\r\n\tThis book aims to explore the issues around the rheology of polymers, with an emphasis on biopolymers as well as the modification of polymers using reactive extrusion.
",isbn:null,printIsbn:"979-953-307-X-X",pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,hash:"5bc21841d2b87388ad498bc09910944b",bookSignature:"Dr. Casparus Johannes Verbeek and Dr. Velram Mohan",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/8880.jpg",keywords:"Extrusion, Injection Moulding, Thermoplastics, Natural Polymers, Biomass, Polymer Modification, Polymer Blends, Compatibilization, Processing Challenges, Reactive Compounding, Screw Design, Process Design",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 6th 2019",dateEndSecondStepPublish:"September 27th 2019",dateEndThirdStepPublish:"November 26th 2019",dateEndFourthStepPublish:"February 14th 2020",dateEndFifthStepPublish:"April 14th 2020",remainingDaysToSecondStep:"a year",secondStepPassed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"102391",title:"Dr.",name:"Casparus",middleName:"Johannes",surname:"Verbeek",slug:"casparus-verbeek",fullName:"Casparus Verbeek",profilePictureURL:"https://mts.intechopen.com/storage/users/102391/images/system/102391.jpeg",biography:"Dr Verbeek is a Chemical Engineer, currently an associate professor at the School of Engineering at the University of Waikato and is also the R&D manager for Aduro Biopolymers. He has 20 years experience in waste and by-product valorisation with an emphasis on renewable materials and biological products. Since his tertiary studies, Johan’s knowledge in the engineering field of sustainable products has led to a number of innovative developments in the engineering industry. His research area covers a wide range of topics, such as polymer extrusion, rheology, material properties, protein analysis, chemical modification of proteins as well as protein composites and nano-composites.",institutionString:"University of Auckland",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"University of Auckland",institutionURL:null,country:{name:"New Zealand"}}}],coeditorOne:{id:"294363",title:"Dr.",name:"Velram",middleName:null,surname:"Mohan",slug:"velram-mohan",fullName:"Velram Mohan",profilePictureURL:"https://mts.intechopen.com/storage/users/294363/images/system/294363.jpeg",biography:null,institutionString:"University of Auckland",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Auckland",institutionURL:null,country:{name:"New Zealand"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"6",title:"Biochemistry, Genetics and Molecular Biology",slug:"biochemistry-genetics-and-molecular-biology"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"300344",firstName:"Danijela",lastName:"Pintur",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/300344/images/8496_n.png",email:"danijela.p@intechopen.com",biography:null}},relatedBooks:[{type:"book",id:"1332",title:"Products and Applications of Biopolymers",subtitle:null,isOpenForSubmission:!1,hash:"8dee78e87e2f654541d4285e7cdd5212",slug:"products-and-applications-of-biopolymers",bookSignature:"Casparus Johannes Reinhard Verbeek",coverURL:"https://cdn.intechopen.com/books/images_new/1332.jpg",editedByType:"Edited by",editors:[{id:"102391",title:"Dr.",name:"Casparus",surname:"Verbeek",slug:"casparus-verbeek",fullName:"Casparus Verbeek"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6694",title:"New Trends in Ion Exchange Studies",subtitle:null,isOpenForSubmission:!1,hash:"3de8c8b090fd8faa7c11ec5b387c486a",slug:"new-trends-in-ion-exchange-studies",bookSignature:"Selcan Karakuş",coverURL:"https://cdn.intechopen.com/books/images_new/6694.jpg",editedByType:"Edited by",editors:[{id:"206110",title:"Dr.",name:"Selcan",surname:"Karakuş",slug:"selcan-karakus",fullName:"Selcan Karakuş"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophanides",surname:"Theophile",slug:"theophanides-theophile",fullName:"Theophanides Theophile"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"68843",title:"The Hot Disputes Related to the Generation of a Unified Theory Combining the Outcomes of ER and EPR Papers",doi:"10.5772/intechopen.88722",slug:"the-hot-disputes-related-to-the-generation-of-a-unified-theory-combining-the-outcomes-of-er-and-epr-",body:'\n\n
1. Introduction
\n
The history of physics involves two great revolutionary theories: relativity and quantum physics. Quantum mechanics and general relativity operate at different space and time scales; therefore, the main problem for unification of these theories is due to the “mystery” of the scale of variables.
