Pseudo-random properties of
\\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:"9256",leadTitle:null,fullTitle:"Risk Management and Assessment",title:"Risk Management and Assessment",subtitle:null,reviewType:"peer-reviewed",abstract:"Risk analysis, risk evaluation and risk management are the three core areas in the process known as ‘Risk Assessment’. Risk assessment corresponds to the joint effort of identifying and analysing potential future events, and evaluating the acceptability of risk based on the risk analysis, while considering influencing factors. In short, risk assessment analyses what can go wrong, how likely it is to happen and, if it happens, what are the potential consequences. Since risk is a multi-disciplinary domain, this book gathers contributions covering a wide spectrum of topics with regard to their theoretical background and field of application. The work is organized in the three core areas of risk assessment.",isbn:"978-1-83880-795-5",printIsbn:"978-1-83880-794-8",pdfIsbn:"978-1-83880-796-2",doi:"10.5772/intechopen.83256",price:119,priceEur:129,priceUsd:155,slug:"risk-management-and-assessment",numberOfPages:114,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"b5547d1d68d2db6f22eedb8f306b0276",bookSignature:"Jorge Rocha, Sandra Oliveira and César Capinha",publishedDate:"October 14th 2020",coverURL:"https://cdn.intechopen.com/books/images_new/9256.jpg",numberOfDownloads:3647,numberOfWosCitations:1,numberOfCrossrefCitations:3,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:3,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:7,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 20th 2019",dateEndSecondStepPublish:"October 9th 2019",dateEndThirdStepPublish:"December 8th 2019",dateEndFourthStepPublish:"February 26th 2020",dateEndFifthStepPublish:"April 26th 2020",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"145918",title:"Ph.D.",name:"Jorge",middleName:null,surname:"Rocha",slug:"jorge-rocha",fullName:"Jorge Rocha",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRCMaQAO/Profile_Picture_1641828146691",biography:"Jorge Rocha achieved his MSc in Geographic Information Systems (2003) and in Spatial Planning (2013), and PhD in Geographic Information Science (2012). He is currently an Assistant Professor of the Institute of Geography and Spatial Planning and a member of the Modelling, Urban and Regional Planning, and Environmental Hazard and Risk Assessment and Management research groups of the Centre of Geographical Studies, University of Lisbon. . His field of expertise is geosimulation and geocomputation involving artificial neural networks, graphs theory, cellular automata, and multi-agent systems. Jorge’s works are quite diverse, focusing mainly on, but not only, in urban morphology, remote sensing, epidemiology, health geography, geomarketing, tourism, smart cities and big data.",institutionString:"University of Lisbon",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"5",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"University of Lisbon",institutionURL:null,country:{name:"Portugal"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"203745",title:"Dr.",name:"Sandra",middleName:null,surname:"Oliveira",slug:"sandra-oliveira",fullName:"Sandra Oliveira",profilePictureURL:"https://mts.intechopen.com/storage/users/203745/images/system/203745.jfif",biography:"Sandra Oliveira is a researcher for the Centre for Geographical Studies, in the Institute of Geography and Spatial Planning. She graduated in Geography from the University of Coimbra and has a MSc in Environmental Sciences from the University of Wollongong (Australia) and a Ph.D. in Forest and Natural Resources Engineering at the School of Agriculture of the University of Lisbon. She started as a Scientific Officer at the Joint Research Centre-EC in Italy, working in the European Forest Fire Information System (EFFIS). She works in environmental risk assessment and geographic information systems (GIS) and her main interests are in climatic risks, wildfires, forest protection and biodiversity. She is currently focused on spatial modelling and vulnerability assessment of vector-borne diseases.",institutionString:"University of Lisbon",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Lisbon",institutionURL:null,country:{name:"Portugal"}}},coeditorTwo:{id:"304987",title:"Dr.",name:"César",middleName:null,surname:"Capinha",slug:"cesar-capinha",fullName:"César Capinha",profilePictureURL:"https://mts.intechopen.com/storage/users/304987/images/system/304987.jfif",biography:"César Capinha has a PhD in Environmental Sciences, a MSc in Geographic Information Systems and Territorial Modelling Applied to Planning, and a Degree in Geography. He is a Research Fellow at the Centre for Geographical Studies (Uni. of Lisbon). César works at the interface between biogeography and biological invasions, looking into how biogeographical patterns are being modified by human-mediated dispersal of species and by other manifestations of global change, such as climate change. César is also very interested in the application and improvement of machine learning and statistical models for ecological modelling, particularly in predicting the risk of invasion by introduced species and in real-time modelling of ecological and epidemiological phenomena.",institutionString:"University of Lisbon",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Lisbon",institutionURL:null,country:{name:"Portugal"}}},coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"272",title:"Management",slug:"management"}],chapters:[{id:"73125",title:"Introductory Chapter: Risk Management",doi:"10.5772/intechopen.93553",slug:"introductory-chapter-risk-management",totalDownloads:563,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Jorge Rocha, Sandra Oliveira and César Capinha",downloadPdfUrl:"/chapter/pdf-download/73125",previewPdfUrl:"/chapter/pdf-preview/73125",authors:[{id:"145918",title:"Ph.D.",name:"Jorge",surname:"Rocha",slug:"jorge-rocha",fullName:"Jorge Rocha"},{id:"203745",title:"Dr.",name:"Sandra",surname:"Oliveira",slug:"sandra-oliveira",fullName:"Sandra Oliveira"},{id:"304987",title:"Dr.",name:"César",surname:"Capinha",slug:"cesar-capinha",fullName:"César Capinha"}],corrections:null},{id:"73218",title:"Risk of Slipping Industrial Landfills",doi:"10.5772/intechopen.91020",slug:"risk-of-slipping-industrial-landfills",totalDownloads:346,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Due to the high rate of industrialization, urbanization and development of the road network, hydrotechnical constructions, etc., larger areas of agricultural and arable lands are affected, some of these being removed from the economic circuit. Due to the magnitude of the involved volumes, industrial waste has lately become a threat to all the components of the environment. In Romania, 90–95% of the total quantity of the produced industrial waste are stored, but only 24% of them have an environmental clearance certificate. The action of the climatic factors increases the risk of the occurrence of some landslides, which leads to the deterioration of the ecosystems and the risk of pollution, the loss of stability, the destruction of some historical objectives. Thus, the risk analyses represent the support for the decision-making process in taking solid measures, meant to lead to the limitation and diminution of the danger of slipping and losing the stability of these deposits. However, the implementation of the measures is based on a systemic model, supported by the concept of risk. This chapter presents the definition and classification of environmental risks, the risk assessment methodology and a risk analysis for waste in a mining area in Romania.",signatures:"Emilia-Cornelia Dunca and Sabina Irimie",downloadPdfUrl:"/chapter/pdf-download/73218",previewPdfUrl:"/chapter/pdf-preview/73218",authors:[{id:"307914",title:"Dr.",name:"Sabina",surname:"Irimie",slug:"sabina-irimie",fullName:"Sabina Irimie"},{id:"313179",title:"Dr.",name:"Emilia",surname:"Dunca",slug:"emilia-dunca",fullName:"Emilia Dunca"}],corrections:null},{id:"71351",title:"Supply Chain FMEA Risk Analysis for the Heavy Industry Sector",doi:"10.5772/intechopen.91042",slug:"supply-chain-fmea-risk-analysis-for-the-heavy-industry-sector",totalDownloads:805,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The discussed problem is associated with the analysis of risk factors affecting supply chain management in the heavy