Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
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We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
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Throughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\n
We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
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In this way we find a review of multi-agents, different techniques applied to the navigation systems, artificial intelligence algorithms, which include deep learning applications, systems where a Kalman filter estimator is extended for visual odometry, and finally the design of an on-chip system for the execution of cognitive agents. Additionally, the development of different ideas in mobile robot applications are included and hopefully will be useful and enriching for readers.",isbn:"978-1-78985-756-6",printIsbn:"978-1-78985-755-9",pdfIsbn:"978-1-83962-086-7",doi:"10.5772/intechopen.74181",price:119,priceEur:129,priceUsd:155,slug:"applications-of-mobile-robots",numberOfPages:228,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"b4993517c29aed9abd474e362370e28a",bookSignature:"Efren Gorrostieta Hurtado",publishedDate:"March 20th 2019",coverURL:"https://cdn.intechopen.com/books/images_new/7227.jpg",numberOfDownloads:14509,numberOfWosCitations:1,numberOfCrossrefCitations:16,numberOfCrossrefCitationsByBook:1,numberOfDimensionsCitations:46,numberOfDimensionsCitationsByBook:1,hasAltmetrics:0,numberOfTotalCitations:63,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"January 25th 2018",dateEndSecondStepPublish:"February 15th 2018",dateEndThirdStepPublish:"April 16th 2018",dateEndFourthStepPublish:"July 5th 2018",dateEndFifthStepPublish:"September 3rd 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"38850",title:"Dr.",name:"Efren",middleName:null,surname:"Gorrostieta Hurtado",slug:"efren-gorrostieta-hurtado",fullName:"Efren Gorrostieta Hurtado",profilePictureURL:"https://mts.intechopen.com/storage/users/38850/images/system/38850.jpg",biography:"Dr. Eng Efren Gorrostieta is a Professor at the Engineering Faculty of the Autonomous University of Queretaro, Mexico. He studied Electronics Engineering, received a master of Science in Control and Automation and a PhD in Mechatronics. He was a co-founder of the Mechatronics Mexican Association, President of the IEEE Querétaro Section and the Chair of the IEEE Queretaro Computational Intelligence Chapter; he has given lectures in Control Systems and Robotics at different universities and has been a chair, reviewer and editor in several national/international congresses related to robotics, automation, and artificial intelligence. He has several publications in conferences and journals in the field.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"Autonomous University of Queretaro",institutionURL:null,country:{name:"Mexico"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1262",title:"Mobile Robot",slug:"psychology-artificial-intelligence-mobile-robot"}],chapters:[{id:"63854",title:"A Survey and Analysis of Cooperative Multi-Agent Robot Systems: Challenges and Directions",doi:"10.5772/intechopen.79337",slug:"a-survey-and-analysis-of-cooperative-multi-agent-robot-systems-challenges-and-directions",totalDownloads:2439,totalCrossrefCites:8,totalDimensionsCites:20,hasAltmetrics:0,abstract:"Research in the area of cooperative multi-agent robot systems has received wide attention among researchers in recent years. The main concern is to find the effective coordination among autonomous agents to perform the task in order to achieve a high quality of overall performance. Therefore, this paper reviewed various selected literatures primarily from recent conference proceedings and journals related to cooperation and coordination of multi-agent robot systems (MARS). The problems, issues, and directions of MARS research have been investigated in the literature reviews. Three main elements of MARS which are the type of agents, control architectures, and communications were discussed thoroughly in the beginning of this paper. A series of problems together with the issues were analyzed and reviewed, which included centralized and decentralized control, consensus, containment, formation, task allocation, intelligences, optimization and communications of multi-agent robots. Since the research in the field of multi-agent robot research is expanding, some issues and future challenges in MARS are recalled, discussed and clarified with future directions. Finally, the paper is concluded with some recommendations with respect to multi-agent systems.",signatures:"Zool Hilmi Ismail and Nohaidda Sariff",downloadPdfUrl:"/chapter/pdf-download/63854",previewPdfUrl:"/chapter/pdf-preview/63854",authors:[{id:"91546",title:"MSc.",name:"Nohaidda Binti",surname:"Sariff",slug:"nohaidda-binti-sariff",fullName:"Nohaidda Binti Sariff"},{id:"135439",title:"Dr.",name:"Zool",surname:"Ismail",slug:"zool-ismail",fullName:"Zool Ismail"}],corrections:null},{id:"62533",title:"Motion Control and Velocity-Based Dynamic Compensation for Mobile Robots",doi:"10.5772/intechopen.79397",slug:"motion-control-and-velocity-based-dynamic-compensation-for-mobile-robots",totalDownloads:1534,totalCrossrefCites:0,totalDimensionsCites:5,hasAltmetrics:1,abstract:"The design of motion controllers for wheeled mobile robots is often based only on the robot’s kinematics. However, to reduce tracking error it is important to also consider the robot dynamics, especially when high-speed movements and/or heavy load transportation are required. Commercial mobile robots usually have internal controllers that accept velocity commands, but the control signals generated by most dynamic controllers in the literature are torques or voltages. In this chapter, we present a velocity-based dynamic model for differential-drive mobile robots that also includes the dynamics of the robot actuators. Such model can be used to design controllers that generate velocity commands, while compensating for the robot dynamics. We present an explanation on how to obtain the parameters of the dynamic model and show that motion controllers designed for the robot’s kinematics can be easily integrated with the velocity-based dynamic compensation controller. We conclude the chapter with experimental results of a trajectory tracking controller that show a reduction of up to 50% in tracking error index IAE due to the application of the dynamic compensation controller.",signatures:"Felipe Nascimento Martins and Alexandre Santos Brandão",downloadPdfUrl:"/chapter/pdf-download/62533",previewPdfUrl:"/chapter/pdf-preview/62533",authors:[{id:"164609",title:"Dr.",name:"Alexandre",surname:"Brandão",slug:"alexandre-brandao",fullName:"Alexandre Brandão"},{id:"246107",title:"Dr.",name:"Felipe",surname:"Martins",slug:"felipe-martins",fullName:"Felipe Martins"}],corrections:null},{id:"62906",title:"Theoretical and Experimental Collaborative Area Coverage Schemes Using Mobile Agents",doi:"10.5772/intechopen.78940",slug:"theoretical-and-experimental-collaborative-area-coverage-schemes-using-mobile-agents",totalDownloads:943,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter is concerned with the development of collaborative control schemes for mobile ground robots for area coverage purposes. The simplest scheme assumes point omnidirectional robots with heterogeneous circular sensing patterns. Using information from their spatial neighbors, each robot (agent) computes its cell relying on the power diagram partitioning. If there is uncertainty in inferring the locations of these robots, the Additively Weighted Guaranteed Voronoi scheme is employed resulting in a rather conservative performance. The aforementioned schemes are enhanced by using a Voronoi-free coverage scheme that relies on the knowledge of any arbitrary sensing pattern employed by the agents. Experimental results are offered to highlight the efficiency of the suggested control laws.",signatures:"Sotiris Papatheodorou and Anthony Tzes",downloadPdfUrl:"/chapter/pdf-download/62906",previewPdfUrl:"/chapter/pdf-preview/62906",authors:[{id:"242670",title:"Dr.",name:"Anthony",surname:"Tzes",slug:"anthony-tzes",fullName:"Anthony Tzes"},{id:"244840",title:"Mr.",name:"Sotiris",surname:"Papatheodorou",slug:"sotiris-papatheodorou",fullName:"Sotiris Papatheodorou"}],corrections:null},{id:"64100",title:"Mobile Robot Feature-Based SLAM Behavior Learning, and Navigation in Complex Spaces",doi:"10.5772/intechopen.81195",slug:"mobile-robot-feature-based-slam-behavior-learning-and-navigation-in-complex-spaces",totalDownloads:975,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Learning mobile robot space and navigation behavior, are essential requirements for improved navigation, in addition to gain much understanding about the navigation maps. This chapter presents mobile robots feature-based SLAM behavior learning, and navigation in complex spaces. Mobile intelligence has been based on blending a number of functionaries related to navigation, including learning SLAM map main features. To achieve this, the mobile system was built on diverse levels of intelligence, this includes principle component analysis (PCA), neuro-fuzzy (NF) learning system as a classifier, and fuzzy rule based decision system (FRD).",signatures:"Ebrahim A. Mattar",downloadPdfUrl:"/chapter/pdf-download/64100",previewPdfUrl:"/chapter/pdf-preview/64100",authors:[{id:"216016",title:"Prof.",name:"Ebrahim",surname:"Mattar",slug:"ebrahim-mattar",fullName:"Ebrahim Mattar"}],corrections:null},{id:"63790",title:"Mobile Robot Navigation in Indoor Environments: Geometric, Topological, and Semantic Navigation",doi:"10.5772/intechopen.79842",slug:"mobile-robot-navigation-in-indoor-environments-geometric-topological-and-semantic-navigation",totalDownloads:1547,totalCrossrefCites:2,totalDimensionsCites:8,hasAltmetrics:0,abstract:"The objective of the chapter is to show current trends in robot navigation systems related to indoor environments. Navigation systems depend on the level of abstraction of the environment representation. The three main techniques for representing the environment will be described: geometric, topological, and semantic. The geometric representation of the environment is closer to the sensor and actuator world and it is the best one to perform local navigation. Topological representation of the environment uses graphs to model the environment and it is used in large navigation tasks. The semantic representation is the most abstract representation model and adds concepts such as utilities or meanings of the environment elements in the map representation. In addition, regardless of the representation used for navigation, perception plays a significant role in terms of understanding and moving through the environment.",signatures:"Ramón Barber, Jonathan Crespo, Clara Gómez, Alejandra C.\nHernámdez and Marina Galli",downloadPdfUrl:"/chapter/pdf-download/63790",previewPdfUrl:"/chapter/pdf-preview/63790",authors:[{id:"158703",title:"Dr.",name:"Ramon",surname:"Barber",slug:"ramon-barber",fullName:"Ramon Barber"},{id:"260264",title:"Dr.",name:"Jonathan",surname:"Crespo",slug:"jonathan-crespo",fullName:"Jonathan Crespo"},{id:"260265",title:"Ms.",name:"Clara",surname:"Gomez",slug:"clara-gomez",fullName:"Clara Gomez"},{id:"260266",title:"Ms.",name:"Alejandra C.",surname:"Hernandez",slug:"alejandra-c.