examined the effects of rPMS combined with MI (rPMS+MI) on corticospinal excitability. The rPMS+MI condition and rPMS alone condition were performed on HS. In the rPMS+MI condition, rPMS was administered simultaneously with a cue for a MI task of dorsiflexion of the right wrist joint. The test muscle was the right ECR. The rPMS frequency was 25 Hz, stimulus duration was 2 s, and stimulus intensity was 1.5 times the motor threshold. In the rPMS alone condition, rPMS was administered under the same stimulation conditions as in the rPMS+MI condition. The results showed that the pre- and post-stimulus MEP ratios were more significant in the rPMS+MI condition than in the rPMS alone-intense condition, which was associated with Movement Imagery Questionnaire-Revised scores. This study suggests that an intervention combining rPMS and MI can induce more corticospinal excitation than rPMS alone.
The studies above did not clarify the effective length of intervention period for the combination of rPMS and MI to promote corticospinal excitability. Therefore, the time course changes in corticospinal excitability when rPMS and MI are used in combination have been examined [9]. rPMS alone, MI alone, and rPMS and MI combination conditions have been performed on HS. In the rPMS alone and rPMS+MI conditions, the ECR was stimulated with rPMS at 25 Hz for 2 seconds at a stimulus intensity of 1.5 times the motor threshold. In addition, the MI and rPMS+MI groups were asked to perform MI of wrist dorsiflexion for 2 seconds.
Consequently, the MEP amplitude increase of the ECR in the rPMS+MI group was observed after 10 minutes. In addition, the MEP amplitude after 20 minutes was more significant in the rPMS+MI group than in the rPMS alone group. This study suggests that the combination of rPMS and MI over 10 minutes increases corticospinal excitation and that the combined effect is more significant than rPMS alone. Overall, the combination of rPMS and MI may induce plasticity in the CNS and promote motor function recovery.
One of the clinical applications of rPMS is its muscle-strengthening effect. It has been reported that rPMS promotes muscle strengthening in animals and humans without causing pain.
Yang et al. [10] investigated the effects of neuromuscular magnetic stimulation (NMMS) on strength, cross-sectional area, and thickness of the quadriceps muscle in HS. NMMS was performed on the quadriceps femoris muscle at a frequency of 10 Hz and at the maximum tolerable intensity that could be tolerated for 15 minutes, thrice weekly for 5 weeks. The results showed that maximal isometric torque and mean peak torque increased significantly after intervention, but there was no change in cross-sectional area or thickness. This study suggests that NMMS effectively trains large or skeletal muscles such as the quadriceps.
Stolting et al. [11] showed that magnetic stimulation of a mouse muscle injury model caused post-traumatic muscle hypertrophy, but the effects of rPMS on human subjects remained unclear. Therefore, Hirono et al. [12] examined the acute changes in skeletal muscle thickness induced by rPMS after low-intensity exercise for clinical application of rPMS. rPMS was applied to the vastus lateralis muscle at the maximum intensity of the rPMS device after an HS performed three sets of 10 isometric knee extension exercises at 30% of maximum muscle strength. The results showed that the muscle thickness of the rectus femoris and vastus lateralis muscles after exercise increased over baseline values, with significant increases only in the vastus lateralis after rPMS. This study suggests that post-exercise rPMS induces muscle expansion
rPMS has the advantage of not causing pain and has been used in clinical practice with the expectation of functional recovery in some cases. Beck et al. [15] studied the effect of early intervention with rPMS on the vastus lateralis muscle after hip replacement surgery. The subjects were patients who underwent hip replacement after a proximal femur fracture. The experimental group received 10 Hz rPMS on the vastus lateralis muscle for 15 sessions daily, five times weekly for 3 weeks, whereas the control group received sham stimulation. The results showed that the root-mean-square value of the electromyogram during the maximum voluntary contraction of the vastus lateralis muscle after rPMS was significantly improved. Tandem rise time and normal walking speed in the rPMS group also improved. This study suggests that early intervention with rPMS on the lateral vastus muscle after hip arthroplasty improves muscle strength, standing balance, and gait function. This study also indicates that rPMS can be applied to patients with pain and wounds and is expected to be widely applied in clinical practice in the future.
As described above, rPMS, which promotes muscle strengthening without causing pain, has excellent potential for clinical applications.
Post-stroke hemiplegia occurs in more than 85% of individuals and 55–75% have residual upper limb dysfunction [16]. After stroke, the recovery rate to a practical level is approximately 60% for lower limb function and approximately 20% for upper limb function [17]. The effectiveness of rehabilitation and physical therapy for stroke has been reported in many cases. In this context, the effectiveness of rPMS for stroke has been reported in recent years.
rPMS is a noninvasive method of activating peripheral nerves at the stimulation site and improving muscle strength and has the advantage of being performed without causing pain. Jiang et al. [18] applied rPMS in the early subacute phase of stroke and studied its effect on severe upper limb disability. In the intervention group, rPMS of 20 Hz, totaling 2400 pulses, was applied daily for 2 weeks to the triceps brachii and extensor digitorum brevis muscles. The results showed that the rPMS group showed significant improvements in the upper limb, Barthel Index, upper limb muscle strength, and root mean square on the Fugl-Meyer Assessment compared with those in the control group. This study demonstrates that rPMS for the upper extremity after stroke improves upper extremity function and muscle strength.
