\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\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:"10908",leadTitle:null,fullTitle:"Advances in Decision Making",title:"Advances in Decision Making",subtitle:null,reviewType:"peer-reviewed",abstract:"This book presents a comprehensive overview of the principles and practices of decision-making. It highlights the interface between engineering/technology and the organizational, administrative, and planning abilities of decision-making. The chapters address decision-making using real-world case studies. They also discuss decision-making theory as well as relevant analysis techniques. The book blends computational techniques, dynamic analysis, probabilistic methods, and mathematical optimization techniques to support the analysis of multi-criteria decision-making problems with defined constraints and requirements.",isbn:"978-1-83969-497-4",printIsbn:"978-1-83969-496-7",pdfIsbn:"978-1-83969-498-1",doi:null,price:119,priceEur:129,priceUsd:155,slug:"advances-in-decision-making",numberOfPages:190,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"126486f7f91e18e2e3539a32c38be7b1",bookSignature:"Fausto Pedro García Márquez",publishedDate:"July 27th 2022",coverURL:"https://cdn.intechopen.com/books/images_new/10908.jpg",numberOfDownloads:1478,numberOfWosCitations:0,numberOfCrossrefCitations:1,numberOfCrossrefCitationsByBook:null,numberOfDimensionsCitations:1,numberOfDimensionsCitationsByBook:null,hasAltmetrics:0,numberOfTotalCitations:2,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 11th 2021",dateEndSecondStepPublish:"March 11th 2021",dateEndThirdStepPublish:"May 10th 2021",dateEndFourthStepPublish:"July 29th 2021",dateEndFifthStepPublish:"September 27th 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"22844",title:"Prof.",name:"Fausto Pedro",middleName:null,surname:"García Márquez",slug:"fausto-pedro-garcia-marquez",fullName:"Fausto Pedro García Márquez",profilePictureURL:"https://mts.intechopen.com/storage/users/22844/images/system/22844.png",biography:"Fausto Pedro García Márquez is a full professor at the University of Castilla–La Mancha (UCLM), Spain, an honorary senior\nresearch fellow at Birmingham University, UK, and a lecturer\nat the Postgraduate European Institute. In 2013/2014, he was\na senior manager at Accenture. He obtained his European\nPh.D. with maximum distinction. He is the recipient of several\nawards from various organizations, including the International\nSociety of Management Science and Engineering Management (ICMSEM). He\nhas published more than 170 journal papers and authored and edited 40 books,\n90 book chapters, and 6 patents. He is an editor for five international journals and\na committee member of more than sixty conferences. He has been the Principal\nInvestigator of more than 150 projects both national and international. His main\ninterests include artificial intelligence, maintenance, management, renewable\nenergy, transport, advanced analytics, and data science",institutionString:"University of Castile-La Mancha",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"12",totalChapterViews:"0",totalEditedBooks:"12",institution:{name:"University of Castile-La Mancha",institutionURL:null,country:{name:"Spain"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"433",title:"Decision Making",slug:"decision-making"}],chapters:[{id:"81401",title:"Introductory Chapter: Introduction to Advances in Decision-Making",doi:"10.5772/intechopen.104550",slug:"introductory-chapter-introduction-to-advances-in-decision-making",totalDownloads:10,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Fausto Pedro García Márquez",downloadPdfUrl:"/chapter/pdf-download/81401",previewPdfUrl:"/chapter/pdf-preview/81401",authors:[{id:"22844",title:"Prof.",name:"Fausto Pedro",surname:"García Márquez",slug:"fausto-pedro-garcia-marquez",fullName:"Fausto Pedro García Márquez"}],corrections:null},{id:"77944",title:"Cognitive Decision-Making in Dynamic Systems: When the Objectivity (of the Processing) Does Not Guarantee the Validity (of the Choice of Action)",doi:"10.5772/intechopen.98937",slug:"cognitive-decision-making-in-dynamic-systems-when-the-objectivity-of-the-processing-does-not-guarant",totalDownloads:108,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Since around 1970, academic studies on decision-making have changed in nature. Whereas they used to be laboratory studies of selected situations giving rise to the expression of individual choices, nowadays studies focus on real situations. These situations are processed in their natural contexts at the time they occur. The decisions to be made concern generally social problems (for instance forest fires, maritime pollution or global warming). This mutation in the nature of situations studied requires a paradigm shift, which leads to elaborate decisions in complex, dynamic and evolving systems, even sometimes resilient to human actions implemented to control them. This chapter analyses, at individual and group level (crisis units), cognitive difficulties encountered by decision-makers in handling such situations. These situations consist in treating information by assigning them, from the outset, meanings (sometimes personal). This is done by looking for temporary interactions, while respecting the global nature of the situation, by focusing on knowing the properties of context as well as those of the temporal evolution of the system concerned. This chapter analyses a case study for which urgent and fundamental decisions could not be taken and proposes an interpretation in terms of paradigms. Previous studies noted that the decision in complex systems, could entail paradoxes. This study on the decision-making dynamic shows that seeking objectivity, as defined under its current intangible form, does not produce a significant increase in the validity of choices made.",signatures:"Bernard Cadet",downloadPdfUrl:"/chapter/pdf-download/77944",previewPdfUrl:"/chapter/pdf-preview/77944",authors:[{id:"232726",title:"Emeritus Prof.",name:"Bernard",surname:"Cadet",slug:"bernard-cadet",fullName:"Bernard Cadet"}],corrections:null},{id:"78344",title:"Single-Period Capacity and Demand Allocation Decision Making under Uncertainty",doi:"10.5772/intechopen.98777",slug:"single-period-capacity-and-demand-allocation-decision-making-under-uncertainty",totalDownloads:129,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The newsvendor model deals with a single-period capacity allocation problem under uncertainty. The real world examples include perishable products (e.g., fish, vegetable), holiday-related products (e.g., Easter, Christmas, Halloween), seasonal products (e.g., fashion), and promotional products. This section addresses three newsvendor models: traditional newsvendor, inverse newsvendor, and sequential newsvendor models. The main decision under the traditional newsvendor setting is capacity allocation (i.e., how much to order), whereas the main decision under the inverse newsvendor setting is demand allocation (i.e., how many customers to be served) under the fixed capacity. This section demonstrates how to compare profit maximization approach to customer-oriented approach under the traditional newsvendor. The inverse newsvendor applies to revenue management for the hospitality industry. The sequential newsvendor model determines the optimal sequence when the number of customers to be served (determined by the inverse newsvendor model) is given. Normal distribution is considered for analytical solution and numerical studies. In addition, a discrete distribution is considered for numerical studies.",signatures:"Sangdo Choi",downloadPdfUrl:"/chapter/pdf-download/78344",previewPdfUrl:"/chapter/pdf-preview/78344",authors:[{id:"352160",title:"Associate Prof.",name:"Sangdo",surname:"Choi",slug:"sangdo-choi",fullName:"Sangdo Choi"}],corrections:null},{id:"77449",title:"Decision Making in the Context of Natural Disasters Based on a Geographic Information System and the Internet of Things (IoT)",doi:"10.5772/intechopen.98778",slug:"decision-making-in-the-context-of-natural-disasters-based-on-a-geographic-information-system-and-the",totalDownloads:193,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Decisions within the company, managers in countries or regions are made by one or more groups of decision-makers. The management of natural disasters involves several specialized decision-makers (experts, firefighters, police officers, drivers,). The aim of the chapter is to improve decision making in the context of natural disasters situation. Zero risk in the world does not exist due to natural phenomena that occur randomly and appear suddenly. It is essential to manage the risks in the situation of natural disasters and also to confront the influence of natural disasters on the phenomenon of Soil-Structure Interaction. For this, this chapter presents a conceptual architecture of a knowledge base to manage the risks of natural disasters remotely by a Geographic Information system (GIS) and embedded systems. This architecture is based on the integration of data via different sources of information (GIS, satellites, electronic sensors and comments from experts). To properly manage this information, this chapter uses the ontology of Soil-Structure Interaction With Agents External (OSSIWAE) in the context of the Internet of Things (IoT). A case study is conducted on a prototype of a model for building a structure three-story for testing the usability of the proposed architecture.",signatures:"Aissa Bensattalah, Rachid Chalal, Tahar Hassaine Daouadji and Tayeb Bensattalah",downloadPdfUrl:"/chapter/pdf-download/77449",previewPdfUrl:"/chapter/pdf-preview/77449",authors:[{id:"176815",title:"Prof.",name:"Tahar",surname:"Hassaine Daouadji",slug:"tahar-hassaine-daouadji",fullName:"Tahar Hassaine Daouadji"},{id:"352539",title:"Dr.",name:"Aissa",surname:"Bensattalah",slug:"aissa-bensattalah",fullName:"Aissa Bensattalah"},{id:"418154",title:"Prof.",name:"Rachid",surname:"Chalal",slug:"rachid-chalal",fullName:"Rachid Chalal"},{id:"418157",title:"Dr.",name:"Tayeb",surname:"Bensattalah",slug:"tayeb-bensattalah",fullName:"Tayeb Bensattalah"}],corrections:null},{id:"79051",title:"Comparison of Cross-Entropy Based MCDM Approach for Selection of Material in Sugar Industry",doi:"10.5772/intechopen.98242",slug:"comparison-of-cross-entropy-based-mcdm-approach-for-selection-of-material-in-sugar-industry",totalDownloads:10,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"One