\n
Recently, a new approach [1, 2, 3] for the unification of general relativity and quantum mechanics was suggested, which involves reconciling relativity’s black hole space and quantum entanglement. Science News [4, 5] announced that a new equation ER = EPR, generated from Einstein’s papers [6, 7], may provide a possible path for connection of principles of general relativity with quantum mechanics. Maldacena and Susskind [2] suggested that two distant black holes of general relativity, connected through the interior wormhole (Einstein-Rosen bridge), could be interpreted as the entangled EPR’s pairs of two black holes. Maldacena and Susskind [2] showed that the formula ER = EPR (bridge between Einstein-Rosen (ER) wormhole [6] and Einstein-Podolsky-Rosen (EPR) entanglement [7]) can be the cornerstone of the new physics theory, connecting relativity and quantum mechanics through space-time wormholes.
\n
Grant [5] suggested that the connection of entanglement with the space-time might help to understand the origin of space-time and its behavior at the small scales of quantum mechanics.
\n
Siegfried [8] also discussed the ER = EPR equation as a possible approach for connection of space-time geometry of relativity with the quantum entanglement.
\n
Van Raamsdonk [9] showed that the existence of space-time is due to the quantum entanglement in the corresponding quantum system.
\n
Carroll suggested [10] a similar approach in accordance of which space can emerge from a quantum state. Caroll’s comments on connection of space-time curvature with energy are similar to the statement of general relativity, but in this approach, origin of space connected with the quantum entanglement.
\n
While a path to quantum gravity through the wormhole became a very hot topic for the generation of new physics, it could be very useful to return to the ER [6] and EPR [7] papers to summarize the basic principles on how the combination of outcomes from the ER and EPR papers may unify different scale interactions.
\n
The main idea of the ER paper [6] is a presentation of the physical space by field equations where space involves two identical, equal halves, separated by the symmetry and connected by a Wormhole Bridge. The separated halves of space describe the same physical space. The idea of this approach is the application of space field equations for the description of quantum level interactions.
\n
The ER bridge, which is also called a wormhole, denotes a shortcut connection between widely separated regions of space-time. In accordance with the hypothetical equation ER = EPR [1, 2, 3], an ER wormhole between two places of space could be considered as an entangled pair in quantum mechanics.
\n
It is necessary to note that the ER paper [6], as was claimed by the authors, does not contain the quantum phenomena and the interaction between two identical pieces of space does not lead to the “quantization of gravity.”
\n
The EPR paper [7] gives an analysis of the basic principles of quantum mechanics such as the description of state by the wave function to predict a particle’s behavior. It establishes the now well-known cornerstone of quantum mechanics that two physical quantities such as position and momentum of a particle cannot be precisely determined simultaneously and that these two quantities cannot have simultaneous reality. The authors showed that the quantum mechanical description of physical reality given by wave functions is also not complete and it is necessary to assign two different wave functions to the same reality.
\n
It is necessary to note that the conjugation of statements of the ER [6] and EPR [7] papers does not reveal a non-hypothetical mathematical equation of a dynamical event, which may explain physical reality regardless of scale.
\n
\n\n
2. The main principles of ER and EPR papers
\n
We can select important statements of these papers, which were the cornerstone [1, 2, 3] for the unification of relativity with quantum mechanics:
Entanglement (connection) of two equal pieces of space through the “Wormhole Bridge” of relativity theory [6].
The common uncertainty principle of quantum mechanics is that when the momentum of a particle is known, its coordinate has no physical reality [7].
\n
We should concentrate our attention to the statement of quantum mechanical uncertainty to understand why the combination of general relativity with quantum mechanics does not generate a valid mathematical formulation, which is applicable for small- and large-scale interactions.
\n
First, it is necessary to show that a particle may have a certain identity when the change of energy in time (conservation of energy) has commutation with the change of energy, consumed in space phase of a particle (conservation of momentum). The mathematical description of momentum may be valid only if the emerged formulation comprises residing of energy-momentum exchange interaction within boundary-mapped space-time frame.
