\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"5782",leadTitle:null,fullTitle:"Clinical Physical Therapy",title:"Clinical Physical Therapy",subtitle:null,reviewType:"peer-reviewed",abstract:"Physical therapy services may be provided alongside or in conjunction with other medical services. They are performed by physical therapists (known as physiotherapists in many countries) with the help of other medical professionals. This book consists of 11 chapters written by several professionals from different parts of the world. It includes different kinds of chapters for clinical physical therapy with precious points for physical therapy, physical therapy for cancer, chronic venous disease, mental health, and other topics. We hope that the information provided in this book will instruct global physical therapists and related professionals.",isbn:"978-953-51-3112-0",printIsbn:"978-953-51-3111-3",pdfIsbn:"978-953-51-4813-5",doi:"10.5772/65235",price:119,priceEur:129,priceUsd:155,slug:"clinical-physical-therapy",numberOfPages:232,isOpenForSubmission:!1,isInWos:1,isInBkci:!1,hash:"4fb576229359708e5e14d59b1083fdc1",bookSignature:"Toshiaki Suzuki",publishedDate:"May 31st 2017",coverURL:"https://cdn.intechopen.com/books/images_new/5782.jpg",numberOfDownloads:28566,numberOfWosCitations:17,numberOfCrossrefCitations:12,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:18,numberOfDimensionsCitationsByBook:1,hasAltmetrics:1,numberOfTotalCitations:47,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 22nd 2016",dateEndSecondStepPublish:"October 13th 2016",dateEndThirdStepPublish:"January 9th 2017",dateEndFourthStepPublish:"April 9th 2017",dateEndFifthStepPublish:"June 8th 2017",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"70872",title:"Prof.",name:"Toshiaki",middleName:null,surname:"Suzuki",slug:"toshiaki-suzuki",fullName:"Toshiaki Suzuki",profilePictureURL:"https://mts.intechopen.com/storage/users/70872/images/system/70872.jpg",biography:"Suzuki Toshiaki, DMSc, is a physical therapist and professor at the Graduate School of Kansai University of Health Sciences, Japan. He investigates the effect and development of neurological physical therapy using electromyography, which he was taught by Fujiwara Tetsuji, MD, and Kimura Jun, MD, emeritus professors at Kyoto University, Japan. He is also interested in the development of Acupoint Stimulation Physical Therapy (ASPT), which combines physical therapy and acupuncture. Dr. Toshiaki has published a number of original papers and books in his field.",institutionString:"Kansai University of Health Sciences",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"Kansai University of Nursing and Health Sciences",institutionURL:null,country:{name:"Japan"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1118",title:"Clinical Electrophysiology",slug:"clinical-electrophysiology"}],chapters:[{id:"54293",title:"The Function of Scapular Muscle",doi:"10.5772/67553",slug:"the-function-of-scapular-muscle",totalDownloads:2198,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In shoulder rehabilitation, it is important to evaluate scapular stability. However, it is not revealed how the mechanism runs for scapular stability. Additionally, the contribution of scapular muscles for scapular stability remains a matter of debate. Wherefore, I suggest some studies in this section to understand the function of scapulothoracic joint and the mechanism of scapular stability in detail. In the results of these studies, it was revealed that each scapular muscle activation is different for shoulder isometric contraction, and the exercise for a scapular muscle increases only the shoulder muscle strength of specific movement direction. If we can consider each scapular muscle individually by utilizing these results, we can provide more effective rehabilitation program.",signatures:"Tomohito Ijiri",downloadPdfUrl:"/chapter/pdf-download/54293",previewPdfUrl:"/chapter/pdf-preview/54293",authors:[{id:"197891",title:"M.Sc.",name:"Tomohito",surname:"Ijiri",slug:"tomohito-ijiri",fullName:"Tomohito Ijiri"}],corrections:null},{id:"54692",title:"Comprehensive Physical Function Assessment in Elderly People",doi:"10.5772/67528",slug:"comprehensive-physical-function-assessment-in-elderly-people",totalDownloads:1430,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:1,abstract:"In elderly people with mobility limitations, abnormalities in posture and gait contribute to the greater decline of physical motor function. The aim of the review article was to determine the comprehensive physical motor function assessment. Muscle function was assessed with the grip strength. Gait function was assessed with walking time tests conducted at a normal pace. Balance function was assessed with one‐legged standing time. The 6‐min walking distance test (6MD) was performed in a 10‐m, straight corridor. Walking efficiency during the 6MD trials was measured using the Cosmed K4b2 (Rome, Italy), an indirect calorimetry system specifically designed to measure energy expenditure in nonlaboratory settings. The center of pressure was recorded using a balance board (Wii; Nintendo Co., Ltd., Kyoto, Japan). A vibratory stimulus was applied alternately to two muscles by fixing two vibrators from the vibration device onto the participant’s gastrocnemius and lumbar multifidus muscle. These findings show that an assessment affecting postural control under proprioceptive stimulation might be a good indicator of elderly people. Also, the objective assessment of walking efficiency might be important for identifying the risk of external activity limitation or functional limitations among the late elderly.",signatures:"Tadashi