Fernandez-Lobera et al. [19] studied the efficacy of rPMS as a tool to assess wrist spasticity in stroke patients. The subjects were HS, acute stroke patients without spasticity (AS), and chronic stroke patients with spasticity (CS). Spasticity was assessed by calculating the index of movement restriction (iMR) from the difference between the maximum passive movement range of the wrist joint and the evoked movement range by rPMS. The stimulation intensity of rPMS was set at 70% of the maximum output of the stimulator, frequency at 25 Hz, and stimulation duration at 2 seconds. The results showed that the amplitude, velocity, and acceleration of rPMS-induced movements were reduced in the CS compared with those in the HS and AS. The iMR values were 2.8 for HS, 13.0 for AS, and 59.2 for CS, with CS having the highest iMR value. Furthermore, the iMR value for CS decreased to 41.1 after treatment with botulinum neurotoxin.
Shoulder joint subluxation is one of the many complications following stroke and is an inhibitor of motor function recovery [20]. In particular, shoulder joint subluxation causes pain in the shoulder joint and has a significant impact on activities of daily living. Therefore, Fujimura et al. [21] investigated the effect of rPMS on shoulder joint dislocation caused by stroke. The subjects were patients who presented with shoulder joint subluxation after stroke. rPMS was performed repetitively on the supraspinatus, posterior deltoid, and infraspinatus muscles. Stimulation intensity was the maximum tolerable intensity and was performed at 30 Hz for 2 seconds for 100 sessions. Results showed that the acromion-humerus interval was significantly reduced after treatment. That shoulder joint pain, shoulder abduction range of motion, and upper extremity scores on the Fugl-Meyer Assessment also improved. This study demonstrates that rPMS for post-stroke shoulder dislocation decreases the degree of shoulder subluxation and pain and improves upper extremity motor function.
Krewer et al. [22] examined the short- and long-term effects of rPMS on spasticity and motor function in stroke patients. rPMS involved a total of 5000 stimuli at 25 Hz and a stimulus intensity of 110% of the resting motor threshold. Stimulation was applied to the extensor and flexor muscles of the upper arm and forearm twice daily for 2 weeks. Results showed short-term effects on wrist flexor spasticity (immediately after the intervention) and long-term effects on elbow extensor spasticity (2 weeks after the intervention) in the rPMS group. In addition, the rPMS group showed an improvement in sensory function. This study demonstrates that rPMS reduces spasticity and improves sensory function in stroke patients in both short and long terms.
Kinoshita et al. [23] investigated the effects of rPMS on the lower limb of chronic stroke patients on gait function. The subjects were stroke patients with lower limb hemiplegia and gait disturbance. The stimulation sites of rPMS were the gluteus maximus, vastus medialis, hamstrings, quadriceps, gastrocnemius, and soleus muscles of the paralyzed lower limb. rPMS was performed twice daily for 15 days at a frequency of 20 Hz for 3 s, 4800 pulses, and a stimulus intensity of 110% of the motor threshold. The results showed that walking speed, walking ability, and balance ability were significantly improved after the intervention. This study suggests that rPMS effectively restores gait function in stroke patients with gait disturbance.
Beaulieu et al. [24] studied the effect of rPMS on lower limb dysfunction in chronic stroke. The stimulation site of rPMS was the anterior tibialis muscle of the paralyzed lower extremity. rPMS was performed at a theta-burst frequency (three 50 Hz pulses each, delivered in 5-Hz bursts) for 190 s at 42% of maximum stimulation intensity. The results showed that the rPMS group increased ankle dorsiflexion range of motion and maximum isometric muscle strength after the intervention and decreased resistance to ankle flexor stretch. The results also suggested that these changes are related to residual corticospinal tracts. This study demonstrates that rPMS improves lower limb dysfunction in chronic stroke patients.
In conclusion, rPMS improves upper and lower limb dysfunction in stroke patients. Therefore, we believe that rPMS is a highly effective tool for evaluation and treatment in stroke rehabilitation.
This chapter outlines the physiological changes, combined effects of MI, muscle strengthening, and effects on stroke patients in rPMS. The rPMS parameters used in studies are listed in Tables 1 and 2. rPMS has attracted attention as a new neuromodulation technique that can noninvasively deliver repetitive magnetic stimulation to peripheral nerves and muscles using induced current from a pulsed magnetic field. Unlike NMES, rPMS is painless and has excellent potential for application in clinical settings. In particular, many clinical studies for stroke rehabilitation have been reported in recent years. Further development of rPMS research is expected, including its effectiveness when combined with other therapies and its integration with technology.