industry sector based on the analysis of entities operating in this industry. During the research, several aspects of key importance in supply chain management in the heavy industry sector were identified. The use of the failure mode and effects analysis (FMEA) method in research has enabled the detection of defects in supply chain management and analysis of factors that may negatively affect the flow of goods. During the research, potential design flaws and the effect of these flaws were identified, indicating the class, cause, and occurrence.",signatures:"Małgorzata Dendera-Gruszka and Ewa Kulińska",downloadPdfUrl:"/chapter/pdf-download/71351",previewPdfUrl:"/chapter/pdf-preview/71351",authors:[{id:"313072",title:"Prof.",name:"Ewa",surname:"Kulińska",slug:"ewa-kulinska",fullName:"Ewa Kulińska"},{id:"313373",title:"Ph.D.",name:"Małgorzata",surname:"Dendera-Gruszka",slug:"malgorzata-dendera-gruszka",fullName:"Małgorzata Dendera-Gruszka"}],corrections:null},{id:"70820",title:"Application of Quantum Physics Assumptions for Risk Assessment",doi:"10.5772/intechopen.90825",slug:"application-of-quantum-physics-assumptions-for-risk-assessment",totalDownloads:679,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Risk assessment is the result of assumptions of people performing it. Therefore, its use may be limited, because in principle it is difficult to predict events that we are not aware of. A certain solution to this problem seems to be the application of inception theory and quantum physics assumptions to describe future phenomena. The aim of the study will be to demonstrate the experience of risk assessment attempts using quantum physics assumptions. The current application of new assumptions for risk assessment in the case of road infrastructure allows for the thesis that a change in the approach to risk assessment is necessary in all areas related to human activity.",signatures:"Marek Rozycki",downloadPdfUrl:"/chapter/pdf-download/70820",previewPdfUrl:"/chapter/pdf-preview/70820",authors:[{id:"254855",title:"Mr.",name:"Marek",surname:"Rózycki",slug:"marek-rozycki",fullName:"Marek Rózycki"}],corrections:null},{id:"71133",title:"Risk Assessment Methodology in Public Financial Institutions",doi:"10.5772/intechopen.91152",slug:"risk-assessment-methodology-in-public-financial-institutions",totalDownloads:639,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter classifies the risk and fundamental elements necessary to manage it. It presents the individual stages of the procedure and standards of conduct in risk management. In accordance with the EU accession agreement, Poland has developed and implemented a system of financial management and control standards in public finance sector units. This chapter presents the risk assessment tools that can be customized to the needs of a specific organization, including public sector entities. Information about how to manage risk in each EU country are made available because of the desire to show the stability and proper monitoring of the risks in order to fulfil the given tasks. This affects the perception of stability in the country, which has a direct impact on the economic effects.",signatures:"Leon Dorozik, Tomasz Strąk and Ireneusz Miciuła",downloadPdfUrl:"/chapter/pdf-download/71133",previewPdfUrl:"/chapter/pdf-preview/71133",authors:[{id:"243649",title:"Dr.Ing.",name:"Ireneusz",surname:"Miciuła",slug:"ireneusz-miciula",fullName:"Ireneusz Miciuła"}],corrections:null},{id:"72611",title:"Risk Management in Biobanks",doi:"10.5772/intechopen.91463",slug:"risk-management-in-biobanks",totalDownloads:616,totalCrossrefCites:3,totalDimensionsCites:3,hasAltmetrics:0,abstract:"The administration of risks is usually an important corner stone of professional operations. Nevertheless, specifically for biobanking organizations, risk recognition, control, management, and easing are inevitably extremely critical elements of everyday operations. The costly kind of unique samples/cell lines, data and also other high-pitched value biobanking products and services such as cell-based drugs, and biologically active pharmaceutical materials call for tremendously precise planning—including the full spectrum of risks. 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\r\n\tCartilage lesions of the knee are common and should be treated correctly if symptomatic. Until now, multiple (surgical) techniques have been described; however, there is no consensus on which one should be used. Also, treatment techniques using platelet-rich plasma, mesenchymal stem cells, and different king of growth hormones have been mentioned. In this book, the importance of other knee structures when treating these knee cartilage defects will be discussed as the meniscus, integrity of ligaments, and the importance of the alignment of the lower limb will be emphasized. The book will give an update on the different treatment approaches in knees with this (osteo-)chondral lesion.
",isbn:"978-1-83768-204-1",printIsbn:"978-1-83769-984-1",pdfIsbn:"978-1-83768-205-8",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"90b8cac7c6b437387a540790d072699f",bookSignature:"Dr. Karl Almqvist, Dr. Ahmed Ebrahim El Hamaky and Dr. Taiceer Abdulwahab",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11693.jpg",keywords:"Defect, Cartilage Function, Subchondral Bone, Envelope of Function, Alignment, Knee Stability, Meniscal Function, Surgical Treatment, Microfracture, Use of Scaffolds, Debridement",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 4th 2022",dateEndSecondStepPublish:"July 7th 2022",dateEndThirdStepPublish:"September 5th 2022",dateEndFourthStepPublish:"November 24th 2022",dateEndFifthStepPublish:"January 23rd 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"a month",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"An experienced researcher, specializing in sports medicine and knee pathologies, is currently involved in the development of innovative techniques for the treatment of cartilage lesions. Dr. Almqvist is an editorial board member at Sage Journals, Affiliated with the Orthocure Clinic, Dubai as an Orthopedic Consultant, Mediclinic City Hospital as a Consultant Orthopaedic surgeon, and is a member of ISAKOS.",coeditorOneBiosketch:"Dr. El Hamaky is a practitioner with over 11 years of experience in Orthopedic Surgery, is a member of the Egyptian Board of Orthopedic Surgery, a member of the AO Foundation, and was awarded his medical degree from the University of Cairo.",coeditorTwoBiosketch:"Dr. Taiceer Abdulwahab is an experienced practitioner, specializing in orthopedic surgery, trauma, and sports medicine, previously affiliated with The University of Bristol, The University of Edinburgh, The University of Warwick, and The University of Leicester, and is a member of the Royal College of Surgeons (MRCS) London, UK.",coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"251312",title:"Dr.",name:"Karl",middleName:null,surname:"Almqvist",slug:"karl-almqvist",fullName:"Karl Almqvist",profilePictureURL:"https://mts.intechopen.com/storage/users/251312/images/system/251312.jpg",biography:"Prof. Dr. Almqvist trained at the University of Ghent in Belgium and worked at the Ghent University Hospital where he was Head of Clinic, Department of Physical Medicine and Orthopaedic Surgery, prior to moving to Dubai in 2014. He also has considerable teaching experience and is an assistant professor in Physiotherapy and Orthopaedic Surgery at Ghent University. Karl Fredrik has published extensively and written a number of book chapters. He is a regular speaker at international meetings and is on the editorial board or is a reviewer for the major sports orthopedic journals.\r\nHe obtained his Ph.D. in 2001 (Human differentiated articular cartilage cells in biodegradable matrices – Preparative studies for their use in the repair of cartilage defects).\r\nKarl Fredrik is active in a number of orthopaedic organisations, and is the past Chairman of the Sports Committee of the International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine as well as the past Chairman of the Cartilage Committee of the European Society of Sports Traumatology, Knee Surgery & Arthroscopy.