Ito",downloadPdfUrl:"/chapter/pdf-download/54692",previewPdfUrl:"/chapter/pdf-preview/54692",authors:[{id:"196581",title:"Ph.D.",name:"Tadashi",surname:"Ito",slug:"tadashi-ito",fullName:"Tadashi Ito"}],corrections:null},{id:"54689",title:"Pelvic Movement in Aging Individuals and Stroke Patients",doi:"10.5772/67510",slug:"pelvic-movement-in-aging-individuals-and-stroke-patients",totalDownloads:1409,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The mobility of the lumbar spine (anteversion and retroversion) may be reflected in seated pelvic mobility. When sitting with the soles of the feet in contact with the floor, friction may restrict the flexion of the knees and, consequently, the pelvic anteversion. In general, joint mobility declines with advancing age. Lumbar spine mobility in anteversion and retroversion also decreases with advancing age. The first half of this chapter is based on a study that investigated the relationship between age and the maximum pelvic anteversion and the retroversion angles in healthy volunteers. The measurements were performed with the subject in a sitting position with free knee movement. On the other hand, the sit-to-stand movement is one of the most mechanically demanding tasks undertaken during daily activity. The sacral sitting posture, which is a characteristic posture of stroke patients, is not ideal for smoothly executing the sit-to-stand movement. Stroke patients may adopt this posture due to the need to increase sitting stability. The second half of this chapter discusses a study that investigated the relationship between the pelvic anteversion and retroversion angles and the ability of stroke patients to perform the sit-to-stand movement.",signatures:"Hitoshi Asai",downloadPdfUrl:"/chapter/pdf-download/54689",previewPdfUrl:"/chapter/pdf-preview/54689",authors:[{id:"198129",title:"Prof.",name:"Hitoshi",surname:"Asai",slug:"hitoshi-asai",fullName:"Hitoshi Asai"}],corrections:null},{id:"54178",title:"Influence of Auditory Pacing on the Control of Rhythmic Movement in Physical Therapy",doi:"10.5772/67428",slug:"influence-of-auditory-pacing-on-the-control-of-rhythmic-movement-in-physical-therapy",totalDownloads:1349,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The electromyographic reaction time data responses to various rhythm shifts are discussed in Section 2 of this chapter. The following four experimental designs were introduced: (1) subliminal rhythm shift with shortened interval, (2) subliminal rhythm shift with lengthened interval, (3) subliminal rhythm shift with random interval, and (4) differences in the rate of rhythm shift. We found that the periodic rhythmic stimulation is predicted to comprise some time duration. Furthermore, the reactive movements can be performed without delay under conditions with an interstimulus‐onset interval shift of 7% of 1500 ms. When the physical therapist facilitates rhythmical reactive periodic movement using an external event such as a handclap, it will be desirable to keep the rhythm shift within 7% of the interstimulus‐onset interval. The variabilities of the intertap interval in the continuation paradigm of sensorimotor synchronization are discussed in Section 3. The participants performed self‐paced, synchronization‐continuation, and syncopation‐continuation tapping tasks. We found that the accuracy of the periodic movement with an interstimulus‐onset interval of 1000 ms can be improved by using auditory pacing. However, the consistency of periodic movement is mainly dependent on innate skill; thus, improvement in consistency from pacing alone is unlikely.",signatures:"Masanori Ito, Yuki Takahashi, Satoshi Fujiwara and Naoki Kado",downloadPdfUrl:"/chapter/pdf-download/54178",previewPdfUrl:"/chapter/pdf-preview/54178",authors:[{id:"197850",title:"Dr.",name:"Masanori",surname:"Ito",slug:"masanori-ito",fullName:"Masanori Ito"},{id:"198091",title:"Dr.",name:"Naoki",surname:"Kado",slug:"naoki-kado",fullName:"Naoki Kado"},{id:"204588",title:"MSc.",name:"Yuki",surname:"Takahashi",slug:"yuki-takahashi",fullName:"Yuki Takahashi"},{id:"204589",title:"MSc.",name:"Satoshi",surname:"Fujiwara",slug:"satoshi-fujiwara",fullName:"Satoshi Fujiwara"}],corrections:null},{id:"55065",title:"Exercise Therapy for Physical Therapist",doi:"10.5772/intechopen.68390",slug:"exercise-therapy-for-physical-therapist",totalDownloads:2376,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter describes exercise therapy in terms of definition, objectives, concept, techniques, mechanisms, and equipment. Mechanisms explaining the effect of exercise training on treatments for other diseases are included. In addition, new biomarkers capable of evaluating exercise performance capacity and progress in training and early detection of overtraining are provided. Very promising are mainly small non‐coding microRNAs (miRNAs). Important background knowledge for exercise therapy is also provided. The knowledge covers the exercise for healthy and unhealthy people. The former includes sedentary and sport player. The latter includes patients with various diseases, for example, metabolic diseases, cardiovascular disease, orthopedics, etc. Importantly, all the knowledge was presented in latest information.",signatures:"Naruemon Leelayuwat",downloadPdfUrl:"/chapter/pdf-download/55065",previewPdfUrl:"/chapter/pdf-preview/55065",authors:[{id:"196387",title:"Associate Prof.",name:"Naruemon",surname:"Leelayuwat",slug:"naruemon-leelayuwat",fullName:"Naruemon Leelayuwat"}],corrections:null},{id:"53866",title:"Physical Therapy in Patients with Cancer",doi:"10.5772/67286",slug:"physical-therapy-in-patients-with-cancer",totalDownloads:4736,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:1,abstract:"Physical