of the major problems faced in engineering is the selection of the material which is most suitable for the product. Material selection from a large number with diverse mechanical, physical and chemical properties and choosing the best material which is the most satisfying for making the job is a very complex process. Material selection is important as it determines durability, reliability and cost of the product. Selection of suitable material which gives maximum performance with minimum cost is often observed to be a multi-criterion decision-making (MCDM) problem with different objectives. This chapter presents an integrated approach to select the suitable material to be used as base of induction cookware which can give maximum performance with minimum cost. In the integrated approach the weights of the criteria are computed using the cross-entropy method and ranking of the alternatives is done using the different MCDM methods. The methods are further illustrated with an example and the result obtained from different cross-entropy MCDM methods are compared for finding the most suitable method for serving the purpose.",signatures:"Syed Abou Iltaf Hussain, Himanshu Chandra and Uttam Kumar Mandal",downloadPdfUrl:"/chapter/pdf-download/79051",previewPdfUrl:"/chapter/pdf-preview/79051",authors:[{id:"323219",title:"Mr.",name:"Syed Abou Iltaf",surname:"Hussain",slug:"syed-abou-iltaf-hussain",fullName:"Syed Abou Iltaf Hussain"},{id:"353726",title:"Dr.",name:"Uttam Kumar",surname:"Mandal",slug:"uttam-kumar-mandal",fullName:"Uttam Kumar Mandal"},{id:"353728",title:"Mr.",name:"Himanshu",surname:"Chandra",slug:"himanshu-chandra",fullName:"Himanshu Chandra"}],corrections:null},{id:"79039",title:"Plithogenic SWARA-TOPSIS Decision Making on Food Processing Methods with Different Normalization Techniques",doi:"10.5772/intechopen.100548",slug:"plithogenic-swara-topsis-decision-making-on-food-processing-methods-with-different-normalization-tec",totalDownloads:108,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Decision making (DM) is a process of choosing the optimal alternative with the maximum extent of criteria satisfaction. The challenging aspect in making optimal decisions is the suitable choice of multi-criteria decision-making (MCDM) methods that consider the initial input as the expert’s opinion on criteria satisfaction by the alternatives. This initial decision-making matrix representation discriminates MCDM as fuzzy, intuitionistic, neutrosophic to handle the decision-making environment that is characterized by uncertainty, impreciseness, and indeterminacy, respectively. A generalized kind of representation by plithogenic sets optimizes the decision-making risks. This chapter aims in developing SWARA-TOPSIS with plithogenic representations and discusses the efficiency of this integrated approach over the method of TOPSIS with equal criterion weight. A comparative analysis of four different normalization techniques is likewise made. The proposed plithogenic integrated MCDM model is validated with the decision making on four food processing methods. The final ranks of the alternatives are also compared under the proposed plithogenic SWARA-TOPSIS and TOPSIS models with different normalization techniques. The results witness the efficiency of the proposed model over the existing models.",signatures:"Nivetha Martin",downloadPdfUrl:"/chapter/pdf-download/79039",previewPdfUrl:"/chapter/pdf-preview/79039",authors:[{id:"352979",title:"Dr.",name:"Nivetha",surname:"Martin",slug:"nivetha-martin",fullName:"Nivetha Martin"}],corrections:null},{id:"78057",title:"Innovation Methodologies to Activate Inclusive Growth in the Organization",doi:"10.5772/intechopen.99150",slug:"innovation-methodologies-to-activate-inclusive-growth-in-the-organization",totalDownloads:144,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Digitalization is transforming the way we move and produce, encouraging the industry to use the best available technologies focusing on people. Non technological innovations, especially, Workplace Innovation (WI) will play a key role in the digital revolution and acceleration of the technological advances, improving the competitiveness of the companies. This draws attention to the importance of the innovation culture and employee engagement focused on improving employee motivation and working conditions, thereby improving labor productivity, organizational efficiency, innovation capacity, market reactivity, and, as a result, business competitiveness. WI is a combination of structural and cultural practices that boosts employees’ participation, improving the quality of work and organizational performance. These strategies aim to promote innovative work behavior to create, introduce and apply new ideas, processes and products. To address these issues this chapter analyses WI in rail sector and defines WI Scheme for rail sector. A theoretical background is presented based on a sample of 203 railway entities across European Union (EU). Then, data analysis and results are examined and the guide to implement WI scheme is defined. Finally, the results of the research, including limitations and concluding remarks are discussed.",signatures:"Garazi Carranza Ruiz de Loizaga and Begoña Sanchez Gonzalez",downloadPdfUrl:"/chapter/pdf-download/78057",previewPdfUrl:"/chapter/pdf-preview/78057",authors:[{id:"414695",title:"Dr.",name:"Garazi",surname:"Carranza Ruiz de Loizaga",slug:"garazi-carranza-ruiz-de-loizaga",fullName:"Garazi Carranza Ruiz de Loizaga"},{id:"418249",title:"Mrs.",name:"Begoña",surname:"Sanchez Gonzalez",slug:"begona-sanchez-gonzalez",fullName:"Begoña Sanchez Gonzalez"}],corrections:null},{id:"76443",title:"Improved Probabilistic Frequent Itemset Analysis Strategy of Learning Behaviors Based on Eclat Framework",doi:"10.5772/intechopen.97219",slug:"improved-probabilistic-frequent-itemset-analysis-strategy-of-learning-behaviors-based-on-eclat-frame",totalDownloads:285,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Interactive learning environment is the key support for education decision making, the corresponding analytics and methodology are the important part of educational technology research and development. As an important part and the research challenge, learning behaviors are uncertain and produce complex data relationships, which makes the learning analysis process more difficult. This chapter studies the feasibility of Eclat framework applying in educational decision making and get the corresponding the data analysis results. We take probabilistic frequent itemsets and association rules as research objectives, extract and standardize multiple data subsets; Based on Eclat framework, using data vertical format, we design and improve the models and algorithms in the process of data management and processing. The results show that the improved models and algorithms are effective and feasible. On the premise of ensuring robustness and stability, the mining quality of probabilistic frequent itemsets and association rules is guaranteed, which is conducive to the construction of key execution topology of learning behaviors, and improves the accuracy and reliability of data association analysis and decision prediction. The whole analysis methods and demonstration processes can provide references for the study of interactive learning environment, as well as decision suggestions and predictive feedback.",signatures:"Xiaona Xia",downloadPdfUrl:"/chapter/pdf-download/76443",previewPdfUrl:"/chapter/pdf-preview/76443",authors:[{id:"350744",title:"Prof.",name:"Xiaona",surname:"Xia",slug:"xiaona-xia",fullName:"Xiaona Xia"}],corrections:null},{id:"79147",title:"The Application of Simple Additive Bayesian Allocation Network Process in System Obsolescence",doi:"10.5772/intechopen.98530",slug:"the-application-of-simple-additive-bayesian-allocation-network-process-in-system-obsolescence",totalDownloads:154,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In designing a system, multi-dimensional obsolescence design criteria such as Scheduling; Reliability, Availability, Maintainability; Performance and Functionality; and Costs affect its overall lifespan. This work examines the impacts of these factors on systems during the design phase using a new application called the Simple Additive Bayesian Allocation Network Process (SABANP). The application uses a combination of Multi-Criteria Decision Making (MCDM) methodology and a Bayesian Belief Network to address the impact of obsolescence on a system. Unlike the requirement of weights that are prevalent in the analysis of MCDM, this application does not require weights. Moreover, this application accounts for functional dependencies of criteria, which is not possible with the MCDM methodologies. A case study was conducted using military and civilian experts. Data were collected on systems’ obsolescence criteria and analyzed using the application to make trade-off decisions. The results show that the application can address complex obsolescence decisions that are both quantitative and qualitative. Expert validation showed that SABANP successfully identified the best system for mitigating obsolescence.",signatures:"Oluwatomi Adetunji",downloadPdfUrl:"/chapter/pdf-download/79147",previewPdfUrl:"/chapter/pdf-preview/79147",authors:[{id:"349375",title:"Dr.",name:"Oluwatomi",surname:"Adetunji",slug:"oluwatomi-adetunji",fullName:"Oluwatomi Adetunji"}],corrections:null},{id:"79217",title:"Political Leadership and Financial Emoluments: A Case of Developing Countries",doi:"10.5772/intechopen.97524",slug:"political-leadership-and-financial-emoluments-a-case-of-developing-countries",totalDownloads:102,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The theoretical concept of political leadership would have to be the most elusive and fluid concept of leadership. It has within its authority dominated policies, influenced security- intelligence, shaped intellectual-cultures, inspired citizens-aspirations and has directed the trajectory of nation-states and sovereignties within international governance and global affairs. The political behaviors of developing nations through foreign policies, national interests and diplomacy have been a reflection of the authority of their political leadership; regime after regime. There are no best-kept secret to the fundamental strengths and