Classification of the olfactory conditions.
\\n\\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\\n\\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/132"}},components:[{type:"htmlEditorComponent",content:'With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 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:"10705",leadTitle:null,fullTitle:"Healthcare Access",title:"Healthcare Access",subtitle:null,reviewType:"peer-reviewed",abstract:"Adequate healthcare access not only requires the availability of comprehensive healthcare facilities but also affordability and knowledge of the availability of these services. As an extended responsibility, healthcare providers can create mechanisms to facilitate subjective decision-making in accessing the right kind of healthcare services as well various options to support financial needs to bear healthcare-related expenses while seeking health and fulfilling the healthcare needs of the population. This volume brings together experiences and opinions from global leaders to develop affordable, sustainable, and uniformly available options to access healthcare services.",isbn:"978-1-83969-567-4",printIsbn:"978-1-83969-566-7",pdfIsbn:"978-1-83969-568-1",doi:"10.5772/intechopen.94675",price:139,priceEur:155,priceUsd:179,slug:"healthcare-access",numberOfPages:354,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"e8e9561a91e5f7771932aa5d49c3b687",bookSignature:"Amit Agrawal and Srinivas Kosgi",publishedDate:"February 9th 2022",coverURL:"https://cdn.intechopen.com/books/images_new/10705.jpg",numberOfDownloads:4207,numberOfWosCitations:0,numberOfCrossrefCitations:3,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:7,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:10,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 23rd 2021",dateEndSecondStepPublish:"March 22nd 2021",dateEndThirdStepPublish:"May 21st 2021",dateEndFourthStepPublish:"August 9th 2021",dateEndFifthStepPublish:"October 8th 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"100142",title:"Prof.",name:"Amit",middleName:null,surname:"Agrawal",slug:"amit-agrawal",fullName:"Amit Agrawal",profilePictureURL:"https://mts.intechopen.com/storage/users/100142/images/system/100142.jfif",biography:"Dr. Agrawal completed his neurosurgery training at the National Institute of Mental Health and Neurosciences, Bangalore, India, in 2003. He is a self-motivated, enthusiastic, and results-oriented professional with more than eighteen years of experience in research and development, as well as teaching and mentoring in the field of neurosurgery. He is proficient in managing and leading teams for running successful process operations and has experience in developing procedures and service standards of excellence. He has attended and participated in many international and national symposiums and conferences and delivered lectures on vivid topics. Dr. Agrawal has published more than 750 scientific articles in various national and international journals. His expertise is in identifying training needs, designing training modules, and executing the same while working with limited resources. He has excellent communication, presentation, and interpersonal skills with proven abilities in teaching and training various academic and professional courses. Presently, he is working at the All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.",institutionString:"All India Institute of Medical Sciences",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"6",totalChapterViews:"0",totalEditedBooks:"8",institution:{name:"All India Institute of Medical Sciences",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"341182",title:"Dr.",name:"Srinivas",middleName:null,surname:"Kosgi",slug:"srinivas-kosgi",fullName:"Srinivas Kosgi",profilePictureURL:"https://mts.intechopen.com/storage/users/341182/images/system/341182.png",biography:"Dr. Srinivas Kosgi is a clinician and academician with sixteen years of experience in the field of psychiatry. He has an excellent track record of working in schizophrenia, forensic psychiatry, child and adolescent psychiatry, de-addiction psychiatry, psychopharmacology, and community psychiatry. His areas of interest are research in thought, language and communication deficits in schizophrenia, and designing treatment strategies for prisoners. Dr. Kosgi has worked in thirty-two multi-center international drug trials. His current functions are developing administrative strategies in improving clinical services in psychiatry hospitals, training postgraduate students in psychiatry, clinical psychology, psychiatric social work, and psychiatric nursing. He currently heads psychiatric hospital services in the capacity of medical superintendent at Dharwad Institute of mental Health and Neuroscience Dharwad, Karnataka. Dr. Kosgi is a pioneer researcher in psychopharmacology and heads the state referral psychiatric hospital as medical superintendent.",institutionString:"Department of Psychiatry, Dharwad Institute of Mental Health and Neurosciences",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1132",title:"Health Care",slug:"medicine-public-health-health-care"}],chapters:[{id:"76728",title:"The Profession of Biokinetics in South Africa: The Need for Access to the Public Healthcare System",doi:"10.5772/intechopen.97756",slug:"the-profession-of-biokinetics-in-south-africa-the-need-for-access-to-the-public-healthcare-system",totalDownloads:323,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:1,abstract:"This chapter reviews the efficacy of the only South African exercise therapy profession (Biokinetics) in the rehabilitation of non-communicable diseases (NCDs). Biokinetics is a South African exercise therapy profession established in 1983 and which operates in both the pathogenic and fortogenic healthcare paradigms. Unfortunately, the profession of Biokinetics is restricted to the South African private healthcare sector. This chapter describes the scope of the profession of Biokinetics, empirical studies illustrating the efficacy of the profession in addressing society’s non-communicable disease epidemic, and the challenges inhibiting the profession from gaining access to the South African public healthcare sector. It is hoped that the presentation and critical appraisal of the empirical evidence which illustrates the contribution of the profession of Biokinetics to the rehabilitation of NCDs justifies the authors’ claims for the inclusion of the aforementioned profession in the South African public healthcare sector.",signatures:"Yvonne Paul, Terry J. Ellapen, Takalani C. Muluvhu and Makwena B. Ntjana",downloadPdfUrl:"/chapter/pdf-download/76728",previewPdfUrl:"/chapter/pdf-preview/76728",authors:[{id:"226652",title:"Dr.",name:"Terry J.",surname:"Ellapen",slug:"terry-j.-ellapen",fullName:"Terry J. Ellapen"},{id:"233596",title:"Prof.",name:"Yvonne",surname:"Paul",slug:"yvonne-paul",fullName:"Yvonne Paul"},{id:"414123",title:"Dr.",name:"Takalani C",surname:"Muluvhu",slug:"takalani-c-muluvhu",fullName:"Takalani C Muluvhu"},{id:"414124",title:"Mr.",name:"Makwena B.",surname:"Ntjana",slug:"makwena-b.-ntjana",fullName:"Makwena B. Ntjana"}],corrections:null},{id:"77267",title:"Structure, Processes and Results in Healthcare System in Slovenia",doi:"10.5772/intechopen.98608",slug:"structure-processes-and-results-in-healthcare-system-in-slovenia",totalDownloads:146,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Achieving high quality in the provision of healthcare services represents a basic factor in meeting the healthcare needs of the individuals. Accessibility to health services in Slovenia over the last two decades has been presented according to some of the core values of quality and safety: performance, quality and patient-centeredness. The focus of the chapter is on three pillars of health system quality: structure, processes, and outcomes. In each part, we presented the standard practice and state of the art, but also the main achievements in the last decade. In the structural part, we highlight the investment in equipment and human resources and in the process part, the role of the primary level as a gatekeeper with the secondary and tertiary level. The results section concentrates on the measurement of the results in healthcare; the use of quality indicators and PROMs is discussed, the role of quality strategy and health technology assessment in the Slovenian healthcare system is presented.",signatures:"Valentina Prevolnik Rupel and Dorjan Marušič",downloadPdfUrl:"/chapter/pdf-download/77267",previewPdfUrl:"/chapter/pdf-preview/77267",authors:[{id:"138181",title:"Mr.",name:"Dorjan",surname:"Marušič",slug:"dorjan-marusic",fullName:"Dorjan Marušič"},{id:"258053",title:"Prof.",name:"Valentina",surname:"Prevolnik Rupel",slug:"valentina-prevolnik-rupel",fullName:"Valentina Prevolnik Rupel"}],corrections:null},{id:"77622",title:"Demand for Health and Healthcare",doi:"10.5772/intechopen.98915",slug:"demand-for-health-and-healthcare",totalDownloads:540,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Healthy human beings are the center of sustainable development, and human beings have long sought to maintain and improve their health by increasing their health reserves. In general, the use of services or the demand for medical services has a vital role in improving the level of health of each person. The demand for healthcare is a demand derived from the demand for health and is influenced by several factors, including price, income, population, etc.",signatures:"Alireza Ghorbani",downloadPdfUrl:"/chapter/pdf-download/77622",previewPdfUrl:"/chapter/pdf-preview/77622",authors:[{id:"355041",title:"Associate Prof.",name:"Alireza",surname:"Ghorbani",slug:"alireza-ghorbani",fullName:"Alireza Ghorbani"}],corrections:null},{id:"77434",title:"Shared Decision-Making towards a Higher Quality of Care: Is This the Norm?",doi:"10.5772/intechopen.98752",slug:"shared-decision-making-towards-a-higher-quality-of-care-is-this-the-norm-",totalDownloads:101,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Patient-doctor relationship has traditionally been paternalistic, in which the doctor decided on behalf of the patient. It focused mainly between the patient who called for help and the doctor whose decisions had to be silently observed and followed by the patient. In this paternalistic model, the physician used his skills to choose the necessary interventions and treatments that were likely to restore the health of the patient. All the information given to the patient was selected to encourage them to consent to the doctor’s decisions. This definition of the asymmetric or unbalanced interaction between physicians and patients has begun to be questioned over the last 20 years. There has been a shift from this direction to one where the patient is more informed, empowered, and independent - a move from a “paternalistic” to a more “complementary” relationship. Critics suggested a more active, autonomous patient-centered role which supports greater patient control, reduced doctors’ dominance, and a more mutual participation. This approach has been described as one where the doctor attempts to enter the patient’s world to see the disease with the eyes of the patient and is becoming the predominant model in clinical practice today.",signatures:"George Athanasiou and Chris Bachtsetzis",downloadPdfUrl:"/chapter/pdf-download/77434",previewPdfUrl:"/chapter/pdf-preview/77434",authors:[{id:"354309",title:"Assistant Prof.",name:"George",surname:"Athanasiou",slug:"george-athanasiou",fullName:"George Athanasiou"},{id:"355107",title:"Dr.",name:"Chris",surname:"Bachtsetzis",slug:"chris-bachtsetzis",fullName:"Chris Bachtsetzis"}],corrections:null},{id:"78550",title:"Coverage: Measure of Achieving Universal Health Coverage in Nigeria",doi:"10.5772/intechopen.98948",slug:"coverage-measure-of-achieving-universal-health-coverage-in-nigeria",totalDownloads:91,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter aims to show that extending social health insurance is a possible road to universal health coverage in Nigeria. We suggest that allowing states to set up and operate their own insurance schemes, which presents a unique opportunity to swiftly scale up prepaid coverage for Nigerians. This paper review various healthcare insurance towards achieving universal health coverage in Nigeria. The paper concluded by suggesting other insurance scheme to be covered towards achieving universal coverage.",signatures:"Habibu Salisu Badamasi",downloadPdfUrl:"/chapter/pdf-download/78550",previewPdfUrl:"/chapter/pdf-preview/78550",authors:[{id:"351936",title:"M.Sc.",name:"Habibu salisu",surname:"Badamasi",slug:"habibu-salisu-badamasi",fullName:"Habibu salisu Badamasi"}],corrections:null},{id:"78198",title:"Factors Influencing Access to Reliable Healthcare Financing among Elderly Population in Africa",doi:"10.5772/intechopen.99578",slug:"factors-influencing-access-to-reliable-healthcare-financing-among-elderly-population-in-africa",totalDownloads:202,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Population is ageing rapidly in all regions of the world and unreliable healthcare financing is capable of hindering older people from seeking competent medical attention which in turn may lead to their suffering, insecurity and/or death. In Africa, lack of access to reliable healthcare financing in old age poses serious development challenges and it is detrimental to healthy ageing, especially because elderly population are known to be facing various health challenges which require huge financial costs. Existing studies have shown that it is not sufficient to provide reliable healthcare financing for older people, it is more important to provide them access to these services. Ensuring that the elderly population has access to reliable healthcare financing in particular as well as other available and possible social support mechanisms that may encourage the provision of and access to reliable healthcare financing in general is a challenge and very key to healthy ageing. Through authors’ experiences in the healthcare system, narrative review of existing literature and interactions with some elderly people, this article explores various factors influencing older people’s access to reliable healthcare financing. It is believed that understanding of factors influencing access to reliable healthcare financing among older people in Africa will go a long way in directing policies toward the right course.",signatures:"Isaac Akintoyese Oyekola, Oludele Albert Ajani and Eyitayo Joseph Oyeyipo",downloadPdfUrl:"/chapter/pdf-download/78198",previewPdfUrl:"/chapter/pdf-preview/78198",authors:[{id:"350959",title:"Ph.D. Student",name:"Isaac",surname:"Akintoyese Oyekola",slug:"isaac-akintoyese-oyekola",fullName:"Isaac Akintoyese Oyekola"},{id:"426897",title:"Dr.",name:"Oludele",surname:"Albert Ajani",slug:"oludele-albert-ajani",fullName:"Oludele Albert Ajani"},{id:"426898",title:"Mr.",name:"Eyitayo",surname:"Joseph Oyeyipo",slug:"eyitayo-joseph-oyeyipo",fullName:"Eyitayo Joseph Oyeyipo"}],corrections:null},{id:"77875",title:"Medical Hegemony and Healthcare: Centrality in Healthcare",doi:"10.5772/intechopen.99174",slug:"medical-hegemony-and-healthcare-centrality-in-healthcare",totalDownloads:211,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Better human healthcare is achieved by increasing the fair use and accessibility of medical information. While this optimism is believed, real-world healthcare can be severely affected by the knowledge and context shared in the healthcare industry and academia. Through the sharing process, the central perception gains consensus in the industry and academic societies and standardized therapies are unified and spread quickly. In this way, mainstreamers’ contexts quickly become standardized. Consequently, the mainstream has hegemony and can be strengthened. Mainstreamers neglect any information different from standardized knowledge and therapy. It is universally known that hegemony stabilize its position by undermining the fair use and accessibility of information. The use of patterned knowledge facilitates the utility of medical information. Smart ICT seems to realize the smart use of medical information in our daily lives as well as professional exercises. The method to eliminate such evils and realize true healthcare is required. The fair use and accessibility contribute to the utility of medical knowledge to end-users. The effect and influence of the commons of information are shown as a solution to eliminating adverse events caused by the hegemonic mainstream. As the most effective means in the coming digital healthcare era, this paper shows the following three points. (1) Allow commons of information to enable fair use and search of information. (2) The commons of information release the cognitive bias set by the measure. (3) By creating such a new theory, we will develop a new field called healthcare digital management and/or healthcare digital economics.",signatures:"Makoto Takayama",downloadPdfUrl:"/chapter/pdf-download/77875",previewPdfUrl:"/chapter/pdf-preview/77875",authors:[{id:"92590",title:"Prof.",name:"Makoto",surname:"Takayama",slug:"makoto-takayama",fullName:"Makoto Takayama"}],corrections:null},{id:"78273",title:"The Implications of Health Financing for Health Access and Equity in Nigeria",doi:"10.5772/intechopen.98565",slug:"the-implications-of-health-financing-for-health-access-and-equity-in-nigeria",totalDownloads:267,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"The Nigeria health system has performed woefully against all vital health indices, trailing behind many African countries despite its enormous potentials. The reason for this is mainly due to the financial risk Nigerians face in accessing healthcare. This study addresses the implications of the current healthcare financing in Nigeria on access and equity. It shows the imperativeness of an alternative healthcare financing in line with best practices, from comparable Low- and Middle-Income Countries (LMICs), apart from the current National Health Insurance Scheme (NHIS). The findings from this study recommend that the NHIS should be strengthened through the policy reform to embrace fund pooling/risk-sharing, subsidisation for the poor and the vulnerable, mandatory enrolment, and fragmentation of NHIS. Other considerations include increasing domestic fiscal space for health and utilising a tax-based financing mechanism that has been progressive in all LMICs, thereby preventing the need for unsustainable reliance on external funding. A comprehensive package of health at the point of care is also necessary. However, all these recommendations require the government to show a commitment to improve the country’s healthcare system through its health spending.",signatures:"Adelakun Edward Odunyemi",downloadPdfUrl:"/chapter/pdf-download/78273",previewPdfUrl:"/chapter/pdf-preview/78273",authors:[{id:"352983",title:"Dr.",name:"Adelakun",surname:"Edward Odunyemi",slug:"adelakun-edward-odunyemi",fullName:"Adelakun Edward Odunyemi"}],corrections:null},{id:"76949",title:"Screening for Antenatal Depression by Midwives in Low Resource Settings in Primary Care Settings in Malawi",doi:"10.5772/intechopen.97411",slug:"screening-for-antenatal-depression-by-midwives-in-low-resource-settings-in-primary-care-settings-in-",totalDownloads:201,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Depression significantly contributes to the disease burden of pregnant women. However, depression is often under diagnosed by health professionals especially in antenatal clinics. This is the situation in Malawi where there is no routine screening for depression in antenatal clinics. Nonetheless, screening can enable the effective management of pregnant