therapists often treat cancer patients. Cancer treatment includes chemotherapy, radiotherapy, and surgery, which are being continuously developed and thus increase survival of patients with each cancer diagnosis. More specifically, 5-year survival rates increase with each cancer diagnosis. Cancer patients have many problems including muscle weakness, pulmonary dysfunction, fatigue, and pain. In the end, patients with cancer tend to have a decline in activities of daily living (ADL) and quality of life (QOL). Additionally, cancer patients often have progressive disease, depression, and anxiety. Physical therapy often helps patients regain strength and physical function and improve their QOL and independence of daily living that they may have lost due to cancer or its treatment. Physical therapy has an important role in increasing physical function of cancer patients, cancer survivors, and children with cancer. In the future, physical therapy may be progressively needed for management of cancer patients.",signatures:"Shinichiro Morishita and Atsuhiro Tsubaki",downloadPdfUrl:"/chapter/pdf-download/53866",previewPdfUrl:"/chapter/pdf-preview/53866",authors:[{id:"139514",title:"Ph.D.",name:"Shinichiro",surname:"Morishita",slug:"shinichiro-morishita",fullName:"Shinichiro Morishita"},{id:"202889",title:"Dr.",name:"Atsuhiro",surname:"Tsubaki",slug:"atsuhiro-tsubaki",fullName:"Atsuhiro Tsubaki"}],corrections:null},{id:"54480",title:"Conservative Management of Chronic Venous Insufficiency",doi:"10.5772/67752",slug:"conservative-management-of-chronic-venous-insufficiency",totalDownloads:2081,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:1,abstract:"Chronic venous insufficiency (CVI) is a common medical condition with major socioeconomic impact. Prevalence in adult population is estimated to be 5–30%. Its pathology is based on venous hypertension on the lower extremities. This results in edema, subcutaneous fibrosis, pigmentation, chronic pain and ulceration. The severity of chronic venous disease is closely related to the magnitude of venous hypertension. Treatment options for CVI include medical, interventional, surgical and physical treatments. The initial management of CVI involves conservative approaches to reduce symptoms and prevent development of secondary complications and progression of disease. It includes the elevation of the limb together with the supportive methods, pharmacotherapy and structured exercise program, as well as complex decongestive physiotherapy (CDP), intermittent pneumatic compression (IPC), compression stocking (CS), patient education and kinesio tape. CVI is a chronic disease that needs a lifelong care. In this review, we present a discussion about pathophysiology and risk factors for CVI development and conservative treatment options.",signatures:"Özlem Çinar Özdemir and Mahmut Surmeli",downloadPdfUrl:"/chapter/pdf-download/54480",previewPdfUrl:"/chapter/pdf-preview/54480",authors:[{id:"185712",title:"Ph.D.",name:"Özlem",surname:"Çinar Özdemir",slug:"ozlem-cinar-ozdemir",fullName:"Özlem Çinar Özdemir"},{id:"193852",title:"Mr.",name:"Mahmut",surname:"Surmeli",slug:"mahmut-surmeli",fullName:"Mahmut Surmeli"}],corrections:null},{id:"55041",title:"Manual Lymphatic Drainage in the Treatment of Chronic Venous Disease",doi:"10.5772/67901",slug:"manual-lymphatic-drainage-in-the-treatment-of-chronic-venous-disease",totalDownloads:1841,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Chronic venous disease (CVD) is a chronic condition that is associated with venous hypertension, vein’s valves damage, venous obstruction, and calf muscle pump impairment. This blood circulatory condition is also characterized by important inflammatory changes affecting the skin, the subcutaneous tissue and the muscles, which are probably triggered by blood stasis and venous edema. With disease progression, severe ulcerative skin damage might occur, which when present represent the more severe stage of this condition. CVD has a significant economic, social and health impact, mostly due to raised morbidity and chronicity.",signatures:"Rute S.S. Crisóstomo and Paulo A.S. Armada-da-Silva",downloadPdfUrl:"/chapter/pdf-download/55041",previewPdfUrl:"/chapter/pdf-preview/55041",authors:[{id:"197861",title:"Ph.D.",name:"Rute",surname:"Crisóstomo",slug:"rute-crisostomo",fullName:"Rute Crisóstomo"},{id:"205140",title:"Prof.",name:"Paulo A. S.",surname:"Armada-Da-Silva",slug:"paulo-a.-s.-armada-da-silva",fullName:"Paulo A. S. Armada-Da-Silva"}],corrections:null},{id:"54472",title:"Physiotherapy and Mental Health",doi:"10.5772/67595",slug:"physiotherapy-and-mental-health",totalDownloads:8519,totalCrossrefCites:6,totalDimensionsCites:11,hasAltmetrics:1,abstract:"Physiotherapy in mental health care and psychiatry is a recognized specialty within physiotherapy. It offers a rich variety of observational and evaluation tools as well as a range of interventions that are related to the patient's physical and mental health problems based on evidence‐based literature and a 50‐year history. Physiotherapy in mental health care addresses human movement, function, physical activity and exercise in individual and group therapeutic settings. Additionally, it connects the physical and mental health needs of humans. This chapter offers general reflections on mental health, the scope of physiotherapy in mental health care and physiotherapy research. Physiotherapy in mental health care and psychiatry can offer added and beneficial value to the treatment of people with mental health problems.",signatures:"Michel