\n
Therefore, momentum “as the quantity of motion” alone without locality is uncertain and cannot give a proper mathematical description of this quantity in any physical theory. If momentum conservation has no commutation with the energy conservation within the space-time frame, it cannot describe an event in a proper way. However, without the space-time boundary, it is difficult to get commutation of energy-momentum conservation laws. Description of motion by a model, involving a certain local boundary of the dynamical space-time frame, generates a reference frame independent of the true momentum conservation principle.
\n
Quantum mechanics states that position and momentum cannot have simultaneous reality, due to the application of the mathematical formulation of uncertainty, which conjugates position, independent from space-time and momentum and also independent from the action-response interaction.
\n
The Heisenberg uncertainty principle in not a mystery of nature; rather, it is an improper mathematical formulation, which does not involve missed local space-time position and conjugation of a local position with the applied force, leading to the change of momentum.
\n
An event of measurement is not a simple displacement of a particle position in the abstract Hilbert space, but it is the change of space-time phases as an outcome of energy-momentum action-response interaction. Therefore, change of position of a system is not a linear transformation of the space dimension; it should describe commutation of local space-time frame with the action-response energy-momentum exchange interactions.
\n
It is necessary to show that commutation of two parameters, such as local space-time position and energy-momentum exchange interaction, is the only way for conservation of energy and momentum within the discrete space-time frame.
\n
The concept, describing entanglement of two pieces of space [6], does not explain the driving force behind why two equal pieces of space, separated by less than two black holes, may form entangled pairs. The two-space piece entanglement approach describes entanglement of two space pieces in abstract space, while space does not have independent existence, and it changes only within space-time frame.
\n
For description of entanglement of particles simultaneously in space and time, we need a proper structure of space-time frame. However, a description of events with the proper mathematical formulation involving dynamical space-time is the main problem associated with physical laws. As was shown by Merali [11], without knowing the origin of space-time, we will not understand physical laws. General relativity suggested the revolutionary idea that space-time and gravitational fields are the same, but an “Einstein’s matter,” which curves space-time, is an external entity and has no inner connection with the space-time frame. Another problem of general relativity is that its space-time has no background frame.
\n
Rovelli’s statement [12] that space-time has a relation to the electromagnetic field is the modification of general relativity. The main problem of the Rovelli’s statement is that he describes quanta as an independent identity, which cannot live in space-time. Rovelli’s statement did not reveal a mathematical formulation, and its quanta have no commutation with the space-time frame. The other problem of this approach is the locality of the quanta, while any particle or antiparticle cannot have independent existence.
\n
According to Rovelli’s opinion [12], there is no difference between a gravitational field and space-time, and the locality of a particle can be defined with respect to the gravitational field. This approach is similar to the Newtonian concept that acceleration has a meaning with respect to the gravitation field. However, any field, particularly a gravitational field, cannot have an independent existence; therefore the relation of locality to the gravitational field leads to the uncertainty in quantum mechanics.
\n
Smolin [13] developed quantum field theory and suggested that at the Planck scale, space exists in the form of fundamental discrete units instead of general relativity’s continuous space-time frame. But quantum field theory, similar to Newtonian physics, do not have space-time structure, which interacts with the event. The origin of discrete space and the condition of its independent existence is also not clear.
\n
Therefore, different views on space-time and the absence of the origin of the background of space-time frame in both theories is the main problem for reconciling these theories into the unified theory. One of the main problems of these theories also is the locality of a particle in the space-time frame.
\n
Einstein showed that space and time are simply different dimensions of the same space-time continuum. By his opinion, energy and momentum are the same quantities of space-time, which has four dimensions. The relative quantity of energy and momentum depends on the observer.
\n
The problem of this approach is that the dynamical nature of the space-time variables connected within the continuum framework, which did not allow distinction of the local properties of time and space identities. General relativity determines the dynamics of matter by the geometry of space-time and does not explain the origin of the mass and energy, which curves the structure of space-time. The problem of Newtonian physics, regarding how the moving body responds to action in relativity theory, also remains an open question.
\n
Unfortunately, the basic formulation of general relativity does not provide the answers to these questions. That is why the theory of relativity itself became the “observer” between Newton’s physics and quantum mechanics.