weaknesses of political Leadership other than the influential impact of the political leader’s self-empowerment, self-leadership and self-legacy. Political Leadership is fundamentally controlled by the polices of choices where decisions meet actions and authoritarian powers redefines humanity. The elusive extent, and fluid depth of political influence through the impact of governance does not measure -up to the assurance of humanity in most developing countries around the world. The political consciousness and idiosyncrasies of most individuals over the years have contributed none or fewer interests to the study, the justification, and the analytical reasoning of the influence of political leadership. This new study and the assertive findings on this chapter are aimed to pragmatically educate, inspire, and reignite the zealousness of visionary leadership, through the consciousness of humanity. The intellectual assertions in this chapter are envisioned to create, expand and illuminate the distinctive reality between of our profound empirical knowledge, theoretical beliefs and interpretive researches on the conceptual understanding of political leadership. The topics in this chapter are aimed to create an endless stream to the consciousness of political leadership and financial gains to the betterment of humanity. It expands the understanding of political leadership through psychological lens beyond the titles, offices and political display of power. Political leadership in developing countries can improve and offer better outcomes in todays world, when humanity meets the consciousness of political leadership in financial prosperity. The societal divisions of ethnicity, wealth and the polarization of political ideologies into sets of beliefs, questions the influential impact of political leadership. As political leaders govern and navigate through their leadership goals, aspirations and visions more often than not, the traits of their ethnic identity, individuality and beliefs constantly create struggles with their understanding and acceptance of humanity as a whole.",signatures:"Daniels Aide Okun and Osama Ose Iyawe",downloadPdfUrl:"/chapter/pdf-download/79217",previewPdfUrl:"/chapter/pdf-preview/79217",authors:[{id:"333785",title:"Ph.D.",name:"Daniels Aide",surname:"Okun",slug:"daniels-aide-okun",fullName:"Daniels Aide Okun"},{id:"333787",title:"Prof.",name:"Osama Ose",surname:"Iyawe",slug:"osama-ose-iyawe",fullName:"Osama Ose Iyawe"}],corrections:null},{id:"77502",title:"New Technologies and Decision-Making for the Military",doi:"10.5772/intechopen.98849",slug:"new-technologies-and-decision-making-for-the-military",totalDownloads:238,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter aims at reviewing the concept of decision-making on the battlefield for military leaders. Thus, it intends to address the changes implied by the use of new technologies (such as Robots, AI) that will gradually invade the battlefield. The leader of tomorrow will have to quickly manage remote information and keep control of high performance automated systems integrating a certain form of autonomy, including lethal autonomous weapon systems. He must ensure that a global meaning is given to the military action taking place on the battlefield. He has to be able to command to achieve his goals.",signatures:"Gérard de Boisboissel",downloadPdfUrl:"/chapter/pdf-download/77502",previewPdfUrl:"/chapter/pdf-preview/77502",authors:[{id:"351406",title:"Dr.Ing.",name:"Gérard",surname:"de Boisboissel",slug:"gerard-de-boisboissel",fullName:"Gérard de Boisboissel"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"9332",title:"Application of Decision Science in Business and Management",subtitle:null,isOpenForSubmission:!1,hash:"72ccbc5aab28621bad2e810c4bd5bd53",slug:"application-of-decision-science-in-business-and-management",bookSignature:"Fausto Pedro García Márquez",coverURL:"https://cdn.intechopen.com/books/images_new/9332.jpg",editedByType:"Edited by",editors:[{id:"22844",title:"Prof.",name:"Fausto Pedro",surname:"García Márquez",slug:"fausto-pedro-garcia-marquez",fullName:"Fausto Pedro García 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Since the introduction of CAPD, four methods have been advocated for the placement of PD catheters: open surgery, percutaneous, peritoneoscopic (Y-Tec; Medigroup, Oswego, Illinois, USA), and laparoscopic placement (2,3,13,17).
The manner in which PD catheters are placed has a significant influence on catheter function, incidence of catheter-related complications, and technique survival (6). Open surgery and especially the percutaneous technique are associated with poor outcomes and sometimes life-threatening complications (20,21). In fact, the incidence of omental wrapping, catheter displacement, and intraabdominal complications, specifically bowel and bladder perforation, is higher with these two methods. In recent years, there has been considerable interest in the use of laparoscopy for creation of peritoneal access. Laparoscopic peritoneal catheter placement is simple, quick, efficient, and minimally invasive. As with any new application of a modality, laparoscopy for peritoneal access is still undergoing procedure-specific adaptation. The strength of laparoscopy is that it allows an opportunity to visibly address problems that adversely effect catheter outcome, namely, catheter tip migration, omental entrapment, and peritoneal adhesions. Identifying and preemptively correcting these problems at the time of the implantation procedure are the advantages of surgical laparoscopy over other catheter insertion techniques (7,8).
Regardless of the technique utilized to implant the PD catheter, there are best-demonstrated practices that should be followed in every case (4,5). Adherence to these recognized practices could reduce the risk of catheter tip migration, pericatheter leakage, hernias, superficial cuff extrusion, and catheter-related infections.
Our catheter implantation technique will be described in detail (14,15,16).
The same team operated on all patients. The laparoscopic procedures were performed in the operating room under general anesthesia. A prophylactic antibiotic, cefazolin — or vancomycin in the event of cephalosporin allergy — was administered prior to the procedure. A Veress needle was inserted into the peritoneal cavity through a stab incision in the right hypochondrium to create a pneumoperitoneum. Pressure limits for abdominal gas insufflation were set between 10 and 12 mmHg. The Veress needle was replaced with a 10-mm port and preliminary laparoscopy was performed to look for adhesions or other anatomical abnormalities that could hinder performance of the Tenckhoff catheter. A 5-mm port was inserted under direct vision in the right iliac fossa. A 1-cm skin incision was made on the left, 2 – 3 cm lateral and inferior to the umbilicus, and a second 5-mm port was placed in a paramedian location and tunneled in a caudal direction through the rectus sheath for a distance of at least 4 cm before entry was made into the peritoneal cavity. We aligned both 5-mm ports and inserted the Endograsp (United States Surgical, Norwalk, Connecticut, USA) through the lower right quadrant port and brought it out through the paramedian port. The paramedian port was then removed but the tip of the Endograsp remained outside the abdominal cavity (Figures 1 and 2). The intraperitoneal portion of the Tenckhoff catheter tip was caught with the grasper and slowly pulled inside the peritoneal cavity through the tunnel created in the abdominal wall (Figure 3). The deep cuff was located at the medial edge of the muscle within the rectus sheath. The intra-abdominal portion of the catheter was placed between the visceral and parietal peritoneum toward the pouch of Douglas. The subcutaneous tunnel tract and skin exit site were directed downwards or laterally. The subcutaneous cuff was positioned at a distance of at least 2 cm from the exit wound. Between each of the preceding steps, catheter patency was checked to ensure that there was adequate inflow and outflow without leakage. The entire procedure was done under direct vision. The laparoscope was then removed and the pneumoperitoneum was allowed to deflate. The fascia of the laparoscopic port site was closed with 2-0 polyglactin suture. Skin wounds were sutured with 3-0 nylon. The protocol for catheter irrigation consisted of a daily in-and-out flush with dialysate solution. Peritoneal dialysis was generally delayed for a minimum of 2 weeks to allow complete wound healing.
Since January 2002, the author performed more then 400 laparoscopic placement of Tenckhoff peritoneal catheter in patients with end-stage renal diseases.
The average operative time was 15 ± 4 minutes and mean duration of hospital stay was 1 day. There were no conversions from laparoscopy to any other conventional method of catheter placement. In patients with intraperitoneal adhesions, laparoscopic adhesiolysis was performed to eliminate intraperitoneal loculations that might interfere with the peritoneal catheter drainage function.
No infections of the exit site or subcutaneous tunnel, hemorrhagic complications, abdominal wall hernias, or extrusion of the superficial catheter cuff were detected.
No mortality occurred in this series of patients. Catheter survival was 97%, 95%, and 91% at 1, 2, and 3 years, respectively (Figure 4).
Peritoneal catheter placement must be regarded as an important surgical intervention, demanding care and attention to detail equal to that of any other surgical procedure and as a consequence a competent and experienced operator must perform the catheter implantation procedure.
Due to its characteristics (simple, quick, efficient, and minimally invasive to the patient), it seems that laparoscopic peritoneal catheter placement should become the preferred approach. In addition, the laparoscopic method offers an excellent view of the abdomen and optimal placement of the catheter within the cavity. The single blind step is the Veress needle insertion; however, the probability of damaging the abdominal organs or epigastric and retroperitoneal blood vessels is very low.
Operative photograph demonstrates the alignment of the two 5-mm ports and insertion of the grasping forceps.
Operative photograph shows that the tunneled5-mm port has been removed and the dialysis catheter has been grasped in preparation of pulling it into the peritoneal cavity.