Probst",downloadPdfUrl:"/chapter/pdf-download/54472",previewPdfUrl:"/chapter/pdf-preview/54472",authors:[{id:"186905",title:"Prof.",name:"Michel",surname:"Probst",slug:"michel-probst",fullName:"Michel Probst"}],corrections:null},{id:"54608",title:"Special Rehabilitation Treatment Methodology: INFINITY method®",doi:"10.5772/67968",slug:"special-rehabilitation-treatment-methodology-infinity-method-",totalDownloads:1308,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The INFINITY method® is a special rehabilitation method developed at the Rehabilitation Institute in Brandys nad Orlici, Czech Republic. It is a kinesitherapy approach based on neurophysiology, biomechanics, and anatomy. The method is employed during rehabilitation of patients with functional and/or structural changes of the musculoskeletal system. It allows adjustment of the postural control system of the body, which gradually improves balance and symmetrization of the whole body in space, thus creating a precondition for better quality and more efficient movement. Specifically, therapy movements can be active and/or passive, and great variability of active movements is a perfect advantage for autotherapy. Now, the corrective therapeutic movement and posture can be conscious, meaning there is an increased awareness and control of the patient’s whole body, and/or subconscious, which is based on a reflex therapy. In both cases, straightening and balancing of the patient's body are increased. This method positively affects the musculoskeletal system and quality of the soft tissue, such as the muscle and connective tissue. Thanks to its well-crafted methodology, easily practiced active exercises, and passive therapy performed with the help of a therapist, the method works well for patients with painful disorders of the spine and joints.",signatures:"Michaela Tomanova",downloadPdfUrl:"/chapter/pdf-download/54608",previewPdfUrl:"/chapter/pdf-preview/54608",authors:[{id:"198202",title:"Ph.D.",name:"Michaela",surname:"Tomanova",slug:"michaela-tomanova",fullName:"Michaela Tomanova"}],corrections:null},{id:"54347",title:"Therapeutic Ultrasounds: Physical Basis and Clinical Assessment",doi:"10.5772/67566",slug:"therapeutic-ultrasounds-physical-basis-and-clinical-assessment",totalDownloads:1321,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Improving quality in US physiotherapeutical treatments is mandatory in order to get ‘evidence‐based’ clinical results. This implies quality assurance protocols for the equipment, as well as some tentative dosimetrical approaches to predict local heating in joints following US parameter setting and operative modality. 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\r\n\tSuccessive historical events prove the use of noble metals in drugs for the welfare of mankind. Silver has been used to treat wounds and ulcers as mentioned by Greek physician Hippocrates. Silver has also been used for storage of drinking water due to its strong antimicrobial potential and hence in the current era its medicinal use is well known. Similarly, the use of copper to sterile water has been reported by ancient Egyptians and medicinal use of Gold by Chinese. In the modern age, the use of metal-based medicines started about 50 years’ back when use of cis-platin was explored for treatment of various types of cancer. Since then the use of metals in medicine remained promising and it is further attracting scientists. During last decade, the use of noble metals (Rhodium, Iridium, Palladium, Osmium, Gold, Silver and Copper) has been the subject of intensive therapeutic investigation leading to syntheses of series of metallo compounds with remarkable anticancer, antirheumatic, antimalarial, antifungal, and antimicrobial drugs. Several research and review articles on the use of noble metals based complexes for medicinal applications has been published.
\r\n\t
\r\n\tThe aim of this book project is to compile the updated research work on medicinal applications of noble metal complexes mainly focusing the structure activity relationship of metal complexes with targeting biological components.
Malignant mesothelioma (MM) is a fatal disease which originates in the mesothelial surfaces of pleura or, more rarely, in other sites such as peritoneum. Most cases have been classically linked to asbestos exposure; however, ionizing radiation may also increase the risk of mesothelioma [1].
\nIts prognosis is very poor and it is difficult to treat, mainly because most patients are diagnosed with advanced disease [1, 2, 3]. Despite clinical research efforts, lack of available therapies remains clear and median overall survival is still approximately 1 year, with only 10% patients alive 5 years after diagnosis. Standard of care treatments and guidelines have not been evolved much along recent years. In this chapter, NCCN and ESMO guidelines have been reviewed, besides an electronic search of the Pubmed database, with a focus on the phase II and III clinical trials, guidelines, meta-analysis, and systematic reviews regarding epidemiology, diagnosis tests, surgical approach, and approved local and systemic treatments, including most important advances. Searched terms included “mesothelioma,” “ESMO and NCCN guidelines,” “diagnosis,” “surgery,” “targeted therapy,” “clinical trials,” “palliative treatment,” and “meta-analysis.” First-line regimen recommendations have not evolved since the phase III pivotal study of cisplatin-pemetrexed was published, and this combination became the standard of care despite its modest benefit in survival. Pemetrexed seems to be the most active drug, but its use in the first-line setting limits its administration in further lines. However, a rechallenge may be done in responder patients, who might still get benefit [4].