Stimulation site | Stimulation frequency | Stimulation intensity | |
---|---|---|---|
Nito et al. [5] | Wrist extensor muscles | 50 Hz, 25 Hz, 10 Hz | 120% of the motor threshold |
Kumru et al. [6] | Extensore carpi radialis muscle | rPMS: 10 Hz rTMS: 0.1 Hz | rPMS: 70% of motor threshold rTMS: 120% of motor threshold |
Krause et al. [7] | Cervical nerve roots (C7/C8) (First dorsal interosseous) | 20 Hz | 120% of motor threshold |
Asao et al. [8] | Extensore carpi radialis muscle | 25 Hz | 150% of motor threshold |
Asao et al. [9] | Extensore carpi radialis muscle | 25 Hz | 150% of motor threshold |
Yang et al. [10] | Quadriceps muscle | 10 Hz | Maximum tolerable intensity |
Hirono et al. [12] | Vastus lateralis muscle | 50 Hz | Maximum intensity of the device |
rPMS parameters in basic research on healthy subjects.
Patients | Stimulation site | Stimulation frequency | Stimulation intensity | |
---|---|---|---|---|
Beck et al. [15] | After hip replacement surgery | Vastus lateralis muscle | 10 Hz | Level where the visible movement of the knee is triggered |
Jiang et al. [18] | Early subacute stroke | Triceps brachii and extensor digitorum muscles | 20 Hz | Triceps brachii muscle: Intensity to induce 30° of elbow extension Extensor digitorum muscle: Intensity to induce 45° of wrist extension |
Fernandez-Lobera et al. [19] | Acute stroke without/with spasticity | Wrist extensor muscles | 25 Hz | 70% of the maximum stimulator power |
Fujimura et al. [21] | Shoulder subluxations caused by stroke | Supraspinatus and posterior deltoid/infraspinatus muscles | 30 Hz | Intensity until patients indicates that any further increase would become uncomfortable |
Krewer et al. [22] | Severe hemiparesis and mild to moderate spasticity resulting from a stroke or a traumatic brain injury | Extensors and flexors of the upper and lower arm. | 25 Hz | 110% of motor threshold |
Kinoshita et al. [23] | Hemorrhagic stroke with lower limb hemiparesis and gait disturbance | Gluteus maximus muscle, gluteus medius, hamstring muscle, musculus quadriceps femoris, gastrocnemius, soleus | 20 Hz | 110% of motor threshold |
Beaulieu et al. [24] | Chronic stroke | Tibialis anterior muscle | Theta-burst frequency (5-Hz bursts of three 50 Hz pulses each) | 42% of the maximal stimulator output |
rPMS parameters in clinical research.
This work was supported by the Yuumi Memorial Foundation for Home Health Care and JSPS KAKENHI Grant Number JP20K11173.
The authors declare no conflict of interest.
rPMS: | repetitive peripheral magnetic stimulation |
NMES: | neuromuscular electrical stimulation |
MEP: | motor-evoked potential |
rTMS: | repetitive transcranial magnetic stimulation |
PAS: | paired associative stimulation |
ECR: | extensor carpi radialis |
rMS: | repetitive magnetic stimulation |
ICI: | intracortical inhibition |
MI: | motor imagery |
NMMS: | neuromuscular magnetic stimulation |
HS: | healthy subjects |
AS: | acute stroke patients without spasticity |
CS: | chronic stroke patients with spasticity |
iMR: | index of movement restriction |
.