women with depression at antenatal clinics. There is therefore a need to integrate screening for depression into routine antenatal services to enhance the early identification of antenatal depression and intervention to improve and maintain the well-being of pregnant women and contribute towards achieving the efforts of the Government of Malawi in scaling up the treatment of depression.",signatures:"Genesis Chorwe-Sungani",downloadPdfUrl:"/chapter/pdf-download/76949",previewPdfUrl:"/chapter/pdf-preview/76949",authors:[{id:"353727",title:"Associate Prof.",name:"Genesis",surname:"Chorwe-Sungani",slug:"genesis-chorwe-sungani",fullName:"Genesis Chorwe-Sungani"}],corrections:null},{id:"77677",title:"Associated Factors and Use of Health Services by Elderly Men in Northeast Brazil",doi:"10.5772/intechopen.98605",slug:"associated-factors-and-use-of-health-services-by-elderly-men-in-northeast-brazil",totalDownloads:78,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The objective of the research was to analyze the factors associated with the use of health services by elderly men in the Northeast region of Brazil. Cross-sectional analytical study with a secondary database of elderly men (n = 3238). The dependent variable was composed of the profiles of the use of health services and the independent variables were factors of predisposition, capacity, and health need. The statistical association and effect were performed using the Rao-Scott test with p < 0.05 and multinomial logistic regression. Elderly men with worse social indicators had a risk effect for using medium/high complexity services and those who had better health indicators were associated with sporadic medical appointment, revealing that healthcare for elderly men is centered on curative and rehabilitative care and that the use of health services is associated with the worst social indicators.",signatures:"Gisele Mariel de Sousa Vasconcelos, Alana Maiara Brito Bibiano, Lucas Fernando Rodrigues dos Santos and Rafael da Silveira Moreira",downloadPdfUrl:"/chapter/pdf-download/77677",previewPdfUrl:"/chapter/pdf-preview/77677",authors:[{id:"89468",title:"Dr.",name:"Rafael",surname:"da Silveira Moreira",slug:"rafael-da-silveira-moreira",fullName:"Rafael da Silveira Moreira"},{id:"417136",title:"BSc.",name:"Gisele Mariel De Sousa",surname:"Vasconcelos",slug:"gisele-mariel-de-sousa-vasconcelos",fullName:"Gisele Mariel De Sousa Vasconcelos"},{id:"417137",title:"MSc.",name:"Alana Maiara Brito",surname:"Bibiano",slug:"alana-maiara-brito-bibiano",fullName:"Alana Maiara Brito Bibiano"},{id:"417138",title:"B.Sc.",name:"Lucas",surname:"Fernando Rodrigues dos Santos",slug:"lucas-fernando-rodrigues-dos-santos",fullName:"Lucas Fernando Rodrigues dos Santos"}],corrections:null},{id:"77298",title:"Access to Emergency Healthcare",doi:"10.5772/intechopen.98574",slug:"access-to-emergency-healthcare",totalDownloads:123,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Access to emergency services is essential for the health and well-being of people. The World Health Organization (WHO) made it a human right for everybody to have access to emergency care and it is an ethical obligation for governments to provide this service for the whole population. In recent years, the overcrowding in emergency departments has become a prominent issue that needs proper solutions. There have been several attempts resolving this ongoing issue. One of those is the patients’ distribution according to the severity level of their chief complaint, since more than half of the urgent cases are of low acuity and can be managed in less equipped facilities. Primary healthcare centers are perfectly suited to look after a significant proportion of cases for many reasons such as their scope of service, their wider geographical distribution, and are a more cost-effective resource for such cases than the use of higher acuity facilities. In Qatar, we have been implementing such model of patient distribution to release the burden on emergency departments since 1999. In this chapter we are proposing a full protocol to distribute emergency patients involving the ambulance service, primary healthcare centers, and emergency departments. Cooperation of all these services with the help of higher authorities and media is expected to show great improvements in patient care and better crowd control in emergency departments.",signatures:"Abdulnasir F.H. Al Jazairi and Guillaume Alinier",downloadPdfUrl:"/chapter/pdf-download/77298",previewPdfUrl:"/chapter/pdf-preview/77298",authors:[{id:"229291",title:"Dr.",name:"Abdulnasir F.H.",surname:"Al-Jazairi",slug:"abdulnasir-f.h.-al-jazairi",fullName:"Abdulnasir F.H. Al-Jazairi"},{id:"419802",title:"Prof.",name:"Guillaume",surname:"Alinier",slug:"guillaume-alinier",fullName:"Guillaume Alinier"}],corrections:null},{id:"77217",title:"A New Approach to Surgical Gowns",doi:"10.5772/intechopen.98563",slug:"a-new-approach-to-surgical-gowns",totalDownloads:301,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Emerging diseases such as Ebola hemorrhagic fever, hepatitis B, hepatitis C, SARS, and most recently the Covid 19 epidemic have increased the importance of hygiene in the world, bringing the need for personal protective equipment (PPE) to the forefront. An important part of PPE in healthcare is surgical gowns, which are worn by doctors and nurses in the operating room to serve a dual function of preventing the transmission of microorganisms and body fluids from surgical staff to patients and from patients to staff. This chapter presents the history and importance of surgical gowns. The factors to be considered in the selection of surgical gowns are discussed. The model characteristics and fabric properties of surgical gowns currently on the market and the environmental impact of reusable and disposable gowns are outlined. Finally, shortcomings in available gowns are discussed, a new knitted surgical gown design is introduced, and recommendations are given in the final section. The chapter provides broad coverage of surgical gowns for both experienced readers and those new to the field.",signatures:"Yüksel Atay, Oktay Pamuk, Bekir Boyaci, Esra Zeynep Yildiz, Tuncay Göksel, Dilek Yeşim Metin, Servet Gül, Gökberk Devrim and Özlem Topbaş",downloadPdfUrl:"/chapter/pdf-download/77217",previewPdfUrl:"/chapter/pdf-preview/77217",authors:[{id:"318369",title:"Dr.",name:"Esra",surname:"Yıldız",slug:"esra-yildiz",fullName:"Esra Yıldız"},{id:"419861",title:"Prof.",name:"Yüksel",surname:"Atay",slug:"yuksel-atay",fullName:"Yüksel Atay"},{id:"419862",title:"Prof.",name:"Oktay",surname:"Pamuk",slug:"oktay-pamuk",fullName:"Oktay Pamuk"},{id:"419863",title:"Mr.",name:"Bekir",surname:"Boyacı",slug:"bekir-boyaci",fullName:"Bekir Boyacı"},{id:"419922",title:"Prof.",name:"Tuncay",surname:"Göksel",slug:"tuncay-goksel",fullName:"Tuncay Göksel"},{id:"419923",title:"Prof.",name:"Dilek Yeşim",surname:"Metin",slug:"dilek-yesim-metin",fullName:"Dilek Yeşim Metin"},{id:"419924",title:"Mr.",name:"Servet",surname:"Gül",slug:"servet-gul",fullName:"Servet Gül"},{id:"419925",title:"Mr.",name:"Gökberk",surname:"Devrim",slug:"gokberk-devrim",fullName:"Gökberk Devrim"},{id:"419926",title:"Ms.",name:"Özlem",surname:"Topbaş",slug:"ozlem-topbas",fullName:"Özlem Topbaş"}],corrections:null},{id:"76118",title:"Occupational Health and Safety in Operating Rooms",doi:"10.5772/intechopen.97223",slug:"occupational-health-and-safety-in-operating-rooms",totalDownloads:306,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Nurses are one of the most endeavored members of healthcare services. Operating rooms, on the other hand, require special caution and contain various hazards for healthcare professionals. Operating rooms contain various risk factors related to applications, infrastructure and humans. It is one of the areas that need nursing care the most since patients are dependent on their nurses to meet their personal needs. Nurses are exposed to various risk and health problems in operating rooms. Healthcare service provided by nurses working in a healthy environment directly affects the health and quality of life of those who receive the service. In order to prevent these problems, intensive up-to-date educations on occupational risks and employee safety should be provided for the nurses working in operating rooms. In addition to the general occupational hygiene measures, different precautions should be taken for the operating rooms. Working in a healthy and safe environment is a human right that every individual must have. Managers of the medical institutions should be attentive to follow the laws and sanctions on occupational health and safety, institutions should be inspected frequently and monitored carefully. In this section, this subject will be studied in line with actual data and resources.",signatures:"Hülya Gül",downloadPdfUrl:"/chapter/pdf-download/76118",previewPdfUrl:"/chapter/pdf-preview/76118",authors:[{id:"113452",title:"Associate Prof.",name:"Hülya",surname:"Gül",slug:"hulya-gul",fullName:"Hülya Gül"}],corrections:null},{id:"77242",title:"Accessing Oral Healthcare within a Context of Economic Transition",doi:"10.5772/intechopen.98615",slug:"accessing-oral-healthcare-within-a-context-of-economic-transition",totalDownloads:57,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In many low-mid income settings, accessibility of health services remains inadequate and inequitable. These observed disparities in accessibility are particularly evident for oral healthcare services. The access to oral healthcare is influenced by the responsiveness of the health system, including availability of human resources for health, oral health facilities’ infrastructure, geographical distribution, equipment and materials as well as community’s awareness and affordability of the provided services. The evolution of oral healthcare access in Tanzania; from the early post-colonial phases of independence to current transition that the country is undergoing from low to a low-mid income economy is presented. The major health policies’ transition from “Free Healthcare” services to “Cost-sharing” and ultimately to “Health Insurance” are presented within the context of their influence towards oral healthcare access.",signatures:"Kasusu Nyamuryekung’e and Febronia Kahabuka",downloadPdfUrl:"/chapter/pdf-download/77242",previewPdfUrl:"/chapter/pdf-preview/77242",authors:[{id:"267724",title:"Prof.",name:"Febronia",surname:"Kahabuka",slug:"febronia-kahabuka",fullName:"Febronia Kahabuka"},{id:"352847",title:"Dr.",name:"Kasusu",surname:"Nyamuryekung\\'E",slug:"kasusu-nyamuryekung'e",fullName:"Kasusu Nyamuryekung\\'E"}],corrections:null},{id:"77914",title:"Patients’ (Clients) Satisfaction with Medical Laboratory Services Contributes to Health and Quality Improvement",doi:"10.5772/intechopen.99290",slug:"patients-clients-satisfaction-with-medical-laboratory-services-contributes-to-health-and-quality-imp",totalDownloads:237,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Patients’ (clients/customer) services and satisfaction in Medical Laboratory Services and general healthcare is one of the twelve (12) quality essentials of Total Quality Management System (TQMS) emphasized by quality standards as seen in ISO 17025, ISO 15189 and ISO 9001. The patients otherwise referred to as customers or clients to Medical Laboratory and healthcare in general, is the heart-beat and kings to the healthcare system. This chapter looks into the quality aspect of medical laboratory services from the patients’ angle towards thorough satisfaction or dissatisfaction index and otherwise creates room for improvement in the services and healthcare in general. The chapter therefore, identified medical laboratory clients to include patients and patients’ relations, physicians and other healthcare workers, public health and government, communities and interested parties, and medical laboratory profession. There is a need to administer services satisfaction survey developed by Director of Medical Laboratory Services or human resources/quality officers in line with the ISO 15189, ISO 17075 and ISO 9001 to customers/clients from time to time so the outcome can be used to correct services errors and cause quality improvement. It is believed that patients’ satisfaction causes improvement in healthcare, quick recovery of patients and willingness of the patient to return to the healthcare facility in future. Patients’ and customers’ in medical laboratory feedback contributes to quality management and improvement to Medical Laboratory services and healthcare as an ingredient of TQMS.",signatures:"Nkereuwem S. Etukudoh and Uchejeso M. Obeta",downloadPdfUrl:"/chapter/pdf-download/77914",previewPdfUrl:"/chapter/pdf-preview/77914",authors:[{id:"329113",title:"Dr.",name:"Obeta",surname:"M. Uchejeso",slug:"obeta-m.-uchejeso",fullName:"Obeta M. Uchejeso"},{id:"333605",title:"Dr.",name:"Nkereuwem S.",surname:"Etukudoh",slug:"nkereuwem-s.-etukudoh",fullName:"Nkereuwem S. Etukudoh"}],corrections:null},{id:"80007",title:"The Modern Universal Total Knee Arthroplasty: Maximized Value, Streamlined Efficiency",doi:"10.5772/intechopen.101572",slug:"the-modern-universal-total-knee-arthroplasty-maximized-value-streamlined-efficiency",totalDownloads:99,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"A universal total knee arthroplasty system able to accurately resurface either left or right knees of all shapes and sizes is compelling as there is an increased need for improved efficiency and value. With a modern universal total knee system, a single instrument tray can be utilized for more than 90% of cases and doesn’t require any specific customization or disposable instruments. This streamlined workflow is accomplished with unique instrumentation that features a symmetrical femoral and tibial implant for all patients. Symmetrical tibial implants have been shown to have equivalent outcomes and low complications compared to asymmetric tibial trays. The universal symmetrical femoral implant, with its deepened trochlear groove, allows for optimal patellar tracking and recent studies have demonstrated this symmetrical femoral implant to have comparable femoral rollback and axial rotation to native knees. This efficient instrumentation reduces overall inventory, decreases turnover times, and exposes fewer instruments that may otherwise be susceptible to contamination. All without detriment to the patient outcome or surgeon workflow. Studies have shown clinical scores of the modern universal total knee arthroplasty system are a great value not only to the surgeon but also to the healthcare system as a whole—a necessity in modern healthcare.",signatures:"Bryant Bonner, Jesua I. Law, Erin Hofmann and Eric Dacus",downloadPdfUrl:"/chapter/pdf-download/80007",previewPdfUrl:"/chapter/pdf-preview/80007",authors:[{id:"338344",title:"M.D.",name:"Bryant",surname:"Bonner",slug:"bryant-bonner",fullName:"Bryant Bonner"},{id:"345208",title:"Dr.",name:"Jesua I.",surname:"Law",slug:"jesua-i.-law",fullName:"Jesua I. Law"},{id:"345652",title:"Dr.",name:"Eric",surname:"Dacus",slug:"eric-dacus",fullName:"Eric Dacus"},{id:"345653",title:"Dr.",name:"Erin",surname:"Hofmann",slug:"erin-hofmann",fullName:"Erin Hofmann"}],corrections:null},{id:"77028",title:"Teva Pharmaceutical: Generic Market Access to Global Healthcare Industry",doi:"10.5772/intechopen.97747",slug:"teva-pharmaceutical-generic-market-access-to-global-healthcare-industry",totalDownloads:269,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The present paper represents a qualitative case study on the pharmaceutical company Teva, including an in-depth exploration of the company within the specific context of pharmaceutical industry. Being a qualitative case study in the business discipline, the company details regarding the shareholders, the stock price fluctuations in recent decades in comparison with other competitors will be presented. The objective of this article is to provide a thorough description of Teva, a global leader in the pharmaceutical industry, by assessing the evolution of the company considering the changes at the corporate level and in the market, like the appearances of new competitors. The results will contribute in providing an insight in how future pharma companies can avoid certain pitfalls and how they should reply to the market competition and different other changes on the market.",signatures:"Neta Kela-Madar",downloadPdfUrl:"/chapter/pdf-download/77028",previewPdfUrl:"/chapter/pdf-preview/77028",authors:[{id:"268981",title:"Ph.D.",name:"Neta",surname:"Kela-Madar",slug:"neta-kela-madar",fullName:"Neta Kela-Madar"}],corrections:null},{id:"77372",title:"Impacts of Medical Tourism on Healthcare Access",doi:"10.5772/intechopen.98682",slug:"impacts-of-medical-tourism-on-healthcare-access",totalDownloads:156,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Today, medical tourism is underrated and mostly perceived as a beauty tourism. However, except dermatological and dental services also organ transplantation, IVF and many other therapies are well present in medical tourism travel arrangements. Medical tourism without any doubt impacts access to healthcare. Healthcare system in many countries allows access to some of these services but all-around world approaches differ. We believe that healthcare access could greatly benefit by opening this kind of services to wider population while at the same time not endangering patient’ safety. Harmonized propositions, accreditations and certificates for medical tourism industry access covered by both, private and public health insurances, would contribute to service transparency and patient’ safety while taking care of moral aspects of such services. Therefore, if consciously incorporated, medical tourism, as a part of global healthcare could easily become an efficient and effective additional access to healthcare.",signatures:"Iskra Alexandra Nola and Zdeslav Radovčić",downloadPdfUrl:"/chapter/pdf-download/77372",previewPdfUrl:"/chapter/pdf-preview/77372",authors:[{id:"271303",title:"M.A.",name:"Zdeslav",surname:"Radovčić",slug:"zdeslav-radovcic",fullName:"Zdeslav Radovčić"},{id:"354692",title:"Prof.",name:"Iskra Alexandra",surname:"Nola",slug:"iskra-alexandra-nola",fullName:"Iskra Alexandra Nola"}],corrections:null},{id:"77218",title:"Ethical Deliberation in the Allocation of Respirators and Beds during the Covid-19 Pandemic in Brazil",doi:"10.5772/intechopen.98589",slug:"ethical-deliberation-in-the-allocation-of-respirators-and-beds-during-the-covid-19-pandemic-in-brazi",totalDownloads:144,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter proposes a theoretical reflection on the ethical deliberation process in the allocation of beds and respirators, in the light of the Theory of Health Justice, the Accountability for Reasonableness approach and the principle of health equity of the Brazilian Unified Health System (SUS, as per its Portuguese acronym), before the COVID-19 pandemic in Brazil. The pandemic has become a serious threat to health systems, as installed capacity has been exceeded whether in terms of material resources, equipment, technology and human resources. Thus, according to the theory of Accountability for Reasonableness, a fair and deliberative process aims to ensure resource allocation through limits and constraints (reasonableness), but government responsibility derived from human rights must be considered, allowing for health programming (accountability). Faced with this scenario, where the situation will often require us to make choices, this chapter intends to discuss the assumptions for ethical deliberation, taking into account the context of the act and its foreseeable consequences.",signatures:"Maristela Rodrigues Marinho, Sandra Pinto, Juliana Dias