-hernandez",fullName:"Alejandra C. Hernandez"},{id:"260267",title:"Ms.",name:"Marina",surname:"Galli",slug:"marina-galli",fullName:"Marina Galli"}],corrections:null},{id:"62978",title:"Intelligent Robotic Perception Systems",doi:"10.5772/intechopen.79742",slug:"intelligent-robotic-perception-systems",totalDownloads:2412,totalCrossrefCites:5,totalDimensionsCites:11,hasAltmetrics:0,abstract:"Robotic perception is related to many applications in robotics where sensory data and artificial intelligence/machine learning (AI/ML) techniques are involved. Examples of such applications are object detection, environment representation, scene understanding, human/pedestrian detection, activity recognition, semantic place classification, object modeling, among others. Robotic perception, in the scope of this chapter, encompasses the ML algorithms and techniques that empower robots to learn from sensory data and, based on learned models, to react and take decisions accordingly. The recent developments in machine learning, namely deep-learning approaches, are evident and, consequently, robotic perception systems are evolving in a way that new applications and tasks are becoming a reality. Recent advances in human-robot interaction, complex robotic tasks, intelligent reasoning, and decision-making are, at some extent, the results of the notorious evolution and success of ML algorithms. This chapter will cover recent and emerging topics and use-cases related to intelligent perception systems in robotics.",signatures:"Cristiano Premebida, Rares Ambrus and Zoltan-Csaba Marton",downloadPdfUrl:"/chapter/pdf-download/62978",previewPdfUrl:"/chapter/pdf-preview/62978",authors:[{id:"203409",title:"Ph.D.",name:"Cristiano",surname:"Premebida",slug:"cristiano-premebida",fullName:"Cristiano Premebida"},{id:"254880",title:"Dr.",name:"Rares",surname:"Ambrus",slug:"rares-ambrus",fullName:"Rares Ambrus"},{id:"254881",title:"Dr.",name:"Zoltan-Csaba",surname:"Marton",slug:"zoltan-csaba-marton",fullName:"Zoltan-Csaba Marton"}],corrections:null},{id:"62563",title:"Online Mapping-Based Navigation System for Wheeled Mobile Robot in Road Following and Roundabout",doi:"10.5772/intechopen.79412",slug:"online-mapping-based-navigation-system-for-wheeled-mobile-robot-in-road-following-and-roundabout",totalDownloads:1468,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"A road mapping and feature extraction for mobile robot navigation in road roundabout and road following environments is presented in this chapter. In this work, the online mapping of mobile robot employing the utilization of sensor fusion technique is used to extract the road characteristics that will be used with path planning algorithm to enable the robot to move from a certain start position to predetermined goal, such as road curbs, road borders, and roundabout. The sensor fusion is performed using many sensors, namely, laser range finder, camera, and odometry, which are combined on a new wheeled mobile robot prototype to determine the best optimum path of the robot and localize it within its environments. The local maps are developed using an image’s preprocessing and processing algorithms and an artificial threshold of LRF signal processing to recognize the road environment parameters such as road curbs, width, and roundabout. The path planning in the road environments is accomplished using a novel approach so called Laser Simulator to find the trajectory in the local maps developed by sensor fusion. Results show the capability of the wheeled mobile robot to effectively recognize the road environments, build a local mapping, and find the path in both road following and roundabout.",signatures:"Mohammed A. H. Ali and Musa Mailah",downloadPdfUrl:"/chapter/pdf-download/62563",previewPdfUrl:"/chapter/pdf-preview/62563",authors:[{id:"32016",title:"Prof.",name:"Musa",surname:"Mailah",slug:"musa-mailah",fullName:"Musa Mailah"},{id:"243606",title:"Dr.",name:"Mohammed A. H",surname:"Ali",slug:"mohammed-a.-h-ali",fullName:"Mohammed A. H Ali"}],corrections:null},{id:"62939",title:"Path Tracking of a Wheeled Mobile Manipulator through Improved Localization and Calibration",doi:"10.5772/intechopen.79598",slug:"path-tracking-of-a-wheeled-mobile-manipulator-through-improved-localization-and-calibration",totalDownloads:1279,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"This chapter focuses on path tracking of a wheeled mobile manipulator designed for manufacturing processes such as drilling, riveting, or line drawing, which demand high accuracy. This problem can be solved by combining two approaches: improved localization and improved calibration. In the first approach, a full-scale kinematic equation is derived for calibration of each individual wheel’s geometrical parameters, as opposed to traditionally treating them identical for all wheels. To avoid the singularity problem in computation, a predefined square path is used to quantify the errors used for calibration considering the movement in different directions. Both statistical method and interval analysis method are adopted and compared for estimation of the calibration parameters. In the second approach, a vision-based deviation rectification solution is presented to localize the system in the global frame through a number of artificial reflectors that are identified by an onboard laser scanner. An improved tracking and localization algorithm is developed to meet the high positional accuracy requirement, improve the system’s repeatability in the traditional trilateral algorithm, and solve the problem of pose loss in path following. The developed methods have been verified and implemented on the mobile manipulators developed by Shanghai University.",signatures:"Tao Song, Fengfeng (Jeff) Xi and Shuai Guo",downloadPdfUrl:"/chapter/pdf-download/62939",previewPdfUrl:"/chapter/pdf-preview/62939",authors:[{id:"65530",title:"Prof.",name:"Guo",surname:"Shuai",slug:"guo-shuai",fullName:"Guo Shuai"},{id:"133537",title:"Prof.",name:"Fengfeng",surname:"Xi",slug:"fengfeng-xi",fullName:"Fengfeng Xi"},{id:"244038",title:"Dr.",name:"Tao",surname:"Song",slug:"tao-song",fullName:"Tao Song"}],corrections:null},{id:"63491",title:"4WD Robot Posture Estimation by Radial Multi-View Visual Odometry",doi:"10.5772/intechopen.79130",slug:"4wd-robot-posture-estimation-by-radial-multi-view-visual-odometry",totalDownloads:948,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter presents a four-wheel robot’s trajectory tracking model by an extended Kalman filter (EKF) estimator for visual odometry using a divergent trinocular visual sensor. The trinocular sensor is homemade and a specific observer model was developed to measure 3D key-points by combining multi-view cameras. The observer approaches a geometric model and the key-points are used as references for estimating the robot’s displacement. The robot’s displacement is estimated by triangulation of multiple pairs of environmental 3D key-points. The four-wheel drive (4WD) robot’s inverse/direct kinematic control law is combined with the visual observer, the visual odometry model, and the EKF. The robot’s control law is used to produce experimental locomotion statistical variances and is used as a prediction model in the EKF. The proposed dead-reckoning approach models the four asynchronous drives and the four damping suspensions. This chapter presents the deductions of models, formulations and their validation, as well as the experimental results on posture state estimation comparing the four-wheel dead-reckoning model, the visual observer, and the EKF with an external global positioning reference.",signatures:"Edgar Alonso Martínez-García and Luz Abril Torres-Méndez",downloadPdfUrl:"/chapter/pdf-download/63491",previewPdfUrl:"/chapter/pdf-preview/63491",authors:[{id:"9751",title:"Dr.",name:"Luz Abril",surname:"Torres-Méndez",slug:"luz-abril-torres-mendez",fullName:"Luz Abril Torres-Méndez"},{id:"84958",title:"Dr.",name:"Edgar A.",surname:"Martínez García",slug:"edgar-a.-martinez-garcia",fullName:"Edgar A. Martínez García"}],corrections:null},{id:"62387",title:"IntelliSoC: A System Level Design and Conception of a System- on-a-Chip (SoC) to Cognitive Agents Architecture",doi:"10.5772/intechopen.79265",slug:"intellisoc-a-system-level-design-and-conception-of-a-system-on-a-chip-soc-to-cognitive-agents-archit",totalDownloads:970,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"This chapter presents a system level design and conception of a System-on-a-Chip (SoC) for the execution of cognitive agents. The computational architecture of this SoC will be presented using the cognitive model of the concurrent autonomous agent (CAA) as a reference. This cognitive model comprises three levels that run concurrently, namely the reactive level, the instinctive level and the cognitive level. The reactive level executes a fast perception-action cycle. The instinctive level receives perceptions from and sends the active behavior to the reactive level, and using a Knowledge Based System (KBS) executes plans by selecting reactive behaviors. The cognitive level receives symbolic information from the instinctive level to update its logical world model, used for planning and sends new local goals to instinctive level. Thus, this work proposes a novel SoC whose architecture fits the computational demands of the aforementioned cognitive model, allowing for fast, energy-efficient, embedded intelligent applications.",signatures:"Diego Ferreira, Augusto Loureiro da Costa and Wagner Luiz Alves\nDe Oliveira",downloadPdfUrl:"/chapter/pdf-download/62387",previewPdfUrl:"/chapter/pdf-preview/62387",authors:[{id:"246122",title:"Prof.",name:"Augusto",surname:"Loureiro Da Costa",slug:"augusto-loureiro-da-costa",fullName:"Augusto Loureiro Da Costa"},{id:"247158",title:"M.Sc.",name:"Diego",surname:"Fonseca Ferreira",slug:"diego-fonseca-ferreira",fullName:"Diego Fonseca Ferreira"},{id:"247159",title:"Prof.",name:"Wagner Luiz",surname:"Alves De Oliveira",slug:"wagner-luiz-alves-de-oliveira",fullName:"Wagner Luiz Alves De Oliveira"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited 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1. Introduction
Osteoporosis is a systemic skeletal disease that deteriorates bone mass and strength and affects the microarchitecture of bone, thus increasing bone turnover and bone fragility [1]. Osteoporosis is categorized into primary and secondary types. Primary osteoporosis is considered decreased bone density attributed to aging, postmenopausal conditions and idiopathic osteoporosis. Secondary osteoporosis occurs in patients with predisposing factors, such as other endocrinopathies and a history of using some drugs. Osteoporotic bone is characterized by a decreased thickness, deranged trabecular structure, reduced mineral content, as well as an increased carbonate-to-phosphate ratio [2]. The reduction in osteoid formation is attributed to the absence of or a deficit in pre-osteoblast differentiation into osteoblasts or a reduction in the number of osteoprogenitor cells and defects in their proliferation and differentiation [3].