\r\nThe main area of interest Karl Fredrik is knee surgery. His expertise covers the whole range of knee conditions from sports injuries to knee replacement.",institutionString:"Orthocure Dubai",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null}],coeditorOne:{id:"452670",title:"Dr.",name:"Ahmed",middleName:null,surname:"Ebrahim El Hamaky",slug:"ahmed-ebrahim-el-hamaky",fullName:"Ahmed Ebrahim El Hamaky",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003N9dpTQAR/Profile_Picture_2022-03-04T13:32:24.jpg",biography:"An orthopedic surgeon with 11 years experience in orthopedic surgery, trained in highly specialized facilities in Egypt such as Al kasr al ainy University hospitals, Al Helal Orthopedic tertiary hospital, Air force specialized hospital. His interest and specialty are mainly sports medicine and surgery either shoulder or knee arthroscopic and primary arthroplasty surgeries. He shifted his career to Dubai Mediclinic City Hospital, Dubai.",institutionString:"Mediclinic City Hospital",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Mediclinic City Hospital",institutionURL:null,country:{name:"United Arab Emirates"}}},coeditorTwo:{id:"204153",title:"Dr.",name:"Taiceer",middleName:null,surname:"Abdulwahab",slug:"taiceer-abdulwahab",fullName:"Taiceer Abdulwahab",profilePictureURL:"https://mts.intechopen.com/storage/users/204153/images/system/204153.jpeg",biography:"Dr. Taiceer Abdulwahab, is an Orthopaedic Surgeon at Mediclinic City Hospital, Dubai, United Arab Emirates. He is also an Assistant Clinical Professor of Orthopaedic Surgery at Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai.\r\nHe is a Master of Surgery (ChM) in Trauma & Orthopaedic Surgery, degree obtained at the University of Edinburgh School of Medicine in partnership with the Royal College of Surgeons of Edinburgh, UK. He received his Master of Science (MSc) in Trauma & Orthopaedic Surgery degree from Warwick School of Medicine, University of Warwick, UK. He also received a Postgraduate Award (PGA) in Understanding Research & Critical Appraisal at the Warwick School of Medicine, University of Warwick, UK.\r\nDr. Abdulwahab obtained his primary medical qualification, Bachelor of Medicine & Bachelor of Surgery (MBChB) from the Bristol School of Medicine, University of Bristol, UK.\r\nDr. Taiceer Abdulwahab is a Member of the Royal College of Surgeons of England (MRCS).\r\nHe has presented at various international conferences including the International Congress for Joint Arthroplasty (ICJR) and the European College of Sports & Exercise Physicians (ECOSEP) with FIFA update, as well as published in peer-reviewed journals, Editor for a book titled 'Meniscus of the Knee', and investigator in several randomized controlled trials.\r\nHe is Trauma Doctor for the annual Emirates Rugby 7s.\r\nHe has a special interest in Sports Surgery (Arthroscopic Shoulder and Knee surgery).",institutionString:"Mediclinic City Hospital",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Mediclinic City Hospital",institutionURL:null,country:{name:"United Arab Emirates"}}},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:"466998",firstName:"Dragan",lastName:"Miljak",middleName:"Anton",title:"Mr.",imageUrl:"https://mts.intechopen.com/storage/users/466998/images/21564_n.jpg",email:"dragan@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. 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The fact that simple equations can exhibit incredible complex behavior continues enthrall engineers to apply chaotic systems to cryptosystem, secure communication, spread spectrum communication, etc. [2].
There is no doubt that nonlinear term is very important to design chaotic systems, which has peculiar complex properties such as ergodicity, highly initial value sensitivity, non-periodicity and long-term unpredictability. According to the literature, the nonlinearities can be piecewise nonlinear function [3], trigonometric function [4], absolute value function [5], or power function [6]. With different nonlinearities, the chaotic system can have various strange attractors as single-scroll [7], double-scroll [8], multi-scroll [9], etc. The majority of such chaotic systems are known for many years, and some chaotic systems with hidden attractors are derived from them [10, 11, 12].
In recent years, chaotic systems with hyperbolic sine nonlinearities have gained the interest of many researchers. With two back-to-back diodes to approximate the hyperbolic sine nonlinearity, these chaotic systems can achieve simplicity of the electrical circuit without any multiplier or sub-circuits. Compared to single-scroll chaotic systems, the chaotic system with hyperbolic sine nonlinearity has richer dynamic behavior because it is symmetrical and can exhibit symmetry breaking, and offers the possibility that attractors will split or merge as some bifurcation parameter is changed [13].
In this chapter, we will systematically summarize the design method, the dynamic behavior and typical engineering applications of chaotic systems with hyperbolic sine nonlinearity. The genesis and general method of generating nth-order (n > 3) chaotic systems with hyperbolic sine nonlinearity are introduced in Section II. Some derived chaotic systems/torus-chaotic system with hyperbolic sine nonlinearity is discussed in Section III. The application such as random number generator algorithm, spread spectrum communication and image encryption schemes are introduced in Section IV. Conclusions are finally drawn in Section V.
In 2011, Sprott and Munmuangsaen proposed an exponential chaotic system [14], which happens to be an example of the simplest chaotic system [15]. In the same year, Sprott used common resistors, capacitors, operational amplifiers, and a diode to successfully implement this system in a circuit [16]. Few years later, the simplest hyperbolic sine chaotic system is proposed [17]. Compared to the exponential chaotic system, the hyperbolic sine chaotic system changed the nonlinearity from exponential function (asymmetric function) to hyperbolic sine function (symmetric function), which can exhibit symmetry breaking, and offers the possibility that attractors will split or merge as some bifurcation parameter is changed [18].
The simplest chaotic system with a hyperbolic sine is described as follows:
Where c is considered as the bifurcation parameter,
When
The corresponding circuit schematic diagram of
Numerical and actual circuit state space plot in
It is obvious that Eq. (1) can be written in the form with jerk equations:
where
where
When n = 4, the equations of fourth-order chaotic systems will be:
The corresponding circuit schematic diagram of Eq. (4) is shown as Figure 3.
The corresponding circuit schematic diagram of
Its numerical and actual circuit state space plot is shown as Figure 4.
Numerical and actual circuit state space plot in
When n = 5, the equations of fifth-order chaotic systems will be:
The corresponding circuit schematic diagram of Eq. (5) is shown as Figure 5.
The corresponding circuit schematic diagram of
Its numerical and actual circuit state space plot is shown as Figure 6.
Numerical and actual circuit state space plot in
One way to construct the derived chaotic systems is to add more nonlinear terms of the equations. For example, the new chaotic system can be constructed by Eq. (4), which is described as follows:
Where
Numerical phase space plot of
The other way to construct the derived chaotic systems is to simplify the known chaotic systems. For example, if we remove the parameter
When initial conditions are set to be
Coexistence attractors of
By introducing a nonlinear feedback controller to system Eq. (5), the following system is obtained:
When c = 1, the Lyapunov exponents are
When c = 1.55 and the initial conditions are set to be
Coexistence attractors of
Figure 10 shows the Lyapunov exponent spectrum, Kaplan–Yorke dimension spectrum and bifurcations of Eq. (8) as the coefficient c is varied over the range c ∈ [0.3, 2]. Those figures suggest there is an interesting route leading to chaos [21].
When c ∈ [0.3, 0.4639], there exists a period-doubling behavior along with
When c ∈ [0.4640, 0.5574], the system exhibits two-torus-chaos behavior except for some 2-torus windows. When the parameter passed c = 0.4639 to c = 0.4640, two-torus-chaos is born by replacing the 2-torus behavior. The Lyapunov exponents at these two critical values are
When c ∈ [0.5575, 0.5901], the system exhibits 2-torus behavior.
When c ∈ [0.5902, 1.5575], the system exhibits 2-torus-chaos behavior except for 2-torus windows. The route leading to chaos is same to point 3.
When c ∈ [1.5575, 2] the system exhibits 2-torus behavior, except for some 3-torus windows like c = 1.6157.