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Stienen, Pooyan Sadr-Eshkevari, Nora Prochnow, Nora Sandu, Benham Bohluli and Bernhard Schaller",authors:[{id:"78171",title:"Prof.",name:"Bernhard",middleName:null,surname:"Schaller",slug:"bernhard-schaller",fullName:"Bernhard Schaller"},{id:"78525",title:"Mr.",name:"Amr",middleName:null,surname:"Abdulazim",slug:"amr-abdulazim",fullName:"Amr Abdulazim"},{id:"78530",title:"Dr",name:"Pooyan",middleName:null,surname:"Sadr-Eshkevari",slug:"pooyan-sadr-eshkevari",fullName:"Pooyan Sadr-Eshkevari"},{id:"126039",title:"Dr.",name:"Martin",middleName:"Nikolaus",surname:"Stienen",slug:"martin-stienen",fullName:"Martin Stienen"},{id:"126040",title:"Dr.",name:"Nora",middleName:null,surname:"Prochnow",slug:"nora-prochnow",fullName:"Nora Prochnow"},{id:"126041",title:"Dr.",name:"Benham",middleName:null,surname:"Bohluli",slug:"benham-bohluli",fullName:"Benham Bohluli"}]},{id:"26863",doi:"10.5772/26362",title:"The Bearing Surfaces in Total Hip Arthroplasty – Options, Material Characteristics and Selection",slug:"the-bearing-surfaces-in-total-hip-arthroplasty-options-material-characteristics-and-selection",totalDownloads:9526,totalCrossrefCites:10,totalDimensionsCites:21,abstract:null,book:{id:"938",slug:"recent-advances-in-arthroplasty",title:"Recent Advances in Arthroplasty",fullTitle:"Recent Advances in Arthroplasty"},signatures:"Hamid Reza Seyyed Hosseinzadeh, Alireza Eajazi and Ali Sina Shahi",authors:[{id:"66361",title:"Dr.",name:"Alireza",middleName:null,surname:"Eajazi",slug:"alireza-eajazi",fullName:"Alireza Eajazi"},{id:"74857",title:"Dr.",name:"Hamid Reza",middleName:null,surname:"Seyyed Hosseinzadeh",slug:"hamid-reza-seyyed-hosseinzadeh",fullName:"Hamid Reza Seyyed Hosseinzadeh"},{id:"173207",title:"Dr.",name:"Alisina",middleName:null,surname:"Shahi",slug:"alisina-shahi",fullName:"Alisina Shahi"}]}],mostDownloadedChaptersLast30Days:[{id:"65467",title:"Anesthesia Management for Large-Volume Liposuction",slug:"anesthesia-management-for-large-volume-liposuction",totalDownloads:6165,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"The apparent easiness with which liposuction is performed favors that patients, young surgeons, and anesthesiologists without experience in this field ignore the many events that occur during this procedure. Liposuction is a procedure to improve the body contour and not a surgery to reduce weight, although recently people who have failed in their plans to lose weight look at liposuction as a means to contour their body figure. Tumescent liposuction of large volumes requires a meticulous selection of each patient; their preoperative evaluation and perioperative management are essential to obtain the expected results. The various techniques of general anesthesia are the most recommended and should be monitored in the usual way, as well as monitoring the total doses of infiltrated local anesthetics to avoid systemic toxicity. The management of intravenous fluids is controversial, but the current trend is the restricted use of hydrosaline solutions. The most feared complications are deep vein thrombosis, pulmonary thromboembolism, fat embolism, lung edema, hypothermia, infections and even death. The adherence to the management guidelines and prophylaxis of venous thrombosis/thromboembolism is mandatory.",book:{id:"6221",slug:"anesthesia-topics-for-plastic-and-reconstructive-surgery",title:"Anesthesia Topics for Plastic and Reconstructive Surgery",fullTitle:"Anesthesia Topics for Plastic and Reconstructive Surgery"},signatures:"Sergio Granados-Tinajero, Carlos Buenrostro-Vásquez, Cecilia\nCárdenas-Maytorena and Marcela Contreras-López",authors:[{id:"273532",title:"Dr.",name:"Sergio Octavio",middleName:null,surname:"Granados Tinajero",slug:"sergio-octavio-granados-tinajero",fullName:"Sergio Octavio Granados Tinajero"}]},{id:"42855",title:"Critical Care Issues After Major Hepatic Surgery",slug:"critical-care-issues-after-major-hepatic-surgery",totalDownloads:8929,totalCrossrefCites:2,totalDimensionsCites:2,abstract:null,book:{id:"3164",slug:"hepatic-surgery",title:"Hepatic Surgery",fullTitle:"Hepatic Surgery"},signatures:"Ashok Thorat and Wei-Chen Lee",authors:[{id:"52360",title:"Prof.",name:"Wei-Chen",middleName:null,surname:"Lee",slug:"wei-chen-lee",fullName:"Wei-Chen Lee"},{id:"157213",title:"Dr.",name:"Ashok",middleName:null,surname:"Thorat",slug:"ashok-thorat",fullName:"Ashok Thorat"}]},{id:"72175",title:"Fontan Operation: A Comprehensive Review",slug:"fontan-operation-a-comprehensive-review",totalDownloads:1286,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Since the first description of the Fontan operation in the early 1970s, a number of modifications have been introduced and currently staged, total cavopulmonary connection with fenestration has become the most commonly used multistage surgery in diverting the vena caval blood flow into the lungs. The existing ventricle, whether it is left or right, is utilized to supply systemic circuit. During Stage I, palliative surgery is performed, usually at presentation in the neonatal period/early infancy, on the basis of pathophysiology of the cardiac defect. During Stage II, a bidirectional Glenn procedure is undertaken in which the superior vena caval flow is diverted into the lungs at an approximate age of 6 months. During Stage IIIA, the blood flow from the inferior vena cava (IVC) is rerouted into the pulmonary arteries, typically by an extra-cardiac conduit along with a fenestration, generally around 2 years of age. During Stage IIIB, the fenestration is closed by transcatheter methodology 6–12 months after Stage IIIA. The evolution of Fontan concepts, the indications for Fontan surgery, and the results of old and current types of Fontan operation form the focus of this review.",book:{id:"9585",slug:"advances-in-complex-valvular-disease",title:"Advances in Complex Valvular Disease",fullTitle:"Advances in Complex Valvular Disease"},signatures:"P. Syamasundar Rao",authors:[{id:"68531",title:"Dr.",name:"P. Syamasundar",middleName:null,surname:"Rao",slug:"p.