\nOnly few drugs have demonstrated a mild activity in refractory MM, and targeted therapies have provided disappointing results so far. However, recent clinical trial data with immunotherapies are bringing some light and may become a new paradigm in the following years.
\nMalignant mesothelioma (MM) is a rare tumor, with an incidence of less than 5 out of 100,000 inhabitants in Europe [1]. Diagnosis is usually done when disease is well advanced, and patients have a high symptom burden [3]. Incidence has decreased along the last decades globally worldwide. Mesothelioma has been typically related to asbestos exposure, which is the most well-known risk factor, although the latency period can be long, with a latency period being approximately 40 years, although in some cases, it may be as long as 60–70 years. Recent reports have suggested that also ionizing radiation may have a role, such as in patients previously treated with radiotherapy (RT). Other studies also suggest that erionite (which may be found in travel roads) increases the risk of MM. Smoking is not a risk factor. There may be a genetic risk in patients with BRCA-1 mutation [5, 6, 7].
\nThe most common type of mesothelioma is malignant pleural mesothelioma, being up to 70% cases, followed by peritoneal (30%) and pericardial mesothelioma (1–2%) [2]. According to histology, there are three subtypes: epithelial, sarcomatoid, and biphasic [3], with epithelial subtype having a better prognosis.
\nPrevalence is highly linked to mortality, and mesothelioma is an unmet medical need due to its very poor prognosis, having a median overall survival of approximately 9–12 months, with only very modest improvements in survival over time [8].
\nMost common symptoms include dyspnea, thoracic pain, and weight loss. Usually unilateral effusions are observed. A detailed occupational history is key, checking asbestos exposure among other previously exposed potential risk factors. Patients often present with advanced disease, but without distant metastases, as local implants or effusion cause pain and/or dyspnea. Brain metastases are rare [3].
\nDiagnosis assessments include chest X-ray, computed tomography (CT) scan of chest and upper abdomen, and thoracentesis, with examination of the pleural effusion and general laboratory blood tests [1]. Citology samples from pleural effusion are frequently negative or inconclusive, hence, histology may bring some further light for a more accurate diagnosis. Some biomarkers may be helpful, including calretinin, WT-1, D2-40, and citokeratyn 5/6, being negative in mesothelioma and positive in lung adenocarcinoma [9]. In order to obtain adequate histology, a thoracoscopy is highly recommended to optimally stage and to allow pleural fluid evacuation (with or without pleurodesis) [9, 10]. Mesothelioma can be difficult to identify and distinguish from benign pleural lesions and from other malignancies; it is therefore recommended to obtain biopsies from the tissue of both abnormal and normal appearance. When a thoracoscopy is not feasible or contraindicated, ultrasound-guided true-cut biopsies are a good alternative [10].
\nMM comprises a heterogeneous group of tumors, which are mainly classified as three subtypes (epithelioid, biphasic, and sarcomatoid), despite the numerous variants that are described in the 2004 WHO classification [9].
\nDiagnosis samples may be obtained from pleural effusions, pleural biopsies, and surgical samples [1, 8, 9, 10]. Cytological diagnosis from effusion samples may be feasible, but sensitivity is highly variant, with variable atypia (usually low grade). Therefore, usually tissue biopsies with immunohistochemistry analysis are pivotal for confirmatory diagnosis.
\nStandardly used and most recommended biomarkers for diagnosis include calretinin, cytokeratin 5/6, WT1, and podoplanin (D240). For non-small cell adcenocarcinoma, the most useful markers are TTF1, CEA, and EP4 [8].
\nStaging procedures are aimed to describe anatomical extent correlating with prognostic features, which is key in order to make treatment decisions. Standard procedures for staging include chest and abdomen CT with contrast and PET/CT (for those patients who may undergo surgery). Video-assisted thoracoscopy (VATS) is recommended if contralateral disease is suspected [3].
\nPatients should be evaluated by a multidisciplinary committee, including oncologist, radiation oncologist, pathologist, pulmonologist, diagnostic imaging specialist, and surgeon.
\nThe limitation of most classifications is their inaccuracy in describing tumor (T-) and node (N-) extent. The most recent staging system was presented by the International Mesothelioma Interest Group (IMIG) [11]. However, it failed to be an independent prognostic factor when analyzed in the clinical setting using multivariate analysis [11, 12, 13, 14]. Hence, further workup is needed in order to get an accurate and prognostic staging system.
\nIf a surgical resection is planned, either mediastinoscopy or endobronchial ultrasound of mediastinal lymph nodes are recommended [15]. Besides, two additional tests may be useful if suggested by imaging: laparoscopy in order to rule out any transdiaphragmatic extension and chest MRI to check vascular involvement [14, 15, 16, 17].