LEs spectrum, Kaplan–Yorke dimension spectrum and bifurcations of
Sensitivity to initial conditions is one of the most important property of chaotic systems. Therefore, chaotic systems are very suitable for the cryptography purpose. But before that, it should be noticed that the probability density distributions (PDD) of chaotic systems are not uniform distribution. Figure 11(a) and 11(b) are the waveform and PDD of
Waveform and PDD before and after de-correlation operation of
To remove physical characteristic, one can use the following de-correlation operation:
In fact, Eq. (9) can be applied in all chaotic/torus-chaotic/hyperchaotic systems. The output sequences can pass fifteen random tests of NIST 800-22, as shown as in Table 1, which indicated the proposed method can provide high security Level. This proposed method can be used as a part of some cyber security systems such as the verification code, secure QR code and some secure communication protocols.
Test | P-value | Result |
---|---|---|
Frequency | 0.841481 | Success |
Block frequency | 0.900704 | Success |
Runs | 0.744455 | Success |
Longest run | 0.172897 | Success |
Rank | 0.368065 | Success |
FFT | 0.762020 | Success |
Non-overlapping template | 0.813121 | Success |
Overlapping template | 0.532736 | Success |
Universal | 0.856573 | Success |
Linear complexity | 0.408679 | Success |
Serial | 0.967366 | Success |
Approximate entropy | 0.433157 | Success |
Cumulative sums | 0.688582 | Success |
Random excursions | 0.075229 | Success |
Random excursions variant | 0.102049 | Success |
Pseudo-random properties of
Image encryption is another widely used engineering application of chaotic system. In this section, we will use Eq. (7) for image encryption purpose.
A flowchart of the encryption scheme is shown in Figure 12.
A flowchart of the encryption scheme.
The detailed encryption process includes the following steps.
Input: Plain image; Initial conditions for the chaotic system; Control parameters of the chaotic system.
Output: Ciphered image.
Step 1: Calculate the average pixel value of the plain image and generate the pseudorandom sequence.
Step 2: Transform the pseudorandom sequence and change pixel value of the image via XOR.
Step 3: Sort the pseudorandom sequence for permutation.
Step 4: Shift the pixel positions by column using the sorted elements.
Step 5: Shift the pixel positions by row using the sorted elements.
To provide a better understanding of this scheme, the pseudocode is provided in Table 2.
Input: Plain image Org_Img, Initial conditions for the chaotic system, Control parameter for the chaotic system, Output: Ciphered Image En_Img |
[m,n] ← size(Org_Img); Avg_pixel_value ← mean2(Org_Img)*10^(-5) % mean2 is a function that returns the % average value of a matrix x(1) ← x(1) + Avg_pixel_value y(1) ← y(1) z(1) ← z(1) u(1) ← u(1) s(1) ← u(1)*10^4 – floor(u(1)*10^4) For i=1:1:m*n % Generate pseudorandom sequence that will % be used for diffusion and permutation [dx, dy, dz, du] ← Runge-Kutta (x(i), y(i), z(i), u(i)) x(i+1) ← x(i) +dx y(i+1) ← y(i) +dy z(i+1) ← z(i) +dz u(i+1) ← u(i) +du s(i+1) ← u(i+1)*10^4 – floor(u(i+1)*10^4) End Count=1 % Count flag For i=1:m % Diffusion Operation For j=i:n diff(Count) ← mod (s(Count)*10^14, 256) % transform s, which could be used for XOR En_Dif(i,j)=bitxor(Org_Img(i,j), diff (Count)); % Bitwise exclusive OR Count= Count+1; End End S_index ← Sort(s) For i=1:n % Column-wise permutation For j=1:m En_per_col (i,j) ← Sort (En_Dif, S_index) End End For i=1:m % Row-wise permutation For j=1:n En_Img (i,j) ← Sort (En_per_col, S_index) End End |
Image encryption scheme.
The decryption process of the proposed algorithm is the reverse process of the encryption algorithm. A flowchart of the decryption process is shown in Figure 13.
A flowchart of the decryption scheme.
The detailed decryption process includes the following steps.
Input: Plain image; Initial conditions for the chaotic system; Control parameter of the chaotic system; Average pixel value of the plain image
Output: Decrypted image
Step 1: Generate the pseudorandom sequence via the initial conditions and the average pixel values of the plain image
Step 2: Sort the pseudorandom sequence for row and column recovery.
Step 3: Shift the pixel positions by row
Step 4: Shift the pixel positions by column
Step 5: Transform the pseudorandom sequence and recover the pixel values of the image via XOR
To provide a better understanding of this scheme, the pseudo-code is provided in Table 3
Input: Ciphered image En_Img, Initial conditions for the chaotic system, control parameter for the chaotic system, Avg_pixel_value of Org_Img Output: Plain Image Org_Img |
[m,n] ← size(En_Img); x(1) ← x(1) + Avg_pixel_value y(1)← y(1) z(1) ← z(1) u(1) ← u(1) s(1) ← u(1)*10^4 – floor(u(1)*10^4) For i=1:1:m*n % Generate a pseudorandom sequence that will % be used for decryption [dx, dy, dz, du] ← Runge-Kutta (x(i), y(i), z(i), u(i)) x(i+1) ← x(i) +dx y(i+1) ← y(i) +dy z(i+1) ← z(i) +dz u(i+1) ← u(i) +du s(i+1) ← u(i+1)*10^4 – floor(u(i+1)*10^4) End S_index ← Sort(s) For i=1:m % Row-wise permutation recovery For j=1:n De_per_row (i,j) ← Sort (En_Img, S_index) End End For i=1:n % Column-wise permutation recovery For j=1:m De_per_col (i,j) ← Sort (De_per_row, S_index) End End Count=1 % Count flag For i=1:m % Diffusion recovery For j=i:n diff(Count) ← mod (s(Count)*10^14, 256) % transform s, which could be used for XOR Org_Img (i,j)=bitxor(De_per_col (i,j), diff (Count)); % Bitwise exclusive OR Count= Count+1; End End |
Image decryption scheme.
The testing results of encryption and decryption are shown in Figure 14.
The testing results of encryption and decryption: (a) is the plain image of cameraman; (b) is the encrypted image of cameraman; (c) is the decrypted image of cameraman; (d) is the plain image of breast CT image; (e) is the encrypted image of breast CT image; (f) is the decrypted image of breast CT image; (g) is the plain image of thorax CT image; (h) is the encrypted image of thorax CT image; (i) is the decrypted image of thorax CT image.
In this system, all the initial conditions and control parameters can be considered as secret keys. Because the basin of attraction of each initial condition is greater than 1, it could have more than 1015∗4 =1060 choices via a resolution of 10−15, in terms of a numeric calculation. Moreover, if a range of control parameters are considered for the key space, the key space of this system would far exceed 1090. Such a large key space provides sufficient security against brute-force attacks.
Correlation coefficients of adjacent pixels in the plain and encrypted image are shown in Table 4.
Figure name | Direction | Plain-image | Ciphered image |
---|---|---|---|
Cameraman Image | Horizontal | 0.983146 | 0.001731 |
Cameraman Image | Vertical | 0.990025 | 0.004141 |
Cameraman Image | Diagonal | 0.973249 | 0.000324 |
Breast CT image | Horizontal | 0.978292 | 0.002500 |
Breast CT image | Vertical | 0.955481 | 0.006207 |
Breast CT image | Diagonal | 0.940737 | 0.003071 |
Thorax CT image | Horizontal | 0.994585 | 0.001267 |
Thorax CT image | Vertical | 0.994761 | 0.001267 |
Thorax CT image | Diagonal | 0.991973 | 0.001558 |
Correlation coefficients of adjacent pixels in the plain and encrypted image.
The NPCR and UACI score of CT image are 99.5804% and 33.3227%.