Reis Pessalacia, Priscila Kelly da Silva Neto, Marcela Tavares de Souza and Tatiana Carvalho Reis Martins",downloadPdfUrl:"/chapter/pdf-download/77218",previewPdfUrl:"/chapter/pdf-preview/77218",authors:[{id:"224763",title:"Dr.",name:"Juliana",surname:"Dias Reis Pessalacia",slug:"juliana-dias-reis-pessalacia",fullName:"Juliana Dias Reis Pessalacia"},{id:"352905",title:"Mrs.",name:"Priscila",surname:"Kelly da Silva Neto",slug:"priscila-kelly-da-silva-neto",fullName:"Priscila Kelly da Silva Neto"},{id:"353826",title:"Dr.",name:"Maristela",surname:"Rodrigues Marinho",slug:"maristela-rodrigues-marinho",fullName:"Maristela Rodrigues Marinho"},{id:"353830",title:"Ms.",name:"Sandra",surname:"Pinto",slug:"sandra-pinto",fullName:"Sandra Pinto"},{id:"419355",title:"Dr.",name:"Marcela",surname:"Tavares De Souza",slug:"marcela-tavares-de-souza",fullName:"Marcela Tavares De Souza"},{id:"419356",title:"Dr.",name:"Tatiana",surname:"Carvalho Reis Martins",slug:"tatiana-carvalho-reis-martins",fullName:"Tatiana Carvalho Reis Martins"}],corrections:null},{id:"77399",title:"Geospatial Clustering of Mobile Phone Use and Tuberculosis Health Outcomes among African Health Systems",doi:"10.5772/intechopen.98528",slug:"geospatial-clustering-of-mobile-phone-use-and-tuberculosis-health-outcomes-among-african-health-syst",totalDownloads:140,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Background: While multiple studies have documented the impacts of mobile phone use on TB health outcomes for varied settings, it is not immediately clear what the spatial patterns of TB treatment completion rates among African countries are. This paper used Exploratory Spatial Data Analysis (ESDA) techniques to explore the clustering spatial patterns of TB treatment completion rates in 53 African countries as well as their relationships with mobile phone use. Using an ESDA approach to identify countries with low TB treatment completion rates and reduced mobile phone use is the first step towards addressing issues related to poor TB outcomes. Methods: TB notifications and treatment data from 2000 through 2015 obtained from the World Bank database were used to illustrate a descriptive epidemiology of TB treatment completion rates among African health systems. Spatial clustering patterns of TB treatment completion rates were assessed using differential local Moran’s I techniques; and local spatial analytics was performed using local Moran’s I tests. Relationships between TB treatment completion rates and mobile phone use were evaluated using ESDA approach. Results: Spatial autocorrelation patterns generated were consistent with Low-Low and High-Low cluster patterns and were significant at different p-values. Algeria and Senegal had significant clusters across the study periods, while Democratic Republic of Congo, Niger, South Africa, and Cameroon had significant clusters in at least two time-periods. ESDA identified statistically significant associations between TB treatment completion rates and mobile phone use. Countries with higher rates of mobile phone use, showed higher TB treatment completion rates overall, indicating enhanced program uptake (P < 0.05). Conclusions: Study findings provide systematic evidence to inform policy regarding investments in the use of mHealth to optimize TB health outcomes. African governments should identify turnaround strategies to strengthen mHealth technologies and improve outcomes.",signatures:"Sunny Ibeneme, Nkiruka Ukor, Joseph Okeibunor and Felicitas Zawaira",downloadPdfUrl:"/chapter/pdf-download/77399",previewPdfUrl:"/chapter/pdf-preview/77399",authors:[{id:"335256",title:"Dr.",name:"Sunny",surname:"Ibeneme",slug:"sunny-ibeneme",fullName:"Sunny Ibeneme"},{id:"418825",title:"Mrs.",name:"Nkiruka",surname:"Ukor",slug:"nkiruka-ukor",fullName:"Nkiruka Ukor"},{id:"418826",title:"Prof.",name:"Joseph",surname:"Okeibunor",slug:"joseph-okeibunor",fullName:"Joseph Okeibunor"},{id:"418827",title:"Dr.",name:"Felicitas",surname:"Zawaira",slug:"felicitas-zawaira",fullName:"Felicitas Zawaira"}],corrections:null},{id:"78328",title:"Improving Healthcare Access through Digital Health: The Use of Information and Communication Technologies",doi:"10.5772/intechopen.99607",slug:"improving-healthcare-access-through-digital-health-the-use-of-information-and-communication-technolo",totalDownloads:221,totalCrossrefCites:0,totalDimensionsCites:2,hasAltmetrics:1,abstract:"Healthcare has been going through major digital transformations due to the extensive use of information and communication technologies (ICT) in the sector. Many patients lack access to healthcare services due to lack of knowledge of the exitance of the service, physical or mental disability, distance, siege, lockdown and other possible reasons. Access to healthcare services has been impacted by a number of innovations including electronic health record, artificial intelligence, sensors, wearable devices, Internet of (medical) things, Blockchain, big data and other applications. COVID-19 has created new realities in accessing healthcare services through telehealth and telemedicine services as many countries have imposed lockdown and physical distancing. Digital health has been used to empower people, in general and patients in particular, to enable them to access healthcare services at the point of care or remotely. Healthcare professionals have been using digital health to enhance their knowledge, skills and more important to enable them to reach to patients to provide guidance and assistance. Using digital health solutions has a number of challenges which can be legal, ethical, infrastructural, human and material resources, training, education, attitude, cultural, organizational and behavioral. A number of national, regional and international agencies have adopted resolutions and developed strategies to support digital health implementation in countries. This chapter provides few examples to demonstrate how access to healthcare services is being enabled and facilitated by information and communication technology (ICT) through proper national planning of digital health.",signatures:"Najeeb Al-Shorbaji",downloadPdfUrl:"/chapter/pdf-download/78328",previewPdfUrl:"/chapter/pdf-preview/78328",authors:[{id:"355385",title:"Dr.",name:"Najeeb",surname:"Al-Shorbaji",slug:"najeeb-al-shorbaji",fullName:"Najeeb Al-Shorbaji"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"563",title:"Brain Injury",subtitle:"Pathogenesis, Monitoring, Recovery and Management",isOpenForSubmission:!1,hash:"6e40d2cf6eebee2041b76a70987f4258",slug:"brain-injury-pathogenesis-monitoring-recovery-and-management",bookSignature:"Amit Agrawal",coverURL:"https://cdn.intechopen.com/books/images_new/563.jpg",editedByType:"Edited by",editors:[{id:"100142",title:"Prof.",name:"Amit",surname:"Agrawal",slug:"amit-agrawal",fullName:"Amit Agrawal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2034",title:"Brain Injury",subtitle:"Functional Aspects, Rehabilitation and Prevention",isOpenForSubmission:!1,hash:"97fb870ccfe237f3270c3ae1b7a7dacd",slug:"brain-injury-functional-aspects-rehabilitation-and-prevention",bookSignature:"Amit Agrawal",coverURL:"https://cdn.intechopen.com/books/images_new/2034.jpg",editedByType:"Edited by",editors:[{id:"100142",title:"Prof.",name:"Amit",surname:"Agrawal",slug:"amit-agrawal",fullName:"Amit Agrawal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5261",title:"Neurooncology",subtitle:"Newer Developments",isOpenForSubmission:!1,hash:"ae1dcb26219bb62290c5a171c87d6936",slug:"neurooncology-newer-developments",bookSignature:"Amit Agrawal",coverURL:"https://cdn.intechopen.com/books/images_new/5261.jpg",editedByType:"Edited by",editors:[{id:"100142",title:"Prof.",name:"Amit",surname:"Agrawal",slug:"amit-agrawal",fullName:"Amit Agrawal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6503",title:"Brain Tumors",subtitle:"An Update",isOpenForSubmission:!1,hash:"055b45888e92391890d4992da9e8a4c3",slug:"brain-tumors-an-update",bookSignature:"Amit Agrawal, Luis Rafael Moscote-Salazar",coverURL:"https://cdn.intechopen.com/books/images_new/6503.jpg",editedByType:"Edited by",editors:[{id:"100142",title:"Prof.",name:"Amit",surname:"Agrawal",slug:"amit-agrawal",fullName:"Amit Agrawal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5517",title:"Hemorrhagic Stroke",subtitle:"An Update",isOpenForSubmission:!1,hash:"33690ae286c58afffac09491a13b3a29",slug:"hemorrhagic-stroke-an-update",bookSignature:"Amit Agrawal",coverURL:"https://cdn.intechopen.com/books/images_new/5517.jpg",editedByType:"Edited by",editors:[{id:"100142",title:"Prof.",name:"Amit",surname:"Agrawal",slug:"amit-agrawal",fullName:"Amit Agrawal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10788",title:"Brain Tumors",subtitle:null,isOpenForSubmission:!1,hash:"3f9a72957ff91750acfdf3843d7108cf",slug:"brain-tumors",bookSignature:"Amit Agrawal",coverURL:"https://cdn.intechopen.com/books/images_new/10788.jpg",editedByType:"Edited by",editors:[{id:"100142",title:"Prof.",name:"Amit",surname:"Agrawal",slug:"amit-agrawal",fullName:"Amit Agrawal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10922",title:"Music in Health and Diseases",subtitle:null,isOpenForSubmission:!1,hash:"6a079df045b086b404399c5ed4ac049a",slug:"music-in-health-and-diseases",bookSignature:"Amit Agrawal, Roshan Sutar and Anvesh Jallapally",coverURL:"https://cdn.intechopen.com/books/images_new/10922.jpg",editedByType:"Edited by",editors:[{id:"100142",title:"Prof.",name:"Amit",surname:"Agrawal",slug:"amit-agrawal",fullName:"Amit Agrawal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1673",title:"Evidence Based Medicine",subtitle:"Closer to Patients or Scientists?",isOpenForSubmission:!1,hash:"d767dfe22c65317eab3fd9ff465cb877",slug:"evidence-based-medicine-closer-to-patients-or-scientists-",bookSignature:"Nikolaos M. Sitaras",coverURL:"https://cdn.intechopen.com/books/images_new/1673.jpg",editedByType:"Edited by",editors:[{id:"108463",title:"Prof.",name:"Nikolaos",surname:"Sitaras",slug:"nikolaos-sitaras",fullName:"Nikolaos Sitaras"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5466",title:"Patient Centered Medicine",subtitle:null,isOpenForSubmission:!1,hash:"bade2265c3b5a9f7b5dffb5f512ed244",slug:"patient-centered-medicine",bookSignature:"Omur Sayligil",coverURL:"https://cdn.intechopen.com/books/images_new/5466.jpg",editedByType:"Edited by",editors:[{id:"179771",title:"Prof.",name:"Omur",surname:"Sayligil",slug:"omur-sayligil",fullName:"Omur Sayligil"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5785",title:"Teaching and Learning in Nursing",subtitle:null,isOpenForSubmission:!1,hash:"9bf55bd1257e7753f3719a64ef05d91e",slug:"teaching-and-learning-in-nursing",bookSignature:"Majda Pajnkihar, Dominika Vrbnjak and Gregor Stiglic",coverURL:"https://cdn.intechopen.com/books/images_new/5785.jpg",editedByType:"Edited by",editors:[{id:"195122",title:"Dr.",name:"Gregor",surname:"Stiglic",slug:"gregor-stiglic",fullName:"Gregor Stiglic"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],ofsBooks:[]},correction:{item:{id:"79356",slug:"corrigendum-to-eating-disorders-as-new-forms-of-addiction",title:"Corrigendum to: Eating Disorders as New Forms of Addiction",doi:null,correctionPDFUrl:"https://cdn.intechopen.com/pdfs/66065.pdf",downloadPdfUrl:"/chapter/pdf-download/66065",previewPdfUrl:"/chapter/pdf-preview/66065",totalDownloads:null,totalCrossrefCites:null,bibtexUrl:"/chapter/bibtex/66065",risUrl:"/chapter/ris/66065",chapter:{id:"52200",slug:"eating-disorders-as-new-forms-of-addiction",signatures:"Francisco J. Vaz-Leal, María I. Ramos-Fuentes, Laura Rodríguez-\nSantos and M. Cristina Álvarez-Mateos",dateSubmitted:"June 28th 2016",dateReviewed:"August 12th 2016",datePrePublished:null,datePublished:"February 1st 2017",book:{id:"5372",title:"Eating Disorders",subtitle:"A Paradigm of the Biopsychosocial Model of Illness",fullTitle:"Eating Disorders - A Paradigm of the Biopsychosocial Model of Illness",slug:"eating-disorders-a-paradigm-of-the-biopsychosocial-model-of-illness",publishedDate:"February 1st 2017",bookSignature:"Ignacio Jauregui-Lobera",coverURL:"https://cdn.intechopen.com/books/images_new/5372.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"323887",title:"Prof.",name:"Ignacio",middleName:null,surname:"Jáuregui-Lobera",slug:"ignacio-jauregui-lobera",fullName:"Ignacio Jáuregui-Lobera"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"188555",title:"Prof.",name:"Francisco J.",middleName:null,surname:"Vaz-Leal",fullName:"Francisco J. 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Their main function is to enable the human body to produce the force needed to move and function. A large series of pathological conditions can affect skeletal muscle, from mild injuries to serious or even life-threatening myopathies. These latter include skeletal muscle dystrophies which encompass a heterogeneous group of more than 30 distinct pathologies causing progressive and irreversible degeneration of skeletal muscle fibers. The causes are genetic; hence, a family with a history of muscular dystrophy increases the chance of having a child affected by the disorder. Diagnosis of inherited myopathies is frequently challenging due to broad genetic and phenotypic heterogeneity. As if that weren't enough, the prognosis is often, if not always, poor for the majority of these conditions since there are no treatments available. Currently available treatments can only help manage and reduce the severity of symptoms. However, the recent technologies led to the identification of responsible genes causing these conditions thus leading to an improvement in the diagnosis and the clinical course of patients. Therefore, a better understanding of the pathogenesis of the disease is pivotal for the development of individual therapies. In this book, thanks to the contribution of all the authors, we aim at gathering information about the latest discoveries and novel research trends concerning technologies and methods underpinning diagnostic and therapeutic advancements in genetic rare orphan diseases.
\r\n\t
Olfaction is among the most preserved senses across species based on its fundamental role for survival. In fact, this sense influences vital activities such as feeding, reproductive and social behavior.
The variety of functions modulated by olfaction relies on the direct connectivity of the olfactory tract to the piriform cortex, entorhinal cortex, hippocampus and amygdala regulating innate and acquired olfactory perception, memory, fear and alertness (Figure 1). In mammals, the major components of the olfactory system consist of the olfactory neuroepithelium (OE), the primary olfactory area, the olfactory bulb (OB) and its cortical projections, considered as secondary olfactory network areas (Figure 1) [1]. The olfactory network is, besides the visual system, the only nerve tract with direct access to the external environment without passage through the BBB and represents a viable and non-invasive source of CNS-derived biomarkers. Furthermore, chemosensory transduction manifests itself through the sense of smell, which is readily testable [2]. The olfactory system starts developing at mid gestation [3, 4, 5] and is mainly unchanged in all vertebrates [6, 7]. After birth, olfaction is essential in assisting the development of locomotor activities and spatial orientation as demonstrated in both rodents and humans [8, 9, 10, 11]. These evidences underlie how the onset of olfactory deficits may induce a wide range of (reversible or irreversible) impairments with potential life-threatening consequences. The most common alterations consist in either an exaggerated sense of smell “hyperosmia,” a reduced sense of smell “hyposmia” or the absence of smell “anosmia”. Hyperosmia is often co-symptomatic to schizophrenia and manic disorders [12, 13], whereas hyposmia occurs naturally with aging [14] and is exacerbated in progressive neurodegenerative disorders, such as Alzheimer’s disease (AD) and Parkinson’s disease (PD) [14, 15, 16, 17]. In addition, olfaction can be also completely lost after trauma [16, 18, 19] or certain types of cancer [20, 21, 22, 23]. Furthermore, the early olfactory deficit in AD [24] has been shown to be a strong predictor of the progression of dementia [25, 26, 27, 28]. Diagnosis of this sense remains underlooked and there is no consensus on the use of olfactory tests to assess/categorize neurological dysfunctions [29]. Interestingly, the studies testing olfaction in Tau and APP mouse models of AD, or 𝛼-synuclein models have shown that this sense is significantly altered [30, 31, 32]. Moreover, recent studies raise the possibility that endogenous [33, 34, 35, 36, 37] (PrP, Aβ, Tau, α-synuclein) and microbial [38, 39] amyloid-like peptides are accumulated in the nasal neuroepithelium and may propagate via retrograde transport to higher brain structures [40]. This might explain why Aβ, Tau, α-synuclein depositions are first observable in the olfactory bulb and olfactory tract, as their accumulation is associated to fibrillary tangle dysgenesis [41] and correlate with Braak staging progression [42].
Olfactory system anatomy in the mammalian brain. Drawing of the primary (I) and secondary (II) network areas of the olfactory system and its corticofugal (continuous lines) and centrifugal (dotted lines) connections. The pseudostratified neuroepithelium located in the upper olfactory mucosa is displayed with its major cell types, epithelial cells (EC), globose basal cells (GBC), sustentacular cells (SUS), olfactory sensory neurons (OSNs). The OSNs project their apical dendritic cilia in the nasal cavity and their axons towards the brain to form the olfactory nerve layer (ONL, blue highlight), by passing through small foramina in the cribriform plate (CP). In the olfactory bulb, the ONL terminals synapse with excitatory mitral cells (MC; positive charge) and tufted cells (TC, not represented) in the glomerular layer (GL). Inhibitory periglomerular cells (PGCs; negative charge), dopaminergic PGCs (DA, positive charge) and inhibitory granular cells (GC, negative charge) modulate the activity of MC and TC through dendrodendritic synapses. MC axonal projections assemble to form the lateral olfactory tract (LOT, yellow highlight) projecting to the piriform cortex, entorhinal cortex, amygdala and hippocampus, representing the olfactory cortex (II). Cholinergic terminals (ACh, orange) from the horizontal limb of the diagonal band of Broca (HDB), serotoninergic efferents (5-HT, light blue) from the raphe nuclei, and noradrenergic fibers (NA, green) from the locus coeruleus innervate the olfactory bulb and olfactory cortex. Dopaminergic neurons of the ventral tegmental area (VTA, red) modulate the activity of the olfactory cortex. Cx: cortex.
Despite the strong evidence indicating that olfactory transmission deficit is an early predictor of neurodegenerative processes, the poor understanding of the molecular and cellular mechanisms underlying olfactory activity in the primary as well as secondary olfactory network areas has marred the use of olfaction and olfactory testing as bona fide targets in clinical setting. In this chapter, we elaborate on the anatomical and physiological properties of the olfactory system, its development by sampling the vast literature of olfaction in mammals. We then expand on the role of olfaction in humans and smell deficits as readout of neurological diseases as well as other pathologies. With this work we aim to provide further support for considering the olfactory system as source of physiological and biological biomarker(s) based on its direct connection with the brain and emphasize the use of this easily accessible sensory system as an ideally suited functio-anatomical window for monitoring brain health as well as for therapeutic targeting.