Dental implant placement has become a common and frequent option for tooth replacement. The success of dental implants largely depends on their osseointegration. Factors that interfere with osseointegration act as potential threats to implant survival. Osteoporosis is considered a questionable condition in dental implant placement since it affects the jaw bones, and bisphosphonates (BPs) are the first line of therapy [4, 5, 6]. Local and systemic factors can influence the osseointegration. The implant surface and the bone are the main interacting entities, and changes to these affect the healing and osseointegration of the implant. It is recognized that any compromise in the bone quality and quantity adversely affects the osseointegration. A microrough implant surface results in better osseointegration than a smooth implant surface. The relationship between osteoporosis and bone formation around implants is still unclear [7, 8]. Osteoporosis in the elderly, especially in postmenopausal women, is significantly correlated with tooth loss [9]. In fractures, delayed bone healing occurs due to low bone density, poor bone quality and osseous microstructural changes [10]. The endosseous implant healing mechanism is similar to that of bone fracture healing; hence, it is reasonable to assume that dental implant survival may be negatively affected by osteoporosis [11]. Animal studies have shown a relatively low rate of osseointegration in an osteoporotic environment [12, 13]. While most of these experimental studies were carried out on long bones rather than jaw bones, [14] studies of experimentally induced osteoporosis in the mandible failed to show a significant difference in peri-implant bone formation [15, 16, 17, 18].
2. Pathophysiology of osteoporosis
Osteoporosis is a condition characterized by decreased bone mineral density and deteriorated bone microarchitecture and hence compromised bone quality. Osteoporosis can be classified into primary and secondary types. Primary osteoporosis can also be subclassified as type I and type II osteoporosis [17]. Type I osteoporosis occurs primarily due to the loss of trabecular bone, leading to distal forearm and vertebral body fractures. Type II osteoporosis is also known as senile osteoporosis and mainly occurs in men and women over the age of 70 years due to the loss of cortical and trabecular bone. Osteoporosis may also result from genetic and endocrine disorders, hypogonadal states, deficiencies, drug-induced and inflammatory states, and hematologic and neoplastic disorders as secondary causes. Estrogen deficiency is thought to be critical in the pathogenesis of postmenopausal osteoporosis. In the postmenopausal period, the bone structure changes due to estrogen deficiency, and osteoporosis can occur as a result of an imbalance in bone remodeling leading to enhanced bone resorption [3].
Osteoporosis leads to bone demineralization, which begins to manifest clinically in the fourth and fifth decades of life. Modifiable and nonmodifiable risk factors are responsible for osteoporosis [19]. Nonmodifiable risk factors include age, sex, genetic factors and early menopause, while modifiable risk factors include inadequate calcium consumption, lack of exercise, and behavioral factors, such as smoking and alcoholism. Other factors that can contribute to the development of osteoporosis include certain endocrine diseases, such as hyperparathyroidism, chronic renal and hepatic disease, malabsorption, and the use of certain drugs, such as oral glucocorticoids [18, 19].
The role of estrogen in the development of osteoporosis is well documented. Studies have shown that sex steroids, particularly estrogen, are important in developing peak bone mass and that estrogen deficiency is an important determinant of bone loss in both sexes [20, 21]. Estrogen can directly and/or indirectly affect osteoclasts, osteoblasts and osteocytes. It has been firmly established that these cells express functional estrogen receptors, [22] and studies have clearly demonstrated that estrogen can induce osteoclast apoptosis through the osteoclast-specific deletion of estrogen receptors. This can reduce osteoclast apoptosis and increase the osteoclast lifespan, which results in decreased trabecular bone mass (Figure 1) [23, 24]. Aging and estrogen deficiency may lead to an impairment in bone formation involving oxidative stress. Estrogen deficiency can also lead to a marked increase in NF-kB activity in osteoblasts. In osteoporotic patients, estrogen treatment induces the expression of sclerostin, a potent inhibitor of bone formation [25]. As sclerostin is expressed by osteocytes, estrogen also affects osteocytes. Estrogen deficiency may enhance the rate of bone loss by stimulating the synthesis of several inflammatory cytokines that regulate osteoclast generation, such as IL-1, IL-2, IL-6, and prostaglandin E [26].
Figure 1.
Orthopantomogram of a 65-year-old patient with osteoporosis. Note the area of low bone density, alveolar bone loss and tooth loss.
A recent study among Swedish women showed a previous history of fracture and low bone mineral density as important factors that can lead to an increased rate of hip and fragility fractures among them [27]. Another study conducted in the United States revealed that several factors, such as age, self-reported health, weight, height, self-reported physical activity, history of fracture after the age of 50, parental hip fracture, smoking, use of corticosteroids, and treated diabetes, may be early indicators of hip fractures [28]. Factors associated with an increased risk for osteoporosis in men include glucocorticoid treatment, hypogonadism, excessive alcohol consumption, anticonvulsant use, osteomalacia, severe hyperthyroidism, and bone marrow neoplasia [29].
3. Dental implants and osteoporosis
Osteoporosis causes a range of skeletal changes that may impact the feasibility of dental implant placement. Greater alveolar ridge resorption, altered trabecular patterns in the anterior maxilla and posterior mandible, erosion of the inferior border of the mandible and increased resorption and thinning of the inferior mandibular cortical margin have been reported among osteoporotic individuals [30, 31]. Subjects with osteoporosis show a decreased number and thickness of trabecular plates as a characteristic feature of the disease. There have also been anecdotal reports that the incidence of maxillofacial fractures during the placement of endosseous implants is increased in patients with osteoporosis [32]. Additionally, bone changes evident on panoramic radiographs can be correlated with general osteoporosis, and dental radiography can serve as both a reliable indicator of bone loss in osteoporosis and a useful tool for diagnosing skeletal osteoporosis [33].
The osseointegration of an implant is a wound healing process that depends upon the quality, quantity, and healing capacity of the host bone and various other systemic conditions. Osseointegration is based on intimate bone-implant contact achieved during healing. Thus, any condition affecting bone quality or quantity or microarchitectural changes in bone structure, including a reduction in the cancellous bone volume and bone-implant contact, could theoretically have a negative impact on the survival and function of an endosseous implant [34]. There are relatively few absolute contraindications to rehabilitation with dental implants, including a recent myocardial infarction or cerebrovascular accident, history of valvular prosthesis placement, immune suppression, bleeding issues, active treatment of malignancy, drug abuse, psychiatric illness, and intravenous BP treatment [35]. Some relative contraindications and conditions that may unfavorably impact the outcomes of dental implant placement discussed in the literature include adolescence, aging, osteoporosis, smoking, diabetes, positive IL-1 genotype, human immunodeficiency virus infection, cardiovascular disease and hypothyroidism [36, 37, 38]. Controversy about the importance and effects of osteoporosis in dental therapy has continued [39].
In a study of implant placement in patients diagnosed with osteoporosis, Friberg et al. [40] found a success rate of 97% for the maxilla and 97.3% for the mandible on follow-up. Most studies have shown that it is feasible to place implants in subjects with osteoporosis, with success rates similar to those in healthy subjects, even in cases of poor bone quality during or after placement [4, 41, 42, 43, 44].
4. Osteoporosis in implant Osseointegration
The osseointegration of an implant can be affected by the characteristics of the implant, the surgical procedure, and patient-dependent variables that can affect the quantity and quality of bone (Table 1). Osteoporosis, characterized by bone loss, microstructural alterations and a reduced bone regeneration capacity, has been considered a potential contraindication to or risk factor for dental implant placement. It has been established that osteoporosis affects the jaw in the same manner as other bones of the skeleton and thus may also alter the metabolic microenvironment of bone around the implant [56]. Bone is constantly metabolized throughout life by bone-resorbing osteoclasts and bone-forming osteoblasts. Osteocytes play an active role in modulating the process of bone metabolism through the lacunocanalicular system [57, 58]. Studies in osteoporotic animal models have shown altered osseointegration, especially in trabecular bone, which resulted in a significant reduction in bone-implant contact [59, 60, 61].
Studies evaluating the outcome of dental implants among subjects with osteoporosis.
Elucidation of the role of osteocytes in peri-implant bone remodeling will help clarify the dynamics of bone metabolism following osseointegration. Since osteocytes are the terminal cells of osteoblasts, understanding the relationship between osteocytes and implants will also shed light on the relationship between osteoblasts and implants in early bone formation. Research on the influence of estrogen deficiency and its treatment with alendronate and estrogen on bone density around osseointegrated implants in rats has shown that estrogen deprivation has a negative effect only on trabecular bone and that treatment with estrogen and alendronate can effectively prevent bone loss around osseointegrated implants [62]. Histological studies in humans have also shown the osseointegration of implants retrieved from osteoporotic individuals [63, 64]. A histological study that evaluated the bone-implant contact of failed implants after retrieval showed no differences between implants originating from patients with and without osteoporosis [41]. The most important complication of implant placement in osteoporotic patients is bisphosphonate-related osteonecrosis of the jaw (BRONJ), that interferes with osseointegration. BPs act by inhibiting and inducing the apoptosis of osteoclasts, increasing collagen synthesis and inhibiting osteoblast proliferation. A systematic review showed that the placement of dental implants in osteoporotic patients who used oral BPs for less than five years did not develop BRONJ and that most adverse effects were related to the intravenous administration of BPs [65].
5. Dental implants and bisphosphonate therapy
Bisphosphonates are widely prescribed for the management of osteoporosis. They are pyrophosphate analogs containing a phosphate-carbon-phosphate bond, which is stable against chemical and enzymatic hydrolysis. BPs strongly bind to hydroxyapatite (HA) crystals and potently inhibit osteoclast-mediated bone resorption while minimally inhibiting osteoblast activity [66]. BPs are used for increasing or maintaining bone mass and reducing excessive bone turnover [67]. By inhibiting osteoclast-mediated bone resorption, BPs contribute to an increase in bone mineral density as well as a decrease in the risk of fracture [68, 69]. Two routes of administration are commonly used: oral and intravenous. BPs act almost exclusively on bone when administered at physiological doses because of their specific affinity to bone; they are deposited both in newly formed bone and in proximity to osteoclasts. The half-life of BPs in the circulation is quite short, ranging from thirty minutes to two hours [70]. However, once incorporated into bone tissue, they can persist for up to 10 years, depending on the skeletal turnover time [71]. Oral BPs are commonly used in the treatment of osteoporosis, Paget’s disease, and osteogenesis imperfecta, whereas intravenous BPs are used in the treatment of osteolytic tumors, hypercalcemia of malignancy, multiple myeloma, bone metastases from solid tumors, and other tumors [72, 73]. The most common oral BPs are alendronate (Fosamax), risedronate (Actonel), and ibandronate (Boniva).