-syamasundar-rao",fullName:"P. Syamasundar Rao"}]},{id:"45712",title:"Serdev Sutures® in Middle Face",slug:"serdev-sutures-in-middle-face",totalDownloads:4950,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"2989",slug:"miniinvasive-face-and-body-lifts-closed-suture-lifts-or-barbed-thread-lifts",title:"Miniinvasive Face and Body Lifts",fullTitle:"Miniinvasive Face and Body Lifts - Closed Suture Lifts or Barbed Thread Lifts"},signatures:"Nikolay Serdev",authors:[{id:"32585",title:"Dr.",name:"Nikolay",middleName:null,surname:"Serdev",slug:"nikolay-serdev",fullName:"Nikolay Serdev"}]},{id:"55812",title:"Postural Restoration: A Tri-Planar Asymmetrical Framework for Understanding, Assessing, and Treating Scoliosis and Other Spinal Dysfunctions",slug:"postural-restoration-a-tri-planar-asymmetrical-framework-for-understanding-assessing-and-treating-sc",totalDownloads:7694,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Current medical practice does not recognize the influence of innate, physiological, human asymmetry on scoliosis and other postural disorders. Interventions meant to correct these conditions are commonly based on symmetrical models of appearance and do not take into account asymmetric organ weight distribution, asymmetries of respiratory mechanics, and dominant movement patterns that are reinforced in daily functional activities. A model of innate, human asymmetry derived from the theoretical framework of the Postural Restoration Institute® (PRI) explicitly describes the physiological, biomechanical, and respiratory components of human asymmetry. This model is important because it gives an accurate baseline for understanding predisposing factors for the development of postural disorders, which, without intervention, will likely progress to structural dysfunction. Clinical tests to evaluate tri-planar musculoskeletal relationships and function, developed by PRI, are based on this asymmetric model. These tests are valuable for assessing patient’s status in the context of human asymmetry and in guiding appropriate exercise prescription and progression. Balancing musculoskeletal asymmetry is the aim of PRI treatment. Restoration of relative balance decreases pain, restores improved alignment, and strengthens appropriate muscle function. It can also halt the progression of dysfunction and improve respiration, quality of life, and appearance. PRI’s extensive body of targeted exercise progressions are highly effective due to their basis in the tri-planar asymmetric human model.",book:{id:"5816",slug:"innovations-in-spinal-deformities-and-postural-disorders",title:"Innovations in Spinal Deformities and Postural Disorders",fullTitle:"Innovations in Spinal Deformities and Postural Disorders"},signatures:"Susan Henning, Lisa C. Mangino and Jean Massé",authors:[{id:"204825",title:"Dr.",name:"Susan",middleName:null,surname:"Henning",slug:"susan-henning",fullName:"Susan Henning"},{id:"206242",title:"Dr.",name:"Lisa C",middleName:null,surname:"Mangino",slug:"lisa-c-mangino",fullName:"Lisa C Mangino"},{id:"206245",title:"Dr.",name:"Jean",middleName:null,surname:"Massé",slug:"jean-masse",fullName:"Jean Massé"}]}],onlineFirstChaptersFilter:{topicId:"202",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82020",title:"Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Novel Technique and Technology with Case Series",slug:"minimally-invasive-transforaminal-lumbar-interbody-fusion-a-novel-technique-and-technology-with-case",totalDownloads:6,totalDimensionsCites:0,doi:"10.5772/intechopen.105187",abstract:"Minimally invasive spine surgery (MIS) transforaminal lumbar interbody fusion (MI-TLIF) has been utilized to treat a variety of spinal disorders. Like other minimally invasive spine surgery techniques and technology, the MI-TLIF approach has the potential to limit the morbidity associated with larger exposures required for open surgery. The MI-TLIF approach has a number of advantages over many other minimally invasive spine surgery approaches including direct decompression of neural elements, collection of morselized autograph from the surgical site to achieve high fusion rates, restoration of spinal canal diameter, foraminal diameter, disk height, and reduction of spondylolisthesis. In this chapter, we discuss a novel technique for performing MI-TLIF developed by the senior author who is a leading minimally invasive spine surgeon. The technique and technology illustrated in this chapter were developed out of a recognition of a need to reduce the learning curve for performing MI-TLIF, as well as need for a cost-effective method that provides a high fusion rate, excellent clinical outcomes, and low complication rate. The indications, surgical planning, postoperative care, complications, and patient outcomes in a large series will be reviewed using this novel MI-TLIF technique.",book:{id:"10634",title:"Minimally Invasive Spine Surgery - Advances