From the above security analysis, the proposed scheme can provide high security for cryptographic applications.
Chaotic systems can also use for spread spectrum communication propose. Different chaos shift keying (DCSK) technology employs nonperiodic and wideband chaotic signals as carriers so as to achieve the effect of spectrum spreading in the process of digital modulation. Figure 15 shows the scheme of modulation for DCSK.
Scheme of DCSK modulation.
In this scheme, every bit has two time slots. The first time slot is used for transmission of a chaotic sequence for the reference signal. The second time slot is used for transmission of another chaotic sequence for the reference signal which has the same length as the first time slot. If the information bit is +1, then the information signal is exactly the same as the reference signal. If the information signal bit is −1, then the information signal is the negative of the reference signal. For bits
Where
For demodulation as shown in Figure 16, the receiver calculates the correlation between the received signal
Scheme of the DCSK demodulation.
Thus, the information bit
The obtained BER performance under additive white Gaussian noise (AWGN) channels for spreading factor
Comparison of the bit error rate for a Chebyshev sequence and the hyperbolic sine system with DCSK.
In this chapter, we first described a third order chaotic system with hyperbolic sine nonlinearity, then we introduced the method to expend this chaotic system to high order chaotic systems. After that, we introduced the method to construct the derived chaotic torus-chaotic systems. Finally, we introduced some applications such as random number generator algorithm, spread spectrum communication and image encryption schemes. The contribution of this chapter is that it systematically summarizes the design method, the dynamic behavior and typical engineering application of chaotic systems with hyperbolic sine nonlinearity, which may widen the current knowledge of chaos theory and engineering applications based on chaotic systems.
Jizhao Liu has received research grants from Sun Yat-sen University.
This study was supported by the Fundamental Research Funds for the Central Universities. No. 19lgpy230.
The authors declare that they have no conflict of interest.
The authors would like to thank professor Julien Clinton Sprott for helpful discussion.
The commonest variant of Chiari malformations, the one that has been labeled “type I,” including some recently derived variants (type 0, type 1.5), is unique among the central nervous system abnormalities by its capacity to elicit just as much apprehension within the community of patients, as bewilderment among the clinicians. Its ominous relationship with sudden death, as well as its resemblance with the tonsillar herniation seen in terminal stages of brain tumors, intracranial hemorrhage, and other space-occupying lesions, would very well serve to explain many of these feelings. Nevertheless, their deeper reason seems rather to be the apparent mystery that clouds its pathogenesis, hindering many attempts at agreement among the authors involved in its investigation.
Notwithstanding, an attentive eye can discover interesting pathogenetic clues issued from recent research that one only has to pin up at the right spots on an older scaffold initiated long ago by some intuitive theories that started to explore into these matters even from the discovery of the hindbrain malformation: while Hans Chiari favored hydrocephalus as the cause of tonsillar descent, Julius Arnold proposed the concept that cord tethering at the level of the associated myelomeningocele determines a caudal traction along the spinal cord that ends in the tonsillar descent of Chiari malformation type II [1].
This is why every effort to unveil the origin and the mechanisms of formation of Chiari malformation type I should be greatly welcomed. It is very likely that the same can be extrapolated to the less common Chiari malformation type II, which could be just a more severe form of the same deformity, caused by more intense but qualitatively similar pathogenetic alterations. The unifying theory that follows is merely the result of attentive, scrupulous efforts to acknowledge valuable data in the middle of puzzling research results and connect them orderly in a logical explanation of the mechanisms likely to be involved in the production of Chiari malformation type I.
The concept of caudal traction as we use it through the following lines should not be understood merely from a physical point of view, as a purely mechanical force, as it refers to a biological system with certain viscoelastic properties and an intrinsic capacity to develop a reaction to any force acting upon it. The development of the human body is a continuous interplay of genetic, molecular, biochemical, and mechanical changes that result in a more or less dynamic structure and function. Absolutely all human beings, as well as other vertebrate species, are subjected to this phenomenon of caudal traction, which is a necessary part of the development of the spinal cord and brainstem, as they grow by lengthening, distinctly from the forebrain and cerebellum, which do it by expansion. In fact, the notion of caudal traction points to a group of deformities of the nervous system and its surrounding tissues, identifiable on diagnostic images and likely to result from this longitudinal growth of its caudal segments during development; they may be discovered at various stages during this process or even later, during adulthood, which is by no means a cease of it, but merely a continuation, as an involution—apparently a reversed process, but in fact an ongoing, caudal traction at a deep structural level of the involved neural organs. After all, the definition and understanding of this dynamic concept will certainly improve in parallel with the abilities of the diagnostic tools that we shall be able to use in these patients.
After an initial presentation of this new pathogenetic theory, we will follow with a second part where we shall bring into view some conditions quite likely to be produced by means of a mechanism of caudal traction and which are frequently associated with Chiari malformation type I. The third part of this chapter will deal with the clinical arguments of our demonstration, presenting a range of suggestive, but often neglected proofs of this pathogenesis, which we meet during the diagnosis and treatment of these patients.
It is very likely that the events that eventually lead to Chiari malformations take place at a very early stage during embryogenesis; a plausible idea if one takes as an example the defects of neural tube closure, related in some way to our problem, as we know well enough that during their evolution, some of them can cause a Chiari malformation type II—and the future will probably show that the relationship between these conditions is not limited to this (and caudal traction could be the link). If some parallel, very early, processes, related but not identical to neurulation abnormalities, would finally result in a Chiari malformation type I, it means that actually all purported etiopathogenetic mechanisms of this condition are in fact late secondary features that simply result from the abnormal development of the cranio-cervical junction. Most importantly, both the small volume of the posterior fossa and the disturbances of cerebrospinal fluid circulation across the foramen magnum would be such
This concept of very early pathogenesis of Chiari malformation type I has also another important consequence in the way we should try to understand it: most, if not all of the morphological and mechanical changes involved in its generation take place in the diminute body of a human embryo, then fetus, and then child (probably of a comparatively decreasing magnitude throughout these stages), even though the diagnosis will eventually be secured only at an adult age. This invalidates many recent research results and actual misconceptions based on mature or adult human anatomy and physiology.
Perhaps Chiari malformation type I is the best example of the meaning of Lewis Wolpert’s famous phrase “It is not birth, marriage, or death, but gastrulation which is truly the most important time in your life” [2], as indeed, the events that finally lead to its development seem to originate during gastrulation (third week postfertilization), that is, at a much earlier stage of embrionary development than that stated by all theories invoked nowadays.
Thus, the primordium of the central nervous system divides along its freshly defined anterior-posterior axis into four regions, corresponding to the future forebrain, midbrain, hindbrain, and spinal cord [3], well in advance of any significant differences in shape or length among them. Interestingly, while the first two limits are represented by discrete junctional areas that function as organizing centers for nearby neural territories—the so-called anterior neural ridge between the forebrain and midbrain and the isthmic organizer between the midbrain and anterior hindbrain [4]—there is no specific anatomical hint as to the precise location of the posterior hindbrain-spinal cord transition [3]; moreover, its final position depends on quite sophisticated but also delicate mechanisms involving a negative feedback loop between retinoic acid signaling, Cdx4 transcription factor, and the Cyp26 enzyme involved in the degradation of retinoic acid [3, 5]. Despite its importance for all future development of the nervous system, this hindbrain-spinal cord transition is exposed to be moved cranially or caudally by various alterations in these complex, interconnected signaling pathways [3, 5]. For example, experimental loss of Cdx4 function in zebrafish led to caudal displacement of the transition as far as that corresponding to two somites inside the spinal cord territory. As a consequence, the hindbrain-spinal cord transition along the developing neural tube will be matched to a different mesodermal counterpart, belonging to the first pairs of somites, either occipital or cervical. In this way, it becomes easy to figure out how an alteration of the Cdx4 gene or an equivalent disturbance of retinoic acid signaling could displace the transition caudally and place the junction between the developing brainstem and the spinal cord at the level of the future atlas, while the cerebellum might be expected to expand until the same area well below the occipital foramen. In fact, maternal administration of exogenous retinoic acid has been used to produce Chiari malformations in an experimental model in hamsters [6].