\nChemotherapy is recommended as the sole therapy for patients with ECOG 0–2 who are not amenable for surgery. For patients with ECOG 3–4, best supportive care is strongly recommended.
\nChemotherapy has a role in the palliative treatment of advanced mesothelioma, getting an improvement of symptoms and modest benefit in survival. Standard first-line treatment is based on platinum doublets, with either pemetrexed or raltitrexed [18, 19], being cisplatin/pemetrexed the only FDA-approved regimen. This combination was investigated in a phase III trial comparing cisplatin/pemetrexed vs. cisplatin monotherapy, getting a benefit in survival by 2.8 months (12.1 vs. 9.3 months, P = 0.02) [18].
\nCarboplatin may be used as an alternative to cisplatin, particularly in fragile patients, with no significant differences in survival and a better safety profile [20, 21].
\nClinical research has been trying to look for an improvement with the addition of several agents; however, several phase II trials have failed to demonstrate improvement over standard treatment with the addition of antioangiogenics such as bevacizumab or sunitinib [22, 23]. However, a phase III trial compared cisplatin/pemetrexed with or without bevacizumab in patients who were suitable for receiving bevacizumab (ECOG 0–2 with no history of bleeding or thrombosis). Experimental arm was better in terms of survival, with a benefit by 2.7 months (18.8 vs. 16.1 months, P = 0.0167). Grade 3–4 adverse events were more common in the experimental arm, 71 vs. 62%, with more cases of hypertension, grade 3 proteinuria and grade 3–4 thromboembolic events in the bevacizumab arm. The NCCN guidelines then recommends cisplatin/pemetrexed plus bevacizumab followed by maintenance bevacizumab in patients without contraindications [24].
\nThere is a lack of treatment options in the second line and beyond setting, this being an important medical need with no standard of care yet. Pemetrexed as single agent when compared with the best supportive care was not able to provide an improvement in survival [25]. Vinorelbine showed a benefit in terms of responses in several small phase II trials [26].
\nBoth immunotherapies and targeted therapies are under evaluation as well, but they have not been yielded into approval [27, 28]. In the absence of the standard second-line or further-line therapy, it is recommended that patients are enrolled into clinical trials. Recent data suggest that checkpoint inhibitors may have a role in this setting, with a response rate slightly higher than that previously obtained by other agents [3].
\nCheckpoint inhibitors target the programmed death-1 (PD-1) receptor, which improves tumor immunity. Both nivolumab and pembrolizumab target PD-1 receptors, but testing this receptor is not required [29].
\nSome immunotherapies have been tested or are under clinical development for MPM, including antibodies blocking immune checkpoints that function as negative regulators of T-cell function, cytotoxic T-lymphocyte-associated antigen 4 (CTLA4), programmed death 1 (PD-1), and programmed death ligand 1 (PD-L1). However, there is still a lack of strong support for their use.
\nIn two nonrandomized studies, the anti-CTLA4 antibody tremelimumab showed preliminary evidence of activity in patients with previously treated mesothelioma [28, 30]. Thereafter, a randomized, placebo-controlled study investigated tremelimumab in patients with mesothelioma (the DETERMINE trial). This trial did not meet the primary end point of OS, as we did not find statistically significant differences in OS between the tremelimumab group [median OS 7.7 months (95% CI: 6.8–8.9)] and the placebo group [median OS 7.3 months (95% CI: 5.9–8.7)] [31].
\nIn the KEYNOTE-028 trial, previously treated patients with PD-L1-positive MPM received pembrolizumab 10 mg/kg every 2 weeks for up to 2 years or until confirmed progression or unacceptable toxicity. Five of 25 patients (20%) had a partial response (objective response rate of 20%) and 13 (52%) patients had stable disease. Additionally, there was a maintained clinical benefit, with a median duration of response 12.0 months (95% CI: 3.7 not reached) [32, 33]. The NivoMes study, which evaluated nivolumab in unselected patients with previously treated mesothelioma reported response rates of 28%. The JAVELIN study of the anti-PDL-1 antibody avelumab in unselected patients with previously treated mesothelioma reported a response rate of 9.4% with a median PFS of 17.1 weeks. Subgroup analysis in the PD-L1-positive population (cutoff > 5%) showed a response rate of 14% [34]. Novel vaccine approaches using MPM neoantigens identified by gene sequencing are also entering clinical trial on the basis of early animal studies [33].
\nAs a summary, preliminary data on PD-1- and PD-L1-targeting monoclonal antibodies in MPM suggest that immunotherapy with single agents may have some benefit, possibly because of its complex biology.
\nAdministering RT to the entire pleural surface without damaging radiosensitive sites and keeping a good safety profile is very challenging. Radiotherapy (RT) is used in different settings as treatment for MM: palliative, adjuvant, and as part of a multimodality treatment.
\nAs palliative treatment for pain relief bronchial obstruction or other disease related symptoms, there is no strong evidence to support its use; however, it may be recommended in cases of infiltration of the chest wall, administered in short courses such as 1 × 10 or 3 × 8 Gy [35], always understanding that dose of radiation should be based on its purpose.