In vertebrates the olfactory network is activated when an odorant, inhaled through the airways, binds to a specific receptor expressed on specialized neurons, known as olfactory sensory neurons (OSNs) or olfactory receptor neurons (ORNs), embedded in the upper olfactory mucosa. Every OSN expresses a specific odorant receptor (OR), which is activated only when a unique ligand (odor molecule) binds to it [43]. In 1991, Buck and Axel identified 18 genes encoding ORs [44] and for such discovery they were awarded the Nobel Prize in 2004. Few years later, more than 1000 OR genes were discovered in rodents [45] but only 378 OR were found in humans [46]. The OSN are characterized by their unique and exclusive ORs expression. The sorted olfactory signal is then transmitted from the OSNs’ axons, bundling as the olfactory nerve layer (ONL) in direction of specific glomeruli located in the OB [47]. Furthermore, innervation of the OB by the OSN axons is spatially segregated along the dorsomedial and lateroventral axis (zone I, II, III, and IV) respecting the spatial positioning of these neurons in the neuroepithelium. This “glomerular convergence” allows OSN projections to be widely dispersed across the bulb, while maintaining specificity for classes of odorant chemicals. For example, the dorsomedial zone I has convergence of OSN axons detecting n-fatty acids or n-aliphatic aldehydes but not alkanes [47, 48, 49]. The chemical and anatomical organization of ONL inputs defines the discrete odorant map of the OB, which is further relayed to the connecting mitral (MC) and tufted cells (TC) via axodendritic synapses [48]. Mitral and tufted principal neurons, constituting the output from the OB to the cortex, are finely tuned through dendrodendritic synapses mostly from periglomerular (PGC) and granular (GC) interneurons. These GABAergic and dopaminergic (DA) neurons are continuously replaced at least in rodents [50, 51, 52] and are essential for modulating mitral and tufted cells’ firing rates and increasing/decreasing their synchronous firing activity in presence/absence of an odorant [53, 54, 55]. Further, cholinergic, serotoninergic and noradrenergic afferents, originating respectively from the horizontal limb of the diagonal band of Broca (HDB) [56], raphe nuclei [57] and locus coeruleus [58], modulate the response of the PGC, MC and GC (Figure 1). These centrifugal afferents innervate the bulb in its integrity and appear to be involved in the early deficit observed in AD and PD [59]. From the bulb, axonal projections of the relay MC, form the lateral olfactory tract (LOT) and innervate higher brain areas (Figure 1). Neuroimaging studies reveal that the higher olfactory areas encompasse different cerebral structures, which are mainly divided in primary and secondary olfactory regions [60, 61]. The first network area comprises the piriform and entorhinal cortices, the amygdala and hippocampus, whereas the second neuronal hub includes the thalamus, the orbitofrontal cortex, cingulate and insula [60, 62, 63]. In these higher brain areas, the signal is integrated and loses spatial resolution [64]. This decomposition effect has been explained by the combinatorial cortical network ideally suited for decoding of incoming spatially segregated signals [65]. Overall, based on the heterogeneity of brain structures implicated in the modulation and processing of olfactory stimuli, the olfactory deficit phenotype and the degree of severity of olfactory impairment may vary substantially.
In all mammals, including humans, neurogenesis is maintained in the neuroepithelium through the presence of neural stem cells located close to the basal lamina. In adult rodents two type of cells populate the stem cell niche, globose basal cells (GBC), representing the neural stem cells population and horizontal basal cells (HBC), with ependymal cell characteristics functioning as supporting neurogenic cells. Conversely, in humans there is no distinction between GBC and HBC, with the first appearing as the only population occupying the niche [66]. GBCs comprise transit amplifying
In rodents, neurogenesis takes also place in the OB, where both GC and PGC are constantly replaced via the migration of neuronal precursors from the lateral ventricles walls to the rostral migratory stream (RMS), to reach their final destination areas: the periglomerular cell layer and granule cell layer [73]. It has been long debated whether OB neurogenesis occurs also in humans. Despite the presence of glia cells in the adult human SVZ, potentially representing a quiescent stem cells’ population, doublecortin positive migrating neurons are observed in the RMS only until the 6th month of age postnatally [74]. Overall, the events promoting the renewal and replacement of the OB interneurons support the cellular turnover of the OB and its evoked odorant activity. This may have an essential role in the regulation of physiological functions in rodents, such as recognition of pheromones and food intake, or in favoring the distribution of infectious substances, entering into the brain via the nostrils and reaching the OE/OB compartment. On the other hand, the lack of OB neurogenesis in humans might be explained on one side by the reduction of olfactory diversity, since they present less turnover in the CNS networks compared to rodents, and by the compensatory use through other senses (vision, hearing, somatosensation, gustation) requiring less adaptive integration from the renewing interneurons.
Olfactory transduction begins at the level of the cilia of the OSN protruding in the nasal cavity and through cascading amplification mechanisms reducing the threshold for odorant molecules detection. Each olfactory sensory neuron has about 12 ciliary branches, which increase the binding probability of the odorant molecules to the receptors compensating for the sequestration of the molecules in the nasal mucous covering the nasal neuroepithelium. Discrete odorants interact with specific olfactory receptors and activate a sequence of intracellular events leading to ionotropic channel activation and excitatory transmission through the ONL to the brain. In rodents, there are about 1000 genes encoding for different ORs. Each olfactory sensory neuron expresses only one type of OR through a monoallelic stochastic gene selection process occurring during the maturation of the OSN [43]. The ORs are G-protein coupled transmembrane receptors characterized by seven hydrophobic domains, whose diversity determines the heterogeneity and specificity of the response [75]. Upon binding to the odor molecule, a G⍺ olf protein, associated to the OR, is activated and converts guanosine 5′-diphosphate (GDP) to guanosine 5′-triphosphate (GTP). Further, by detachment of the beta/gamma subunits it activates the adenylate cyclase (AC) transmembrane protein converting ATP into a c-AMP [76]. This secondary messenger, c-AMP, has a high diffusion speed (20 𝜇m/s) [77] and is rapidly sensed by the surrounding ionotropic Ca2+/Na+ gated channels (CNG) allowing Ca2+/Na+ inflow [78]. The rise in Ca2+ activates the Cl(Ca) channels, which extrude Cl-ions, potentiating by about 90% the depolarizing inward current [79, 80]. Intracellular ciliary Ca2+ influences the sensitivity of the CGN to c-AMP determining its desensitization or adaptation when exposure to an odor is prolonged or when the interval between exposures is short [81]. This mechanism needs to be taken into account when planning an olfactory testing paradigm in rodent and humans. Finally, unrelated odorants switch off CNG channels in a phenomenon called masking, which preserves the specificity of signal transduction to the OB [82]. These cascading events expand the signal transduction time from 1 millisecond to the order of 100 millisecond [83] producing a molar non-linear amplification of the signal and contributing to the signal persistence. The excitatory signal from the ONL axons is then transferred to the apical dendrites of MC through glutamatergic synapses [84] and modulated through presynaptic and postsynaptic inputs of DAergic and GABAergic afferents of PGC and juxtaglomerular interneurons spanning one or more glomeruli and regulating the spatiodynamic resolution of the odors evoked responses [85, 86]. Further, firing synchronization and signal amplification is achieved by dendrodendritic inhibitory synapses between GC and MC located in the external plexiform layer [87, 88]. The fine-tuned excitatory signal is relayed through the LOT to the cortical and neocortical structures, where an odor-evoked depression, by presynaptic metabotropic glutamate receptor (mGluR) II/III activation, contributes to signal adaptation and attenuation, typical of the cortical sensory responsiveness [89, 90]. Despite the physiology of olfactory transmission has been well characterized in rodents, much less is known about the physiology of this system in humans.
Olfaction is among the most preserved senses throughout species and plays a vital role in daily life, being fundamental for feeding, reproductive and social behavior. Several studies described that in mammals, including humans, the sense of smell is developed during the first weeks of fetal life [9, 22, 91, 92]. Both in rats and humans, it has been shown that the odor of the amniotic fluid and the milk from the mother are perceived and memorized by the fetus, which, after birth, is capable to recognize and distinguish them from those of a surrogate mother [8, 10]. Moreover, experiments of olfactory stimulation in rat pups just after birth (0, 1, 2 hours) show an increase in locomotor activity compared to the unexposed pups [9].
In humans, clinical observations conducted on infants revealed their capability in locating the mother’s breast without assistance [93, 94], suggesting that the maternal breast odor is the driving force guiding their orientation and providing a sense of protection [9]. For instance, during hospitalization, the maternal contact and odor have a beneficial effect on relaxing the neonate when crying. These aspects constitute the “non-verbal communication”, which plays a fundamental role during the early neonatal phase to build and reinforce the mum-infant bonds [10]. Infants familiarize with odorants during pregnancy through mum’s diet, through a chemosensory transmission mother-infant [92]. Thus, in the critical period of early postnatal development, when vision is still poor, olfaction is employed as one of the first senses besides touch to make contact with the external world. Even if with adulthood, olfaction becomes less relevant for survival, particularly in modern humans, it underlies strong odor-cued memories and emotions. These associative processes triggered by odor perception depend on the output of the LOT to the hippocampus and amygdala and have been essential for animals to locate food [95], for the selection of mating candidates [96] and to identify predators [97, 98]. One of the most striking examples of olfactory sensitivity for foraging is the ability of the brown bear to sniff odors from more than 10 miles away, therefore representing a significant threat to campers and hikers carrying food in natural reserves. Studies indicate that the acuity and high sensitivity to odors of larger canid depends on the extended olfactory surface areas of the turbinates rather than the relative size of the olfactory system to the brain [99]. Furthermore, the smell-based mate selection is most prominent in females and appear to be dependent on the HLA variants inherited by the father [100, 101], triggering an emotional and behavioral response aimed at reproductive activity and species’ preservation. Finally, the “smell of danger” has been employed in odor-based fear conditioning to test amygdala’s function as well as hippocampal plasticity [102, 103]. Interestingly, fox or cat urine is widely used in testing passive olfactory avoidance in rodents despite these laboratory animals never encountered a predator [104]. This suggests that odor-cued memories are ingrained in the DNA and research demonstrated that are the result of heritable epigenetic modifications [105]. Furthermore, studies in humans showed that most odor-cued memories are formed in the first decade of life [106] and appear stronger than the ones evoked by words or visual cues reflecting accurately one’s autobiography throughout life [107, 108]. Finally, olfactory acuity is particularly developed in occupational workers such as sommelier, perfumers and chefs, which can perceive hedonic odors among a mix to deliver unique pleasant and palatable combinations [109, 110]. It remains unclear whether odor protheticity depends on the plasticity of the neuroepithelium or the distribution of the olfactory receptive elements. With aging, humans of both genders progressively lose their olfactory acuity and the ability to identify an odor: more than 50% of individuals aged 65–82 suffer from olfactory deficit [14, 111, 112]. Several factors account for the dysfunction including chronic damage to the neuroepithelium by neurotoxins and misfolded proteins [113], depletion of ciliary ORs, neuroinflammation and reduced vascularization [114]. As a result of the OSN damage with age, bulbar atrophy [115] and glomerular degeneration are associated to neurofibrillary tangle (NFT) depositions and olfactory processing and perception deficits [117]. Olfactory dysfunction (OD) in the elderly represents a source of discomfort and can pose a serious risk to safety [118]. Last, olfactory deficit has been shown to be an early predictor of mortality in old age [119]. This body of data indicates that olfaction is one of the primary form of environmental communication in mammals [120].
The olfactory activity is mainly composed of two hierarchical independent processes, where the first, defined as “peripheral”, is based on the acuity or capability to perceive an odorant, while the second, named as “central”, is involved on the memory or ability to identify an odor [61, 121]. Alteration in peripheral processes is linked to deficits occurring at the olfactory neuroepithelium, specifically at the levels of the OSN. On the other hand, damages to central processes can be attributed to deficits in the OB compartment and in higher cerebral regions, such as cortical and limbic system structures. This observation is supported by studies showing impaired odor identification with unaffected threshold activity in subjects presenting injures in the orbitofrontal cortex or the dorsomedial thalamic nucleus [122]. The integrity of olfactory perception, normosmia, can be impaired by alterations which can be divided in two main categories indicating a (1) quantitative or (2) qualitative impairment of the sense of smell. The first category is composed by anosmia, hyposmia or microsmia and hyperosmia, whereas the second one is represented by dysosmia, subdivided in parosmia and phantosmia or olfactory hallucination. These categories and their definition are summarized in Table 1. Apart from normosmia, which represents the physiological condition of the sense of smell, all the other cases can be determined by a wide spectrum of causes. In order to assess olfaction in humans, several tests are nowadays available to monitor the sensitivity of the olfactory system aiming to detect at an early stage the presence of different disorders. A test, which is commonly adopted to evaluate the olfactory responsiveness, is the University of Pennsylvania Smell Identification Test (UPSIT), developed by Doty and colleagues in 1984 [29]. This scratch and smell test enables the evaluation of the general smell function, e.g. odor identification and odor detection, assigning a final score which reflects the individual ability to recognize by exclusion several odors. The original tests includes 40 booklets with 4 odor per booklet, although shorter mini-UPSIT (Brief Smell Identification Test – BSIT) of 12, 15 and 16 odors have been used before [123, 124, 125] and they seem to be a viable solution for testing olfaction on human subjects limiting desensitization mechanisms intrinsic to olfactory transduction. On the other hand, a “forced-choice phenyl ethyl alcohol odor detection threshold test” [26], also called as the Snap and Sniff® Threshold Test, allows for rapid and reliable determinations of olfactory detection thresholds. Subjects are exposed to concentrations of phenyl ethyl alcohol, ranging from 10−2 to 10−9 log vol/vol in half-log concentration steps, along with blanks for forced-choice testing [126]. This test controls for a subject’s response bias or criterion for responding independently of the subject’s actual sensory sensitivity. Both tests can be self-administered and are equipped with a score card making olfactory testing accessible and convenient for both clinical and personal use.
Normosmia: normal olfactory function |
Anosmia: total loss of smell |
Hyposmia: decreased sense of smell |
Hyperosmia: increased sense of smell |
Dysosmia: qualitative alteration of the sense of smell. It includes: |
(1) Parosmia: odor distortion |
(2) Phantosmia: odor perception without the presence of the source |
Classification of the olfactory conditions.
Hereafter, we describe some human pathologies which can lead to olfactory dysfunctions (Figure 2).
Breakdown of affected regions and potential mechanisms in olfactory deficiencies and window for diagnostic/treatment. Related processes, diseases and possible therapeutic approaches centered on the olfactory neuroepithelium (A), olfactory bulb (B) and olfactory cortex (C). Abbreviations: EC, epithelial cells; GBC, globose basal cells; SUS, sustentacular cells; OSN, olfactory sensory neuron; GC, granule cell; PGC, periglomerular cell; PGC (DA), periglomerular dopaminergic cells; ONL, olfactory nerve layer; CP, cribriform plate; GL, glomerular layer; MC, mitral cell; LOT, lateral olfactory tract; ACh, acetylcholine; DA, dopamine; 5-HT, 5-hydroxytryptamine; NA, noradrenaline; NFT, neurofibrillary tangles; AD, Alzheimer’s disease; PD, Parkinson’s disease; HD, Huntington’s disease; ALS, Amyotropic lateral sclerosis; ASD, autistic spectrum disorders.
Many pathological events are characterized by a persistent inflammatory response, as observed in patients suffering from sinonasal diseases, such as acute or chronic rhinosinusitis, allergic or non-allergic rhinitis [127, 128, 129] (Table 2). In addition to nasal congestion and altered mucus secretion, these conditions represent a common cause of olfactory impairment [127, 128, 130, 131, 132]. For instance, it has been reported that between 14 and 30% of the patients affected by chronic rhinosinusitis (CRS) show olfactory dysfunction [129, 132, 133, 134]. The inflammatory event underlying sinonasal pathologies can be divided in two processes: the inflammatory mechanism itself and the conductive (or transport) component [127, 128, 129, 135], which compromises the proper diffusion of odorants towards the olfactory neuroepithelium [136, 137, 138]. The functionality of the nasal epithelium is affected since the topical inflammation reduces the airflow and subsequently the binding of the odor molecules to the ORs expressed on their cilia. The synthesis of pro-inflammatory factors can induce the loss or impairment of the ORs, which are then unable of signal transmission due to a reduced detection threshold [129, 135]. Several studies suggest that the relation between CRS and olfactory dysfunction could be multifactorial, since several events can trigger olfactory disbalance in chronic rhinosinusitis cases, such as the different degree of the inflammatory response [131, 132, 137] or the medical or surgical intervention in patients suffering from this pathology [129, 132]. Moreover, it has been described that CRS patients with anosmia present an altered mucus composition, which affects olfactory epithelium neurogenesis [139]. To evaluate and monitor the entity of olfactory loss in CRS subjects various tests can be carried out [140, 141] and also the detection of biomarkers, such as neuron-specific enolase [142] could provide further support in predicting the development of such disorder. All together, these evidence indicate that a constant inflammatory status of the nasal mucosa, in presence of rhinitis, sinusitis and rhinosinusitis can lead to a variable spectrum of olfactory dysfunctions whose severity depends from the inflammatory degree itself. The chronic inflammation in CRS and the absence of the BBB between the primary and secondary olfactory areas poses a serious risk for the propagation of neuroinflammatory species leading to neurodegenerative events. Indeed, a recent report indicates that patients with a history of chronic sinusitis are more prone to develop dementia [143] or stroke [144, 145]. This supports the notion that peripheral sinus inflammation should be promptly treated with pharmacological and surgical approaches, to contain the symptoms of nasal obstruction and prevent the neuroinflammatory spread.
Pathology | Olfactory impairment | References |
---|---|---|
Chronic inflammation (Chronic Rhinosinusitis) | Anosmia, hyposmia | 127–129, 133, 134 |
Cancer (Head–neck cancer) | Hyposmia, dysosmia | 20, 146, 156, 157 |
Traumatic brain injury | Reversible anosmia, reversible hyposmia, reversible parosmia | 19, 176–179, 184, 185 |
Neuropsychiatric disorders (Schizophrenia and ASD) | Hyposmia, hyperosmia, dysosmia | 60, 61, 189–193, 196–198, 219, 220 |
Neurodegenerative diseases (Alzheimer’s, Parkinson’s and Huntington’s disease) | Hyposmia | 17, 24–26, 226–228, 236–240 |
Summary of the diseases described in this chapter and their observed olfactory alterations.
Studies on head and neck cancer (HNC) reported that different symptoms associated to the treatment, such as radiotherapy and chemotherapy, can include smell and taste dysfunction [20] (Table 2). The impairment in these senses can appear early in HNC patients and progressively become more severe in the long-term period [146]. Laryngeal cancer patients which are best treated by total laryngectomy, based on removal of the nasal neuroepithelium, suffer from hyposmia and gustatory alteration [21, 147]. In normal conditions the olfactory receptors are not considered as potential contributors in cancerogenesis, but their physiological capability in binding to organic compounds and the subsequent signal transduction essential for survival or migratory events could support their involvement in fostering cancer cells [148, 149, 150]. Interestingly, it has been described that some ORs are present in other tissues and organs not related to the “olfactory circuit”, such as muscle [151], kidney [152] and lung [22]. Former studies demonstrated that one OR is implicated in the pathobiology of prostate cancer cell migration and proliferation, making this protein a possible parameter to monitor the patient’s clinical condition [150, 153, 154]. Recently, Ranzani and colleagues investigated the characteristics of olfactory receptors in cancer cell lineage and tumors. Interestingly, they found that several ORs are expressed in different tumorigenic cell lines and tumors, e.g. the OR2C3 has been observed both in diverse cancer lines and melanomas, suggesting that this receptor might participate to the development of this tumor [23, 155]. Numerous studies showed that more than 70% of cancer cases show taste and smell dysfunctions [156]. Most of these alterations are reported after cancer treatment [157], whereas changes in these senses in pre-treatment phase are not clarified. The reasons could be attributed to multiple events, like (1) mechanical interference, due to tumor obstruction of the chemoreceptor sites; (2) neurological origin, where cancer affects signal transmission; and (3) metabolic, related to a higher urea concentration in the saliva associated to tissue catabolism [23, 158].