This method is particularly useful in patients that have already undergone previous abdominal operations (8). Patients with peritoneal adhesions that might interfere with drainage function can be treated with adhesiolysis and displaced catheters can be repositioned.
In addition, laparoscopy is useful for the diagnosis and treatment of abdominal wall hernias and peritoneo– vaginal canal persistence.
Another advantage of laparoscopy is the possibility of performing a selective prophylactic omentopexy, a technique that has been separately described by Ogunc and Crabtree (10,11). In conjunction with rectus sheath tunneling and adhesiolysis, it is possible that selective use of omentopexy could have prevented the omental obstruction and the need for revisionary surgery that occurred in 6 of our patients.
Some centers use laparoscopic insertion with local anesthesia on the assumption that it is safer (12). We suggest that modern general anesthesia is safe for the vast majority of patients and allows a better view of the peritoneal cavity. Different techniques have been described for the placement of peritoneal catheters by laparoscopy using specially designed devices. The distinctive characteristic of our technique is that we used nothing more than conventional laparoscopic equipment available in any facility that routinely performs laparoscopic surgery. Laparoscopy is a commonly performed procedure in general practice but it also has an inherently steep learning curve. A junior surgeon, under close supervision of a consultant, performed some of the later procedures without technical difficulties.
Operative photograph shows the catheter tip pulled inside the peritoneum through the tunnel created in the abdominal wall.
Cumulative probability of peritoneal dialysis catheter survival following laparoscopic placement. The ticks on the survival curve represent censored data points.
Abdominal wall leaks, our major complication occurred at the beginning of our experience. At that time, the length of the musculofascial tunnel was shorter and in our opinion resulted in a higher incidence of leaks. Successful management of these leaks consisted of delaying the beginning of dialysis.
We did not experience intraoperative complications such as intra-abdominal organ injury, as has been reported for conventional techniques. In fact, in our series we had no intra-abdominal catastrophes and the incidence of catheter displacement was lower than that reported using open surgery technique. Furthermore, we did not encounter problems commonly reported for open catheter placement, such as hematoma, seroma, or infections. No perioperative mortality occurred in this case series. Our long-term catheter survival exceeds the targets recommended by published guidelines and is higher than most reported experiences.
Despite widespread acceptance of peritoneal dialysis, patients with previous history of abdominal operations are frequently excluded from consideration.
Abdominal surgery can lead to the formation of adhesions. Adhesive scarring within the peritoneal space can complicate catheter placement. Compartmentalization of the peritoneal cavity by adhesions can impede insertion of the catheter, produce kinking or malpositioning of the tubing, block the side drainage holes resulting in flow dysfunction, and limit the available dialyzable space. It is not unreasonable to surmise that intraperitoneal adhesions would not only increase the difficulty and risk of catheter insertion but also adversely affect catheter survival.
Peritoneal adhesions have been reported to form after 70-90% of abdominal operations. Catheter implantation using conventional approaches in patients with intra-abdominal adhesions has been associated with an increased incidence of postoperative complications. In the presence of adhesions, catheter insertion can be complicated by visceral injury, hemorrhage and catheter malposition with flow dysfunction. Visualization of peritoneal cavity during implantation of PD catheters using laparoscopic methods can determine the presence and extent of intra-abdominal adhesions and help direct the placement of catheters. Patients with peritoneal adhesions that might interfere with drainage function can be treated with adhesiolysis and displaced catheters can be repositioned. Therefore this method is particularly useful in patients that have already undergone previous abdominal operations.
Omental wrap is a common cause of catheter obstruction. The mechanism of omental wrap is uncertain. A redundant omentum can adhere to the distal end of the catheter and displace it out of the pelvis. A catheter that has migrated out of the pelvis is at risk of being wrapped by the omentum. Catheter displacement as seen on plain abdominal radiograph could in fact be omental wrap.
Laparoscopic intervention is an effective treatment for omental wrap. The tiny projections of the omentum insinuate through the side holes of the catheter and obstruct its lumen. On close-up view, the omental fat forms a dumb-bell shaped plug in the side hole. The plug is snug and firm. While the catheter is being steadied by laparoscopic graspers, the omental plugs have to be pulled in the right direction to be released. A less precise manoeuvre, such as pulling the catheter away from the omentum, is unlikely to free the catheter entirely, and bleeding might occur as the omental plugs together with the small vessels supplying them are avulsed. This can happen in fluoroscopic stiff-wire manipulation, since the movement involved is similar. Reports of stiff wire manipulation under fluoroscopic guidance showed a high incidence of recurrent malfunction and the need for repeat manipulation.
Omental wrap remains one of the likely reasons for failure of non-laparoscopic treatments. In one study, 50% of the patients who had undergone unsuccessful fluoroscopic wire manipulation were found to have omental wrap at laparoscopic salvage. One definitive laparoscopic procedure is likely to be more effective than multiple wire manipulations. For recurrent catheter migration or malfunction, laparoscopy should be the next step. Open removal and replacement of catheter risks recurrent malfunction since the cause of malfunction has not been resolved.
Laparoscopy provides visual diagnosis of the cause of catheter malfunction and when used as first-line management, has shown high success rates.
A procedure on the greater omentum appears important in preventing catheter malfunction. A low rate of obstruction has been demonstrated by series of primary open insertion of catheter where prophylactic omentopexy or subtotal omentectomy had been performed. Crabtree and Fishman reported an obstruction rate of only 0.7% in 153 patients when selective prophylactic omentopexy during laparoscopic implantation of catheter was performed. Reports of laparoscopic salvage have found an incidence of omental wrap ranging from 57 to 92%. The incidence of obstruction causing poor flow of dialysate is 6.0 to 20.5%. Occlusion by the greater omentum is therefore an important etiology of catheter malfunction. Current laparoscopic techniques for salvaging catheters include simple repositioning with or without catheter fixation, omentopexy, omentectomy and omental folding.
Omentopexy is a laparoscopically enabled procedure shown to be of value in preventing omental entrapment. Ogunc recommended it for all implantation procedures whereas Crabtree
In contrast to omentopexy, which fixes the omentum to the anterior or lateral abdominal wall, or to the falciform ligament, omental folding fixes the omentum to itself. Omental folding creates a safe distance between the catheter and the omentum by shortening the latter. Technically, omental folding is a form of omentopexy. The other effect of folding is that the distal omentum with its slender projections is converted into a rounded edge.
Omental folding can thus be performed with the most basic laparoscopic equipment found in most surgical units. With practice, the folding of the omentum can be performed within 10 minutes and the whole salvage procedure can take less than 40 minutes and is a safe and effective technique for salvaging PD catheters (19).
A laparoscopic approach for placing Tenckhoff catheters can be accomplished with complete compliance to recommended best practices for PD access. Moreover, laparoscopy permits advantages over conventional implantation techniques through the use of adjunctive procedures such as rectus sheath tunneling to prevent catheter tip migration, adhesiolysis to assure adequate dialysate drainage function of the catheter, and omentopexy, omentectomy or omental folding to prevent omental wrapping. The catheter implantation method described in this chapter uses standard laparoscopic equipment and techniques completely familiar to any surgeon who routinely performs laparoscopic surgery. The procedure can be performed with low risks of morbidity and mortality. The patient benefits from a minimally invasive approach and the assurance of obtaining successful long-term catheter function. The results reported here support our opinion that laparoscopic Tenckhoff catheter implantation should become the standard of care for clinical practice.
The human papillomavirus (HPV) is a double-stranded DNA virus whose only host is humans. It is the most common sexually transmitted pathogen in the world today. Epidemiological studies indicate the global prevalence of HPV is close to 12% [1]. The main reason for this high prevalence is that HPV infection is usually asymptomatic. The clinical course of HPV infection is divided into three periods—the latent, subclinical, and clinical phases [2]. Up to 90% of HPV infections are controlled by host adaptive immunity, thereby remaining in the latent phase and eventually becoming undetectable. However, 10% of cases progress to intraepithelial neoplasia or condylomatous lesions, and 1% transform into invasive cancer [3]. While over 200 HPV types have been identified to date, only 40 of them cause anogenital infections and HPV-associated malignancies [4]. Unlike many other viruses, HPVs are classified according to genetic sequence rather than antigenic structures. Therefore, instead of serotypes, they are numbered by genotype and in the order of discovery [5]. Despite its largely benign nature, HPV is a high-profile public health issue and poses a substantial socioeconomic burden due to its oncogenic properties. HPV and Epstein–Barr virus (EBV) are responsible for the most frequent virus-related cancers [6], with HPV linked to nearly 10% of cancers globally [7]. Based on their oncogenic potential, HPVs are divided into high-risk (HR-HPV) and low-risk (LR-HPV) types. HR-HPVs disrupt the cell cycle via their E6 and E7 oncoproteins, preventing progression from G1 to S phase [8]. The E6 oncoprotein inhibits the function of tumor suppressor protein p53. This increases the risk of cell transformation due to a lack of genetic stability and inhibition of apoptosis. The E7 oncoprotein inactivates another tumor suppressor protein, retinoblastoma (Rb). This results in the uncontrolled synthesis of the proteins necessary for cell cycle progression, and the cell enters a state of continuous proliferation [9]. Unlike HR-HPVs, the E6 and E7 oncoproteins of LR-HPVs do not inactivate p53 and Rb to the same degree [10].