There have been conflicting reports regarding installation of dental implants in patients undergoing bisphosphonate therapy [74, 75]. Experimental studies have shown a positive effect of BPs on peri-implant bone in experimental animals [76, 77]. Although some studies have reported that BPs have no effect on implant stability, [78] a few other reports have suggested that BPs may have a negative impact on osseointegration. Additionally, osteointegration failure has been reported in patients on BP therapy [79, 80, 81]. Current guidelines indicate that implant placement may be avoided if the patient has a serious bone disease or is on high doses of BPs. Osteoporotic patients on lower doses need to provide fully informed consent before proceeding with treatment, and patients with existing implants on BP therapy should be regularly monitored. Increased bone density around the implant may also occur. If bone pain or loss of integrity occurs, the superstructure should be removed, and the implant should be left submerged [82]. In such cases, bone surgery must be avoided because the bone is exceedingly dense, and avascular necrosis may occur (Figure 2).
Figure 2.
Schematic diagram showing the possible mechanism of development of BP-associated osteonecrosis. BP, bisphosphonate (adapted and modified from Anil et al. [83]).
The chances of developing osteonecrosis depend on the potency and duration of BP exposure [84, 85, 86]. BRONJ is a condition characterized by nonhealing exposed necrotic bone in the mandible or maxilla persisting for more than 8 weeks in a patient who has taken or is currently taking a BP and who has no history of radiation therapy of the jaw [84, 87]. Incidents of osteonecrosis of the jaw have been reported in persons using BPs and undergoing invasive dental treatment procedures, including tooth extraction, dental implant placement, and surgical and nonsurgical periodontal treatment [88, 89]. Although BPs have been reported to cause oral mucosal alterations, the changes occurring in the jaw bone are of greater significance to the dentist [90, 91]. Osteonecrosis of the jaw is less often reported among patients who have received treatment with oral BPs at lower doses, used for osteoporosis, than among patients who have received treatment with higher doses, used for metastatic cancer. Even though the exact incidence of BRONJ is unknown, reports have estimated it to be approximately 1 in 10,000 for intravenous BPs. There is also an incomplete understanding of how BP therapy may affect tissue healing and the success rate of dental implantation [75, 80]. Advanced cases of BRONJ can lead to pathological fractures, especially in edentulous patients with long-standing oral implants [92].
6. Bisphosphonate-related osteonecrosis of the jaw
BPs alter the bone tissue metabolism by inhibiting bone resorption and reducing bone turnover. At the cellular level, BPs affect the recruitment of osteoclasts, their viability, the bioavailability of their progenitors, and their effect on bone. From a molecular point BPs have been proposed to modulate the function of osteoclasts by reacting with a surface receptor or with an intracellular enzyme [93]. BRONJ is defined as an area of exposed bone in the maxillofacial region that does not heal within 8 weeks in a patient who is receiving treatment with a BP. BRONJ develops secondary to the mechanisms of action of BPs in anti-osteoclastic and antiangiogenic activities, which alter bone metabolism, inhibit bone resorption and reduce bone turnover. Additional signs and symptoms may include pain, swelling, paresthesia, suppuration, soft tissue ulceration, intra- or extraoral sinus tract formation, tooth loosening, and radiographic variability. These symptoms most commonly occur at sites of previous tooth extractions or other dental surgical interventions but may occur spontaneously. The exact role of BPs remains to be determined, and alterations in bone homeostasis coupled with odontogenic or surgical insult, or both, may be key to the development of osteonecrosis of the jaw [88, 93]. Cases of BRONJ are more common when frequent doses of intravenous BPs are used in treating malignancy than when oral BP regimens are used in treating osteoporosis [94].
The diagnosis of BRONJ is primarily based on the patient’s history and the findings of a clinical examination. Most of the time, these patients have necrotic bone exposure ranging from a few millimeters to larger areas and can be asymptomatic for weeks, months, or years (Figure 3). The incidence of BRONJ is higher in the mandible than in the maxilla and in areas of thin mucosa overlying bony prominences, such as tori and the mylohyoid ridge. The management of BRONJ mainly comprises pain control measures, antibiotic therapy, mouth rinsing, BP discontinuation, hyperbaric chamber therapy, laser therapy, and surgical debridement [95, 96]. Assessments of markers of bone resorption, such as the serum C-terminal telopeptide of type I collagen; CTx or ITCP) test, can be used to assess the risk of developing BRONJ. Patients with a CTx level lower than 150 pg./mL should consider discontinuation of BP therapy for a period of 4–6 months.
Figure 3.
BRONJ in a 63-year-old woman subsequent to extraction of mandibular molar. The patient was on intravenous zoledronate for 1 year (adapted and modified from Anil et al. [83]).
7. Conclusion
Osteoporosis is a common skeletal disorder characterized by reduced bone mass and altered bone architecture, leading to an increase in bone fragility and the risk of fracture. This condition is associated with a decrease in bone quality and quantity, which might affect dental implant osseointegration. The placement of dental implants in patients with osteoporosis is still debated because of the quality of the bone, which is a key factor that determines the success of dental implantation. Although osteoporosis is not considered a risk factor for dental implant failure, the initial implant stability can be influenced by both the local and skeletal bone density, and the healing time is prolonged in osteoporotic patients. While the risk of osteonecrosis of the jaw in patients on BPs is low, patients should be informed of this risk and sign a consent form including this specific point. Based on the available literature, it can be concluded that implants placed in patients with systemic osteoporosis did not present higher failure rates than those placed in patients without osteoporosis.
Conflict of interest
The authors declare no conflict of interest.
\n',keywords:"osteoporosis, osteopenia, bisphosphonates, osseointegration, implant, bone mineral density, risk factors",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/78703.pdf",chapterXML:"https://mts.intechopen.com/source/xml/78703.xml",downloadPdfUrl:"/chapter/pdf-download/78703",previewPdfUrl:"/chapter/pdf-preview/78703",totalDownloads:104,totalViews:0,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:0,impactScore:0,impactScorePercentile:33,impactScoreQuartile:2,hasAltmetrics:0,dateSubmitted:"August 19th 2021",dateReviewed:"September 2nd 2021",datePrePublished:"September 21st 2021",datePublished:null,dateFinished:"September 21st 2021",readingETA:"0",abstract:"Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and susceptibility to fractures. Osteoporosis also results in loss of bone mineral density throughout the body, including the maxilla and mandible. Successful osseointegration of dental implants is attributed to their ability to integrate well with bone. The influence of bone quality on dental implant osseointegration has been discussed in several studies, and higher rates of dental implant failure have been reported in patients with low bone quality and an inadequate bone volume. Osteoporosis represents a risk factor for osseointegration, and this relationship may be derived from the association of the disease with a deficiency in bone formation. This condition would compromise the healing capacity and the apposition of bone at the implant interface. Currently, there is no clear consensus regarding dental implant treatment in osteoporotic individuals. Studies have revealed contradictory reports regarding the success and failure of dental implants in patients with osteoporosis. Antiresorptive agents have been widely used to treat osteoporosis. Dental implant placement in patients on bisphosphonate therapy may trigger osteonecrosis of the bone. Hence, it is important to analyze factors that have to be taken into consideration prior to implant therapy in patients with osteoporosis and those undergoing treatment. This chapter outlines dental implant osseointegration under osteoporotic conditions. The possible effect of bisphosphonate therapy on dental implant survival will also be discussed based on the current literature.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/78703",risUrl:"/chapter/ris/78703",book:{id:"10808",slug:null},signatures:"Sara Gibreel, Hasaan Gassim Mohamed, Amartya Raj Suraj and Sukumaran Anil",authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Pathophysiology of osteoporosis",level:"1"},{id:"sec_3",title:"3. Dental implants and osteoporosis",level:"1"},{id:"sec_4",title:"4. Osteoporosis in implant Osseointegration",level:"1"},{id:"sec_5",title:"5. Dental implants and bisphosphonate therapy",level:"1"},{id:"sec_6",title:"6. Bisphosphonate-related osteonecrosis of the jaw",level:"1"},{id:"sec_7",title:"7. Conclusion",level:"1"},{id:"sec_11",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Johnell O, Kanis JA: An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006, 17(12):1726-1733.'},{id:"B2",body:'Gadeleta SJ, Boskey AL, Paschalis E, Carlson C, Menschik F, Baldini T, Peterson M, Rimnac CM: A physical, chemical, and mechanical study of lumbar vertebrae from normal, ovariectomized, and nandrolone decanoate-treated cynomolgus monkeys (Macaca fascicularis). Bone 2000, 27(4):541-550.'},{id:"B3",body:'Feng X, McDonald JM: Disorders of bone remodeling. Annu Rev Pathol 2011, 6:121-145.'},{id:"B4",body:'Li Y, He S, Hua Y, Hu J: Effect of osteoporosis on fixation of osseointegrated implants in rats. 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Clin Oral Implants Res 2009, 20(12):1402-1408.'},{id:"B82",body:'Serra M, Llorca C, Donat F: Oral implants in patients receiving bisphosphonates: a review and update. Med Oral Patol Oral Cir Bucal 2008, 13:E755-E760.'},{id:"B83",body:'Anil S, Preethanath RS, AlMoharib HS, Kamath KP, Anand PS: Impact of osteoporosis and its treatment on oral health. Am J Med Sci 2013, 346(5):396-401.'},{id:"B84",body:'Bagan J, Scully C, Sabater V, Jimenez Y: Osteonecrosis of the jaws in patients treated with intravenous bisphosphonates (BRONJ): A concise update. Oral Oncol 2009, 45(7):551-554.'},{id:"B85",body:'Kawahara M, Kuroshima S, Sawase T: Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review. Int J Implant Dent 2021, 7(1):47.'},{id:"B86",body:'Rupel K, Ottaviani G, Gobbo M, Contardo L, Tirelli G, Vescovi P, Di Lenarda R, Biasotto M: A systematic review of therapeutical approaches in bisphosphonates-related osteonecrosis of the jaw (BRONJ). Oral Oncol 2014, 50(11):1049-1057.'},{id:"B87",body:'Hoff AO, Toth BB, Altundag K, Johnson MM, Warneke CL, Hu M, Nooka A, Sayegh G, Guarneri V, Desrouleaux K et al: Frequency and risk factors associated with osteonecrosis of the jaw in cancer patients treated with intravenous bisphosphonates. J Bone Miner Res 2008, 23(6):826-836.'},{id:"B88",body:'Marx RE: Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003, 61(9):1115-1117.'},{id:"B89",body:'Ficarra G, Beninati F, Rubino I, Vannucchi A, Longo G, Tonelli P, Pini Prato G: Osteonecrosis of the jaws in periodontal patients with a history of bisphosphonates treatment. Journal of clinical periodontology 2005, 32(11):1123-1128.'},{id:"B90",body:'Gonzalez-Moles MA, Bagan-Sebastian JV: Alendronate-related oral mucosa ulcerations. J Oral Pathol Med 2000, 29(10):514-518.'},{id:"B91",body:'Demerjian N, Bolla G, Spreux A: Severe oral ulcerations induced by alendronate. Clin Rheumatol 1999, 18(4):349-350.'},{id:"B92",body:'Pogrel M: Bisphosphonates and bone necrosis. J Oral Maxillofac Surg 2004, 62(3):391-392.'},{id:"B93",body:'Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL: Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg 2004, 62(5):527-534.'},{id:"B94",body:'Bamias A, Kastritis E, Bamia C, Moulopoulos LA, Melakopoulos I, Bozas G, Koutsoukou V, Gika D, Anagnostopoulos A, Papadimitriou C et al: Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors. J Clin Oncol 2005, 23(34):8580-8587.'},{id:"B95",body:'Vescovi P, Merigo E, Manfredi M, Meleti M, Fornaini C, Bonanini M, Rocca JP, Nammour S: Nd:YAG laser biostimulation in the treatment of bisphosphonate-associated osteonecrosis of the jaw: clinical experience in 28 cases. Photomed Laser Surg 2008, 26(1):37-46.'},{id:"B96",body:'Magopoulos C, Karakinaris G, Telioudis Z, Vahtsevanos K, Dimitrakopoulos I, Antoniadis K, Delaroudis S: Osteonecrosis of the jaws due to bisphosphonate use. A review of 60 cases and treatment proposals. Am J Otolaryngol 2007, 28(3):158-163.'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Sara Gibreel",address:null,affiliation:'
Department of Dentistry, Oral Health Institute, Hamad Medical Corporation, Qatar
Department of Dentistry, Oral Health Institute, Hamad Medical Corporation, Qatar
College of Dental Medicine, Qatar University, Qatar
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1. Introduction
This chapter aims to reveal the role of architecture and urbanism in the prevention and mitigation of pandemics. Although since the 19th century the built environment traditionally had a decisive role in mitigating pandemics, such as tuberculosis, the emancipation of medicine, after the discovery of antibiotics, gradually excluded architecture and urbanism from the strategies against pandemics. In the context of COVID-19, there are relevant reasons for an interdisciplinary scientific approach of pandemics including the built environment and for a reevaluation of the future international strategies.