\nLimited evidence is available, extracted from retrospective studies only. In general results are poor, in terms of disease control rate, because of the complex growth patterns of the disease. Furthermore, its safety profile is poor due to the wide field size and neighboring vital organs. The introduction of intensity-modulated RT (IMRT) seem to overcome most of these issues and allow the remaining tumor tissue to be properly irradiated. Preliminary results adjuvant IMRT seemed particularly promising. Further studies are needed to better establish the role of RT. Recent studies have underlined the importance of RT technique, both in terms of local control and toxicity. It is therefore recommended that RT is delivered in specialized centers (expert advice) [36, 37].
\nSurgery may be recommended for patients with stage I to IIIA disease who are in good conditions and are medically operable. A careful assessment before proceeding to surgery is strongly recommended [1, 3].
\nObjectives of surgery are staging, palliative, and, more uncommonly, curative intent.
\nIt cannot be considered to have a real radical intention, as its objective is actually obtaining a macroscopic resection removing as much tumor as possible since it is virtually impossible to obtain free resection margins [1]. It can include pleurectomy/decortication (complete removal of involved pleural and all gross tumor) or extrapleural pneumonectomy, including in bloc resection of pleura, lung diaphragm, and often also part of pericardium [38].
\nSome studies assessed a second-step surgery, following an induction chemotherapy, which is reported as a trimodality approach. Different combined modality regimens have been investigated.
\nThe European Organization for Research and Treatment of Cancer (EORTC) analyzed trimodality therapy in a phase II trial (EORTC 08031). Patients with MM (up to stage cT3N1M0) received induction chemotherapy (cisplatin and pemetrexed × 3) followed by surgery within 21–56 days. Forty-two out of 57 (73.7%) included patients could undergo surgery. Survival figures were positive, with an overall survival of 18.4 months and 13.9 months progression-free survival. Operative mortality was 6.4% [39].
\nOther phase II trial with a similar design was performed in the USA and included 77 patients, achieving an overall survival of 16.8 months, with an operative mortality of 7% [40].
\nAlthough trimodal therapy seemed feasible in selected patients with promising results, it was further evaluated in a phase III trial in the UK with negative results (MARS1 study). In this trial, mortality was as high as 18.8%, with only 45% patients undergoing surgery after induction treatment, and with a lower survival for patients undergoing surgery compared to the control arm where patients received only the induction therapy (14 vs. 19 months) [41].
\nHowever, a systematic review performed afterward, including 34 studies from 26 institutions, found highly variant results, with the median survival ranging from 9.4 to 27.5 months and surgical morbidity from 22 to 82%. Probably, it may be explained by different surgical approaches, variability in terms of surgeon’s prior experience, and heterogeneity of included patients, but some patients may get benefit from this treatment [42]. A multidisciplinary team with sufficient experience should provide recommendations on the suitability of patients for trimodality therapy.
\nControl pleural effusion, talc poudrage, or even decortication in a captured lung may be performed through surgery. One study compared VATS (partial) pleurectomy vs. standard talc poudrage in 196 patients. There was no benefit in terms of survival, but control of pleural effusion and quality of life were significantly better for experimental arm at 6 and 12 months [43].
\nThis chapter shows a review of both NCCN and ESMO guidelines besides PubMed available literature. Mesothelioma is one of those tumors with less advanced in the recent years, probably due to its aggressive nature and the limited incidence, which makes clinical research more time consuming. This is considered still as a medical need due to the lack of treatment options beyond the second line. However, research is improving and some immunooncology agents have started to show a small but significant benefit in terms of survival.
\nThe author declares no conflict of interest.
The Internet has irrevocably changed the dynamics of scholarly communication and publishing. Consequently, we find it necessary to indicate, unambiguously, our definition of what we consider to be a published scientific work.
",metaTitle:"Prior Publication Policy",metaDescription:"Prior Publication Policy",metaKeywords:null,canonicalURL:"/page/prior-publication-policy",contentRaw:'[{"type":"htmlEditorComponent","content":"A significant number of working papers, early drafts, and similar work in progress are openly shared online between members of the scientific community. It has become common to announce one’s own research on a personal website or a blog to gather comments and suggestions from other researchers. Such works and online postings are, indeed, published in the sense that they are made publicly available. However, this does not mean that if submitted for publication by IntechOpen they are not original works. We differentiate between reviewed and non-reviewed works when determining whether a work is original and has been published in a scholarly sense or not.
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\\n\\nIn order to facilitate the tracking of a manuscript’s publishing history and its development from its earliest draft to the manuscript submitted, we encourage Authors to disclose any instances of a manuscript’s prior publication, whether it be through a conference presentation, a newspaper article, a working paper publicly available in a repository or a blog post.
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\\n\\nAll submitted manuscripts originating from a previously published conference paper must contain at least 50% of new original content to be accepted for review and considered for publication.