Another fundamental aspect which connects cancer and olfaction is the employment of this sense in early detection of this pathology. In particular, canine olfaction and lately electronic noses (e-noses) represent a promising, non-invasive manner to screen tumors [159, 160, 161]. The high sensitivity of dogs in odorants perception render them suitable for this clinical purpose, in fact they are used to distinguish healthy controls and cancer subjects upon exposure of biological samples, whereas the electronic noses present chemo-sensory components able to identify specific biomarkers in exhaled breath [161]. Both canines and e-noses can detect volatile organic compounds (VOCs) in biological specimens. It is well recognized that dogs can perceive specific VOCs in several samples, such as urine, expired breath, blood and stool [162, 163, 164, 165, 166]. For instance, diverse VOCs have been identified in the breath of individuals affected by lung, ovarian, prostate, bladder and colorectal tumor [167, 168, 169, 170]. The use of electronic noses is increasing as differently from dogs, do not require training and maintenance, are relatively inexpensive and easy to handle. These new devices can analyze volatile molecules present in expired air via gas chromatography and chemosensory apparatus [171, 172, 173, 174, 175]. Notably, both canine olfaction and e-noses represent two powerful systems in detecting several kinds of tumors during their asymptomatic stages allowing an earlier and potentially more effective therapy. Overall, it appears that olfactory deficits are involved in the clinical phase of cancer progression, and atypical odor identification can be employed to diagnose mutagenic processes early on.
Traumatic brain injury (TBI) constitutes one of most frequent causes of olfactory dysfunction, affecting both genders [19, 176, 177, 178] (Table 2). One of the first medical reports about OD, in 1864, described a post-traumatic total loss of smell and a more dated description of anosmia was reported in 1837 after head trauma (HT) from a horse riding accident [179]. Depending on the severity of the trauma, the degree of olfactory impairment can show a quite diverse clinical outcome ranging from microsmia to anosmia [178, 180, 181, 182], which can be in both cases partially recovered [181, 182]. Subjects affected by parosmia show a gradual recovery of olfactory ability following a medium-long term period after the accident [178, 181]. The severity of the trauma depends also from the cranial region interested, i.e. frontal injury is associated with a lower olfactory disability compared to the temporal and occipital lobes [181], although there is contradictory evidence on the latter [179]. After head injury, MRI analysis revealed a reduction in olfactory bulb volume as compared to control subjects [178, 181]. The reason why after HT the sense of smell is often permanently lost is due to the failed regeneration of the olfactory neuroepithelium, which directly impacts the signal transmission to the OB. In particular, the axonal re-growth of the OSNs is influenced by the injury degree [183], since it can severely compromise the ONL over its whole length [181]. A crucial aspect, which is widely debated, is the olfactory function recovery after a traumatic brain injury (TBI), which distinguishes the post-TBI hyposmia as mild, medium and severe [178]. Several studies indicate a proportional cause–effect event between trauma severity and olfactory impairment [184, 185], whereas other works suggest that the TBI entity is not directly correlated with the degree of olfactory dysfunction [179, 180]. The trauma can also have indirect consequences on the olfactory system performance, affecting cortical and subcortical areas, which are involved in the physiological olfactory responsiveness. In clinical trials, it has been observed that administration of therapeutics, such as steroids, might improve the olfactory activity in trauma subjects [186, 187, 188]. By favoring the re-absorption of the edema or removal of the hematoma in the affected area, steroids can increase or restore the sense of smell [188]. Overall, these observations indicate that hyposmia is one of the subtlest sensory changes after trauma, which may phenotypically signal regenerative processes in these patients.
A substantial number of studies indicates a correlation between schizophrenia and olfactory impairment (Table 2). There are several aspects of olfaction that can be assessed to characterize the schizophrenia-spectrum disorders (SSD). In particular, subjects affected by this neuropsychiatric disease present alterations in performing correctly diverse olfactory tasks, such as odor sensitivity, identification and discrimination, when exposed to different odorants [60, 61, 189, 190, 191, 192]. Due to the disbalance in olfactory activity, it has been suggested to consider this deficit as a parameter to identify SSD. Moreover, the negative symptoms which characterize this illness have been related to the dysfunction in olfactory accuracy [193]. Nevertheless, there are controversial reports describing an alteration in the sense of smell in schizophrenia-associated disorders [190, 194] and others showing the absence of olfactory changes between psychotic patients and healthy controls [193, 195, 196]. Starting from this discrepancy, Auster and colleagues addressed whether the presence of olfactory deficits could represent a reliable marker for subjects potentially susceptible to develop schizophrenia. They investigated this aspect comparing the smell functionality in four different groups: (1) schizophrenic individuals, (2) persons with different mental disorders than schizophrenia, (3) subjects affected by schizotypy and (4) healthy controls [193]. To achieve their goal, they modified a common olfaction test, the “Sniffin’ Sticks” [193, 197], in order to expand its efficiency for free recall tests in addition to olfaction ability and discrimination. They observed that schizophrenic people appear to have a reduced assortment of pleasant odors compared to healthy subjects and they report smells as less good over the controls [193, 196, 198], being in line with other reports [66, 193, 196, 198, 199]. Functional and structural alterations of the olfactory circuitry have been observed in schizophrenic patients using fMRI analysis [200] and electro olfactogram (EOG) measuring olfactory evoked potentials (EP) [194, 201]. At the biomarker level, cell culture preparations from nasal epithelium showed an alteration in G protein-coupled receptors (GPCRs) cascade, likely affecting the olfactory processing observed in this psychiatric disorder [202]. Another study reported that schizophrenic subjects are characterized by aberrant neuronal differentiation in the nasal neuroepithelium [203] suggesting that neurodevelopmental deficits may underlie the olfactory dysfunction. Indeed, prenatal or perinatal inflammation [204, 205] affect brain development and may cause the excitatory/inhibitory (E/I) disbalance characteristic of schizophrenia. Works in mice have demonstrated that NMDA hypofunction has a characteristic temporal and spatial resolution that explains the onset of schizophrenia: in early postnatal life, NMDA dysfunction occurs first in GABAergic interneurons, leading to excitatory derepression. As a compensatory mechanism, a progressive homeostatic downregulation of glutamatergic of NMDA transmission, results in NMDA hypofunction of cortical excitatory networks in the adult [206]. Based on the composition of the olfactory bulb, with a major inhibitory component and mitral cells representing the only excitatory neurons, it is conceivable that olfactory transmission defect can arise early on due to the interference of feedforward inhibition of PGC and GC onto mitral cells, necessary for olfactory signal sorting/scaling [207, 208, 209]. The connection between neurodevelopmental deficits, E/I imbalance and olfactory deficits in adult life is captured by the numerous studies indicating that the developmental molecule Reelin [210], regulating synaptic plasticity, behavior [211, 212, 213] and olfaction [30], is reduced in a subset of interneurons in the prefrontal cortex of schizophrenic patients [214]. Interestingly, Reelin deficiency has also been reported in AD [215, 216, 217], suggesting common mechanisms between schizophrenia and progressive neurodegeneration. E/I imbalance also alters dopaminergic transmission. In the setting of local and corticofugal dopaminergic innervation to the bulb, it is expected that olfactory signal transmission may be also affected, as previously demonstrated in rats treated with inhibitors of D2 receptor [218]. This body of studies supports the notion that olfactory impairment may be an early indicator of E/I imbalance.
Only recently the attention has been pointed on the possibility of olfactory deterioration in autism spectrum disorders (ASD), comprising autism (stricto sensu) and Asperger syndrome [219, 220] (Table 2). ASD individuals reported an unpleasant strong perception of odors and Galle and colleagues demonstrated that depending on the olfactory tasks performed, a difference in autistic, Asperger and control subjects could be recognized. In particular, the olfactory identification was affected in autistic individuals compared to the other groups [219]. Furthermore, studies using rodent models indicate the olfactory bulb among the brain regions critical for ASD pathogenesis [221, 222, 223]. Moreover, the OR2L13G-protein locus, initializing neuronal response to odorants, was shown to be differentially methylated in ASDs suggesting a possible rationale for olfactory dysfunction in these pathologies.
Developmental NMDA hypofunction is also reported in ASD [224, 225]. In both schizophrenia and ASD, E/I imbalances at bulbar and cortical level likely underlie the olfactory transmission alterations.
Olfactory activity progressively decreases with aging [14] and its decline is even accelerated with chronic neurodegenerative disorders, such as Alzheimer’s disease (AD) [25, 26], Parkinson’s disease (PD) [17, 24] and Huntington’s disease (HD) [226, 227] (Table 2). Olfactory dysfunction in PD is very prominent (90% of the cases) [228] and the extent of the impairment is comparable to the one observed in early onset AD and other progressive neurodegenerative disorders. Indeed, in the initial stages of AD the olfactory function is the first to be affected [24], so this sense could represent an early predictor of the disease. Olfactory dysfunction observed in progressive neurodegenerative diseases could underlie impairments in either the olfactory neuroepithelium, OBs, LOT or olfactory cortices [42]. Interestingly, it has been reported that proteinaceous aggregates, like Amyloid-β [33], phosphorylated Tau [34, 35, 229], α-synuclein [230, 231], which are characteristic of AD, PD and HD, are deposited in first instance in the olfactory mucosa where they are thought to exert a bactericidal action [232]. The aberrant accumulation of misfolded proteins can trigger several side effects, causing a transduction deficit and inflammatory responses attempting to reduce/avoid the microbial diffusion into the brain. Based on the absence of the BBB in the olfactory tract, cells and misfolded proteins can be easily propagated within the brain and subsequently affect other olfactory system components, as olfactory cortices and connected areas (hippocampus and amygdala) [233]. All these cerebral structures and their related functions are damaged in AD, and to a lesser extent in normal aging [42]. Interestingly, OB and olfactory tract axonal atrophy has been already detected in MCI which might progressively evolve in AD [234]. In the initial Braak stages, the OB undergoes axonal atrophy [235] and in the majority of definite AD cases the olfactory impairment correlate with cortical AD pathology [236, 237, 238, 239, 240]. These observations implicate an early critical involvement of the olfactory system in neurodegenerative disorders.
Several molecular mechanisms contributing to AD pathobiology have been demonstrated to interfere with olfaction:
Amyloid-β, which is overexpressed in AD and contributes to the amyloidogenic pathway, has physiological functions, ranging from metal ion sequestration, synaptic plasticity modulation, and antimicrobial activity [33]. The amyloid peptide shares some aspects with a highly conserved antimicrobial proteins (AMPs) family [232]. Based on their ability to form oligomers and fibrils to surround harmful microbial agents, toxic substances and even aberrant cells, the AMPs produced by the OSNs represent the first and only defensive barrier of the CNS against pathogens. Furthermore, beside its endogenous production, Aβ may also have a microbial origin, aggravating the neurodegenerative process [39, 241]. The gastrointestinal (GI) compartment represents the principal source of the human microbiome and is tightly connected with the CNS through the GI tract-CNS axis, which interconnects these structures via immune system molecules, cytokines, hormones and nervous signals [39, 242, 243, 244]. Interestingly, the microorganisms residing in the GI tract can synthesize several peptides including lipopolysaccharides (LPS) and amyloids [241, 242, 245, 246]. These evidence indicate that a mutual benefit host-microbiome is also related to the production of these amyloid exudates within a “homeostatic range”, that, when disbalanced, could likely contribute to the etiology of chronic neurodegenerative diseases [247, 248, 249, 250]. Therefore, the impairment observed in amyloid turnover and clearance during neurodegenerative pathologies could be attributed to the combination of “human Aβ burden” and the additional microbial Aβ peptides. This growing amyloid load in the OE and GI tract, can cause chronic inflammation which on the long run may affect BBB integrity and functionality [38, 39, 247, 251, 252, 253]. Overall, the deposition of insoluble Amyloid-β causes several side effects as (i) olfactory transduction deficit due to interference with OSN surface receptors, (ii) inflammatory responses attempting to reduce/prevent the microbial diffusion and (iii) seeding activity into the brain.
ApoE4 carriers have a higher incidence of olfactory deficit and are at risk for developing AD [254]. Moreover, ApoE4 blocks OE cultures neurite outgrowth in contrast to the trophic role of ApoE2 and ApoE3 [255].
Reports show SOD upregulation in OE and OB in AD patients compared to healthy controls [256] as well as an increase in oxidative response in AD neuroepithelium [255].
Along with network hyperactivity in the early stages of dementia, a reduction of calcium binding proteins has been observed in OSNs [257].
Imbalances in Acetylcholine (ACh) [258, 259], Dopamine (DA) [260, 261, 262], Serotonin (5-HT) [57, 263], and Norepinephrine (NA) [264] of the centrifugal afferents to the bulb or olfactory cortex affect olfactory transmission but can also influence microglia activation and neuroinflammatory processes [265, 266].
Transient overexpression of hAPP impacts the glomeruli structure and axonal projections towards the corresponding target [267], which is partially rescued by switching off the synthesis of hAPP.
Dystrophic axon terminals favor amyloid deposition in AD and other disorders [116].
Progressive reduction in neuronal signaling components such as Reelin [268, 269] and Notch [270, 271] in AD may influence olfactory transmission as shown in rodent models [30, 272].
Despite the non-specificity of olfactory dysfunction in neurodegenerative diseases, this deficit is apparent in the pre-symptomatic phase [273, 274]. The underlying mechanisms are still poorly understood and only few studies have analyzed olfactory behavior in animal models of AD (Tg2576 [36], hTau [36]) and PD (
The advantage of nasal biopsies in investigating specific olfactory disorders and also related neurodegenerative pathologies is still debated. Several studies suggest that this surgical procedure might not be specific enough to be routinely adopted in identifying primary events which anticipate neurodegenerative diseases [280]. Nevertheless, both the accessibility and heterogeneous cytoarchitecture of the olfactory neuroepithelium, make this specimen valuable for molecular diagnosis of neurological diseases [281]. Furthermore, the increasing precision and accuracy in obtaining nasal biopsies through laser surgery render this procedure safe, fast and with no major consequences, due to the constant neurogenesis occurring in the OE [282]. Nasal biopsies can be employed to detect aberrant misfolded proteins (Aβ, p-Tau, α-Syn, PrP, etc.,), produced by the OSNs, reflecting early neural network imbalances in the asymptomatic phase of different neurological pathologies. Furthermore, the stem cells population residing in the olfactory mucosa is a relevant source of biological material for diagnosing genetic modification related to neurological diseases, performing
Olfaction is one of the most essential senses in mammals throughout life and appears to be a relevant readout for both peripheral and central neural processes. The research in the past 30 years has used mouse models to cast light on important cellular and molecular mechanisms governing odor specification in the olfactory neuroepithelium and olfactory bulb and signal encoding in the cerebral cortex. During the same period, a bulk of clinical studies reported a strong association between many neurological diseases and olfactory deficits, suggesting that olfactory activity can sentinel subtle changes in key brain areas connected to the olfactory system. Nevertheless, the processes underlying this quite ubiquitous phenotypical dysfunction are poorly understood. Indeed, despite the clinical evidence from patients, relevant clinical models of neurological diseases have been rarely tested to unravel the basis of olfactory alteration. We believe that this field needs to close the gap between bench-side and bed-side research to devise better diagnostic and therapeutic strategies, which can exploit the accessibility and non-invasiveness of this cranial nerve.
This work is supported by the Swiss National Fund Grant No. 163470.
The authors declare no conflict of interests.
The exploration and development lead time of a geothermal prospect directly affects its profitability because of the yearly interest factored into the cost. Sufficient profits purely produced by geothermal resources without financial support from other budgets are essential to enhance the development of environmentally friendly geothermal resources. This is why we cannot avoid trade-offs between exhaustively studying a geothermal reservoir and rapidly advancing a geothermal project.
Figure 1 shows an example of a fiscal annual schedule during an explorational and developmental project in which the author was involved as a reservoir engineer. The project was conducted in a snowy and mountainous area in northeastern Japan, where several geothermal projects have been conducted over the last decade [1]. In such areas, the schedules of drilling, well testing, and any other work at a site are strictly limited by the snowy season. In addition, mountainous conditions limit the number of site locations that can satisfy the following conditions:
Accessibility to targets using directional or vertical drilling;
Sufficient space to install facilities for drilling and well testing;
Sufficient water supplies from nearby streams;
Accessibility to the site via paths constructed within realistic time and cost constraints including snow removal; and
The possibility of receiving permission and authorization while obeying numerous national regulations.
Example of an annual schedule during an explorational and developmental project.
Under these severe limitations, project personnel usually identify a small number of possible locations following a large amount of effort, rather than easily selecting a location from a large number of options.
Geoscientists and engineers have only a few weeks to update a reservoir model by analyzing, considering, discussing, and updating their understanding of a geothermal system after collecting all the new data from a given year (Figure 1). Under such severe conditions, it is essential to account for the updated reservoir model when planning for the subsequent fiscal year. This chapter describes a concept and techniques to construct and update a reservoir model, as well as to estimate the reservoir productivity, by making the most of the highly limited time available during an active explorational and developmental project. The concept and techniques are based on the author’s experience as a reservoir engineer in a real project even though specific information regarding the project, including the observational data, cannot be shown because of confidentiality reasons. The techniques described in this chapter have been partially reviewed and published in several articles and proceedings. This chapter focuses on practical procedures to construct a reservoir model by assembling these techniques.
Let us begin by discussing the fundamental concept involved in conventional reservoir modeling approaches. As widely accepted and detailed in textbooks [2, 3], the standard legitimate approach first involves the development of a conceptual model driven by several geological, hydrological, geophysical, and geochemical observations. This first step of the standard approach establishes the basis of the understanding of a geothermal system and requires exhaustive discussions that can comprehensively and consistently explain all the geoscientific observations. A good conceptual model plays a key role in successful reservoir modeling.