Because HPV shows epithelial tropism, squamous cell carcinoma is the most common histologic type of HPV-related cancer. HPV association has been reported in 96% of cervical carcinomas, 75% of vulvar carcinomas, 41% of oropharyngeal carcinomas, and 36% of anal carcinomas [11, 12, 13]. The results of meta-analyses suggest that the presence of HPV is a favorable prognostic factor in anogenital and head and neck cancers [13, 14, 15]. Although it is not clear how the presence of HPV improves prognosis in these carcinomas, it was reported that HPV-negative primary cancers showed high metastatic potential and had more aggressive p53 mutations, resulting in more severe deregulation of normal growth control and poorer prognosis compared to HPV-positive cancers [16].
Considering the close anatomical proximity to anogenital carcinomas, researchers have investigated the relationship between HPV and urological malignancies for approximately three decades. Among these cancers, only penile cancer has been clearly associated with HPV. The relationship between HPV and other urological malignancies such as prostate, kidney, bladder, and testicular cancers remains controversial today. This lingering uncertainty is the result of limitations arising from methodological differences in past publications. These limitations can be summarized as small case series, lack of fresh tissue sampling, the use of serological tests for HPV detection, and the inadequacy of case–control studies [17, 18, 19]. In recent years, however, remarkable advances in polymerase chain reaction (PCR) assay technology have enabled the identification of more genotypes in a single sample, and DNA extraction from formalin-fixed, paraffin-embedded (FFPE) tissues, has become more efficient. Therefore, it is clear that results obtained two to three decades ago must be reevaluated.
Penile cancer is rare, accounting for approximately 0.5% of all cancers in men, with a peak prevalence in the sixth decade of life [20]. The incidence of penile cancer varies by geographical region depending on the hygienic, cultural, and religious characteristics of the population. Its incidence is between 0.3 and 1 per 100,000 in developed countries, while it reaches 4 per 100,000 in developing countries [1]. At present, the main known risk factors are phimosis, chronic inflammation of the penis, poor personal hygiene, smoking, polygamy, and HPV infection. Histopathologically, 95% of penile cancers are different variations of squamous cell carcinoma [21]. The fact that HPV-associated cancers are of squamous histology led to the early discovery of the relationship between HPV and penile carcinomas. Although there are methodological differences in HPV detection among published studies, the prevalence of HPV in penile cancers is reported to be between 39.7% and 59.3% [22]. According to a recent meta-analysis evaluating 2531 patients in 270 studies, the prevalence of HPV-DNA in patients with penile cancer was 48% (confidence interval [CI]: 40.0%–57.0%) [7]. HPV type 16 is the dominant type identified in HPV-associated penile cancers, with more than half of cases attributed to this type alone [23]. The second most common strain detected in penile carcinomas is HPV type 18, and together these two types are responsible for more than 70% of HPV-associated penile carcinomas [24].
Penile intraepithelial neoplasia (PIN) is a penis cancer precursor lesion similar to cervical intraepithelial neoplasia (CIN). The extent to which the natural course of PIN mirrors that of CIN is unclear, and its clinical management is less standardized compared to CIN [25]. However, the link between PIN and HPV is noteworthy. Studies have indicated 70–100% association between HPV and PIN, much stronger than its relationship with penile carcinoma [26]. An important biomarker currently being studied in HPV-associated carcinomas is p16INK4a, a protein whose expression is stimulated by the E7 oncoprotein [27]. Numerous recent studies suggest that p16INK4a expression can be used as an alternative marker of infection in cervical and other HPV-associated carcinomas due to its association with HR-HPV carcinogenesis [27]. Martins et al. reported that the expression of p16INK4a was significantly associated with the presence of HR-HPV in penile cancers, and could serve as a marker of HPV in penile cancer [28]. A recent meta-analysis by Olesen et al. investigating p16INK4a positivity in penile cancers and PIN yielded the interesting finding that the rate of p16INK4a positivity was 79.6% in HPV-positive patients with penile cancer but only 49.5% among those with PIN [29]. In this meta-analysis, of the histological subtypes of HPV-related penile squamous cell carcinomas, the highest prevalence of HPV was reported to be 84% in basaloid squamous cell carcinoma, followed by 75.7% in warty-basaloid squamous cell carcinoma.
There is little information in the literature regarding the relationship between HPV and tumor grade in penile squamous cell carcinoma. However, tumor grade and lymph node metastasis are the most important prognostic factors for disease-free survival [30]. Hölters et al. observed an association between HPV and histological grade in their study, reporting that the prevalence of HR-HPV types was higher in poorly differentiated grade 3 tumors [31]. Similarly, a recent study also demonstrated a positive correlation between HR-HPV and high-grade penile squamous cell carcinoma, especially in HPV-related basaloid and warty-basaloid carcinomas [32]. In light of these findings, it can be speculated that unlike cervical, anal, and oropharyngeal carcinomas, the presence of HPV may be a negative prognostic factor in penile carcinomas.
Circumcision is known to be an important protective factor against penile cancer, though it is not clear whether circumcision protects against HPV infection. Van Howe et al. determined that the prevalence of HPV did not differ between circumcised and uncircumcised men but reported a longer HPV clearance time in men who were uncircumcised [33]. In a study by Lu et al., viral clearance was higher for HR-HPV types in circumcised men than uncircumcised men, while there was no significant difference between the two groups in the clearance of LR-HPV types [34]. Gray et al. showed that circumcision reduced transmission of both HR-HPV and LR-HPV types [35]. In the latest report from Davis et al., male circumcision was found to reduce HR-HPV viral load in female partners, leading the authors to recommend circumcision for the reduction of HPV infection in both men and women [36].
Bladder cancer is the fourth most common malignancy in men and the eighth most common in women, causing an estimated 400,000 new cases and 186,000 deaths per year worldwide [37]. Important known risk factors include age, ethnicity, smoking tobacco, chemical exposure (aromatic amines and hydrocarbons), and in some regions, schistosomiasis. Histologically, more than 90% of bladder cancers are urothelial cell carcinoma. The incidence of bladder cancer has shown a marked increase over the last three decades, and despite extensive efforts, it is still difficult to predict tumor progression, optimal treatment, and final clinical outcomes [38]. Over the same period, the relationship between HPV and bladder cancer has also been investigated and two hypotheses have been proposed to explain their association. The first hypothesis is that the urethra is the first point of contact during sexual transmission of the virus and serves both as a viral reservoir and direct connection between the urinary bladder and genital area, possibly providing a natural route of viral migration. The second hypothesis is based on the natural epithelial tropism of HPV [39]. In a pooled meta-analysis of 2855 cases in 52 studies, the prevalence of HPV in bladder cancer samples ranged between 0% and 100% [40]. However, this extremely wide range of HPV prevalence is open to interpretation. In the past, extracting DNA from FFPE tissue was a challenge, and most publications stating that there is no relationship between HPV and bladder cancer were conducted in FFPE tissues using older technologies in HPV research [41, 42, 43]. Li et al. emphasized this in their meta-analysis, noting that the prevalence of HPV was higher in studies using fresh tissue than in studies using FFPE and suggesting that FFPE tissues may yield false-negative results. In the same meta-analysis, it was also determined that the HPV prevalence in patients with bladder cancer was 16.88% and HPV types 16 and 18 were the major types detected [40]. Another meta-analysis by Jimenez-Pacheco et al. including 20 controlled studies of HPV-DNA revealed a significant association between HPV presence and bladder cancer, with a pooled odds ratio (OR) of 2.19 (95% CI: 1.40–3.43) [44]. Most recently, Sarier et al. conducted a case–control study using fresh tissue and demonstrated a strong correlation between urothelial carcinoma of the bladder and HPV infection (OR: 4.24, 95% CI: 1.63–12.34) [45].
Although squamous cell carcinoma of the bladder accounts for 2% of all bladder cancers, scientific interest in its relationship with HPV has persisted due to its histological structure [46]. However, because it is rare cancer, published series are small and studies have yielded conflicting results [47, 48, 49]. In a recent study by Collins et al. investigating the presence of p16 and HR-HPV in 33 patients with squamous cell carcinoma of the bladder using in situ hybridization (ISH), P16 expression was detected in 28% of the patients, while HR-HPV was not detected in any patient [50].
Tumor grade is an important factor in terms of bladder cancer progression. However, the literature also includes conflicting reports regarding the relationship between tumor grade and HPV. An association between HPV and low-grade tumors was reported by Tenti et al. [51], while an association with high-grade tumors was observed by Cai et al. [52]. In contrast, Sarier et al. observed no significant correlation between tumor grade and HPV in their study [45].