By and large, the tonsillar descent seen in Chiari malformation type I would thus be the result of delicate molecular abnormalities that occur early in a critical area of the future body plan, representing the precise border separating the head, with a neural-driven expansile growth in three directions, from the spine, with a somatic-driven tensile growth in one predominant direction (Figure 1). This is why its developmental importance and pathological associations and consequences are so complex and puzzling in their diversity, far outweighing the apparent trivial significance that it still has in the eyes of many clinicians.
The interplay of molecular and growth influences that grant a special importance to the cranio-cervical junction.
Of course, it is difficult to apply such an ultra-early pathogenesis involving molecular and genetic signaling pathways to what we actually think and know about Chiari malformation type I, but here we have again a point where an analogy with Chiari malformation type II is quite welcome. Since Julius Arnold’s days, it was already supposed that a myelomeningocele would “tether” the growing child’s spinal cord and thus determine a progressive caudal traction on the cerebellum and the tonsillar descent through the occipital foramen. The concept of “tethering” involves both a pathological lesion that fixes the spinal cord to the vertebral column at some point and an uncompensated load, either in the form of continuous growth, repetitive forward flexion movements, or a fracture-dislocation with sudden cord traction. In fact, there is also a third, mandatory component, the lack of an adequate adaptive reaction of the body, which may be due to the overwhelming intensity, suddenness, or persistence of the pull. Now, all these features can yet be expressed in another way if we view tethering more generally, as a relative shortness of the spinal cord, underlying both Chiari malformation types I and II, with the mention that in the former, there is absolutely nothing of spinal cord tethering.
Therefore, patients with Chiari malformation type I would tend to have relatively shorter spinal cords because the neural territory assigned to the formation of the future spinal cord is reduced with respect to the nearby somitic mesoderm, a disproportion that will result in a continuous spinal cord tension during growth, as the neural tissue will always be “one step behind” its mesodermal counterpart (Figure 1).
Interestingly, similar arguments in favor of these pathogenetic mechanisms have come from the other side of the problem, that is, from attempts to explain a supposedly defective development of the mesodermal tissue composing the prospective vertebral column, resulting in idiopathic scoliosis: the so-called “Roth-Porter theory” invokes exactly the same “asynchronism” between the spinal cord and spine during growth [7, 8, 9], reflected in the tridimensional deformity of idiopathic scoliosis in a much more visible manner [10] than in the case of Chiari malformation type I, but we shall develop more of these aspects later.
Just as a collateral observation, here we should mention that retinoic acid was also suspected as a pathogenetic factor in adolescent idiopathic scoliosis [11].
By the way, given its role of mechanical support, the development of osseous tissue has always been regarded as being associated to the creation and maintenance of tensile or compressive forces in the neighboring tissues. Thus, the development of the cranial vault by intramembranous ossification seems to proceed by means of tensile forces created in the sutures by the growth of the underlying brain [12]. Just in the same way, it should not be surprising that the growing vertebral column could exert a barely perceptible but relentless, tensile force that by some yet unknown mechanism stimulates the growth of the contained spinal cord accordingly. Well, this would be exactly the Achilles’ heel in individuals with Chiari malformation type I, as they are exposed more than normal people to a deficiency of the homeostatic mechanisms that maintain coupled the growth of the two structures. In selected cases, this uncoupling can occur also in the absence of a tonsillar descent or with a minimal one, so that its pathological consequences do not require the 5 mm of descent that most authors use to define Chiari malformations.
Without pretending to be exhaustive, Chiari malformation type I is associated with a few pathological conditions that could be explained by similar mechanisms involving genetic and molecular abnormalities followed by an axial traction throughout the spinal cord and the brainstem. But before all, in order to have a crystal clear vision of these associations, we have to rule out any tonsillar descent that is obviously secondary to compressive forces from above, as in benign intracranial hypertension, hydrocephalus of any etiology, craniosynostosis, or Paget disease of the bone and other conditions with calvarial thickening, as these are not real instances of Chiari malformation [1] and only compound the problem unnecessarily: one should better consider them as merely secondary tonsillar descents in specific clinical contexts that require only the treatment of the primary pathology and nothing more, just as is always done in the posterior fossa tumors, the deadliest cause of downward displacement of the cerebellar tonsils, where nobody disputes the foremost therapeutic objective. Nevertheless, if really and honestly open-minded, one has to acknowledge that perhaps every tonsillar descent is secondary to a pathological process, even though in most cases its nature is still unknown. But in the actual state of knowledge, we should better consider as “Chiari malformation type I” only the apparently
Malformations of the occipito-cervical junction, representing a diverse and complex group of pathological conditions and related deformities, are often multiple in the same patient and many times occur in conjunction with Chiari malformation type I—with as many as 38–40% of hindbrain herniations in cases of atlas assimilation combined with Klippel-Feil syndrome [13]. In these patients, the abnormal fusions involving the occiput, atlas, and other cervical vertebrae would most probably be generated by defects in the functions of Hox and Pax-1 genes at different levels in the occipital and cervical somites [14] at a more delayed stage than those mentioned above. A possible explanation could be that the genetic and molecular alterations are more severe and thus extend their effects over segmentation and resegmentation of the somites and specification of the sclerotomes, not only affecting the hindbrain-spinal cord boundary as we have mentioned. A second possibility might be that the anomalous establishment of this boundary creates the conditions for a defective feedback from the neural counterpart to the mesoderm, disturbing these molecular pathways and secondarily the formation of cervical vertebrae. And we could add to these qualitative alterations the obvious quantitative one: if too much mesodermal tissue has been wrongly assigned to build the prospective spine, it goes without saying that the amount of tissue left for building the skull will be insufficient (Figure 1). The consequences of this relative lack of occipito-cervical mesodermal tissue will be distinct from those of the lack of spinal cord progenitor tissue, as the prospective growth of this segment of somitic mesoderm will be governed by the underlying hindbrain which, as far as we know, is very strictly divided in rhombomeres with distinct features, as opposed to the monotony of the spinal cord organization in these early stages. Their feedback over their corresponding (and quantitatively defective) mesodermal counterpart will put quite stressful limits on the availability of compensatory mechanisms and thus determine an abnormal formation of the osseous and ligamentous elements of the occipito-cervical junction.
The same could happen also at more cranial levels, corresponding to the first occipital rhombomeres, where the same disproportion between the neural tissue contained within and the nearby mesoderm that receives its developmental induction would produce the deformities of basilar impression, platybasia, brainstem kinking, and retroflexed odontoid, found in 7.7% of our patients with Chiari malformation type I (Royo-Salvador et al., unpublished data). All these osseous anomalies could probably be explained by the interplay of discrete but persistent compressive and tensile forces developed among occipito-vertebral mesodermal segments during their development, secondarily to the mentioned genetic and molecular defects, recording somehow to the tenets of the Hueter-Volkmann law as applied to the spine [15].