After the exhaustive study needed to construct a conceptual model, a natural-state model is developed to obey the principles of fluid dynamics, such as the conservation of mass and energy, as well as Darcy’s law governing mass fluxes in a reservoir. Numerical reservoir simulators such as TOUGH2 [4] can be adopted in this and following steps. Steady-state fluid flow due to thermal convection is generally assumed in a reservoir. The natural-state model needs to reproduce the observed static temperature and pressure wireline logging data at the explorational wells while obeying the conceptual model. Calibration of the natural-state model to satisfy these requirements involves adjusting several conditions such as the permeability distributions and boundary conditions and often necessitates numerous trial runs of the reservoir simulator. After completing the natural-state modeling, the transient pressure and temperature responses in the reservoir during well testing are finally simulated to enable history matching and the forecasting of future operational scenarios. These later steps also require trial-and-error simulations and may require going back to earlier steps to reconsider and modify the model.
Planning for the next fiscal year, including decisions with respect to continuing or stopping the explorational and developmental project, as shown in Figure 1, requires both updates of the understanding of the geothermal system to determine drilling targets and estimates of the reservoir productivity to evaluate the project profitability. Following the abovementioned standard approach, we can obtain an update of the former at an early step, while an update of the latter becomes available after completion of the final step. As a result, estimates of reservoir productivity are strongly affected by the progress of earlier steps and are often delayed.
We can attempt another approach to overcome the difficulties causing delays in the reservoir productivity estimation by advancing inversely in parallel with the standard approach [5]. A comparison between the standard and new approaches is illustrated in Figure 2. The new approach first refers to the transient pressure responses during well testing, as well as the other transient responses of the temperature and tracer concentration if possible. In this step, we focus on reproducing these transient responses using a simple reservoir model.
Comparison between the standard and new approaches.
The reservoir model may, at first, be very simple, represented by a single horizontal planar porous medium, as generally assumed in a conventional well test analysis (e.g., [6]). As the study progresses, the reservoir model is extended to become increasingly sophisticated and realistic by considering the dip and strike of the planar porous medium and three-dimensional connections between multiple planar porous media, as common in fracture reservoirs in Japan. The geometry and connectivity of the planar porous media are primarily based on direct observations, such as those made while drilling and logging, as well as pressure interference and tracer testing, rather than referring to geological or other geoscientific interpretations. Once the observed transient responses are successfully reproduced, we can progress to forecasting future operational scenarios and obtain an estimate of the reservoir productivity (i.e., the possible steam and/or brine production rate during an assumed operational period). Appropriately calibrated wellbore models using production logging data are often combined with the reservoir model to forecast future scenarios.
Accordingly, we can rapidly obtain a first estimate of the reservoir productivity by primarily referring to direct observations, a technique that is free of the conceptual and steady-state models considered in the standard approach. Referring to this estimate, a project manager can prepare a plan for the next fiscal year and make decisions concerning continuing or stopping the project in parallel with the ongoing standard approach. As the understanding of the geothermal system is improved with the standard approach, the reservoir model in the new approach evolves into an ever more sophisticated model that is consistent with the conceptual and natural-state models. The estimate of the reservoir productivity is also repeatedly updated. The estimates and their update history are reported continuously to the project manager; this is advantageous not only for successful project management but also for quantifying the impact of each estimate update. This new approach enables us to improve the efficiency and timeliness of estimating the reservoir productivity and to contribute to on-schedule project management.
The author developed a mathematical model and numerical code to implement this new approach for a real explorational and developmental project [5]. Instead of a multi-purpose code designed to cover a wide range of conditions, the model and code were designed to be applicable to several specific projects in which the author was involved as a reservoir engineer. Therefore, a type of discrete fracture network model was adopted to represent a single-phase fracture reservoir. As often seen in geothermal prospects in Japan, the fracture network was assumed to be roughly distributed. In other words, at most, a countable number of large fractures or fractured zones with high permeability–thickness products totally or partially intersected a geothermal field (Figure 3). Wells in such geothermal fields intersect at most at a few fractures within their drilling depths of approximately 2000 m. Excepting these fractures, formation permeabilities tend to be very low to negligible. Representative examples of such reservoirs can be found in the Takigami [7] and Ogiri [8] fields in southwestern Japan. Each fracture or fractured zone in the model is represented by a planar porous medium with a relatively high permeability–thickness product of 10−11 m2 or more. Formations, except fractures, allow only thermal conduction without mass flow.
Conceptual schematic of the reservoir model: (a) an assumed geothermal field and (b) a three-dimensional view of the fracture reservoir model beneath the assumed geothermal field.
Let us consider simulating the assumed reservoir illustrated in Figure 3 as an example. The reservoir consists of three vertical fractures generated by Faults A–C that are represented by planar porous media with the dimensions shown in Figure 4. The vertical length of each fracture is assumed to be 2 km based on geological interpretations, while the horizontal length is assumed based on a specific concept of this approach discussed in Section 5. Several production, reinjection, and monitoring wells directionally intersect the fractures. The vertical initial pressure distribution obeys hydrostatic pressure with a specified value of 10 MPa at a depth of 1000 m from the top of the fractures. The initial distribution of the specific enthalpy is uniformly 1085.8 kJ/kg, which indicates an initial reservoir temperature of approximately 250 °C. The top and bottom boundaries of each fracture are modeled with impermeable and adiabatic boundary conditions, while the left boundary of each fracture and the right boundary of Fracture C maintain constant pressure and specific enthalpy values at the initial values.
Dimensions of the planar porous media representing faults A–C illustrated in
For both the surveyed and unsurveyed regions, the permeability, thickness, and porosity of each planar porous medium representing a fracture are set to 1.0 × 10−11 m2, 5.0 m, and 20%, respectively, while the thermal conductivity and volumetric heat capacity are set to 3.0 W m−1 K−1 and 2.0 × 106 J m−3 K−1, respectively. We assume that local thermal equilibrium between the fluid in the pores and the rock matrixes within a planar porous medium is reached immediately. This implies that the selection of the thickness value controls the heat exchange efficiency between the fluid and the formation under a constant thickness–porosity product value (i.e., the effective opening width of the fracture). For example, a case with a thickness of 1 m and a porosity of 10% and a case with a thickness of 10 m and a porosity of 1% have the same thickness–porosity product value of 0.1 m; however, the latter case has a larger heat exchange efficiency. This is because the volume of the rock matrix immediately exchanging heat with the fluid in the latter case is approximately 10 times larger than that in the former case. The one-dimensional conductive heat flux in the formation perpendicular to each fracture is also included. The grid size for the numerical simulation in each fracture is a uniform 100 m near the wells and expands exponentially in the horizontal direction.
First, we consider simulating a production test for a month using a production well P1, a reinjection well R1, and monitoring wells M1, P2, and R2. This problem addresses simulating the pressure interference observed at the monitoring wells by referring to the observed flow rates at the production and reinjection wells. We assume that the observed flow rates at P1 and R1 are constant at 250.0 t h−1 and 191.6 t h−1, respectively, which implies that the produced reservoir fluid is separated into steam and water under a separator pressure of 0.35 MPaA (Figure 5a). The specific enthalpy of the reinjected water is assumed to be 561.5 kJ kg−1, and the reinjected water is composed of saturated water at a pressure of 0.30 MPaA. Then, the pressure interference at each monitoring well is simulated, as shown in Figure 5b. In practice, for a real field, we would perform matching of the simulation results with the observations by adjusting parameters such as the permeability, thickness, and porosity of the planar porous media, as well as their network structure. In the cases encountered by the author at several real fields, simulations could accurately reproduce the observed pressure interference after a few tens of trial runs.
Conditions and results of the simulation. (a) Assumed flow rates at the production well P1 and the reinjection well R1. Positive values indicate production, while negative values indicate reinjection. (b) Simulated pressure interference at the monitoring wells M1, P2, and R2.
Next, a wellbore flow model is connected to the reservoir model; this is necessary to simulate and forecast future operational scenarios under specific conditions, such as a constant wellhead pressure. The author’s numerical code implements this connection via two procedures. One is based on tabular data of the production rate depending on the feed zone pressure and the specific enthalpy. The other applies a highly refined local grid to simulate steep changes in the reservoir pressure around the wellbores.
Let us extend the reservoir model described in Section 3 by connecting it to a wellbore flow model. Using an appropriate wellbore flow simulation code (e.g., [9, 10, 11, 12, 13, 14]), we assume that the production rate at a production well P1 with a constant wellhead pressure depends on the feed zone pressure and the specific enthalpy, as shown in Figure 6. Referring to the discretized tabular data, the code dynamically determines the production rate corresponding to arbitrary values of the pressure and the specific enthalpy via a bicubic interpolation. The reinjection rate at the reinjection well R1 is also dynamically determined by referring to the production rate at P1. Note that the code can only assume the steady-state wellbore flow represented by the tabular data. Simulating unstable transient wellbore flows, which is often a problem in operational power plants, connected to a reservoir model is a goal for future studies.
Assumed production rate for the production well P1 depending on the feed zone pressure and the specific enthalpy.
The pressure distribution covering the overall reservoir, including in the vicinities of wellbores, is simulated seamlessly using the highly refined local grids described in detail by [15]. The local grid defined around a wellbore enables steep pressure changes generated by production and reinjection at the well to be simulated by adopting grid sizes down to 1 mm, which is several orders of magnitude smaller than the size of the global grid covering the total planar porous medium. As shown in Figure 7, the ring-shaped local grid has external and internal boundaries. The variable values at the external boundary are dynamically determined by the values distributed in the global grid and are interpolated using a bilinear interpolation. Conversely, the variable values at the inner boundary corresponding to the wellbore surface are dynamically determined by the mass and enthalpy flow rates between the wellbore and the reservoir. When considering the skin effect, an extra pressure loss is considered between the internal boundary and the inside of the wellbore. When assuming the dependence of the production rate, as described in the previous paragraph, the production rate is determined as a solution of a coupled problem between this dependence and the fluid flow in the local grid. The determined production rate is referenced by the global grid to simulate the fluid flow in the global grid. Therefore, simulations in the global and local grids are dynamically coupled by referring to each other.
Highly refined local grid around an 8.5-inch wellbore superimposed on a global grid shown on different scales.
The simulated production and reinjection rates, as well as the pressure interference, using the extended model are shown in Figure 8. In this model, the production well P1 is equipped with tabular data for the production rate and a highly refined local grid assuming a hole size of 8.5 in. Selecting a value of 1.0 for the skin factor of P1, the simulated production and reinjection rates are similar to those assumed in the model described in Section 3. In fact, the production rate decreases gradually from 270.6 t h−1 to 243.0 t h−1 over the simulation period of 30 d. In this step of practical modeling connecting the wellbore and reservoir models, only the skin factors are modified to match the simulated production rates with the observations, and the other parameter values of the planar porous media, such as permeability, thickness, and porosity, are maintained. In other words, the procedures in Sections 3 and 4 are straightforward.
Results of the simulation. (a) Simulated flow rates at the production well P1 and the reinjection well R1 using tabular data for the production rate and a highly refined local grid. Positive and negative values indicate production and reinjection, respectively. (b) Simulated pressure interference at the monitoring wells M1, P2, and R2.
The simulated pressure distribution around the production well P1 is shown in Figure 9 on linear and logarithmic scales. The pressure distribution simulated using the local grid is smoothly connected to that simulated using the global grid and successfully reproduces a steep pressure drop in the vicinity of P1 (Figure 9a). On the logarithmic scale, it can be seen that the pressure increases proportionally to the logarithmic distance from the wellbore axis (Figure 9b), which is consistent with the solution of the problem assuming radial flow from a line-source adopted in the conventional well test analysis (e.g., [6]).
Horizontal pressure distribution at the feed zone depth of the production well P1. (a) Pressure distribution on a linear scale simulated using the local grid (solid line) superimposed on that simulated using the global grid (broken line). (b) Pressure distribution on a logarithmic scale simulated using the local grid.
Finally, let us estimate the productivity of the above-discussed reservoir model by forecasting operational scenarios. We consider 15-year scenarios using the production wells P1 and P2, reinjection wells R1 and R2, and monitoring well M1. Both production wells obey the wellbore flow model described in the previous section. Forecasting scenarios for 15 years based on production tests for, at most, a few months involves uncertainty. We attempt to quantify this uncertainty by defining the surveyed and unsurveyed regions as illustrated in Figure 4.
Performing a longer production test, transient reservoir pressure responses are constrained by the wider spatial range reservoir properties, as discussed using the radius of investigation in the conventional well test analysis. We define the surveyed region as the region that constrains the simulated pressure responses when matching with observations, while the unsurveyed region is too distant to constrain the simulated pressure responses. Examining the effects of modifying the reservoir properties on the simulated pressure responses, the boundaries between the surveyed and unsurveyed regions are determined by trial and error. The boundaries move farther when performing longer production tests, indicating that the uncertainty in the forecasting scenarios becomes smaller. Note that defining the surveyed and unsurveyed regions, as well as extending the reservoir model to a huge horizontal distance, are symbolic parameterization methods for the uncertainty in terms of the transient pressure responses and do not include geological or other geoscientific insights.
Once we define the unsurveyed region, natural recharge and/or discharge over the boundaries between the surveyed and unsurveyed regions can be quantified using the permeability in the unsurveyed region as a symbolic parameter. Theoretically, the most optimistic case is to take the limit as the permeability approaches infinity, which is equivalent to assuming constant-pressure boundaries between the surveyed and unsurveyed regions. Conversely, the most pessimistic case is to set the permeability to zero, indicating impermeable boundaries. Modifying the permeability between zero and infinity, we can continuously control the magnitude of natural recharge and/or discharge. Even though, in the strictest sense, we have no information about the unsurveyed region, a probable case can be defined by giving the unsurveyed region the same permeability value as that in the surveyed region. All the parameters in the unsurveyed region, except the permeability, are assumed to be equal to those in the surveyed region.
In this chapter, we assume that the boundaries between the surveyed and unsurveyed regions are approximately 100 km from the wells (Figure 4). In the unsurveyed regions, the permeability values are randomly and independently selected in a range from 1.0 × 10−13 m2 to 1.0 × 10−9 m2 at each planar porous medium, while the permeability in the surveyed region is constant at 1.0 × 10−11 m2. The probability distribution of the selection is assumed to be uniform in this range on a logarithmic scale. Under these conditions, temporal changes in the simulated total production rates from the two production wells P1 and P2, as well as the pressure changes at the monitoring well M1, for 100 trial runs are shown in Figure 10. For reference, the probable, most optimistic, and most pessimistic cases are also shown; these cases assume uniform permeability values in the unsurveyed regions of 1.0 × 10−11 m2, 1.0 × 10−9 m2, and 1.0 × 10−13 m2, respectively. The simulated changes in the production rates and the reservoir pressures for all trial runs exhibit unique changes for approximately three months following the start of production. This indicates that the surveyed region extending 100 km from the wells constrains the changes during this period.
Temporal changes in the total production rates at the production wells P1 and P2, as well as the pressure changes at the monitoring well M1, for 100 trial runs. Because the code is only capable of simulating single-phase reservoirs, runs whose reservoir pressure drops below the boiling pressure are terminated prior to 15 y.
Summarizing the results of all the trial runs, we obtain monomodal frequency distributions for the production rates and the pressure changes, as shown in Figure 11. The medians of these distributions indicate a slightly more optimistic case (i.e., a larger production rate and a smaller pressure interference) than the probable case. This implies that a relatively high permeability value occurring in one unsurveyed region can result in a large overall reservoir productivity regardless of the low permeabilities in the other unsurveyed regions.
Frequency distributions for the total production rates at the production wells P1 and P2, as well as the pressure changes at the monitoring well M1, after production for 8.0 y for 100 trial runs.
Accordingly, we obtain a present estimate of the reservoir productivity. Accounting for the power generation capacities corresponding to the forecasted production rates, the price of electricity, and the costs for the entire project, we can calculate the series of cash flows during the project period, as well as several profitability indices, such as the net present value and the internal rate of return. If the reservoir model is updated as a result of the in-parallel progress of the standard approach, the frequency distributions shown in Figure 11 are also immediately updated via the procedures described in this chapter. The author mentions again and emphasizes that the new approach proposed in this chapter cannot stand alone because the standard approach, which exhaustively studies the geothermal system in terms of several geoscientific fields, is also essential. The combination of these approaches enables us to make the most of the limited time available during active explorational and developmental projects.
Here, we briefly remark on forecasting temperature changes. As mentioned above, this chapter’s approach aims to directly adhere to the observed transient responses as much as possible rather than referring to geological or other geoscientific interpretations. However, it is generally difficult to effectively forecast temperature changes in a reservoir over the decades of an assumed operational period. This is because promising prospects often do not exhibit detectable temperature changes at both production and monitoring wells during production tests. Even though tracer testing provides useful insights into advection from reinjection to production wells, it is not always sufficient to constrain the heat exchange efficiency between the fluid and the formation (i.e., it is not sufficient to determine the thickness of a planar porous medium, as mentioned in Section 3) while flowing in a reservoir.
To overcome this limitation, we need to develop measures to determine the heat exchange efficiency between the fluid and the formation rather than improve the modeling techniques. One possible technique may be to use dual tracers with different thermal resistivities, as proposed by [16]. The authors of that study proposed that temporal changes in the concentration ratio of a mixture of thermo-resistant and thermo-sensitive tracers depend on the temperature. Using this principle, we can monitor the temperatures experienced by reinjected fluid while it flows between the reinjection and production wells; this depends on the heat exchange efficiency between the reinjected fluid and the formation. A simulation from this viewpoint using dual tracers by [5] demonstrated the detection of two flow paths with different temperatures in a reservoir. Another possible technique may be to perform a push-pull test, which compares the temperatures of injected and pumped-up fluids using a single well.
The author has developed an approach to estimate reservoir productivity under severe schedule limitations. Such limitations can originate from limited access to sites for drilling and well testing under snowy and mountainous conditions. To make the most of the limited time available, the new approach progresses in parallel with the conventional standard approach with an inverse approach using the transient responses observed while performing production tests, which are referenced in the final step of the standard approach. Combining these approaches, estimates of reservoir productivity can be rapidly generated. This feature is of value to successfully manage explorational and developmental projects.
Assuming a practical geothermal field, the author has demonstrated the procedures of this new approach. The procedures are straightforward: the pressure interference is simulated at the monitoring wells, the production and reinjection rates are simulated by combining the wellbore and reservoir models, then future operational scenarios are forecasted. By defining surveyed and unsurveyed regions, the reservoir model strictly divides the simulation period into an earlier period constrained by observations through the parameters in the surveyed region and a later period with no constraints. Performing a number of trial runs while randomly selecting permeability values in the unsurveyed regions, we can obtain frequency distributions for estimates of the reservoir productivity and successfully make project management decisions.