and Innovations",coverURL:"https://cdn.intechopen.com/books/images_new/10634.jpg"},signatures:"Mick J. Perez-Cruet, Ramiro Pérez de la Torre and Siddharth Ramanathan"},{id:"78335",title:"Safety and Efficiency of Cervical Disc Arthroplasty in Ambulatory Surgery Centers",slug:"safety-and-efficiency-of-cervical-disc-arthroplasty-in-ambulatory-surgery-centers",totalDownloads:5,totalDimensionsCites:0,doi:"10.5772/intechopen.99589",abstract:"Introduction Anterior cervical surgeries have been safely performed in ambulatory surgery centers since 1995 with the first cases being one level anterior cervical discectomies without fusion, then in 1996, one level anterior cervical discectomies with fusion (ACDF). When it is was certain that outpatient fusion was safe, the number of ACDF levels slowly and methodically were increased to the now standard outpatient maximum of four level ACDF. During this evolution, with the introduction of arthroplasty surgery, one level arthroplasties were considered appropriate for outpatient surgery and now two-level outpatient cervical arthroplasties are routine and some three level arthroplasties have been performed with no additional morbidity compared to one level procedures. The author first reported a series of 27 patients in 2010 who underwent cervical disc replacement at an ASC. (Wohns, R. Safety and cost-effectiveness of outpatient cervical disc arthroplasty. Surg. Neurol. Int. 1, 77, 2010). The average operative time was 40 minutes and the patients were observed over a period of three hours prior to discharge. None of the patients had major complications and there were no reports of worsening or persistent pain. The results of a Delphi study in 2018 compared the safety and efficiency of one-level and two-level arthroplasty procedures performed in an ASC and in a hospital setting. (Gornet et al. Safety and Efficiency of Cervical Disc Arthroplasty in Ambulatory Surgery Centers vs Hospital Settings. Int’l J of Spine Surgery. Vol. 12, No.5, 2018, pp. 557-564). The study analyzed outcomes of 145 ASC patients, 348 hospital outpatients and 65 hospital inpatients and the conclusion was that both one and two-level arthroplasties may be performed safely in an ASC. Surgeries in ASCs are of shorter duration and performed with less blood loss without increased AEs. At the present time, there does not appear to be any contra-indication to performing the vast majority of cervical arthroplasties in an ambulatory surgery center (ASC). Furthermore, the cost of an outpatient arthroplasty is commonly 30% to 50% of the cost of hospital-based procedures.",book:{id:"10634",title:"Minimally Invasive Spine Surgery - Advances and Innovations",coverURL:"https://cdn.intechopen.com/books/images_new/10634.jpg"},signatures:"Richard N.W. Wohns"},{id:"82255",title:"Minimally Invasive Laminectomy for Lumbar Stenosis with Case Series of Patients with Multi-level (3 or More Levels) Stenosis",slug:"minimally-invasive-laminectomy-for-lumbar-stenosis-with-case-series-of-patients-with-multi-level-3-o",totalDownloads:28,totalDimensionsCites:0,doi:"10.5772/intechopen.105186",abstract:"Lumbar stenosis is the most common pathology seen and treated by spine surgeons. It is often seen in the elderly population who frequently have multiple medical co-morbidities. Traditional approaches remove the spinous process and detach paraspinous muscles to achieve adequate canal decompression. This approach can damage the posterior tension band leading to permanent muscle damage, scar tissue formation, iatrogenic flatback syndrome, and increase risk of adjacent segment disease requiring reoperation. Performing lumbar laminectomy in a cost-effective manner is critical in effectively treating patients with lumbar stenosis. This chapter reviews a minimally invasive muscle-sparing approach to treating lumbar stenosis. The technique is performed through a tubular retractor. Direct decompression of the spinal stenosis is achieved while preserving the paraspinous muscle attachments and spinous process. This technique has multiple advantages and can potentially reduce load stress on adjacent levels and subsequent adjacent level pathology leading to further surgical intervention. In addition, the procedure shows how facet fusion is performed using the patient’s own locally harvested drilled morselized autograph to achieve bilateral facet fusion. By fusing the facets, we have shown that restenosis at the operative level is less likely to occur. This chapter will review a case series of multilevel lumbar stenosis including clinical outcomes.",book:{id:"10634",title:"Minimally Invasive Spine Surgery - Advances and Innovations",coverURL:"https://cdn.intechopen.com/books/images_new/10634.jpg"},signatures:"Mick J. Perez-Cruet, Ramiro Pérez de la Torre and Siddharth Ramanathan"},{id:"80705",title:"Cervical Arthroplasty",slug:"cervical-arthroplasty",totalDownloads:37,totalDimensionsCites:0,doi:"10.5772/intechopen.102964",abstract:"Technological advances have allowed spine surgery to follow the trend toward minimally invasive surgery in general. Specifically, we have seen a corresponding rise in the popularity of cervical arthroplasty. For the treatment of cervical disc disease, arthroplasty is a less invasive option than the gold standard of cervical discectomy and arthrodesis, which by nature is more disruptive to surrounding tissues. Arthroplasty preserves the facets, maintains motion, and reduces the rate of adjacent segment breakdown. These factors