\n
It is necessary to note that problems of founding a unified theory are due to the problems of energy conservation, which is not complete in the theory of relativity and quantum physics. The approaches related to the generation of a unified theory do not use the principle of conservation of energy as the basis for the unification of relativity and quantum physics. The theory of relativity has a problem with the conservation of energy, which leads to the problem of singularity at small scales. Quantum mechanics suggests that particles borrow energy for some time and then return them. However, quantum mechanics does not explain the origin of this energy, which is borrowed and conserved in the wave function.
\n
It is clear that for the generation of unified theory, we have to find a proper mathematical formulation of the conservation of energy, covering the higher scale space-time of relativity and the small-scale quanta of quantum mechanics. The model connecting relativity and quantum mechanics should involve the dynamic local state of space and time variables which, independent of the energy input, can operate between the small scale of quantum physics and large scale of relativity.
\n
The known statements of Noether’s theorem on conservation of energy, being philosophical in nature, are not applicable for generation of a mathematical formulation of the space-time picture of a particle.
\n
Lagrange and Hamilton have suggested the conservation of energy in the form of differential equations, which is widely used in classical and quantum mechanics. The problem associated with these differential equations is that they describe the dynamical laws in abstract space with an independently moving interval of time.
\n
Another principle, which is related to the conservation of energy, is the Lagrangian action principle. For the action integral to be well defined, the trajectory has to be determined simultaneously in time and space coordinates. However, the Lagrangian action principle does not cover these requirements.
\n
Usually, the known mathematical formulations of dynamical laws either simplify space to conserve the details of time or simplify time to preserve the spatial dimension. The Lagrangian or Hamiltonian mechanics are the examples of such an approach, which was the reason for the replacement of differential equations of classical physics by Schrödinger’s wave function.
\n
To compose a unified theory, first, it is necessary to solve the locality problem of classical physics and quantum mechanics, which describe an event as a change of state of something without relation to something itself.
\n
\n\n
3. Commutation of space-time with the principle of conservation of energy
\n
In our early studies [14, 15, 16], we suggested that the change of a function in relation to its local position (Δf/f1) could be a sufficient entity for the identification of change. The non-unitary function Δf/f1 with the fractional feature has a “quantum mechanical behavior”: the classic operator in the form of Δf/f1 portion describes the fraction of the change (spinning or vibration) of a function around its dynamical initial locality to repeat its origin. Similarly, the operator ∆S/S1 describes the fluctuation of space with the applied force in relation to its origin, while the operator ∆t/t1 describes the fluctuation of time about instant of action.
\n
In the conjugated space-time field frame, the position of a particle, localized within the space-time frame in relation to its origin, is not a point; it exists within a very certain discrete non-virtual space-time manifold, commuting dynamic energy, which is distributed within space and time fields. On this basis, the origin of space-time is the energy, which generates space-time and holds its conservation within space and time phases.
\n
In accordance with the above-described principle of conservation of energy within the space-time frame, the space-time becomes the resulting non-unitary inner product of energy distribution, which comprises the portions of energy consumed in space phase (event mass) and restored in time phase:
\n
\n\n\n\n\n∆S\n\nS\n1\n\n\n\n∆t\n\nt\n1\n\n\n\n=\n\n\n\nE\nap\n\n−\n\nE\ns\n\n\n\nE\ns\n\n\n\nE1
\n
\n\n\n\n\n\n\n∆S\n∆t\n\n=\n\n\nS\n1\n\n\nt\n1\n\n\n\n\n\n\nE\nap\n\n\nE\ns\n\n\n−\n1\n\n\n\n\n\n\nE2
\n
\n\n\n\n\n\nλ\n=\n\n\nE\nap\n\n\nE\ns\n\n\n−\n1\n\n\n\n\nE3
\n
at λ = 1, Eap = 2Es.
\n
S1 and t1 are the space and time variables corresponding to the dynamic local boundary; Eap and Es are the energies of action and under action systems of interaction at conditions corresponding to the local boundaries of S1 and t1. On this basis, the space and time phases, which “absorb” applied force and carry energy, attain features of an energetic field. The minimum portion of quanta generates an elementary space-time frame.