2. The limits of the contemporary healthcare system response to pandemics
In the second half of the 20th century, a complex set of measures was set in place that successfully fought against pandemics. Pharmaceutical interventions brought substances such as antibiotic drugs against tuberculosis or such as vaccine products against influenzas. In 1997, International Coordination Group (ICG) was established by the World Health Organization (WHO) “to manage and coordinate the provision of emergency vaccine supplies and antibiotics to countries [1]”. Unfortunately, although existing influenza vaccines are among the most effective protections and strategic stockpiles for several influenza types are gathered, they are ineffective against new strains. Developing and distributing a new vaccine takes several months, delaying the pharmaceutical response. As for antibiotics, WHO started, since the 1990s, to strengthen the surveillance of the drug resistance for the tuberculosis.
Lack of pharmaceutical means, non-pharmaceutical interventions “should be put in place, at the early stage of a pandemic [1]”. The foreseen interventions included hygiene, social distancing, using facemasks and schools’ closures. The non-pharmaceutical interventions were established as part of the international response interventions: anticipation, early detection, containment, control and mitigation as well as elimination or eradication. These measures were regulated, since 1969, by the International Health Regulations that aimed to “prevent, protect against, control and respond to the international spread of disease”. Events that might have international consequences were supposed to be promptly reported by the states to WHO for assessment.
The COVID-19 pandemic showed the limits of the existing healthcare system strategies. By the end of 2020, lack of adequate response, the pandemic led to a dramatic health impact, with more than 1.5 million deaths by December 2020 [1], to a huge social disruption and an economic result that brought to the biggest global recession since the 1930s Great Depression.
Without an effective treatment for COVID-19, governments adopted the 19th century traditional measures concerning people and the built environment. The 2020 approach was contrary to the WHO politics of 2018, which stated that “many traditional containment measures are no longer efficient” and that “measures such as quarantine, for example, once regarded as a matter of fact, would be unacceptable to many populations today [1]”. People oriented measures in 2020 addressed individuals, like hygiene or wearing face masks, or were related to contacts with people, like the social distancing (or physical distancing), curfew, isolation, quarantine and confinement (lockdown). Building oriented measures were also adopted by interior air control through ventilation.
The COVID-19 pandemic brought into attention other non-pharmaceutical methods that may prevent or mitigate the effects of pandemics. One of the directions concerns the environmental approaches. As for the role of the built environment in fighting against pandemics, scientific studies undergone during 2020 concerning pollution, urban heat islands, land use, green areas, urban density and interior air quality suggest that the buildings and the built environment may play a decisive role in the international strategies against future pandemics.
3. The One Health system response to pandemics and the role of the built environment
In the 1980s, after increased outbreaks of zoonoses, human healthcare system became aware of the benefits in approaching human and animal diseases together with the unifying concept of One Medicine [2]. In the 1990s, due to the alteration of the ecosystems which led to new ways of diseases spread, the role of the environment in human health became relevant [3]. During the decade of the 2000s, the unification was extended to the humans, animals and environment resulting the One Health system in the 2000’s [4, 5]. A broader spectrum of professions was brought together, gathering veterinarians, ecologists, economists, sociologists or wildlife managers.
The 2010 decade brought an increased awareness of the urbanization risks for pandemics. The approaches were quantitative and focused on the overlapping of habitats, the heat that provide high-risk habitats for animals and the high density of people. As for the building health, there is also consistent literature about its role in supporting physical, social or psychological health. One of the key aspects is the indoor environmental quality, focused on the air quality.
Despite these advances in understanding the role of the built environment in human health, by the end of 2020 the was still not international strategy that included buildings and the built environment in the fighting against pandemics.
4. The historical role of the built environment in pandemics before the advent of antibiotics
Until the arrival of antibiotics in the middle of the 20th century, the main historical methods against bacterial pandemics were limiting the contacts between individuals through isolation, quarantine and confinement (lockdown) and, from the 19th century, the architectural and urban measures concerning air quality and sunlight.
In the case of leprosy, containment led to the appearance of the first dedicated architectural program, the leprosarium. The measure was common in Medieval Europe [6], although “less uniform and prescriptive [7]”.
Plagues were the deadliest pandemics. The 1346–1353 Black Death supposedly killed up to half of Europe’s population [8]. They pushed to a diversification of measures aiming the limitation of contacts between individuals, such as isolation, quarantine, confinement, the use of plague mask and the introduction of the medical passport. They also led to dedicated constructions, such as the 27 km long, six feet tall, Plague Wall in the French Vaucluse mountains traced in 1721 [9, 10]. Since the 19th century, plagues impact diminished.
The tuberculosis, “the white plague”, took the relay, with a peak mortality rate in Western Europe in 1800 [11]. Tuberculosis deaths counts for 45% between 1790 and 1796 in Bristol, 33.2% of deaths between 1751 and 1778 in Marseille [12] and for 25% of death between 1810 and 1815 in New York City [13]. In 1900, it remained the third cause of mortality after cardiovascular diseases and influenza–pneumonia in the US [14].
In France, the backbone of the fight against tuberculosis was the Hygiene movement in which public health was supposed to scientifically guide political decisions, architecture and urbanism. The movement started in the 1820s, continued with the creation of the Hygiene Commissions (1848) and of the Commission for Unhealthy Housing (1950) [15] and reached its peak in the urban renewal during the Haussmann period as Seine (Paris) prefect (1853–1870). The French capital applied the hygiene reform at the largest scale ever seen: sewage, wastewater treatment, waste removal, air circulation inside and between buildings, sunlight.
Hygiene movement derived principles definitively marked architecture and urbanism. The sunlight that kills bacteria imposed the sanatoriums as general architectural models, with vast windows stretching from one side to the other of the room and terraces for sun baths. Sunlight and ventilation at the 45th parallel north are the reason for imposing distances in between buildings greater than the building height.
At the turn of the 20th century emerged the British Garden City movement, started with the Ebenezer Howard’s 1898 book, republished in 1902 as Garden Cities of To-morrow. In Germany and Switzerland appeared the Lebensreform (Life Reform) movement.
The turn of the 20th century brought the first International Congresses on Tuberculosis: Berlin (1899), London (1901), Paris (1905). The First International Congress for Sanitation and Housing Health Safety was held in Paris (1904). The congress report correlates population density and health. The European research of the French dr. Samuel Bernheim concludes that “The tuberculosis mortality is proportional to the housing density; the danger of infection is all the greater when the residents are more cramped in their housings [15]”.
The hygiene measures led to a decline of tuberculosis and, at the turn of the 20th century, mortality was reduced at half in Paris between 1872–1900 and 1901–1925 periods [12].
The 19th century Hygiene movement marked the Interwar modernist architecture. Architect’s Le Corbusier Five Points of a New Architecture are derived from Hygiene movement theories. The house on pilotis, reinforced concrete columns raising the house from the ground, allows aeration. The roof garden is inspired by the sanatorium sunbath terraces. The free plan allows the liberation from being the “slave of the load-bearing walls”. The horizontal window, “essential goal of the house”, which “runs from one end to the other of the façade” is directly taken from the 19th century recommendations. The free façade in front of the columns is a “lightweight membrane made of isolating walls or windows”. Modernist urbanism is synthesized by the Le Corbusier architect book Athens Charter (1933) and the Josep Lluís Sert architect Can our cities survive? (1942). Hygiene movement principles were employed, emphasizing lighting and sunlight, light-oriented buildings and air circulation inside and between buildings.
One year later, in 1943, the discovery of the streptomycin antibiotic brought the first effective treatment for tuberculosis. The health strategies against bacterial pandemics no longer needed the support of architecture and urbanism.
5. Architecture and urbanism after the emancipation of medicine
As human health ceased to be an architectural and urban issue, Modernist movement, that promoted air, sun and light, was judged by social and environmental concerns determined by the functional segregation and the automobile-based traffic. In 1972 was symbolically declared the death of the modernist movement with the demolishment of a 1955 modernist US housing planned according to the principles of Le Corbusier [16].