Tumor recurrence is an important and common event in bladder cancer. Exposure to infectious agents is recognized as one of the risk factors for urological malignancies, especially those with a high tumor recurrence rate [53]. Although the literature data on the relationship between HPV and bladder tumor recurrence are limited, the results are impressive and largely consistent among studies. Badawi et al. reported a significant association between HPV type 16 and tumor recurrence rate [54]. Moghadam et al. found that HPV was significantly associated not only with tumor recurrence but also with tumor stage [55]. In their 2-year follow-up study, Sarier et al. observed higher tumor recurrence rates in patients with bladder tumors associated with HPV-DNA [56].
Prostate cancer is the second most common cancer and a fourth most common cause of cancer deaths in men and therefore poses a serious burden worldwide [57]. The most important risk factors are age over 50 years, ethnicity, family history of prostate cancer, diet, and infection, although the available data are limited. There is evidence to suggest that chronic inflammation of the prostate is quite common in adults and may directly contribute to the development and progression of prostate malignancy [58]. This inflammation forms the basis of the main hypothesis for the relationship between HPV and prostate cancer. Epithelial damage caused by chronic inflammation may result in loss of tolerance to normal prostate-associated antigens, thereby triggering a sustained autoimmune reaction [59]. The immune evasion strategies of viruses contribute to persistent viral infection and induce chronic inflammation through cytokines. This presents a mechanism by which HPV may trigger chronic inflammation of the prostate glandular epithelium [59].
In fact, numerous studies have investigated the relationship between infection and prostate cancer. Taylor et al. demonstrated a significant association between prostate cancer risk and infection with any sexually transmitted disease-related agents in their meta-analysis of 29 studies including 6022 prostate cancer patients and 7320 control cases [60].
As with bladder cancer, a wide range has been reported for the prevalence of HPV in prostate cancer (0–100%). Again, methodological approaches are the major limitation. The use of serology-based tests for HPV detection is controversial. These tests identify general exposure to HPV infection but are not able to identify HPV infection in specific organs, such as the prostate. Although ISH is an effective method for detecting HPV, PCR is considered the gold standard [61]. By using multiple degenerate primary pairs in the amplification reaction, the PCR assay can easily be adapted to detect most HPV types associated with anogenital tract disease. A recent meta-analysis by Lawson et al. is valuable in this regard. In the part of their study evaluating 14 serology-based studies including 5149 prostate cancer patients and 7794 benign prostate controls, HPV antibodies were detected in 20% of both groups. Based on this finding, they stated that when evaluated serologically, there is no difference in the prevalence of HPV antibodies between men with and without prostate cancer. However, in another part including only PCR-based studies conducted after the year 2000 (including 1071 prostate cancer patients and 1103 benign prostate controls), the HPV prevalence was found to be 21.6% in prostate cancer patients and 6.7% in controls (p = 0.001) [17]. The authors concluded from this meta-analysis that HR-HPV has a causal role in prostate cancer. Other meta-analyses conducted in the last decade using different parameters also showed similar results. In a meta-analysis by Sasidharanpillai et al. evaluating the relationship between HPV and oropharyngeal and anogenital cancers based on recent molecular studies (nine studies, 876 men), significant HPV association was reported in prostate cancer tissue specimens (19%, CI: 10–29%) [7]. Yin et al. also determined that HPV was associated with an increased risk of prostate cancer (OR: 2.27) in their meta-analysis of 24 case–controlled studies including 971 prostate cancer and 1085 benign prostate patients [62]. In a meta-analysis of 26 tissue-based case–control studies conducted by Yang et al., the prevalence of HPV infection was found to be 18.93% and overall HPV positivity in prostate tissues was associated with a significantly higher risk of prostate cancer (OR: 1.79, 95% CI: 1.29–2.49) [57]. Moghoofei et al. reported that the two major genotypes associated with prostate cancer were HPV types 16 and 18, respectively [63].
Gleason score is an important pathological parameter for the prognosis of prostate cancer. However, the data on the relationship between HPV and Gleason score are controversial. Singh et al. reported that Gleason score was high (≥ 8) in 74% of patients with HPV-related prostate cancer (p = 0.003), whereas Moghadam et al. found no significant difference in Gleason score in his patient group [64].
Glenn et al. published an interesting study regarding HPV and prostate cancer. The researchers identified HR-HPVs in the benign prostate tissue specimens of patients who developed prostate cancer 1–10 years later. A remarkable finding from their study was that E7 oncoprotein expression was detected in 82% of samples at the time of benign prostatic hyperplasia diagnosis but only 29% of prostate cancer specimens were from the same patients. The authors suggested that HPV has an oncogenic role in the early stage of prostate tumorigenesis [65].
Kidney cancer is responsible for an estimated 2% of global cancer diagnoses and deaths, and its global burden is expected to increase [66]. The two most common subtypes are renal cell carcinoma and urothelial cell carcinoma. However, there are few studies on its possible association with HPV in the literature, and based on the evidence to date, the relationship between kidney cancers and HPV remains unclear. In a PCR-based study of 28 patients with kidney cancer, Grce et al. did not detect HPV in any patient [67]. Similarly, Hodges et al. did not detect HPV in any of their 62 patients with renal tumors by using ISH, leading the authors to conclude that HPV appears to have no oncogenic role in benign or malignant renal tumors [68]. In contrast, in their small case–control study (49 renal cell carcinoma cases, 16 controls), Salehipor et al. determined using PCR that the prevalence of HPV was 14.3% in the patient group and 0% in the control group [69]. Kamel et al. evaluated 56 patients with renal cell carcinoma using ISH and determined the prevalence of HPV to be 52% [70]. Although this is a remarkable finding, the fact that the study was not case-controlled can be seen as an important limitation. More recently, Farhadi et al. investigated the presence of HPV in 122 patients with renal cell carcinoma and demonstrated HPV association in 30.3%, with HPV type 18 being the most common type identified [71]. In terms of the case series, an important study by Koury et al. based on the Cancer Genome Atlas Database, which includes 3775 malignant neoplasms, indicated that there was no relationship between HPV infection and kidney cancer [72].
Although testicular cancers represent only 1% of all malignancies in men, they are the most common organ malignancy in men between 20 and 40 years of age [73]. The main known risk factors for testicular cancer are undescended testes, a family history of testicular cancer, and the presence of germ cell cancer in the opposite testicle [74]. While testicular tumors are still relatively uncommon, there has been an unexplained increase in their incidence over the last two decades [75]. Researchers have recently focused on the potentially important role of inflammation in the formation and progression of testicular cancer, as seen in the pathogenesis of other cancers [76]. In fact, the relationship between viral infections and testicular cancer was first investigated approximately 40 years ago [77]. Unfortunately, few studies have been published on the relationship between HPV and testicular cancer in the intervening period. In their study of 39 testicular cancer and 48 control cases, Strickler et al. determined the prevalence of HPV to be 5% in testicular cancer specimens and 4% in the control group [78]. A PCR-based study evaluating the presence of HPV in 19 testicular cancer patients and one control case was not able to demonstrate a relationship between HPV infection and testicular cancer [79]. Similarly, Bertazzoni et al. reported that HPV was not detected by PCR in any specimens from 61 seminomas and 23 control cases [80]. Finally, in a meta-analysis of 20 studies and 265,057 patients to evaluate the relationship between testicular cancer and viral infections, Garolla et al. determined that testicular cancer was not associated with HPV, cytomegalovirus, or parvovirus b-19 infections, whereas EBV and HIV infections were significantly associated with a higher risk of developing testicular germ cell tumors (OR: 7.38, 95% CI: 1.89–28.75, OR: 1.71, 95% CI: 1.51–1.93, respectively) [81]. An important point to keep in mind when evaluating the relationship between testicular germ cell neoplasms and HPV is that HPV shows epithelial tropism, and germ cell neoplasms of the testicle do not arise from the epithelium.
The link between penile cancers and HPV is now well known. In this regard, the significant relationship between HPV and tumor grade should be taken into consideration and further studies should be conducted to elucidate the prognostic significance of HPV presence in penile cancers. The association between HPV and urothelial carcinoma of the bladder has become clearer in recent years with the use of molecular tests in HPV diagnosis and the findings of studies conducted with fresh tissue. In bladder cancer, the significant relationship between HPV and tumor recurrence should be kept in mind. The development of PCR technology has had a major impact on our understanding of the link between HPV and prostate cancer. Compared to previous serology-based studies, the results obtained using nucleic acid amplification tests such as PCR are noteworthy and show that a reevaluation of this relationship is needed. A key point here may be studied on the relationship between HPV and inflammation in the pathophysiology of prostate cancer. In contrast, it is premature to talk about an association between kidney cancer and HPV based on the limited evidence available today. Case-controlled studies with larger patient series will be elucidating. The existing evidence regarding testicular cancer indicates no association with HPV infection.