At the same time, the disproportion between the contained, apparently hypertrophic hindbrain and the corresponding scarcely available mesodermal tissue will create the conditions for what Roth described in 1986 with such a brilliant intuition as “cranio-cervical growth collision” [16]: the impaction of the developing hindbrain against the growing vertebral column, which surpasses and deforms the insufficient occipito-cervical junction mesodermal primordium (the former from the inside, the latter from below (Figure 1)), accentuating the tonsillar descent, enlarging the occipital foramen, and leaving too little room for the formation of the occipital bone. It is amazing how the actual general opinion is able to conceive only this last developmental step [1, 17], but yes, finally, there is a para-axial mesodermal insufficiency associated with the Chiari malformations, but it is an associated phenomenon, somehow delayed and of secondary importance.
Among cranio-cervical junction malformations, a special mention deserves odontoid retroflexion, as it is a bony deformity that although it is less known and more imprecisely defined, it was found to be more marked and more common in children and adults with Chiari malformation type I than in normal controls [18, 19]. Moreover, in children with Chiari malformation type I, a study found it was correlated with the presence of syringomyelia and with a lower position of the
Since long ago, observations were published on the frequent association between Chiari malformation type I and idiopathic scoliosis [20], even though no coherent explanation of this fact has ever been provided. As a specific point, we have to insist that the presence of syringomyelia is not really necessary, as many have thought so far. Among our patients, Chiari malformation type I was associated with idiopathic scoliosis in 78.8% of cases, out of which only 52.1% also had idiopathic syringomyelia (Royo-Salvador et al., unpublished data). Instead, a common pathogenesis, based on an abnormal caudal traction, seems more likely to be involved: in fact, as we mentioned before, the concept of “neuro-vertebral growth asynchrony” was coined in the realm of idiopathic scoliosis and constitutes the mainstay of the Roth-Porter pathogenetic theory [7, 8, 9], which uses various mechanical experimental models to demonstrate that an uncoupling of the growth velocity between the spine and spinal cord makes the latter to lag behind, putting tension on the posterior elements which will grow at a slower pace (here we come once again in close contact to the Hueter-Volkmann law), so that the anterior elements will grow too much and the vertebral bodies, “tethered” posteriorly, will start to rotate around an axis represented by the spinal cord itself and will deviate to one side as they grow restrained in this way, thus creating the scoliotic curve [21]. It is not difficult to imagine how a similar mechanism of caudal traction would produce both a Chiari malformation type I and an idiopathic scoliosis if this intrinsic “tether” acted continuously over the vertebral column and spinal cord throughout their development and associated longitudinal growth, a fact especially conceivable if, following the mentioned alterations in the definition of the hindbrain-spinal cord boundary, there is a relative excess of mesenchymal tissue composing the sclerotomes of the future thoracic spine, even though it would be much later that this unbalanced tissue distribution would become manifested, during the growth spurt of the adolescence.
Last but not the least, among enlightening pathological associations of Chiari malformation type I is the tethered cord syndrome, maybe the most interesting of all, the most difficult to explain, and nevertheless, the most important, as it forms a bridge between Chiari malformation types I and II. In fact, this association should be better regarded as a separate third category of Chiari malformations, taking into account the different mechanism of relative spinal cord “shortening”: if in Chiari malformation type I this originated in a caudal displacement of the hindbrain-spinal cord boundary and in Chiari malformation type II, in the traction exerted by a caudal myelomeningocele on the growing spinal cord, here there is an abnormal
Now of course, if one accepts that the pathogenesis of Chiari malformations includes a common pathway of relative shortening of the spinal cord with respect to the vertebral column, of various etiologies that can be grouped into these three large groups, an important question comes about: why not any patient with this relative spinal cord shortening has a tonsillar descent? Well, the answer is quite simple, because, as we have already pointed out, there is another decisive factor that will eventually determine the occurrence or not of a Chiari malformation: the adequacy of the neural tissue reaction to the tensile forces developed as a consequence of the growth asynchrony. In other words, the tonsils will descend only if this homeostatic mechanism doesn’t function properly for one reason or another; moreover, any degree of tonsillar descent and of brainstem and fourth ventricle distortion should be possible in every one of the three main etiopathogenetic groups mentioned, so it should be time that we stop associating Chiari malformation type II only to myelomeningocele and instead, consider, for example, three degrees of tonsillar descent, perhaps labeled as Chiari malformation types 1, 1.5, and 2 (even four if a Chiari malformation type 0 were added) and defined with clear-cut morphological criteria, including measures of brainstem elongation and fourth ventricle distortion [22].
Magnetic resonance imaging, if scrutinized really carefully, can provide much more information than just detect Chiari malformation type I. Early on, we mentioned the special meaning that a retroflexed odontoid can get as a proof of caudal traction applied on the occipito-cervical junction (Figure 2).
The causative vector of a retroflexed odontoid is likely parallel to the caudal traction (arrow).
In many Chiari malformation type I patients, we can ascertain a descent not only of the cerebellar tonsils but seemingly of the whole cerebellum, as there is a readily identifiable difference of width of subarachnoid spaces above and behind the cerebellum, a feature that others have labeled “obliteration of retrocerebellar cerebrospinal fluid spaces” [17] following a different interpretation; of course, if a diminished posterior fossa volume were the cause of the tonsillar descent, there would be no free subarachnoid space visible underneath the tentorium as we see in many patients (Figure 3).
Increased subarachnoid spaces between the tentorium and the cerebellum reflect the global displacement of the latter towards the
But maybe the most spectacular image testimony of the mechanisms mentioned above is the feature that we called “tense spinal cord,” which has also been described in relation to idiopathic scoliosis [9] but that we could identify in many patients with Chiari malformation type I with or without scoliosis: in sagittal cuts, the spinal cord does not follow closely to the curves of the spinal canal, but instead, it takes the shortest route within the canal and is thus more or less straightened, in some cases even stuck on the concave side of the lordotic or kyphotic curve of the spinal canal (Figure 4a), corresponding in axial cuts to an eccentric position of the spinal cord in the canal, closer to the concave side (Figure 4b).
Tense spinal cord in a sagittal cut (a) and an axial one (b). The spinal cord travels closer to the concavity of the curves and occupies an eccentric downward position in axial images (arrows).
We interpret in a similar way another associated image feature, denominated “lateralized spinal cord,” visible in coronal or axial cuts (Figure 5) and that can be understood as a marker of tension through the spinal cord if one keeps in mind Porter’s experimental model [9], this time conditioned by the presence of at least a minimal degree of scoliosis. All this is even easier to figure out by neurosurgeons, because here the spine recalls the principle of functioning of the Leyla retractor system introduced by Gazi Yasargil and so often used to hold brain spatulas. In other words, a central cable in a hollow curved construct will deviate towards the concavity if subjected to axial tension, and in the vertebral column, this can happen either in the sagittal plane, in the coronal plane, or in both.
Lateralized spinal cord deviated towards the left inside the spinal canal.
As an expected consequence of an incomplete understanding of the etiopathogenesis of Chiari malformation type I, its surgical treatment seems the unhappy heir of a mysterious real estate, haunted by dreadful ghosts such as sleep apnea and sudden death. If in some cases it is indeed elementary caution and justified to do no treatment at all, as the tonsillar descent is merely an asymptomatic deformity discovered incidentally, in many other instances, the patients are left to struggle with their own despair as the obvious symptoms and signs they present are not recognized as such by the neurosurgeons in charge. And the reverse is also true: when an active treatment is chosen, it consists usually of suboccipital craniectomy, C1 laminectomy, and duraplasty, which is equivalent to performing an en bloc resection with healthy borders followed by radiotherapy and chemotherapy for a tumor of unknown behavior (not to mention the tonsillar resection added at times). Well, some minimalizing technical advances have been proposed, like leaving the dura mater or the atlas intact, but their problem rests in not getting to the heart of the matter—so, they might lack the desired efficacy. Recent efforts complicating more this subject have tried to define instances of cranio-cervical or atlantoaxial instability that supposedly would require complicated and risky procedures applied without firstly securing more confidently a diagnosis of genuine instability—one that is perfectly plausible in selected cases of traumatic spine injury.