The environmental counterreaction appeared in the late 1960s with the green architecture, as a reaction to the suburban sprawl and to the energy crisis. Different approaches are green city, sustainable city, eco city, zero & low carbon cities, zero energy city, livable city, compact city, smart city or resilient city. They concern pollution, carbon emission, energy, water, waste management and recycling, green-space ratios, forests and agricultural land loss.
The counterreaction to the social environment led in the US to the New Urbanism movement, in the 1980s. It emphasized mixed-use neighborhood and encouraged walking and bicycle transportation [17]. At the same time emerged in Europe the Urban Village movement that also promotes mixed use zoning aiming for partial self-containment by combining working, leisure and living, leads to medium-density housing, encourages walking and bicycling as well as public space encounters.
6. Health engaged architecture and urbanism certifications
At the end of the 20th century were introduced building certification systems. At the architectural level, green building certifications of the 1990s concerned health issues, such as the 1990 Building Research Establishment’s Environmental Assessment Method (BREEAM) and the 1993 Leadership in Energy and Environmental Design (LEED). They relate to indoor air quality, ventilation, interior lighting and daylight, thermal comfort, acoustic performance and the quality of views.
More health-oriented certifications started in the 2010s with the 2012 Fitwel, a joint initiative led by the US Centers for Disease Control and Prevention (CDC) and General Services Administration (GSA), or WELL Building Standard from the International WELL Building Institute, launched in 2014.
At the urban scale, healthy cities topics are only generally addressed by initiatives such as the WHO European Healthy Cities Network or the Urban Low Emissions Development Strategy (Urban LEDS). As for the LEED for Neighborhood Development, it repeatedly addressed health as a main issue: preferred location within existing cities to avoid the health consequences of sprawl, reduced motor vehicle use to reduce pollution, promote bicycling, walkable streets “to improve public health”, compact development, access to public space and connected community “to improve public health”, access to recreation facilities to “improve public health by providing recreational facilities close to work and home”, neighborhood schools “to improve students’ health by encouraging walking and bicycling to school [18]”.
7. The last decades warnings about future pandemics
According to a 2008 Nature paper, emerging infectious diseases, dominated by zoonoses, “are increasing significantly over time”, with “the emergence of 335 infectious diseases between 1940 and 2004” and “reflecting a large number of drug-resistant microbes [19]”. The most commonly cited reasons for this increase are the environmental issues, such as overlapping of habitats due to the agricultural intrusion in the ecosystems [20, 21, 22] or the global warming [23, 24] and urban heat islands [25, 26].
During the last decades, there was such concern about the zoonotic diseases impact that the COVID-19 pandemic seems the precise illustration: “Virtually every expert on influenza believes another pandemic is nearly inevitable, that it will kill millions of people, and that it could kill tens of millions—and a virus like 1918, or H5N1, might kill a hundred million or more—and that it could cause economic and social disruption on a massive scale. This disruption itself could kill as well. Given those facts, every laboratory investigator and every public health official involved with the disease has two tasks: first, to do his or her work, and second, to make political leaders aware of the risk. The preparedness effort needs resources. Only the political process can allocate them [27].” In the 2016 United Nations Environment Programme report about the “Emerging Issues of Environmental Concern”, zoonosis arrived second out of the six issues [28]. In 2018, WHO estimated that “another influenza pandemic is inevitable but unpredictable [1]”.
8. COVID-19 scientific findings with impact on the built environment design
The inevitable came with the COVID-19 pandemic. It led to an important allocation of resources in scientifically addressing the pandemic. Although the most notorious studies concern vaccines and antivirals, other research directions regard non-pharmaceutical measures aimed to prevent or mitigate pandemics. As in the 19th century, the implementation of some of these findings needs a dedicated built environment approach.
8.1 Pollution
Air pollution was already subject to studies that proved the effects on human health, such as respiratory diseases or lung cancer [29]. The correlation between road traffic, pollution and health has been associated with heart disease mortality [30].
Studies undergone in 2020 almost unanimously found that the relationship between air pollution and the COVID-19 led to a “large increase [31]” in the US, clear increases in the Netherlands [32], to a “significant relationship [33]” in China, “aggravating [34]” in a study on nine cities form India, China, Pakistan, and Indonesia and “increase vulnerability [35]” or positively associated with higher fatality rates [36] in Italy.
8.2 Green areas
Pre-pandemic studies already concluded not only that “the percentage of green space in people’s living environment has a positive association with the perceived general health [37]” but also “consistent negative association between urban green space exposure and mortality, heart rate, and violence, and positive association with attention, mood, and physical activity [38]”.
In the context of the COVID-19 pandemic, studies interpreted the distribution of green areas as part of the environment role on the infection’s risks [39]. Green spaces are also interpreted as a barometer for health inequity [39]. The green spaces help regulate the heat islands [40], generally considered as a zoonotic pandemic aggravating factor. There are studies that show how suburban forest fragmentation led to increased human disease risk.
8.3 Urban population density
Studies carried over time aimed to determine the correlation between population density and pandemics. For the 1918 Spanish flu, in England and Wales, research found “30–40% higher rates in cities and towns compared with rural areas” but “no association between transmissibility, death rates and indicators of population density and residential crowding [41]”. A research on India stretches that districts with a lower density experienced lower rates of population loss [42]. A US research revealed “the positive correlation between population density and influenza mortalities [43]” although another paper finds no significant correlation between population density and transmissibility measured by the reproductive number (R) [44]. As for Japan, a paper concluded that “lower morbidity in the towns and cities is likely explained by effective preventive measures in urban areas [45].”
Other researchers investigated the correlation between population density and epidemics of tuberculosis or avian flu [46, 47, 48, 49]. Paper also discussed on the impact of urban form and land use on the transmission of vector-borne viruses [50].
During the COVID-19 pandemic, most of the researches consider increased population density as a health risk. Papers in Japan concluded that “the correlations between the morbidity and mortality rates and population density were statistically significant [51]” or “the population density was shown to be a major factor [52]”. In India, there was a “moderate association between Covid-19 spread and population density [53]”. In Algeria, “there is a strong correlation [54]”. In Turkey, “population density mediated the effect of wind speed (9%) on the number of COVID-19 cases [55]”. US studies show contradictory results which must be further analyzed through different criteria. A paper concludes that “counties with greater population density have greater rates of transmission [56]“. Some concluded that denser locations more likely to have an early outbreak but did not found evidence that linked the population density to the COVID-19 cases and deaths [57]. Another study pointed that “county density leads to significantly lower infection rates and lower death rates […] possibly due to superior health care systems [58]”.
Those conclusions must be correlated with studies that include income, education or health care systems [36, 59]. A study involving more variables was realized in Italy, showing that population density was not statistically significant but, instead, car and firm density were positively associated with higher fatality rates [36].
These researches are limited though by the ability of collecting geolocation data. In the US and in the EU, gathering spatial data about people movements was neither intended by the governments nor embraced by citizens’ free participation [60].
8.4 Air control
Respiratory route transmitted diseases can spread either by droplets or by aerosols (suspensions in air of finer particles). By 2020, “virtually all infectious disease dynamics models on influenza have thus far ignored aerosol-transmission [61]”.
Research conducted during the COVID-19 pandemic showed that aerosols could be one of the most dangerous way of transmission in the interior spaces. A paper concluded that “virus could be detected in aerosols up to 3 hours post aerosolization [61]”. The badly ventilated rooms present the highest risk as an article on a Wuhan Hospital shows that the highest virus concentration was found in the toilets [62].
A 2020 research shows that 3 air changes per hour, which is common in most countries legislation, “generated reductions in expected outbreak sizes that would normally only be possible with a substantial vaccination coverage of 50–60%, which is within the range of observed vaccination rates in school settings [63]”.
Studies show also that recirculating the air without proper filtration presents a potential risk. According to the study of a closed restaurant in Guangzhou, published on 2 April 2020, “droplet transmission was prompted by air-conditioned ventilation” and therefore the virus might have traveled through the central HVAC system [64]. The finding was confirmed by the April 2020 statement of the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHARE) that “infectious aerosols can be disseminated through buildings by pathways that include air distribution systems and interzone airflows [65]”.
9. Architectural and urban measures in mitigating pandemics
During the COVID-19 pandemic, the established principles were opposed to contrary solutions:
the need for creating public spaces for encounters was replaced by social distancing
the dense city paradigm, as opposed to the urban sprawl, posed virus transmission problems
encouraging public transport was replaced by the individual transportation.
Based on the scientific findings during the COVID-19 pandemic and based on previous experiences, architecture and urbanism can provide solution with the design of the buildings and of the built environment:
interior spaces: air quality
residential: middle density and the intermediate housing
public spaces: the key for the social interaction
green areas: a perennial goal
working: downsizing and dispersion
shopping: proximity and downscaling
transportation: walking, bicycling, shared mobility and robo-taxies
city scale: mixed use neighborhoods
9.1 Interior spaces: air quality
In the interior spaces, the virus transmission can be reduced by air control through ventilation, humidifying and filtering.
A 2020 research shows that 3 air changes per hour, which is common in most countries legislation, “generated reductions in expected outbreak sizes that would normally only be possible with a substantial vaccination coverage of 50–60%, which is within the range of observed vaccination rates in school settings [63]”.
As for filtering, pre-pandemic experiments have been conducted since 1968 on the efficiency of HEPA filters that “showed an average reduction of 99.996% [66]” or in which “aerosol transmission of PRRSV occurred in 0 of the 10 HEPA-filtration replicates [67]”. During COVID-19 pandemic, HEPA filters were recommended in hospitals for air filtering in operating rooms or in the breathing circuit [68, 69]. Some papers recommend HEPA for filtering the recirculating air in closed rooms or vehicles [70, 71], although certain studies are reserved concerning the HEPA filters capacity of filtering submicron size particles [70].
Humidifying could play an important role as long as a 2013 research concluded that “maintaining indoor relative humidity >40% will significantly reduce the infectivity of aerosolized virus [72]”.
As in the 19th century, air control becomes a key measure in mitigating pandemics in 2020.