We thank Martha Evonuk, PhD, from Edanz Group (https://en-author-services.edanz.com/ac) for editing a draft of this manuscript.
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Pedro",middleName:null,surname:"García Márquez",slug:"fausto-pedro-garcia-marquez",fullName:"Fausto Pedro García Márquez"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10669",title:"Corrosion",subtitle:"Fundamentals and Protection Mechanisms",isOpenForSubmission:!1,hash:"4a76d54f8a40fc2e7002a8d13fd617c1",slug:"corrosion-fundamentals-and-protection-mechanisms",bookSignature:"Fahmina Zafar, Anujit Ghosal and Eram Sharmin",coverURL:"https://cdn.intechopen.com/books/images_new/10669.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"89672",title:"Dr.",name:"Fahmina",middleName:null,surname:"Zafar",slug:"fahmina-zafar",fullName:"Fahmina Zafar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10677",title:"Advanced Topics of Topology",subtitle:null,isOpenForSubmission:!1,hash:"bf964c52f9e653fac20a7fcab58070e5",slug:"advanced-topics-of-topology",bookSignature:"Francisco Bulnes",coverURL:"https://cdn.intechopen.com/books/images_new/10677.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"92918",title:"Dr.",name:"Francisco",middleName:null,surname:"Bulnes",slug:"francisco-bulnes",fullName:"Francisco Bulnes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"11195",title:"Recent Advances in Biometrics",subtitle:null,isOpenForSubmission:!1,hash:"2d32e33e0f499cb5241734bb75dd2a83",slug:"recent-advances-in-biometrics",bookSignature:"Muhammad Sarfraz",coverURL:"https://cdn.intechopen.com/books/images_new/11195.jpg",editedByType:"Edited by",publishedDate:"July 27th 2022",editors:[{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"338",title:"Arboriculture",slug:"arboriculture",parent:{id:"38",title:"Horticulture",slug:"horticulture"},numberOfBooks:3,numberOfSeries:0,numberOfAuthorsAndEditors:121,numberOfWosCitations:61,numberOfCrossrefCitations:58,numberOfDimensionsCitations:106,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicId:"338",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"11334",title:"Olive Cultivation",subtitle:null,isOpenForSubmission:!1,hash:"a783fb2885f272e9cc191abc84c097a1",slug:"olive-cultivation",bookSignature:"Taner Yonar",coverURL:"https://cdn.intechopen.com/books/images_new/11334.jpg",editedByType:"Edited by",editors:[{id:"190012",title:"Associate Prof.",name:"Taner",middleName:null,surname:"Yonar",slug:"taner-yonar",fullName:"Taner Yonar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10900",title:"Prunus",subtitle:"Recent Advances",isOpenForSubmission:!1,hash:"9261926500acb26c4ae5a29eee78f0db",slug:"prunus-recent-advances",bookSignature:"Ayzin B. Küden and Ali Küden",coverURL:"https://cdn.intechopen.com/books/images_new/10900.jpg",editedByType:"Edited by",editors:[{id:"200365",title:"Prof.",name:"Ayzin B.",middleName:"B.",surname:"Küden",slug:"ayzin-b.-kuden",fullName:"Ayzin B. Küden"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5179",title:"Organic Fertilizers",subtitle:"From Basic Concepts to Applied Outcomes",isOpenForSubmission:!1,hash:"93748f3bd6a9c0240d71ffd350d624b1",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",bookSignature:"Marcelo L. Larramendy and Sonia Soloneski",coverURL:"https://cdn.intechopen.com/books/images_new/5179.jpg",editedByType:"Edited by",editors:[{id:"14764",title:"Dr.",name:"Marcelo L.",middleName:null,surname:"Larramendy",slug:"marcelo-l.-larramendy",fullName:"Marcelo L. Larramendy"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:3,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"50478",doi:"10.5772/62473",title:"Bio-Organo-Phos: A Sustainable Approach for Managing Phosphorus Deficiency in Agricultural Soils",slug:"bio-organo-phos-a-sustainable-approach-for-managing-phosphorus-deficiency-in-agricultural-soils",totalDownloads:2095,totalCrossrefCites:8,totalDimensionsCites:18,abstract:"Sustainable agriculture is essential for a positive relationship between supply and demand of food for the growing world population. This relationship was found to be affected by many environmental factors, including biotic and abiotic. From the point of view of crop nutrition, sustainability in the supply of essential nutrients particularly phosphorus is vital. Due to the energy crisis, the fluctuation in the prices of chemical fertilizers, environmental concerns, and cessation in the supply of high quality rock phosphate (RP) are hindering the use of chemical phosphatic fertilizers for sustainable crop production. Therefore, there is great need for a sustainable solution to this problem. It could be solved by employing a strategy to use native low quality RP. It is only possible by composting of organic material in the presence of RP and phosphate solubilizing microorganisms. During composting, most of organic P is mineralized. Due to release of organic acids, P availability to crop plants increases. In this chapter, the importance of economical and sustainable sources of P and comparative efficacy of the use of organic fertilizer containing RP for legumes is critically reviewed.",book:{id:"5179",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",title:"Organic Fertilizers",fullTitle:"Organic Fertilizers - From Basic Concepts to Applied Outcomes"},signatures:"Allah Ditta and Azeem Khalid",authors:[{id:"149636",title:"Dr.",name:"Allah",middleName:null,surname:"Ditta",slug:"allah-ditta",fullName:"Allah Ditta"}]},{id:"50720",doi:"10.5772/62529",title:"Use of Organic Fertilizers to Enhance Soil Fertility, Plant Growth, and Yield in a Tropical Environment",slug:"use-of-organic-fertilizers-to-enhance-soil-fertility-plant-growth-and-yield-in-a-tropical-environmen",totalDownloads:5117,totalCrossrefCites:11,totalDimensionsCites:18,abstract:"Soils rarely have sufficient nutrient for crops to reach their potential yield. Applying organic fertilizers without prior knowledge of their properties may cause yield decline under low application or pollute the environment with excessive application. Understanding the nutrient variability and release pattern of organic fertilizers is crucial to supply plants with sufficient nutrients to achieve optimum productivity, while also rebuilding soil fertility and ensuring protection of environmental and natural resources. This chapter presents the authors’ experiences with different organic amendments under Hawaii's tropical conditions, rather than an intensive literature review. For meat and bone meal by‐products (tankage), batch‐to‐batch variability, nutrient content/release pattern and quality, and plant growth response to the liquid fertilizer produced from tankage were evaluated. For animal livestock, dairy manure (DM) and chicken manure (CM) quality, changes in soil properties, and crop biomass production and root distributions were evaluated. For seaweed, an established bio‐security protocol, nutrient, especially potassium (K) variability, and plant growth and yield response were evaluated in different tropical soils.",book:{id:"5179",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",title:"Organic Fertilizers",fullTitle:"Organic Fertilizers - From Basic Concepts to Applied Outcomes"},signatures:"Amjad A. Ahmad, Theodore J.K. Radovich, Hue V. Nguyen, Jensen\nUyeda, Alton Arakaki, Jeana Cadby, Robert Paull, Jari Sugano and\nGlenn Teves",authors:[{id:"178933",title:"Dr.",name:"Amjad",middleName:"A.",surname:"Ahmad",slug:"amjad-ahmad",fullName:"Amjad Ahmad"},{id:"184973",title:"Dr.",name:"Theodore",middleName:null,surname:"Radovich",slug:"theodore-radovich",fullName:"Theodore Radovich"},{id:"184974",title:"Prof.",name:"Hue",middleName:null,surname:"Nguyen",slug:"hue-nguyen",fullName:"Hue Nguyen"},{id:"184975",title:"MSc.",name:"Jensen",middleName:null,surname:"Uyeda",slug:"jensen-uyeda",fullName:"Jensen Uyeda"},{id:"184976",title:"MSc.",name:"Alton",middleName:null,surname:"Arakaki",slug:"alton-arakaki",fullName:"Alton Arakaki"},{id:"184977",title:"Mr.",name:"Glenn",middleName:null,surname:"Teves",slug:"glenn-teves",fullName:"Glenn Teves"},{id:"184978",title:"MSc.",name:"Jeana",middleName:null,surname:"Cadby",slug:"jeana-cadby",fullName:"Jeana Cadby"},{id:"184979",title:"Prof.",name:"Robert",middleName:null,surname:"Paull",slug:"robert-paull",fullName:"Robert Paull"},{id:"184980",title:"MSc.",name:"Jari",middleName:null,surname:"Sugano",slug:"jari-sugano",fullName:"Jari Sugano"}]},{id:"51059",doi:"10.5772/64195",title:"Organic Fertilizers: Public Health Intricacies",slug:"organic-fertilizers-public-health-intricacies",totalDownloads:2749,totalCrossrefCites:10,totalDimensionsCites:16,abstract:"Organic fertilizers are an essential source for plant nutrients and a soil conditioner in agriculture. Due to its sources and the composition of the organic inputs as well as the type, functionality and failures of the applied treatment process, the organic fertilizer may contain various amounts of infectious agents and toxic chemicals, especially the antibiotics that can be introduced to the subsequent food chain. A range of human and animal pathogens of bacterial, viral and parasitic origin have been the cause of food-borne epidemics due to unintended contamination from organic fertilizers. The use of antibiotics by humans and in animal feeds will also end up in the organic fertilizers. These antibiotics and other chemicals, depending on the sources of the organics, will enhance the likelihood of occurrence of resistant and multi-resistant strains of microorganisms in society and have been reported to cause ecotoxicological environmental effects and disruption of the ecological balance. Exposure of microorganisms to sublethal concentration of antibiotics in the organic products induces antibiotic resistance. WHO guidelines for the reuse of excreta and other organic matters identify the risk for the exposed groups to the reuse of the excreta and are applicable in the use of organic fertilizers in agriculture.",book:{id:"5179",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",title:"Organic Fertilizers",fullTitle:"Organic Fertilizers - From Basic Concepts to Applied Outcomes"},signatures:"Anthony A. Adegoke, Oluyemi O. Awolusi and Thor A. Stenström",authors:[{id:"175730",title:"Dr.",name:"Anthony Ayodeji",middleName:null,surname:"Adegoke",slug:"anthony-ayodeji-adegoke",fullName:"Anthony Ayodeji Adegoke"},{id:"180623",title:"Dr.",name:"Oluyemi Olatunji",middleName:null,surname:"Awolusi",slug:"oluyemi-olatunji-awolusi",fullName:"Oluyemi Olatunji Awolusi"},{id:"186321",title:"Prof.",name:"Thor Axel",middleName:null,surname:"Stenstrom",slug:"thor-axel-stenstrom",fullName:"Thor Axel Stenstrom"}]},{id:"50516",doi:"10.5772/63047",title:"Soil Amendments for Agricultural Production",slug:"soil-amendments-for-agricultural-production",totalDownloads:2390,totalCrossrefCites:5,totalDimensionsCites:10,abstract:"The word organic, applied to fertilizers, indicates that the nutrients are derived from the remains or by‐products of a once‐living organism. Farmers are continually searching for alternatives to synthetic inorganic fertilizers to alleviate the escalating production costs associated with the increasing costs of energy and fertilizers and the problems of soil and surface water deterioration associated with intensive use and release of inorganic fertilizers such as N and P fertilizers. One of the advantages of organic fertilizers is that they provide their nutrients especially the principal nutrients (NPK) to growing plants over a long period of time in a slow release process. The soil has to be moist and warm enough to allow soil microorganisms to decompose and breakdown the complex forms of organic fertilizers. Generally, the application of organic amendments to agricultural soils makes good use of natural resources and reduces the need of synthetic inorganic fertilizers. Soil structure, nutrient composition, and microbiological activity of soil are usually increased following the application of organic amendments. This is because of the presence of sugars and amino acids as simple molecules in organic amendments that contribute to microbiological activity and fertility and elevated levels of enzymes secreted by soil microbes. To investigate the soil microbiological activity after the addition of soil amendments, three enzymes that control the C, N, and P cycles should be monitored in the plant rhizosphere zone, which is defined as the zone of increased microbial and enzyme activity where soil and root make contact. An increase of organic waste originated from different humans and productive activities is a continuous concern. Waste application (i.e., municipal sewage sludge, chicken manure, horse manure, and cow manure) to soil is proposed as a solution to disposal problem. This practice is popular in the agricultural fields because of the value of this waste as organic fertilizer. At KSU, numerous studies have been conducted on organic soil amendments and their impact on crop yield and quality, soil erosion and nutrient availability, soil enzymes activity, and bioremediation of heavy metals in organic amendments.",book:{id:"5179",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",title:"Organic Fertilizers",fullTitle:"Organic Fertilizers - From Basic Concepts to Applied Outcomes"},signatures:"George F. Antonious",authors:[{id:"174916",title:"Dr.",name:"George",middleName:"Fouad",surname:"Antonious",slug:"george-antonious",fullName:"George Antonious"}]},{id:"50233",doi:"10.5772/62388",title:"Integrated Use of Phosphorus, Animal Manures and Biofertilizers Improve Maize Productivity under Semiarid Condition",slug:"integrated-use-of-phosphorus-animal-manures-and-biofertilizers-improve-maize-productivity-under-semi",totalDownloads:2482,totalCrossrefCites:9,totalDimensionsCites:10,abstract:"Phosphorus unavailability and lack of organic matter in the soils under semiarid condition are the major reasons for low crop productivity. Field trial was conducted to investigate the impact of different animal manures (poultry, cattle, and sheep manures) and phosphorus levels (40, 80, 120, and 160 kg P2O5 ha−1) on yield and yield components of hybrid maize (CS-200) with (+) and without (−) phosphate-solubilizing bacteria (PSB) seed treatment at the Agronomy Research Farm of The University of Agriculture Peshawar, during summer 2014. Our results confirmed that the application of poultry manure significantly (P ≤ 0.05) increased yield and yield components of maize. Phosphorus applied at the rate of 120 kg P2O5 ha−1 increased ear length, grains ear−1, and shelling percentage, while the highest rate of 160 kg P ha−1 increased grains weight, grain yield, and harvest index. Maize seeds treated with PSB (+) before sowing had produced higher yield and yield components than untreated seeds (−). We concluded from this study that combined application of 160 kg P2O5 ha−1 + poultry manure and seed treatment with PSB (+) could improve crop productivity and profitability under semiarid condition.",book:{id:"5179",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",title:"Organic Fertilizers",fullTitle:"Organic Fertilizers - From Basic Concepts to Applied Outcomes"},signatures:"Dr. Amanullah and Shah Khalid",authors:[{id:"178825",title:"Dr.",name:"Dr.",middleName:null,surname:"Amanullah",slug:"dr.-amanullah",fullName:"Dr. Amanullah"}]}],mostDownloadedChaptersLast30Days:[{id:"50720",title:"Use of Organic Fertilizers to Enhance Soil Fertility, Plant Growth, and Yield in a Tropical Environment",slug:"use-of-organic-fertilizers-to-enhance-soil-fertility-plant-growth-and-yield-in-a-tropical-environmen",totalDownloads:5116,totalCrossrefCites:11,totalDimensionsCites:18,abstract:"Soils rarely have sufficient nutrient for crops to reach their potential yield. Applying organic fertilizers without prior knowledge of their properties may cause yield decline under low application or pollute the environment with excessive application. Understanding the nutrient variability and release pattern of organic fertilizers is crucial to supply plants with sufficient nutrients to achieve optimum productivity, while also rebuilding soil fertility and ensuring protection of environmental and natural resources. This chapter presents the authors’ experiences with different organic amendments under Hawaii's tropical conditions, rather than an intensive literature review. For meat and bone meal by‐products (tankage), batch‐to‐batch variability, nutrient content/release pattern and quality, and plant growth response to the liquid fertilizer produced from tankage were evaluated. For animal livestock, dairy manure (DM) and chicken manure (CM) quality, changes in soil properties, and crop biomass production and root distributions were evaluated. For seaweed, an established bio‐security protocol, nutrient, especially potassium (K) variability, and plant growth and yield response were evaluated in different tropical soils.",book:{id:"5179",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",title:"Organic Fertilizers",fullTitle:"Organic Fertilizers - From Basic Concepts to Applied Outcomes"},signatures:"Amjad A. Ahmad, Theodore J.K. Radovich, Hue V. Nguyen, Jensen\nUyeda, Alton Arakaki, Jeana Cadby, Robert Paull, Jari Sugano and\nGlenn Teves",authors:[{id:"178933",title:"Dr.",name:"Amjad",middleName:"A.",surname:"Ahmad",slug:"amjad-ahmad",fullName:"Amjad Ahmad"},{id:"184973",title:"Dr.",name:"Theodore",middleName:null,surname:"Radovich",slug:"theodore-radovich",fullName:"Theodore Radovich"},{id:"184974",title:"Prof.",name:"Hue",middleName:null,surname:"Nguyen",slug:"hue-nguyen",fullName:"Hue Nguyen"},{id:"184975",title:"MSc.",name:"Jensen",middleName:null,surname:"Uyeda",slug:"jensen-uyeda",fullName:"Jensen Uyeda"},{id:"184976",title:"MSc.",name:"Alton",middleName:null,surname:"Arakaki",slug:"alton-arakaki",fullName:"Alton Arakaki"},{id:"184977",title:"Mr.",name:"Glenn",middleName:null,surname:"Teves",slug:"glenn-teves",fullName:"Glenn Teves"},{id:"184978",title:"MSc.",name:"Jeana",middleName:null,surname:"Cadby",slug:"jeana-cadby",fullName:"Jeana Cadby"},{id:"184979",title:"Prof.",name:"Robert",middleName:null,surname:"Paull",slug:"robert-paull",fullName:"Robert Paull"},{id:"184980",title:"MSc.",name:"Jari",middleName:null,surname:"Sugano",slug:"jari-sugano",fullName:"Jari Sugano"}]},{id:"51059",title:"Organic Fertilizers: Public Health Intricacies",slug:"organic-fertilizers-public-health-intricacies",totalDownloads:2749,totalCrossrefCites:10,totalDimensionsCites:16,abstract:"Organic fertilizers are an essential source for plant nutrients and a soil conditioner in agriculture. Due to its sources and the composition of the organic inputs as well as the type, functionality and failures of the applied treatment process, the organic fertilizer may contain various amounts of infectious agents and toxic chemicals, especially the antibiotics that can be introduced to the subsequent food chain. A range of human and animal pathogens of bacterial, viral and parasitic origin have been the cause of food-borne epidemics due to unintended contamination from organic fertilizers. The use of antibiotics by humans and in animal feeds will also end up in the organic fertilizers. These antibiotics and other chemicals, depending on the sources of the organics, will enhance the likelihood of occurrence of resistant and multi-resistant strains of microorganisms in society and have been reported to cause ecotoxicological environmental effects and disruption of the ecological balance. Exposure of microorganisms to sublethal concentration of antibiotics in the organic products induces antibiotic resistance. WHO guidelines for the reuse of excreta and other organic matters identify the risk for the exposed groups to the reuse of the excreta and are applicable in the use of organic fertilizers in agriculture.",book:{id:"5179",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",title:"Organic Fertilizers",fullTitle:"Organic Fertilizers - From Basic