Many of the delusions and mishaps issued from the actual therapeutic strategy applied to Chiari malformation type I could be avoided if, taking into account patiently all the facts presented above, one should switch his or her vision from the actual obsession to perform a
The most logical initial step for interfering with this pathogenesis, considering caudal traction as a final common pathway of multiple etiologies, would be to interrupt this unique route of producing damage to the brain, spinal cord, and spine itself. Technically, this is straightforward if done at the caudal end of the tense spinal cord instead of a frontal attack upon the delicate, impacted cranio-cervical junction. This should consist of a
Of course, the actual surgical approach of suboccipital craniectomy
Interestingly, against all odds, some subtle developments occurred in recent years in the surgical treatment of Chiari malformation type I, proving that more and more clinicians are starting to accept that maybe suboccipital craniectomy is not the only surgical solution to this condition. For this reason, we can present here three “surgical” testimonies in favor of the theory of caudal traction, as follows:
In fact, it is suboccipital craniectomy itself that opened these new perspectives when in the hands of some fearless teams [23, 24]; it started to be used for treating patients with syringomyelia without tonsillar descent, with encouraging results, but they did not realize their meaning not even when they discovered that in these children, there were image features suggesting a caudal elongation of the brainstem with displacement of the obex and increased diameter of the
Another ingenious team discovered that if they performed idiopathic scoliosis correction by a technique of posterior vertebral column resection with spine shortening and instrumentation after applying compressive forces, the cerebrospinal fluid flow at the level of the
Yet the most important testimony came from the hands of a group which operated 318 patients presenting both tethered cord syndromes defined according to very exigent criteria and Chiari malformation type I or low-lying cerebellar tonsils of 0–4 mm descent (that we consider as being also Chiari malformation type I, together with more and more authors [1]), but the technique used was not suboccipital craniectomy, but sectioning of the
Preoperative (a) and postoperative (b, at 30 months) magnetic resonance images of a 56-year-old male patient with Chiari malformation type 0, operated of filum terminale sectioning; the improvement of his idiopathic syringomyelia, visible also in a previous control (not shown), is now quite obvious, pointing to caudal traction as a possible mechanism.
Preoperative (A–F) and postoperative (G–L, at 3 months) photographs, radiographs, and magnetic resonance images of a 17-year-old male patient with Chiari malformation type I, idiopathic syringomyelia, and severe scoliosis, operated of spinal resection and instrumentation, with marked improvement of his syringomyelia (with permission from Wang et al. [
Preoperative (a) and postoperative (b, at 7 years) magnetic resonance images of a 49-year-old female patient with Chiari malformation type I, operated of
In the actual state of knowledge, it is imperative to recognize that the development of the hindbrain and the spinal cord is a complex process regulated by genetic, molecular, mechanical, endocrine, and nervous homeostatic mechanisms that compensate one for another—within certain limits—in case of imbalances and disturbances. Nevertheless, it is exactly this complexity, coupled with the elevated functional requirements that the cranio-cervical junction has to meet, that makes their union so sensitive to various pathogenetic factors and determines malformations among which the one known as Chiari malformation type I is the most common. According to all the arguments presented in this chapter, the final common pathway of these etiopathogenetic aggressions seems to be caudal traction, a complex biological phenomenon that by no means should be reduced to a simple mechanical force of axial pull. There is still much left to discover about the physiologic mechanisms that govern the coupling between the growth of the vertebral column and that of the spinal cord during somatic development, where maybe future research will define the roles played by the pineal gland, the subcommissural organ, and the
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Various technical variants of this test can detect antigen (native or foreign) or antibody, determine the intensity of the immune response whether pathological or not; the type of induced immune response as well as the innate immunity potential; and much more. These capabilities, as well as the high sensitivity and robustness of the test and a small price, make it possible to quickly and reliably diagnose diseases in most laboratories. Besides, ELISA is a test that is also used in veterinary medicine, toxicology, allergology, food industry, etc. Despite the fact that it has existed for almost 50 years, different ELISA tests with different technical solutions are still being developed, which improves and expands the application of the this exceptional test. The aim of this chapter is to empower the rider to optimize, standardize and validate an enzyme linked immunosorbent assay.",book:{id:"9850",slug:"norovirus",title:"Norovirus",fullTitle:"Norovirus"},signatures:"Rajna Minic and Irena Zivkovic",authors:[{id:"325806",title:"Ph.D.",name:"Irena",middleName:null,surname:"Zivkovic",slug:"irena-zivkovic",fullName:"Irena Zivkovic"},{id:"325839",title:"Dr.",name:"Rajna",middleName:null,surname:"Minic",slug:"rajna-minic",fullName:"Rajna Minic"}]},{id:"56750",title:"Laboratory Approach to Anemia",slug:"laboratory-approach-to-anemia",totalDownloads:6255,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"Anemia is a major cause of morbidity and mortality worldwide and can be defined as a decreased quantity of circulating red blood cells (RBCs). The epidemiological studies suggested that one-third of the world’s population is affected with anemia. Anemia is not a disease, but it is instead the sign of an underlying basic pathological process. However, the sign may function as a compass in the search for the cause. Therefore, the prediagnosis revealed by thorough investigation of this sign should be supported by laboratory parameters according to the underlying pathological process. 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A pregnant woman has an increased risk (up to four times) of getting malaria and twice the chances of dying from malaria, compared to a non‐pregnant adult, becuase the immune system is partially suppressed during pregnancy. Malaria in pregnancy not only affects the mother but also has a dangerous sequel for the developing foetus, resulting in premature delivery or intrauterine growth retardation. Diagnosis of malaria in pregnancy remains a challenge due to the low parasite density and placental sequestration of Plasmodium falciparum. Thus, there is an urgent need for new diagnostic methods to detect malarial parasites in the pregnant women. Though antimalarial drugs are available, which can be safely given in the pregnancy, increasing drug resistance of malarial parasite may pose a big problem in the future. 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He also obtained an MSc in Molecular and Genetic Medicine, and a Ph.D. in Clinical Immunology and Human Genetics from the University of Sheffield, UK. He also completed a short-term fellowship in Pediatric Clinical Immunology and Bone Marrow Transplantation at Newcastle General Hospital, England. Dr. Rezaei is a Full Professor of Immunology and Vice Dean of International Affairs and Research, at the School of Medicine, Tehran University of Medical Sciences, and the co-founder and head of the Research Center for Immunodeficiencies. He is also the founding president of the Universal Scientific Education and Research Network (USERN). Dr. Rezaei has directed more than 100 research projects and has designed and participated in several international collaborative projects. He is an editor, editorial assistant, or editorial board member of more than forty international journals. He has edited more than 50 international books, presented more than 500 lectures/posters in congresses/meetings, and published more than 1,100 scientific papers in international journals.",institutionString:"Tehran University of Medical Sciences",institution:{name:"Tehran University of Medical Sciences",country:{name:"Iran"}}},{id:"180733",title:"Dr.",name:"Jean",middleName:null,surname:"Engohang-Ndong",slug:"jean-engohang-ndong",fullName:"Jean Engohang-Ndong",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180733/images/system/180733.png",biography:"Dr. Jean Engohang-Ndong was born and raised in Gabon. After obtaining his Associate Degree of Science at the University of Science and Technology of Masuku, Gabon, he continued his education in France where he obtained his BS, MS, and Ph.D. in Medical Microbiology. 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. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). 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. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. 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. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). 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Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. 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He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. 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