CI | Confidence interval |
EBV | Epstein–Barr virus |
FFPE | Formalin-fixed, paraffin-embedded |
HR | High-risk |
HPV | Human papillomavirus |
ISH | in situ hybridization |
LR | Low-risk |
OR | Odds ratio |
PCR | Polymerase Chain Reaction |
PIN | Penile intraepithelial neoplasia |
Rb | Retinoblastoma |
IntechOpen - where academia and industry create content with global impact
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\n\nSara Uhac, COO
\n\nSara Uhac was appointed Managing Director of IntechOpen at the beginning of 2014. She directs and controls the company’s operations. Sara joined IntechOpen in 2010 as Head of Journal Publishing, a new strategically underdeveloped department at that time. After obtaining a Master's degree in Media Management, she completed her Ph.D. at the University of Lugano, Switzerland. She holds a BA in Financial Market Management from the Bocconi University in Milan, Italy, where she started her career in the American publishing house Condé Nast and further collaborated with the UK-based publishing company Time Out. Sara was awarded a professional degree in Publishing from Yale University (2012). She is a member of the professional branch association of "Publishers, Designers and Graphic Artists" at the Croatian Chamber of Commerce.
\n\nAdrian Assad De Marco
\n\nAdrian Assad De Marco joined the company as a Director in 2017. With his extensive experience in management, acquired while working for regional and global leaders, he took over direction and control of all the company's publishing processes. Adrian holds a degree in Economy and Management from the University of Zagreb, School of Economics, Croatia. A former sportsman, he continually strives to develop his skills through professional courses and specializations such as NLP (Neuro-linguistic programming).
\n\nDr Alex Lazinica
\n\nAlex Lazinica is co-founder and Board member of IntechOpen. After obtaining a Master's degree in Mechanical Engineering, he continued his Ph.D. in Robotics at the Vienna University of Technology. There, he worked as a robotics researcher with the university's Intelligent Manufacturing Systems Group, as well as a guest researcher at various European universities, including the Swiss Federal Institute of Technology Lausanne (EPFL). During this time he published more than 20 scientific papers, gave presentations, served as a reviewer for major robotic journals and conferences and, most importantly, co-founded and built the International Journal of Advanced Robotic Systems, the world's first Open Access journal in the field of robotics. Starting this journal was a pivotal point in his career since it proved to be the pathway to the foundation of IntechOpen with its focus on addressing academic researchers’ needs. Alex personifies many of IntechOpen´s key values, including the commitment to developing mutual trust, openness, and a spirit of entrepreneurialism. Today, his focus is on defining the growth and development strategy for the company.
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Examples of IKS such as Ayurveda from India and Acupuncture from China are well known. IK covers diverse areas of importance for society, spanning issues concerned with the quality of life - from agriculture and water to health. The IK resident in India and China have high relevance to rural life, especially given the level of engagement with agricultural and health technologies. The goal is to establish a heuristic whereby IK can be reviewed and evaluated within particular contexts to determine if the IKS can lead to the development of appropriate technology (AT) addressing that need sustainably. Although much work on cataloguing and documenting IKS has been completed in these two countries, a paucity of attention has been paid to the scientific rationale and technological content of these IKS. Evaluation of many indigenous technologies reveal that many of these technologies can be classified as ‘appropriate’, focused on basic needs of water, sanitation and agriculture, and many have origins in IKS that survived. Thus, IKS must be validated, exploited and integrated into AT innovation and development.",book:{id:"5866",slug:"indigenous-people",title:"Indigenous People",fullTitle:"Indigenous People"},signatures:"John Tharakan",authors:[{id:"198534",title:"Prof.",name:"John",middleName:null,surname:"Tharakan",slug:"john-tharakan",fullName:"John Tharakan"}]},{id:"56510",doi:"10.5772/intechopen.69890",title:"Role of Traditional Ethnobotanical Knowledge and Indigenous Institutions in Sustainable Land Management in Western Highlands of Kenya",slug:"role-of-traditional-ethnobotanical-knowledge-and-indigenous-institutions-in-sustainable-land-managem",totalDownloads:2612,totalCrossrefCites:4,totalDimensionsCites:5,abstract:"The objective of this chapter is to elucidate the relevance of indigenous knowledge and institutions in natural resource management using western highlands of Kenya as a case study. The research design was a mixed method, combining qualitative and quantitative methods. A total of 350 individuals (comprising farmers, herbalists and charcoal burners) from households were interviewed using a structured questionnaire, 50 in-depth interviews and 35 focus group discussions. The results show that indigenous knowledge and institutions play a significant role in conserving natural resources in the study area. There was gender differentiation in knowledge attitude and practice (KAP) of indigenous knowledge as applied to sustainable land management. It is recommended that deliberate efforts should be put in place by the County Governments to scale up the roles of indigenous institutions in managing natural resources in the study area.",book:{id:"5866",slug:"indigenous-people",title:"Indigenous People",fullTitle:"Indigenous People"},signatures:"Chris A. Shisanya",authors:[{id:"200734",title:"Prof.",name:"Chris",middleName:null,surname:"Shisanya",slug:"chris-shisanya",fullName:"Chris Shisanya"}]},{id:"68484",doi:"10.5772/intechopen.88118",title:"Journey to America: South Asian Diaspora Migration to the United States (1965–2015)",slug:"journey-to-america-south-asian-diaspora-migration-to-the-united-states-1965-2015-",totalDownloads:1225,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"This chapter examines the immigration of South Asian and Indian populations to the United States between 1820 and 2015. More specifically, this effort scrutinizes legislative changes in immigration policy enabling this group to become the second largest immigrant group after Mexicans in the United States. These changes include the following: the removal of national origin quotas, the introduction of temporary skilled worker programs, and the creation of employment-based permanent visas. Because of these policy changes, by 2015, South Asian immigrants, primarily Indians, had become the top recipients of high-skilled H-1B temporary visas and were the second-largest group of international students in the United States. All told, this study will answer the following questions: What are the origins and demographics of these emigrants who make up the South Asia diaspora? What fields of endeavor are they drawn to by their prior education and skill sets? To what geographic locations have they migrated? And how successful are they in assimilating into their new surroundings?",book:{id:"8522",slug:"indigenous-aboriginal-fugitive-and-ethnic-groups-around-the-globe",title:"Indigenous, Aboriginal, Fugitive and Ethnic Groups Around the Globe",fullTitle:"Indigenous, Aboriginal, Fugitive and Ethnic Groups Around the Globe"},signatures:"John P. Williams",authors:[{id:"264648",title:"Prof.",name:"John",middleName:null,surname:"Williams",slug:"john-williams",fullName:"John Williams"}]},{id:"68416",doi:"10.5772/intechopen.87583",title:"Feeding the Roots of Cultural Identity: Indigenous Wellness in Canada",slug:"feeding-the-roots-of-cultural-identity-indigenous-wellness-in-canada",totalDownloads:772,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"While responses to native addictions and mental issues are continued priorities, the overarching focus is to recognize the diasporic status of indigenous peoples, to improve native wellness, and to establish cross-cultural identity for all Canadians. Historical culture, ways of knowing and language support strength-based approaches, alongside which relational structures—elders, families, communities, creation—play essential roles in native whole health. A comprehensive Continuum Framework guides federal, provincial, and territorial stakeholder efforts toward native wellness, supported by engaging indigenous communities. Indigenous wellness balances the physical, spiritual, emotional, and mental quadrants of whole health. Balanced well-being is enriched by (i) purpose in individuals’ daily lives through education, employment, caregiving, and cultural ways of being and doing; (ii) hope for the future grounded in a sense of core identity, indigenous values, and spirit; (iii) a sense of belonging and connectedness with all relations and culture; and (iv) understanding and deriving meaning from individual, family, and community lives as part of creation and rich history. Indigenous philosophy can be understood and appreciated through the lenses of various Western theoretical approaches that are constructionist by design, whereby Canadians may get one step closer toward achieving a cross-cultural identity. This shared vision requires innovative leadership, sustained commitment, and effective partnerships.",book:{id:"8522",slug:"indigenous-aboriginal-fugitive-and-ethnic-groups-around-the-globe",title:"Indigenous, Aboriginal, Fugitive and Ethnic Groups Around the Globe",fullTitle:"Indigenous, Aboriginal, Fugitive and Ethnic Groups Around the Globe"},signatures:"Carina Fiedeldey-Van Dijk",authors:[{id:"265608",title:"Dr.",name:"Carina",middleName:null,surname:"Fiedeldey-Van Dijk",slug:"carina-fiedeldey-van-dijk",fullName:"Carina Fiedeldey-Van Dijk"}]},{id:"56426",doi:"10.5772/intechopen.70104",title:"Indigenous Resource Management Practices and the Local Social-Cultural Context: An Insight towards Self-Directed Resource Management by People who ‘Coexist’ with Supernatural Agents",slug:"indigenous-resource-management-practices-and-the-local-social-cultural-context-an-insight-towards-se",totalDownloads:1810,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"In recent arguments in the governance of natural resource management, effectiveness and desirability of collaborative management among various stakeholder including indigenous people has been recognized. In the context of Indonesia, the reformation movement has stimulated the growth of a new perception of indigenous