\\n\\nAuthors are required to report any links their manuscript might have with their earlier conference papers and presentations in a note to the Academic Editor, as well as in the manuscript itself. Additionally, Authors should obtain any necessary permissions from the publisher of their conference paper if copyright transfer occurred during the publishing process. Failure to do so may prevent Us from publishing an otherwise worthy work.
\\n\\n2. NEWSPAPER & MAGAZINE ARTICLES
\\n\\nNewspaper and magazine articles usually do not pass through any extensive peer or editorial review and we do not consider them to be published in the scholarly sense. Articles appearing in newspapers and magazines rarely possess the depth and structure characteristic of scholarly articles.
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\\n\\n3. GREY LITERATURE
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\\n\\nAlthough such papers are regularly made publicly available via personal websites and institutional repositories, their general purpose is to gather comments and feedback from Authors’ colleagues in order to further improve a manuscript intended for future publication.
\\n\\nWhen submitting their work, Authors are required to disclose the existence of any publicly available earlier drafts in a note to the Academic Editor. In cases where earlier drafts of the submitted version of the manuscript are publicly available, any overlap between the versions will generally not be considered an instance of self-plagiarism.
\\n\\n4. SOCIAL MEDIA, BLOG & MESSAGE BOARD POSTINGS
\\n\\nWe feel that social media, blogs and message boards are generally used with the same intention as grey literature, to formulate ideas for a manuscript and gather early feedback from like-minded researchers in order to improve a particular piece of work before submitting it for publication. Therefore, we do not consider such internet postings to be publication in the scholarly sense.
\\n\\nNevertheless, Authors are encouraged to disclose the existence of any internet postings in which they outline and describe their research or posted passages of their manuscripts in a note to the Academic Editor. Please note that we will not strictly enforce this request in the same way that we would instructions we consider to be part of our conditions of acceptance for publication. We understand that it may be difficult to keep track of all one’s internet postings in which the researcher´s current work might be mentioned.
\\n\\nIn cases where there is any overlap between the Author´s submitted manuscript and related internet postings, we will generally not consider it to be an instance of self-plagiarism. This also holds true for any co-Author as well.
\\n\\nFor more information on this policy please contact permissions@intechopen.com.
\\n\\nPolicy last updated: 2017-03-20
\\n"}]'},components:[{type:"htmlEditorComponent",content:'A significant number of working papers, early drafts, and similar work in progress are openly shared online between members of the scientific community. It has become common to announce one’s own research on a personal website or a blog to gather comments and suggestions from other researchers. Such works and online postings are, indeed, published in the sense that they are made publicly available. However, this does not mean that if submitted for publication by IntechOpen they are not original works. We differentiate between reviewed and non-reviewed works when determining whether a work is original and has been published in a scholarly sense or not.
\n\nThe significance of Peer Review cannot be overstated when it comes to defining, in our terms, what constitutes a published scientific work. Peer Review is widely considered to be the cornerstone of modern publishing processes and the key value-adding contribution to a scholarly manuscript that a publisher can make.
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\n\nIn order to facilitate the tracking of a manuscript’s publishing history and its development from its earliest draft to the manuscript submitted, we encourage Authors to disclose any instances of a manuscript’s prior publication, whether it be through a conference presentation, a newspaper article, a working paper publicly available in a repository or a blog post.
\n\nA note to the Academic Editor containing detailed information about a submitted manuscript’s previous public availability is the preferred means of reporting prior publication. This helps us determine if there are any earlier versions of a manuscript that should be disclosed to our readers or if any of those earlier versions should be cited and listed in a manuscript’s references.
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\n\nAll submitted manuscripts originating from a previously published conference paper must contain at least 50% of new original content to be accepted for review and considered for publication.
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\n\nNewspaper and magazine articles usually do not pass through any extensive peer or editorial review and we do not consider them to be published in the scholarly sense. Articles appearing in newspapers and magazines rarely possess the depth and structure characteristic of scholarly articles.
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\n\nAs with the conference papers and presentations, Authors should obtain any necessary permissions from the newspaper or magazine that published the work, and indicate that they have done so in a note to the External Editor.
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\n\nAlthough such papers are regularly made publicly available via personal websites and institutional repositories, their general purpose is to gather comments and feedback from Authors’ colleagues in order to further improve a manuscript intended for future publication.
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\n\nWe feel that social media, blogs and message boards are generally used with the same intention as grey literature, to formulate ideas for a manuscript and gather early feedback from like-minded researchers in order to improve a particular piece of work before submitting it for publication. Therefore, we do not consider such internet postings to be publication in the scholarly sense.
\n\nNevertheless, Authors are encouraged to disclose the existence of any internet postings in which they outline and describe their research or posted passages of their manuscripts in a note to the Academic Editor. Please note that we will not strictly enforce this request in the same way that we would instructions we consider to be part of our conditions of acceptance for publication. We understand that it may be difficult to keep track of all one’s internet postings in which the researcher´s current work might be mentioned.
\n\nIn cases where there is any overlap between the Author´s submitted manuscript and related internet postings, we will generally not consider it to be an instance of self-plagiarism. This also holds true for any co-Author as well.
\n\nFor more information on this policy please contact permissions@intechopen.com.
\n\nPolicy last updated: 2017-03-20
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