\n
The portion of energy conserved in space phase (Es) generates momentum of a particle with the mass, which curves the space-time frame to bring energy conservation to the initial state. Therefore, the space-time itself generates curvature to hold the conservation of energy within the boundary-mapped space-time frame. As Eq. (2) shows, the increase of Es and the reduction of (Eap − Es) function gradually generate a curved space-time which in the form of gravitation returns an event to the initial state.
\n
In accordance with Eq. (2), conservation of energy does not exist without localization in space-time frame, and the localization has to be non-uniform. It is easy to show that space and time are the resulting non-unitary portions of a non-uniform distribution of energy, consumed in space phase (forming mass) and restored in time phase:
\n
In accordance with Eq. (2), the energy portion inserted to the space-time frame travels through wave of exchange interaction and determines the exact pathway of a particle. The right side of Eq. (2) describes the frequency of energy consumption in space by the matter particles, while the left side shows the frequency of the change of space and time wave fields. Following Einstein’s approach that energy and momentum are the same quantities of space-time, we can show that the right side of Eq. (1) shows the ratio of available energy and momentum, commuted with the left side space-time frame. The entities ∆t, t1 and ∆S, S1 perform as the same identities of energy carrier, existing in the opposite phases. Equation (1) describes a mathematical formulation of the energy-momentum relation where space and time are the products of energy conservation and energy-momentum ingredients are the conjugated outcomes of space-time. Therefore, energy and momentum are same quantities as Einstein stated; moreover, space and time are the inner products of the energy-momentum conservation.
\n
Now we may give specification of space, which is different from Caroll’s [10] statement. We think that the relationship between space-time curvature and energy is the natural consequence of a non-uniform conservation of energy, which generates a space-time frame, carrying non-separable portions of boundary-mapped energy.
\n
We can now give specifications of entanglement based upon the conjugation of the space-time frame with the energy resources. The phenomenon called entanglement may appear only within conjugated space and time phases, carrying conservation of energy-momentum pairs though growth of the space-time frame.
\n
Thus, any interaction of two different pieces of space (entanglement) in reality is the entanglement of space and time phases carrying out the conservation of energy through portions of energy, distributed within these phases. The space phase without entanglement with time cannot exist. The identity called space is the materialized portion of energy, while time destroys the material portion of energy, bringing an event to the initial state. When all the available energy is consumed in space (Eap = 0), “space” particles decay to “time” antiparticles.
\n
The entanglement of space and time phases as displayed in the form of gravitation appears with the accumulation of energy in space phase and generation of tendency to return space phase back to the background state.
\n
The right side of Eq. (1) describes particle and antiparticle relations. Equation (2) treats the matter field through space phase, while the antimatter field is treated with the time phase. The coupling of these phases in space-time unit carries the non-uniform conservation of energy. Therefore, mass does not exist out of space-time and does not appear by sudden spontaneous symmetry breaking; at zero mass of particles, energy is not conserved.
\n
\n\n
4. Matter-antimatter asymmetry
\n
The space-time symmetry, which may present matter-antimatter symmetry, is possible only when energy is equally distributed between two phases. In this case, “energy is not consumed and not destroyed.” This is the timeless symmetry, which violates the classical principles of energy conservation that “energy is neither generated nor destroyed but rather is transformed from one state to another.”
\n
At the small scale, energy distributed in the small portion of the space phase in the form of mass is low, and energy is predominantly distributed in time phase ingredients, performing as antiparticles. This situation takes place in the case of a proton. The total mass of quarks, forming protons, is much smaller than the mass of protons.
\n
We can now explain matter-antimatter asymmetry and the generation of more particles than antiparticles in a pair of collision experiments. To conserve energy, any action should lead to the consumption of energy (Eap < 2Es) in order to eliminate infinite timeless symmetry. The condition Eap = 2Es describes symmetry which is possible when two particles exist in symmetry with one antiparticle. This condition takes place only in proton-neutron pairs, which carry discrete symmetry of quarks with 1:2 relations.
\n
In accordance with Eq. (2), due to the consumption of kinetic energy of collisions for the locality of generated particles, the energy carried by the produced particles is less than the energy required to restore particle-antiparticle symmetry.