people’s rights to their land in the country. This recent transition presents a growing opportunity for indigenous people who live in nature-rich areas (national parks, etc.) to collaborate with ‘outside stakeholders’ such as governmental agencies, scholars and environmental NGOs in natural resource management. In such situations, it is necessary to deeply understand the value of indigenous resource management (IRM) practices to promote self-directed and effective resource management. This chapter focuses on local forest resource management and its suitability in the local social-cultural context in central Seram, east Indonesia. First, I describe how the well-structured forest resource use is constructed and maintained through the indigenous resource management practices based on ‘supernatural enforce mechanism’. After that, I investigate what social-ecological roles the IRM in Amanioho has, and how IRM practices relate to the social-cultural context of an upland community in central Seram. Then, I discuss the possible future applications for achieving self-directed resource management by people who ‘coexist’ with supernatural agents.",book:{id:"5866",slug:"indigenous-people",title:"Indigenous People",fullTitle:"Indigenous People"},signatures:"Masatoshi Sasaoka",authors:[{id:"198898",title:"Dr.",name:"Masatoshi",middleName:null,surname:"Sasaoka",slug:"masatoshi-sasaoka",fullName:"Masatoshi Sasaoka"}]}],mostDownloadedChaptersLast30Days:[{id:"56426",title:"Indigenous Resource Management Practices and the Local Social-Cultural Context: An Insight towards Self-Directed Resource Management by People who ‘Coexist’ with Supernatural Agents",slug:"indigenous-resource-management-practices-and-the-local-social-cultural-context-an-insight-towards-se",totalDownloads:1810,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"In recent arguments in the governance of natural resource management, effectiveness and desirability of collaborative management among various stakeholder including indigenous people has been recognized. In the context of Indonesia, the reformation movement has stimulated the growth of a new perception of indigenous people’s rights to their land in the country. This recent transition presents a growing opportunity for indigenous people who live in nature-rich areas (national parks, etc.) to collaborate with ‘outside stakeholders’ such as governmental agencies, scholars and environmental NGOs in natural resource management. In such situations, it is necessary to deeply understand the value of indigenous resource management (IRM) practices to promote self-directed and effective resource management. This chapter focuses on local forest resource management and its suitability in the local social-cultural context in central Seram, east Indonesia. First, I describe how the well-structured forest resource use is constructed and maintained through the indigenous resource management practices based on ‘supernatural enforce mechanism’. After that, I investigate what social-ecological roles the IRM in Amanioho has, and how IRM practices relate to the social-cultural context of an upland community in central Seram. Then, I discuss the possible future applications for achieving self-directed resource management by people who ‘coexist’ with supernatural agents.",book:{id:"5866",slug:"indigenous-people",title:"Indigenous People",fullTitle:"Indigenous People"},signatures:"Masatoshi Sasaoka",authors:[{id:"198898",title:"Dr.",name:"Masatoshi",middleName:null,surname:"Sasaoka",slug:"masatoshi-sasaoka",fullName:"Masatoshi Sasaoka"}]},{id:"56259",title:"Indigenous Knowledge Systems for Appropriate Technology Development",slug:"indigenous-knowledge-systems-for-appropriate-technology-development",totalDownloads:4147,totalCrossrefCites:7,totalDimensionsCites:8,abstract:"Indigenous knowledge systems (IKS) comprises knowledge developed within indigenous societies, independent of, and prior to, the advent of the modern scientific knowledge system (MSKS). Examples of IKS such as Ayurveda from India and Acupuncture from China are well known. IK covers diverse areas of importance for society, spanning issues concerned with the quality of life - from agriculture and water to health. The IK resident in India and China have high relevance to rural life, especially given the level of engagement with agricultural and health technologies. The goal is to establish a heuristic whereby IK can be reviewed and evaluated within particular contexts to determine if the IKS can lead to the development of appropriate technology (AT) addressing that need sustainably. Although much work on cataloguing and documenting IKS has been completed in these two countries, a paucity of attention has been paid to the scientific rationale and technological content of these IKS. Evaluation of many indigenous technologies reveal that many of these technologies can be classified as ‘appropriate’, focused on basic needs of water, sanitation and agriculture, and many have origins in IKS that survived. Thus, IKS must be validated, exploited and integrated into AT innovation and development.",book:{id:"5866",slug:"indigenous-people",title:"Indigenous People",fullTitle:"Indigenous People"},signatures:"John Tharakan",authors:[{id:"198534",title:"Prof.",name:"John",middleName:null,surname:"Tharakan",slug:"john-tharakan",fullName:"John Tharakan"}]},{id:"56510",title:"Role of Traditional Ethnobotanical Knowledge and Indigenous Institutions in Sustainable Land Management in Western Highlands of Kenya",slug:"role-of-traditional-ethnobotanical-knowledge-and-indigenous-institutions-in-sustainable-land-managem",totalDownloads:2612,totalCrossrefCites:4,totalDimensionsCites:5,abstract:"The objective of this chapter is to elucidate the relevance of indigenous knowledge and institutions in natural resource management using western highlands of Kenya as a case study. The research design was a mixed method, combining qualitative and quantitative methods. A total of 350 individuals (comprising farmers, herbalists and charcoal burners) from households were interviewed using a structured questionnaire, 50 in-depth interviews and 35 focus group discussions. The results show that indigenous knowledge and institutions play a significant role in conserving natural resources in the study area. There was gender differentiation in knowledge attitude and practice (KAP) of indigenous knowledge as applied to sustainable land management. It is recommended that deliberate efforts should be put in place by the County Governments to scale up the roles of indigenous institutions in managing natural resources in the study area.",book:{id:"5866",slug:"indigenous-people",title:"Indigenous People",fullTitle:"Indigenous People"},signatures:"Chris A. Shisanya",authors:[{id:"200734",title:"Prof.",name:"Chris",middleName:null,surname:"Shisanya",slug:"chris-shisanya",fullName:"Chris Shisanya"}]},{id:"56296",title:"Empowering Namibian Indigenous People through Entrepreneurship: The Case from the Nama People",slug:"empowering-namibian-indigenous-people-through-entrepreneurship-the-case-from-the-nama-people",totalDownloads:1638,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The challenge emanating from the colonial and apartheid regimes on the Nama people of Namibia have not only resulted in them losing nearly half of its population, but they also appeared to have lost their social identity. To that end we continually find convergences and divergences in clothing and accessories, food, traditional dances, homes, and traditional beauty cosmetics, between the past and present. This chapter seeks to explore whether the Nama people have always used money to acquire the aforementioned past? If not, what have they done right in the past to acquire all these items? These are one of the few questions this chapter seeks to explore and understand, and the role Nama entrepreneurial activities play for their own socio-economic advancement. Critical discourse can lead to a better understanding and appreciation of entrepreneurship among indigenous people in Namibia. This will in turn result in an enhanced understanding of the role entrepreneurship and culture can play in both a local and international context. After a brief introduction to Namibia and the Nama people, the cultural values and entrepreneurial initiatives of the Nama people are discussed, followed by discussions, recommendations and conclusions. Research methods employed were in-depth interviews and participant observation.",book:{id:"5866",slug:"indigenous-people",title:"Indigenous People",fullTitle:"Indigenous People"},signatures:"Wilfred Isak April, Daniel Ileni Itenge, Josef Petrus Van der\nWesthuizen and Lazarus Shimwaningi Emvula",authors:[{id:"110034",title:"Dr.",name:"Wilfred",middleName:"Isak",surname:"April",slug:"wilfred-april",fullName:"Wilfred April"},{id:"204208",title:"Mr.",name:"Daniel",middleName:"Ileni",surname:"Itenge",slug:"daniel-itenge",fullName:"Daniel Itenge"},{id:"204209",title:"Mr.",name:"Lazarus",middleName:null,surname:"Emvula",slug:"lazarus-emvula",fullName:"Lazarus Emvula"},{id:"204916",title:"Mr.",name:"Josef",middleName:"P.",surname:"Van Der Westhuizen",slug:"josef-van-der-westhuizen",fullName:"Josef Van Der Westhuizen"}]},{id:"55689",title:"Usages and Customs of the Indigenous Communities in Favour of the Reduction of the Digital Divide: A Case Study of the Ñuu Savi People",slug:"usages-and-customs-of-the-indigenous-communities-in-favour-of-the-reduction-of-the-digital-divide-a-",totalDownloads:1312,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"This research is of ethnographic nature, focusing on the study of the Ñuu Savi people (people of the rain), also called the Mixtec people, of pre-Columbian origin belonging to the Mixteca Region of the state of Oaxaca, Mexico. On the basis of sociocultural theory and the theory of the diffusion and adoption of technological innovations, the study on the cultural identity of the ethnolinguistic group, whose social platform is the “uses and customs,” is carried out. As a result of this research, the descriptive analysis is presented, detailing the effect of information and communication technologies (ICTs) on the situation of the vulnerable and disadvantaged group. Likewise, cultural elements have been identified that allow the formulation of a model for the development and inclusion of the ethnic minority. An educational strategy is designed and implemented through the model. 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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. 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Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. 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