counteract the negative impacts of fusion while maintaining the benefits. Arthroplasty implants themselves have become more streamlined to implant as well with less native bone destruction, and biomechanics more compatible with the native disc. While initial implants were ball and socket devices with complex fixation and plane-specific movements, later devices incorporated such motions as translation and compression. Viscoelastic components and materials more closely resembling native tissues afford a more biocompatible implant profile. Until cell-based therapies can successfully reproduce native tissue, we will rely on artificial components that closely resemble and assimilate them.",book:{id:"10634",title:"Minimally Invasive Spine Surgery - Advances and Innovations",coverURL:"https://cdn.intechopen.com/books/images_new/10634.jpg"},signatures:"Jason M. Highsmith"},{id:"80605",title:"Minimally Invasive Treatment of Spinal Metastasis",slug:"minimally-invasive-treatment-of-spinal-metastasis",totalDownloads:42,totalDimensionsCites:0,doi:"10.5772/intechopen.102485",abstract:"Advancements in the treatment of systemic cancer have improved life expectancy in cancer patients and consequently the incidence of spinal metastasis. Traditionally, open spinal approaches combined with cEBRT (conventional external beam radiation therapy) allowed for local tumor control as well as stabilization and decompression of the spine and neural elements, but these larger operations can be fraught with one complications and delayed healing as well as additional morbidity. Recently, minimally invasive spine techniques are becoming increasingly popular in the treatment of spinal metastasis for many reasons, including smaller incisions with less perioperative complications and potential for expedited time to radiation therapy. These techniques include kyphoplasty with radiofrequency ablation, percutaneous stabilization, laminectomy, and epidural tumor resection through tubular retractors, as well as minimally invasive corpectomy. These techniques combined with highly conformal stereotactic radiosurgery have led to the advent of separation surgery, which allows for decompression of neural elements while creating space between neural elements and the tumor so adequate radiation may be delivered, improving local tumor control. The versatility of these minimally invasive techniques has significantly improved the modern management of metastatic disease of the spine by protecting and restoring the patient’s quality of life while allowing them to quickly resume radiation and systemic treatment.",book:{id:"10634",title:"Minimally Invasive Spine Surgery - Advances and Innovations",coverURL:"https://cdn.intechopen.com/books/images_new/10634.jpg"},signatures:"Eric R. Mong and Daniel K. Fahim"},{id:"76620",title:"Minimally Invasive Lateral Approach for Anterior Spinal Cord Decompression in Thoracic Myelopathy",slug:"minimally-invasive-lateral-approach-for-anterior-spinal-cord-decompression-in-thoracic-myelopathy",totalDownloads:145,totalDimensionsCites:0,doi:"10.5772/intechopen.97669",abstract:"Myelopathy can result from a thoracic disc herniation (TDH) compressing the anterior spinal cord. Disc calcification and difficulty in accessing the anterior spinal cord pose an operative challenge. A mini-open lateral approach to directly decompress the anterior spinal cord can be performed with or without concomitant interbody fusion depending on pre-existing or iatrogenic spinal instability. Experience using stand-alone expandable spacers to achieve interbody fusion in this setting is limited. Technical advantages, risks and limitations of this technique are discussed. We conducted a retrospective chart review of all patients with thoracic and upper lumbar myelopathy treated with a lateral mini-open lateral approach. Review of the literature identified 6 other case series using similar lateral minimally invasive approaches to treat thoracic or upper lumbar disc herniation showing efficient and safe thoracic disc decompression procedure for myelopathy. This technique can be combined with interbody arthrodesis when instability is suspected.",book:{id:"10634",title:"Minimally Invasive Spine Surgery - Advances and Innovations",coverURL:"https://cdn.intechopen.com/books/images_new/10634.jpg"},signatures:"Edna E. Gouveia, Mansour Mathkour, Erin McCormack, Jonathan Riffle, Olawale A. Sulaiman and Daniel J. Denis"}],onlineFirstChaptersTotal:12},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"6",title:"Infectious Diseases",doi:"10.5772/intechopen.71852",issn:"2631-6188",scope:"This series will provide a comprehensive overview of recent research trends in various Infectious Diseases (as per the most recent Baltimore classification). Topics will include general overviews of infections, immunopathology, diagnosis, treatment, epidemiology, etiology, and current clinical recommendations for managing infectious diseases. Ongoing issues, recent advances, and future diagnostic approaches and therapeutic strategies will also be discussed. This book series will focus on various aspects and properties of infectious diseases whose deep understanding is essential for safeguarding the human race from losing resources and economies due to pathogens.",coverUrl:"https://cdn.intechopen.com/series/covers/6.jpg",latestPublicationDate:"August 