\n
The boundary-mapped space-time frame, involving a limitation on maximum velocity of the speed of light, is a requirement for energy conservation. Equation (2) presents the boundary of space-time by local position, dynamically growing in accordance with the available portion of energy. In a simple form, if there is a local position, there should be a boundary of the change of the energy, which carried by the space-time field.
\n
The left side of Eq. (2) involves the dynamic conservation of the space-time frame as non-unitary “grains,” while the right side shows the non-uniform conservation of the energy-momentum exchange relation, carrying the dynamic flux of the energy portion to the local S1/t1 metric of space-time frame. The gradient of energy in relation to the initial state (Eap − Es)/Es as an equivalent form of space-time “grain” becomes the “non-unitary quanta” which describes the change of the local space-time frame as an exchange interaction of a particle with the applied force. The portion of energy, distributed in space and time phases, determines the strength of force and repulsive reaction (inertia) of matter.
\n
It is easy to show that the non-uniform conservation of energy has to be the ground concept for the unification of relativity and quantum physics. Starting from the basic statement of general physics that energy is conserved through its conversion from one form to another, we arrive at the concept that a dynamical event of energy conversion has to have locality within finite space and time coordinates. In principle, the features of energy conservation during its conversion from one form to another are clear from Planck’s theory of black body radiation, which changes the frequency of energy with radiation. The change of frequency of radiation is the result of non-uniform locality of energy within the space-time field.
\n
The known statement of energy conservation that energy can neither be created nor destroyed but can only be transformed from one form to another does not involve the space-time frame of this transformation. Noether’s theorem, describing energy and momentum conservation, separately also does not describe change of energy in space-time frame because time and space are not separable entities.
\n
The non-uniform conservation of energy leads to the collapse of the concepts on uniformly moving different reference frames in relation to which all-physical laws are valid. It is clear that even light cannot be the reference frame because light energy is non-uniformly conserved.
\n
Eq. (1) shows that the space-time frame, which emerges from the non-uniform splitting of photons, is the fundamental building block of energy and matter: the space-time frame generates ordinary matter, which in energy-mass exchange interaction carries accelerated conservation of energy.
\n
Within the non-uniform conservation of energy through the space-time frame, the unification of electromagnetism with the space-time frame becomes an obvious concept. The multiple S1/t1 (Eap/Es − 1) of Eq. (2) is the localization of the electromagnetic field (Eap/Es − 1) within the local space-time S1/t1 frame. The local space-time S1/t1 metric undergoes change with the consumption of energy flux. The energy flux (Eap/Es − 1) is not uniform and presents the local energy portion, remaining from the exchange interaction. That is why electromagnetism is not Galilean invariant.
\n
Equation (2), due to the involvement of the local frame of space-time and exchange energy-mass interaction, predicts the precise measurement of velocity and the local position of a particle; the exchange interaction eliminates the reference frame phenomenon, and different observers will have the same measurement if they have the same exchange interaction, coupled with the local position.
\n
Equation (2) explains the uncertainty principle in a way that, in order to probe the small scale of space, we have to apply large amounts of energy. Probing the state of a particle to get information is possible only through an exchange interaction. At the Planck scale, there is no space-time frame, and the exchange interaction (2) is the reason why we cannot obtain any information and probe the state of a particle at Planck’s scale. On this basis, by probing vacuum we can get information only on discrete uniform conservation of energy in the form of particles-antiparticles, breaking the symmetry with the formation of the space-time frame.
\n
The condition, when the portion of energy conserved in space phase is equal to the portion of energy in time phase, could be considered as a uniform conservation of energy in the form of “Noether’s symmetry.” This condition corresponds to the relation:
\n
\n\n\nE\nap\n\n=\n\n2E\ns\n\n\n\n2\n\n\n∆S\n/\n\nS\n1\n\n=\n∆t\n/\n\nt\n1\n\n\n\n3\n\n\n∆S\n/\n∆t\n=\n\nS\n1\n\n/\n\nt\n1\n\n\nE4
\n
At the condition (3), the unlimited translation of energy portions between the opposite phases of space-time variables in the form of matter-antimatter fluctuations should lead to the “ultraviolet catastrophe.” However, annihilation takes place within an asymmetric space-time frame; therefore, the non-uniform distribution energy moves in the direction of space expansion, which eliminates the ultraviolet catastrophe. On this basis, continuous uniform conservation of energy, matter-antimatter symmetry, and uniform continuous existence of any type of symmetry is impossible.