9.2 Residential: middle density and the intermediate housing
There seems to be a conflict between epidemiologic studies that suggest a lower people density and the environmental approach that recommends the increasing of the built density. The urban sprawl is considered to increase pollution, to cause the loss of a sense of community [73], global warming [74], higher transportation costs and create health effects due to the dependence on automobiles [75]. It is addressed by professional organizations such as Architects’ Council of Europe, the American Institute of Architects and the American Planning Association, by agencies such as European Environment Agency or by national legislation, such as the French law for Solidarity and Urban Renewal.
On the other hand, lowering the people density is not only implied by studies carried over time that correlate population density and pandemics but also the public preference. Pre-pandemic surveys showed that 76% of French [76] and 80% of US Americans [77] would choose to live in single-family houses. The COVID-19 pandemic increased this desire. Teleworking and the reduced access to shops, “led to a reduced demand for housing in neighborhoods with high population density”, trend which strengthen after the market recovery in June 2020 [78].
The solution to reconcile the dense city environmental paradigm with the low density of population suggested by epidemiologic studies can only find the answer in architecture and urbanism. For most epidemiological approaches, people density is a figure in a quantitative approach while for architecture and urbanism there is also a shape-related morphological and typological building approach. Urban approach also considers different densities, such as population density (related to inhabitants’ number), residential density (related to number of housings) or built density (related to gross floor area). Moreover, the same people density can be achieved with different urban typologies, such as parallel buildings, courtyard or scattered. Architectural approach also takes into account building morphology. The same people density can be achieved under different morphologies, such as detached houses, row houses or blocks. Therefore, addressing population density as a figure is not enough for analyzing the complexity of the built environment.
A more detailed approach should also be based on studies carried over the virus transmission in the interior spaces. Small, confined and poorly ventilated spaces, such as stairs or elevators, must be carefully planned as they are the most susceptible for aerosol contamination [79].
Medium density environments are the mostly supposed to reach this goal. Both New Urbanism and Urban village movements promote medium density housing. There are urban and architectural approaches that stay in between the single family detached house and the block paradigm. The French Intermediate Housing concept addresses buildings with more than one superposed apartments and with private access to each apartments. The definition appears in a French 1973 decree: the social intermediate housing (habitat social intermédiaire) is supposed to have a private access, a private exterior space of one quarter of the apartment surface and a height of no more than three floors. The organization led to densities of 80 to 100 dwellings per hectare for intermediate housing compared to the 10–50 dwellings per hectare for dense single-family houses [80].
9.3 Public spaces: the key for the social interaction
One of the problems the COVID-19 pandemic created was the social disruption. The public space was put under scrutiny [81]. In this matter, exterior public spaces could play a key role. The COVID-19 droplets transmission occurs up to 6 feet (2 meters). According to Edward T. Hall’s proxemics theories, the social distance far phase is in between 7 and 12 ft. (2.1–3.7 m) and the public distance is in between 12 and 25 ft. (3.7–7.6 m) for the close phase and more than 25 ft. (7.6 m) for the far phase. Therefore, far social and public contacts could be achieved in exterior spaces without transmission risks.
According to Jan Gehl’s theories, social contacts in public spaces are among the most important. They have the characteristic of being spontaneous because people interact as a result of necessary or optional activities. The space in between the buildings is ideal for conversation, greetings, children playing: “life between buildings as dimension of architecture, urban design and city planning to be carefully treated [82]”.
9.4 Green areas: a perennial goal
As recent scientific studies show, green areas can improve the response to pandemics. They were already present in the 1900s urban theories and they maintain their permanent importance.
9.5 Working: downsizing and dispersion
Architectural measures can be taken in the case of office buildings. Some approaches concern general building measures, such as air control by ventilation filtration and humidification. Other methods should lean on morphologic changes that consider access separation and office space distribution.
There is also question of the offices size and their urban distribution. During the COVID-19 pandemic, an Italian multicriterial research concluded that firm density, based on an over 250 employees firm index for each region, was positively associated with higher fatality rates [36].
The COVID-19 pandemic also accelerated the use of telecommuting (teleworking or working from home). In 2019, 5.5% of workers in the US already worked from home [83] and, in April 2020, already 20% of Americans were able to work from home and doing so [84]. Estimations from 2020 are that “37 percent of U.S. jobs that can plausibly be performed at home account for 46 percent of all wages [85]”. Telecommuting has an indirect environment impact by reducing the greenhouse emissions, fuel and energy usage and network congestion [86, 87].
9.6 Shopping: proximity and downscaling
Apart air quality methods, different measures can be taken for shops. Reducing the size cold lead to a better ventilation and less potential contacts. Proximity shopping is also an environmental desideratum as it allows for less automobile transportation, lead to pedestrian cities, reduced pollution, less energy consumption and less environmental impacts. Recent study shows that “to achieve a balance between energy consumption, GHG [Greenhouse Gas] emissions and energy generation potential, a neighborhood should contain an optimal ratio of commercial to residential buildings of about 0.25 [88].”
The proximity and downscaling decision have long term social and environment motivations more than short term economic reasons. An example are hypermarkets, huge stores combing supermarkets to department stores. It is symptomatic how France, the country that first implemented hypermarkets with Carrefour, in 1963, prevented their implantation in cities ten years later, by the Royer law which regulated the creation of shops over 1500 m2 inside towns.
9.7 Transportation: walking, bicycling, shared mobility and robo-taxis
Before the pandemic there was already very strong evidence of aerosol transmission over long distances [89]. Studies during 2020 showed substantial transmission in closed vehicles and suggest “future efforts at prevention and control must consider the potential for airborne spread of SARS-CoV-2, which is a highly transmissible pathogen in closed environments with air recirculation [90]”. At the beginning of 2020, studies drew a warning about public transportation showing that, for New York City, the subway system was the major disseminator of COVID-19 [91].
To keep the present transportation system there could be applied methods that reduce the viral transmission. Airborne virus spread in public transport can be reduced by installing HEPA filters and surface disinfection can be done by UV disinfection.
There is also question of changing the current transportation paradigm. Changes that may reduce the virus transmission in the transportation system already begun before the COVID-19 pandemic. Cities designed at the scale of walking or bicycle distances were proposed by the 1900s Garden City movement, the 1970s Intermediate Housing or 1980s New Urbanism and Urban Village movements.
Mobility sharing with bicycles can increase the efficiency of an urban public transport network [92] and has health benefits [93]. Starting with the white bicycle and white path proposed by the Provo movement in Amsterdam, in 1965, the Vélib’ in Paris, launched in 2007 and reached the Chinese bike sharing system where the two largest operators, Ofo, launched in 2014, and Mobilke 2015, totalize over 50 million orders per day [94]. Electric car sharing, on which UV disinfection could be applied, could be a pandemic and environmental solution too. It has a positive environmental approach by “reducing 29% of CO2 emissions and increasing 36% electric vehicle adoption, when compared to the business-as-usual scenario [95]”. Along with UV disinfection, robo-taxis (robo-cabs, self-driving taxis or driverless taxis) could be used. Experiment in Beijing with electric robo-taxis showed a good impact in lower energy consumption, zero tailpipe emissions, traffic decongestion and reduced health risks [96] while simulation in Milan “propose that introducing a robo-taxi fleet of 9500 vehicles, centered around mid-size 6 seaters, can solve traffic congestion and emission problems in Milan [97]”.
From the larger urban point of view, transportation is influenced not only by the means of transport but also by the overall cities’ organization.
9.8 City scale: mixed use neighborhoods
Reducing transportation while maintaining social contacts and the access to urban facilities is a key aspect in preventing and mitigating pandemics. Research done during the 2020 pandemic suggest that “connectivity matters more than density in the spread of the COVID-19 pandemic [98]”. The risks are represented by commuting, tourists and businesspeople. Studies emerged during pandemic concern health inequities derived from the urban development [99].
This desideratum can be reached by designing mixed use neighborhoods that could concentrate transportation on walking and bicycling. These neighborhoods are likely to lead to a medium density environments [100]. They should combine living with working, leisure, education and public space encounters.
The concept is not new, as it is already present in Ebenezer Howard’s Garden City with self-contained mixed-use new towns and socially mixed population. It is also relevant for the US 1980s New Urbanism or for the European Urban Village.
10. Opportunities
There is a consistent scientific literature about the opportunities highlighted by COVID-19 pandemic in different domains. There is also an expressed confidence that “architecture and urbanism after the COVID-19 epidemic will never be the same [101]”. Some built environment related trends may be accelerated by the pandemic:
the recognition of the role of environmental impacts on zoonosis, such as deforestation and destroying natural habitats
an increased awareness of the public space importance
the architectural research on new medium density typologies
the acceleration of promoting mixed-use neighborhood and encouraging walking and bicycle transportation
accelerate advancements in transportation such as shared mobility and robo-taxis.
11. Conclusion
Healthcare shape our cities and vice versa.
Although fighting against pandemics was traditionally associated with the built environment, the 20th century pharmaceutical progress allowed medicine to emancipate from architecture and urbanism. As WHO stated in 2018, “Will history repeat itself? The answer must be: Yes, it will [1].” Last decades evolutions which culminated with the COVID-19 pandemic stretched the role of a new interdisciplinary strategy in both combating and mitigating future outbursts.
There is an important COVID-19 scientific literature concerning pollution, green areas role, urban population density or air control that can be addressed mainly through built environment measures. These measures include air control, residential measures, public spaces, green areas design, working, transportation and mixed neighborhoods.
The COVID-19 pandemic dramatic implications can be also perceived as an opportunity for setting up a more stable health and built environment systems. Scientific evidence is not enough and it should be doubled by public awareness and by political implication. Otherwise, it may end like The Great Illusion, the 1910 book of the Nobel Prize winner Sir Norman Angell, which, although scientifically proved that economic interconnection among nations made future wars illogical and counterproductive, was followed by two World Wars.