2nd, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:13,editor:{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},editorTwo:null,editorThree:null},subseries:{paginationCount:5,paginationItems:[{id:"3",title:"Bacterial Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",editor:{id:"205604",title:"Dr.",name:"Tomas",middleName:null,surname:"Jarzembowski",slug:"tomas-jarzembowski",fullName:"Tomas Jarzembowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKriQAG/Profile_Picture_2022-06-16T11:01:31.jpg",biography:"Tomasz Jarzembowski was born in 1968 in Gdansk, Poland. He obtained his Ph.D. degree in 2000 from the Medical University of Gdańsk (UG). After specialization in clinical microbiology in 2003, he started studying biofilm formation and antibiotic resistance at the single-cell level. In 2015, he obtained his D.Sc. degree. His later study in cooperation with experts in nephrology and immunology resulted in the designation of the new diagnostic method of UTI, patented in 2017. He is currently working at the Department of Microbiology, Medical University of Gdańsk (GUMed), Poland. Since many years, he is a member of steering committee of Gdańsk branch of Polish Society of Microbiologists, a member of ESCMID. He is also a reviewer and a member of editorial boards of a number of international journals.",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorTwo:{id:"484980",title:"Dr.",name:"Katarzyna",middleName:null,surname:"Garbacz",slug:"katarzyna-garbacz",fullName:"Katarzyna Garbacz",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003St8TAQAZ/Profile_Picture_2022-07-07T09:45:16.jpg",biography:"Katarzyna Maria Garbacz, MD, is an Associate Professor at the Medical University of Gdańsk, Poland and she is head of the Department of Oral Microbiology of the Medical University of Gdańsk. She has published more than 50 scientific publications in peer-reviewed journals. She has been a project leader funded by the National Science Centre of Poland. Prof. Garbacz is a microbiologist working on applied and fundamental questions in microbial epidemiology and pathogenesis. Her research interest is in antibiotic resistance, host-pathogen interaction, and therapeutics development for staphylococcal pathogens, mainly Staphylococcus aureus, which causes hospital-acquired infections. 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He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. 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He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. 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She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. 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The combination of electronics and computer science with biology and medicine has improved patient diagnosis, reduced rehabilitation time, and helped to facilitate a better quality of life. Nowadays, all medical imaging devices, medical instruments, or new laboratory techniques result from the cooperation of specialists in various fields. The series of Biomedical Engineering books covers such areas of knowledge as chemistry, physics, electronics, medicine, and biology. This series is intended for doctors, engineers, and scientists involved in biomedical engineering or those wanting to start working in this field.",coverUrl:"https://cdn.intechopen.com/series/covers/7.jpg",latestPublicationDate:"August 3rd, 2022",hasOnlineFirst:!0,numberOfOpenTopics:3,numberOfPublishedChapters:107,numberOfPublishedBooks:12,editor:{id:"50150",title:"Prof.",name:"Robert",middleName:null,surname:"Koprowski",fullName:"Robert Koprowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTYNQA4/Profile_Picture_1630478535317",biography:"Robert Koprowski, MD (1997), PhD (2003), Habilitation (2015), is an employee of the University of Silesia, Poland, Institute of Computer Science, Department of Biomedical Computer Systems. 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. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},subseries:[{id:"7",title:"Bioinformatics and Medical Informatics",keywords:"Biomedical Data, Drug Discovery, Clinical Diagnostics, Decoding Human Genome, AI in Personalized Medicine, Disease-prevention Strategies, Big Data Analysis in Medicine",scope:"Bioinformatics aims to help understand the functioning of the mechanisms of living organisms through the construction and use of quantitative tools. The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",fullName:"Reda R. Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",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.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. Osma",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDv7QAG/Profile_Picture_1626602531691",institutionString:null,institution:{name:"Universidad de Los Andes",institutionURL:null,country:{name:"Colombia"}}},{id:"69697",title:"Dr.",name:"Mani T.",middleName:null,surname:"Valarmathi",fullName:"Mani T. Valarmathi",profilePictureURL:"https://mts.intechopen.com/storage/users/69697/images/system/69697.jpg",institutionString:"Religen Inc. | A Life Science Company, United States of America",institution:null},{id:"205081",title:"Dr.",name:"Marco",middleName:"Vinícius",surname:"Chaud",fullName:"Marco Chaud",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDGeQAO/Profile_Picture_1622624307737",institutionString:null,institution:{name:"Universidade de Sorocaba",institutionURL:null,country:{name:"Brazil"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/71988",hash:"",query:{},params:{id:"71988"},fullPath:"/chapters/71988",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()