Concepts to Applied Outcomes"},signatures:"Anthony A. Adegoke, Oluyemi O. Awolusi and Thor A. Stenström",authors:[{id:"175730",title:"Dr.",name:"Anthony Ayodeji",middleName:null,surname:"Adegoke",slug:"anthony-ayodeji-adegoke",fullName:"Anthony Ayodeji Adegoke"},{id:"180623",title:"Dr.",name:"Oluyemi Olatunji",middleName:null,surname:"Awolusi",slug:"oluyemi-olatunji-awolusi",fullName:"Oluyemi Olatunji Awolusi"},{id:"186321",title:"Prof.",name:"Thor Axel",middleName:null,surname:"Stenstrom",slug:"thor-axel-stenstrom",fullName:"Thor Axel Stenstrom"}]},{id:"50612",title:"Green Manures and Crop Residues as Source of Nutrients in Tropical Environment",slug:"green-manures-and-crop-residues-as-source-of-nutrients-in-tropical-environment",totalDownloads:2608,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"Tropical areas have prevalence of soils with low fertility, which makes the management of soil fertility a necessary practice to maintain a farming system economically and environmentally sustainable. The purpose of this chapter is to demonstrate the importance of green manure and the use of crop residues as management for soil fertility. We highlight the potential of these practices to increase/sustain productivity by providing nutrients. First, we made a short review on the main factors influencing the decomposition and mineralization processes. Subsequently, we discuss green manure techniques, presenting the main green manures, criteria for choosing, managements, potential for nutrient accumulation, and advantages and disadvantages of this practice. Finally, we use some examples to demonstrate the potential nutrient supply of crop residues from the main crops grown in the tropics. The difficulties and limitations involved are also discussed.",book:{id:"5179",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",title:"Organic Fertilizers",fullTitle:"Organic Fertilizers - From Basic Concepts to Applied Outcomes"},signatures:"Rafael Vasconcelos Valadares, Lucas de Ávila‐Silva, Rafael da Silva Teixeira, Rodrigo Nogueira de Sousa and Leonardus Vergütz",authors:[{id:"179932",title:"M.Sc.",name:"Rafael",middleName:null,surname:"Vasconcelos Valadares",slug:"rafael-vasconcelos-valadares",fullName:"Rafael Vasconcelos Valadares"},{id:"183947",title:"MSc.",name:"Lucas",middleName:null,surname:"De Avila-Silva",slug:"lucas-de-avila-silva",fullName:"Lucas De Avila-Silva"},{id:"183948",title:"MSc.",name:"Rafael",middleName:null,surname:"Da Silva Teixeira",slug:"rafael-da-silva-teixeira",fullName:"Rafael Da Silva Teixeira"},{id:"183949",title:"Mr.",name:"Rodrigo",middleName:null,surname:"Nogueira De Sousa",slug:"rodrigo-nogueira-de-sousa",fullName:"Rodrigo Nogueira De Sousa"},{id:"184785",title:"Prof.",name:"Leonardus",middleName:null,surname:"Vergutz",slug:"leonardus-vergutz",fullName:"Leonardus Vergutz"}]},{id:"50167",title:"On-Farm-Produced Organic Amendments on Maintaining and Enhancing Soil Fertility and Nitrogen Availability in Organic or Low Input Agriculture",slug:"on-farm-produced-organic-amendments-on-maintaining-and-enhancing-soil-fertility-and-nitrogen-availab",totalDownloads:1631,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"Maintaining and enhancing soil fertility are key issues for sustainability in an agricultural system with organic or low input methods. On-farm–produced green manure as a source of soil organic matter (SOM) plays a critical role in long-term productivity. But producing green manure requires land and water; thus, increasing biodiversity, such as by intercropping with green manure crops, could be an approach to enhance the efficiency of renewable resources especially in developing countries. This article discusses soil fertility and its maintenance and enhancement with leguminous intercropping from four points of view: soil fertility and organic matter function, leguminous green manure, intercropping principles, and soil conservation. Important contributions of leguminous intercropping include SOM enhancement and fertility building, biological nitrogen (N) and other plant nutrition availability. Under a well-designed and managed system, competition between the target and intercropping crops can be reduced. The plant uptake efficiency of biologically fixed N is estimated to be double that of industrial N fertilizers. After N-rich plant residues are incorporated into soil, the carbon (C):nitrogen ratio of added straw decreases. Another high mitigation potential of legume intercropping lies in soil conservation by preventing soil and water erosion. Many opportunities exist to introduce legumes in short-term rotation, intercropping, living mulch, and cover crops in an organically managed farm system. Worldwide, long-term soil fertility enhancement remains a challenge due to the current world population and agricultural practices. Cropping system including legumes is a step in the right direction to meeting the needs of food security and sustainability.",book:{id:"5179",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",title:"Organic Fertilizers",fullTitle:"Organic Fertilizers - From Basic Concepts to Applied Outcomes"},signatures:"Yani Nin, Pinchun Diao, Qian Wang, Qingzhong Zhang, Ziliang\nZhao and Zhifang Li",authors:[{id:"178869",title:"Dr.",name:"Zhifang",middleName:null,surname:"Li",slug:"zhifang-li",fullName:"Zhifang Li"},{id:"180022",title:"BSc.",name:"Yani",middleName:null,surname:"Ning",slug:"yani-ning",fullName:"Yani Ning"},{id:"184348",title:"MSc.",name:"Pinchun",middleName:null,surname:"Diao",slug:"pinchun-diao",fullName:"Pinchun Diao"},{id:"184349",title:"Prof.",name:"Qian",middleName:null,surname:"Wang",slug:"qian-wang",fullName:"Qian Wang"},{id:"184350",title:"Prof.",name:"Qingzhong",middleName:null,surname:"Zhang",slug:"qingzhong-zhang",fullName:"Qingzhong Zhang"},{id:"184351",title:"MSc.",name:"Ziliang",middleName:null,surname:"Zhao",slug:"ziliang-zhao",fullName:"Ziliang Zhao"}]},{id:"50244",title:"An Overview of the Studies on Biochar Fertilizer Carried Out at the Beginning of the Twentieth Century in Japan",slug:"an-overview-of-the-studies-on-biochar-fertilizer-carried-out-at-the-beginning-of-the-twentieth-centu",totalDownloads:2062,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"Biochar is a recently coined term for charred organic matter used as a soil amendment. Although the term is relatively new, the substance has been used for a long time throughout the world, including Japan. After we read a Japanese book entitled Nibai Shukaku Tenri Nouhou (How to Double Crop Yield by Almighty Farming System) originally published in 1912, we found that there were conflicting opinions between the author (Mr. Katsugoro Oyaizu) and soil scientists of the time (Dr. Gintaro Daikuhara and others) on the benefits of the use of biochar fertilizer. Previous publications on this topic have been written in Japanese from a sociological viewpoint. By referring to the literature published at the beginning of the twentieth century in Japan, we attempt to shed light on the conflict between traditional knowledge of biochar fertilizer and new concepts of soil science imported from the Western countries. We also describe briefly the socioeconomic impacts on the use of biochar fertilizer in the later generations.",book:{id:"5179",slug:"organic-fertilizers-from-basic-concepts-to-applied-outcomes",title:"Organic Fertilizers",fullTitle:"Organic Fertilizers - From Basic Concepts to Applied Outcomes"},signatures:"Naoki Moritsuka and Kaori Matsuoka",authors:[{id:"179714",title:"Dr.",name:"Naoki",middleName:null,surname:"Moritsuka",slug:"naoki-moritsuka",fullName:"Naoki Moritsuka"}]}],onlineFirstChaptersFilter:{topicId:"338",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:140,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:123,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:22,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"6",title:"Infectious Diseases",doi:"10.5772/intechopen.71852",issn:"2631-6188",scope:"This series will provide a comprehensive overview of recent research trends in various Infectious Diseases (as per the most recent Baltimore classification). Topics will include general overviews of infections, immunopathology, diagnosis, treatment, epidemiology, etiology, and current clinical recommendations for managing infectious diseases. Ongoing issues, recent advances, and future diagnostic approaches and therapeutic strategies will also be discussed. This book series will focus on various aspects and properties of infectious diseases whose deep understanding is essential for safeguarding the human race from losing resources and economies due to pathogens.",coverUrl:"https://cdn.intechopen.com/series/covers/6.jpg",latestPublicationDate:"August 12th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:13,editor:{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},editorTwo:null,editorThree:null},subseries:{paginationCount:6,paginationItems:[{id:"22",title:"Applied Intelligence",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",isOpenForSubmission:!0,annualVolume:11418,editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",slug:"carlos-travieso-gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",biography:"Carlos M. Travieso-González received his MSc degree in Telecommunication Engineering at Polytechnic University of Catalonia (UPC), Spain in 1997, and his Ph.D. degree in 2002 at the University of Las Palmas de Gran Canaria (ULPGC-Spain). He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. He won the “Catedra Telefonica” Awards in Modality of Knowledge Transfer, 2017, 2018, and 2019 editions, and awards in Modality of COVID Research in 2020.\n\nPublic References:\nResearcher ID http://www.researcherid.com/rid/N-5967-2014\nORCID https://orcid.org/0000-0002-4621-2768 \nScopus Author ID https://www.scopus.com/authid/detail.uri?authorId=6602376272\nScholar Google https://scholar.google.es/citations?user=G1ks9nIAAAAJ&hl=en \nResearchGate https://www.researchgate.net/profile/Carlos_Travieso",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"23",title:"Computational Neuroscience",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",isOpenForSubmission:!0,annualVolume:11419,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null},{id:"24",title:"Computer Vision",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",isOpenForSubmission:!0,annualVolume:11420,editor:{id:"294154",title:"Prof.",name:"George",middleName:null,surname:"Papakostas",slug:"george-papakostas",fullName:"George Papakostas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hYaGbQAK/Profile_Picture_1624519712088",biography:"George A. Papakostas has received a diploma in Electrical and Computer Engineering in 1999 and the M.Sc. and Ph.D. degrees in Electrical and Computer Engineering in 2002 and 2007, respectively, from the Democritus University of Thrace (DUTH), Greece. Dr. Papakostas serves as a Tenured Full Professor at the Department of Computer Science, International Hellenic University, Greece. Dr. Papakostas has 10 years of experience in large-scale systems design as a senior software engineer and technical manager, and 20 years of research experience in the field of Artificial Intelligence. Currently, he is the Head of the “Visual Computing” division of HUman-MAchines INteraction Laboratory (HUMAIN-Lab) and the Director of the MPhil program “Advanced Technologies in Informatics and Computers” hosted by the Department of Computer Science, International Hellenic University. He has (co)authored more than 150 publications in indexed journals, international conferences and book chapters, 1 book (in Greek), 3 edited books, and 5 journal special issues. His publications have more than 2100 citations with h-index 27 (GoogleScholar). His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,annualVolume:11421,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. Dr Ventura also holds the positions of Affiliated Professor at Virginia Commonwealth University (Richmond, USA) and Distinguished Adjunct Professor at King Abdulaziz University (Jeddah, Saudi Arabia). Additionally, he is deputy director of the Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI) and heads the Knowledge Discovery and Intelligent Systems Research Laboratory. He has published more than ten books and over 300 articles in journals and scientific conferences. Currently, his work has received over 18,000 citations according to Google Scholar, including more than 2200 citations in 2020. In the last five years, he has published more than 60 papers in international journals indexed in the JCR (around 70% of them belonging to first quartile journals) and he has edited some Springer books “Supervised Descriptive Pattern Mining” (2018), “Multiple Instance Learning - Foundations and Algorithms” (2016), and “Pattern Mining with Evolutionary Algorithms” (2016). He has also been involved in more than 20 research projects supported by the Spanish and Andalusian governments and the European Union. He currently belongs to the editorial board of PeerJ Computer Science, Information Fusion and Engineering Applications of Artificial Intelligence journals, being also associate editor of Applied Computational Intelligence and Soft Computing and IEEE Transactions on Cybernetics. Finally, he is editor-in-chief of Progress in Artificial Intelligence. He is a Senior Member of the IEEE Computer, the IEEE Computational Intelligence, and the IEEE Systems, Man, and Cybernetics Societies, and the Association of Computing Machinery (ACM). Finally, his main research interests include data science, computational intelligence, and their applications.",institutionString:null,institution:{name:"University of Córdoba",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"26",title:"Machine Learning and Data Mining",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",isOpenForSubmission:!0,annualVolume:11422,editor:{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. His research interests include intelligent and embedded systems.",institutionString:"Universidad Autonoma de Queretaro",institution:{name:"Autonomous University of Queretaro",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null},{id:"27",title:"Multi-Agent Systems",coverUrl:"https://cdn.intechopen.com/series_topics/covers/27.jpg",isOpenForSubmission:!0,annualVolume:11423,editor:{id:"148497",title:"Dr.",name:"Mehmet",middleName:"Emin",surname:"Aydin",slug:"mehmet-aydin",fullName:"Mehmet Aydin",profilePictureURL:"https://mts.intechopen.com/storage/users/148497/images/system/148497.jpg",biography:"Dr. Mehmet Emin Aydin is a Senior Lecturer with the Department of Computer Science and Creative Technology, the University of the West of England, Bristol, UK. His research interests include swarm intelligence, parallel and distributed metaheuristics, machine learning, intelligent agents and multi-agent systems, resource planning, scheduling and optimization, combinatorial optimization. Dr. Aydin is currently a Fellow of Higher Education Academy, UK, a member of EPSRC College, a senior member of IEEE and a senior member of ACM. In addition to being a member of advisory committees of many international conferences, he is an Editorial Board Member of various peer-reviewed international journals. He has served as guest editor for a number of special issues of peer-reviewed international journals.",institutionString:null,institution:{name:"University of the West of England",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null}]},overviewPageOFChapters:{paginationCount:20,paginationItems:[{id:"83065",title:"Interventions and Practical Approaches to Reduce the Burden of Malaria on School-Aged Children",doi:"10.5772/intechopen.106469",signatures:"Andrew Macnab",slug:"interventions-and-practical-approaches-to-reduce-the-burden-of-malaria-on-school-aged-children",totalDownloads:4,totalCrossrefCites:0,totalDimensionsCites:0,authors:[{name:"Andrew",surname:"Macnab"}],book:{title:"Malaria - Recent Advances, and New Perspectives",coverURL:"https://cdn.intechopen.com/books/images_new/11576.jpg",subseries:{id:"5",title:"Parasitic Infectious Diseases"}}},{id:"82804",title:"Psychiatric Problems in HIV Care",doi:"10.5772/intechopen.106077",signatures:"Seggane Musisi and Noeline Nakasujja",slug:"psychiatric-problems-in-hiv-care",totalDownloads:2,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Future Opportunities and Tools for Emerging Challenges for HIV/AIDS Control",coverURL:"https://cdn.intechopen.com/books/images_new/11575.jpg",subseries:{id:"6",title:"Viral Infectious Diseases"}}},{id:"82827",title:"Epidemiology and Control of Schistosomiasis",doi:"10.5772/intechopen.105170",signatures:"Célestin Kyambikwa Bisangamo",slug:"epidemiology-and-control-of-schistosomiasis",totalDownloads:6,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"New Horizons for Schistosomiasis Research",coverURL:"https://cdn.intechopen.com/books/images_new/10829.jpg",subseries:{id:"5",title:"Parasitic Infectious Diseases"}}},{id:"82817",title:"Perspective Chapter: Microfluidic Technologies for On-Site Detection and Quantification of Infectious Diseases - The Experience with SARS-CoV-2/COVID-19",doi:"10.5772/intechopen.105950",signatures:"Andres Escobar and Chang-qing Xu",slug:"perspective-chapter-microfluidic-technologies-for-on-site-detection-and-quantification-of-infectious",totalDownloads:3,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"SARS-CoV-2 Variants - Two Years After",coverURL:"https://cdn.intechopen.com/books/images_new/11573.jpg",subseries:{id:"6",title:"Viral Infectious Diseases"}}}]},overviewPagePublishedBooks:{paginationCount:13,paginationItems:[{type:"book",id:"6667",title:"Influenza",subtitle:"Therapeutics and Challenges",coverURL:"https://cdn.intechopen.com/books/images_new/6667.jpg",slug:"influenza-therapeutics-and-challenges",publishedDate:"September 19th 2018",editedByType:"Edited by",bookSignature:"Shailendra K. Saxena",hash:"105e347b2d5dbbe6b593aceffa051efa",volumeInSeries:1,fullTitle:"Influenza - Therapeutics and Challenges",editors:[{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",institutionURL:null,country:{name:"India"}}}]},{type:"book",id:"7064",title:"Current Perspectives in Human Papillomavirus",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7064.jpg",slug:"current-perspectives-in-human-papillomavirus",publishedDate:"May 2nd 2019",editedByType:"Edited by",bookSignature:"Shailendra K. Saxena",hash:"d92a4085627bab25ddc7942fbf44cf05",volumeInSeries:2,fullTitle:"Current Perspectives in Human Papillomavirus",editors:[{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",institutionURL:null,country:{name:"India"}}}]},{type:"book",id:"7123",title:"Current Topics in Neglected Tropical Diseases",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7123.jpg",slug:"current-topics-in-neglected-tropical-diseases",publishedDate:"December 4th 2019",editedByType:"Edited by",bookSignature:"Alfonso J. 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He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"117248",title:"Dr.",name:"Andrew",middleName:null,surname:"Macnab",slug:"andrew-macnab",fullName:"Andrew Macnab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. 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The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. This series will focus on various crucial factors related to emerging viral infectious diseases, including epidemiology, pathogenesis, host immune response, clinical manifestations, diagnosis, treatment, and clinical recommendations for managing viral infectious diseases, highlighting the recent issues with future directions for effective therapeutic strategies.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11402,editor:{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. 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Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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