\n',keywords:"architecture, urbanism, green buildings, built environment, pandemics, health, environment, ecology, COVID-19, SARS-CoV-2",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/76976.pdf",chapterXML:"https://mts.intechopen.com/source/xml/76976.xml",downloadPdfUrl:"/chapter/pdf-download/76976",previewPdfUrl:"/chapter/pdf-preview/76976",totalDownloads:301,totalViews:0,totalCrossrefCites:1,dateSubmitted:"December 12th 2020",dateReviewed:"May 6th 2021",datePrePublished:"June 15th 2021",datePublished:"December 1st 2021",dateFinished:"May 31st 2021",readingETA:"0",abstract:"This chapter aims to assess the historical role of architecture and urbanism in the prevention and mitigation of pandemics and the place it may occupy in future international strategies. During COVID-19, the contemporary healthcare system response to pandemics showed its limits. There must be investigated a more interdisciplinary answer in which the role of the built environment in the One Health should be clarified. Since the 19th century, the built environment traditionally occupied a decisive role in mitigating pandemics. The war against tuberculosis led to the Hygiene movement which set the principles of the Modernist architectural and urban movement. With the discovery of antibiotics, the medicine emancipated from architecture. In the absence of health implications, the social and environmental counterreactions to the Modernist movement led to the Green Architecture, New Urbanism or Urban Village movements. After the last decades warnings about future pandemics, some of the present COVID-19 scientific findings have notable impact on the built environment design: pollution, green areas, urban population density or air quality control. Finally, the chapter analyses architectural and urban measures for preventing and mitigating future pandemics: air control, residential approaches, public spaces, green areas design, working, transportation and mixed neighborhoods.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/76976",risUrl:"/chapter/ris/76976",signatures:"Bogdan Andrei Fezi",book:{id:"10535",type:"book",title:"SARS-CoV-2 Origin and COVID-19 Pandemic Across the Globe",subtitle:null,fullTitle:"SARS-CoV-2 Origin and COVID-19 Pandemic Across the Globe",slug:"sars-cov-2-origin-and-covid-19-pandemic-across-the-globe",publishedDate:"December 1st 2021",bookSignature:"Vijay Kumar",coverURL:"https://cdn.intechopen.com/books/images_new/10535.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-1-83968-756-3",printIsbn:"978-1-83968-755-6",pdfIsbn:"978-1-83968-757-0",isAvailableForWebshopOrdering:!0,editors:[{id:"63844",title:"Dr.",name:"Vijay",middleName:null,surname:"Kumar",slug:"vijay-kumar",fullName:"Vijay Kumar"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"335777",title:"Associate Prof.",name:"Bogdan Andrei",middleName:null,surname:"Fezi",fullName:"Bogdan Andrei Fezi",slug:"bogdan-andrei-fezi",email:"bogdan.fezi@arcvision.ro",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Ion Mincu University of Architecture and Urbanism",institutionURL:null,country:{name:"Romania"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. The limits of the contemporary healthcare system response to pandemics",level:"1"},{id:"sec_3",title:"3. The One Health system response to pandemics and the role of the built environment",level:"1"},{id:"sec_4",title:"4. The historical role of the built environment in pandemics before the advent of antibiotics",level:"1"},{id:"sec_5",title:"5. Architecture and urbanism after the emancipation of medicine",level:"1"},{id:"sec_6",title:"6. Health engaged architecture and urbanism certifications",level:"1"},{id:"sec_7",title:"7. The last decades warnings about future pandemics",level:"1"},{id:"sec_8",title:"8. COVID-19 scientific findings with impact on the built environment design",level:"1"},{id:"sec_8_2",title:"8.1 Pollution",level:"2"},{id:"sec_9_2",title:"8.2 Green areas",level:"2"},{id:"sec_10_2",title:"8.3 Urban population density",level:"2"},{id:"sec_11_2",title:"8.4 Air control",level:"2"},{id:"sec_13",title:"9. Architectural and urban measures in mitigating pandemics",level:"1"},{id:"sec_13_2",title:"9.1 Interior spaces: air quality",level:"2"},{id:"sec_14_2",title:"9.2 Residential: middle density and the intermediate housing",level:"2"},{id:"sec_15_2",title:"9.3 Public spaces: the key for the social interaction",level:"2"},{id:"sec_16_2",title:"9.4 Green areas: a perennial goal",level:"2"},{id:"sec_17_2",title:"9.5 Working: downsizing and dispersion",level:"2"},{id:"sec_18_2",title:"9.6 Shopping: proximity and downscaling",level:"2"},{id:"sec_19_2",title:"9.7 Transportation: walking, bicycling, shared mobility and robo-taxis",level:"2"},{id:"sec_20_2",title:"9.8 City scale: mixed use neighborhoods",level:"2"},{id:"sec_22",title:"10. Opportunities",level:"1"},{id:"sec_23",title:"11. Conclusion",level:"1"}],chapterReferences:[{id:"B1",body:'World Health Organization. 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Sustainable cities and society, 61, 102350. https://doi.org/10.1016/j.scs.2020.102350'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Bogdan Andrei Fezi",address:"bogdan.fezi@arcvision.ro",affiliation:'
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Stevic (1958), zstevic@etf.rs , zstevic@tfbor.bg.ac.rs , zstevic@live.com is a full professor at the University of Belgrade, Technical Faculty in Bor and School of Electrical Engineering in Belgrade, Serbia. He received his Ph.D. degree from the School of Electrical Engineering in Belgrade, University of Belgrade. His research areas include power electronics, IR thermography, computer measurement, and process control, supercapacitors, energy efficiency, renewable energy sources, system modeling, sensors, optoelectronics, and electrochemistry. He is a member of IEEE, IBPSA, SMEITS, and SCS. He published over 350 papers (over 50 refereed full papers in Scientific Journals), 5 books, and 5 chapters. Also, he was the project coordinator and member of working groups on many scientific and technical projects. He is a professional in thermography (level II acc. 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UK Research and Innovation (former Research Councils UK (RCUK) - including AHRC, BBSRC, ESRC, EPSRC, MRC, NERC, STFC.) Processing charges for books/book chapters can be covered through RCUK block grants which are allocated to most universities in the UK, which then handle the OA publication funding requests. It is at the discretion of the university whether it will approve the request.)
UK Research and Innovation (former Research Councils UK (RCUK) - including AHRC, BBSRC, ESRC, EPSRC, MRC, NERC, STFC.) Processing charges for books/book chapters can be covered through RCUK block grants which are allocated to most universities in the UK, which then handle the OA publication funding requests. It is at the discretion of the university whether it will approve the request.)
Wellcome Trust (Funding available only to Wellcome-funded researchers/grantees)
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Then, the chapter will discuss three aspects of 5G which are, namely, (1) Regulations, (2) security, and (3) the 5 enabling Technologies. Then, the chapter will discuss the real-life case of South Korea mobile carrier.",book:{id:"8511",slug:"cyberspace",title:"Cyberspace",fullTitle:"Cyberspace"},signatures:"Evon Abu-Taieh, Issam H. Al Hadid and Ali Zolait",authors:null},{id:"68561",title:"Cyberspace and Artificial Intelligence: The New Face of Cyber-Enhanced Hybrid Threats",slug:"cyberspace-and-artificial-intelligence-the-new-face-of-cyber-enhanced-hybrid-threats",totalDownloads:1236,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"While, until recently, cyber operations have constituted a specific subset of defense and security concerns, the synergization of cyberspace and artificial intelligence (AI), which are driving the Fourth Industrial Revolution, has raised the threat level of cyber operations, making them a centerpiece of what are called hybrid threats. 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In the present work, we address the relevance of cyberspace-based operations and artificial intelligence for the implementation of hybrid operations and reflect on what this cyber dimension of hybrid operations implies for the concept of what constitutes a cyberweapon, the concept of hybrid human intelligence (hybrid HUMINT) and possible responses to the hybrid threat patterns.",book:{id:"8511",slug:"cyberspace",title:"Cyberspace",fullTitle:"Cyberspace"},signatures:"Carlos Pedro Gonçalves",authors:[{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves"}]},{id:"52156",title:"Case Study: Installing RFID Systems in Supermarkets",slug:"case-study-installing-rfid-systems-in-supermarkets",totalDownloads:2471,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Radio frequency identification technology (RFID) is considered as the reference technology for wireless identification and item traceability. 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The first challenge of this chapter is to provide a complete analysis of those physical and environmental factors, hardware and software limitations, and standard and regulation restrictions that have a direct impact on the RFID system performance in supermarkets. This analysis is addressed by communication layers, paying attention to the point of view of providers, supermarket companies, and final customers. Some of the most feasible and influential research works that address individual problems are also enumerated. 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He also obtained an MSc in Molecular and Genetic Medicine, and a Ph.D. in Clinical Immunology and Human Genetics from the University of Sheffield, UK. He also completed a short-term fellowship in Pediatric Clinical Immunology and Bone Marrow Transplantation at Newcastle General Hospital, England. Dr. Rezaei is a Full Professor of Immunology and Vice Dean of International Affairs and Research, at the School of Medicine, Tehran University of Medical Sciences, and the co-founder and head of the Research Center for Immunodeficiencies. He is also the founding president of the Universal Scientific Education and Research Network (USERN). Dr. Rezaei has directed more than 100 research projects and has designed and participated in several international collaborative projects. He is an editor, editorial assistant, or editorial board member of more than forty international journals. He has edited more than 50 international books, presented more than 500 lectures/posters in congresses/meetings, and published more than 1,100 scientific papers in international journals.",institutionString:"Tehran University of Medical Sciences",institution:{name:"Tehran University of Medical Sciences",country:{name:"Iran"}}},{id:"180733",title:"Dr.",name:"Jean",middleName:null,surname:"Engohang-Ndong",slug:"jean-engohang-ndong",fullName:"Jean Engohang-Ndong",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180733/images/system/180733.png",biography:"Dr. Jean Engohang-Ndong was born and raised in Gabon. After obtaining his Associate Degree of Science at the University of Science and Technology of Masuku, Gabon, he continued his education in France where he obtained his BS, MS, and Ph.D. in Medical Microbiology. He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{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. 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\r\n\tIf we aim to prosper as a society and as a species, there is no alternative to sustainability-oriented development and growth. Sustainable development is no longer a choice but a necessity for us all. Ecosystems and preserving ecosystem services and inclusive urban development present promising solutions to environmental problems. Contextually, the emphasis on studying these fields will enable us to identify and define the critical factors for territorial success in the upcoming decades to be considered by the main-actors, decision and policy makers, technicians, and public in general.
\r\n
\r\n\tHolistic urban planning and environmental management are therefore crucial spheres that will define sustainable trajectories for our urbanizing planet. This urban and environmental planning topic aims to attract contributions that address sustainable urban development challenges and solutions, including integrated urban water management, planning for the urban circular economy, monitoring of risks, contingency planning and response to disasters, among several other challenges and solutions.
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Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. 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In recent years, the application of chemistry to biological molecules has gained significant interest in medicinal and pharmacological studies. This topic will be devoted to understanding the interplay between biomolecules and chemical compounds, their structure and function, and their potential applications in related fields. Being a part of the biochemistry discipline, the ideas and concepts that have emerged from Chemical Biology have affected other related areas. 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Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. 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Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. 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