\n
In symmetry, the space-time manifold of a particle after the change should look the same (4). But at Eap = 2Es (2), the space and time fields are symmetrically interchangeable only in a discrete mode (2) where after the change the space-time frame holds the local state (4) only within the frame of discrete symmetry.
\n
We think that the performance of the three particles of baryonic space-time n-p matter in the form of boson-fermions relations follows this requirement. Therefore, without discrete performance of energy-mass exchange interaction in an elementary space-time unit, baryonic matter cannot exist in a symmetric manner. The strong and weak forces appear as the coupling product of exchange interaction in order to hold the discrete symmetry of the space-time frame of the baryonic matter.
\n
In accordance with the non-uniform conservation of energy, the spin as the space-time identity is the “face” of a particle. The particle may have identity of baryonic structure if it has the space-time frame in discrete symmetry at Eap = 2Es with the participation of dynamic three jet particles.
\n
Therefore, within the principles of non-uniform conservation of energy, light is not a uniformly moving reference frame. Light photons cannot exist without space-time frame and, due to the moving within the non-uniform space and time phases, have features of electromagnetic wave.
\n
The space-time, which has to carry conservation of energy, generates a non-virtual local frame and moves it relative to the state of energy restoration.
\n
The condition Eap = 0 of Eq. (2) is the background state of the discrete space-time field where asymmetric space and time variables, for maintaining conservation cycles, undergo the discrete translation as the portions of energy in the different fields. At this state, all types of the interactions are discretely unified.
\n
In accordance with Eq. (2), the gravitational field is the reverse phase of the electromagnetic field (negative energy solution), which restores energy at the origin. In the gravitational field, there is no space-time frame, while the electromagnetic field generates the space-time field and moves in the form of a wave through this frame. Due to the conservation of electromagnetic waves through the space-time frame, it propagates through transverse waves, while gravity moves back to background state through a longitudinal wave.
\n
It is necessary to note that it is not possible to get singularity-free quantization of space without a background space-time frame. The time parameter in quantum mechanics is an external entity, and quantum theories do not provide a dynamical space-time frame. The model in the form of Eq. (2) provides an entirely new function for the quantization of time.
\n
Model (2) shows that energy appears as the inner product of the coupling of space and time fields (right-handed translation), and in reverse order, the origin of space-time variables is the decay of energy into virtual space and time entities (left-handed translation), with restoration of energy at the background state. This is the non-uniform, non-static conversion of energy from one form to another. On this basis, time appears as the product and boundary of the discrete non-Noetherian dynamic conservation of energy, carrying energy within the space-time frame. Due to the action-response interaction (2), we observe an event only in the past.
\n
Model (2) describes a background-dependent space-time frame where the background state is not a fixed state but the dynamical origin of energy conservation cycles.
\n
The space and time phases of energy conservation at the background Planck scale do not have a space-time frame; rather, they exist in the form of condensate without a shape. This approach is different from Wheeler’s opinion that at Planck scale space and -time have a space-time foam [11].
\n
According to Rovelli, [11] the state of the system may be certain when it has reference to a second physical system. In accordance with model (2), the second system is the applied force (energy) which generates the exchange interaction.
\n
\n\n
5. Detailed features of the uncertainty principle of quantum mechanics
\n
Now based on model (2), we can explain details why the combination of momentum-position in quantum physics leads to uncertainty. Model (2) predicts that local position in the form of a point cannot give information about momentum or position, which can be relevant only to the exchange interaction with the applied force. Force and an event individually have no free existence, and they exist only through an exchange interaction. The exchange interaction generates velocity, which describes this interaction in the form of discrete packets showing how many times the reflected energy of exchange interactions repeats that interaction.
\n
The uncertainty principle describes the commutation of momentum and position in the form, which does not hold conservation of energy. The uncertainty principle does not describe the change of position within the space-time frame and presents momentum without the energy-momentum exchange interaction.
\n
When there is no applied energy (Eap = 0), gravitational and inertial forces cancel each other, and a particle falls back to the initial state. This approach explains electromagnetic phenomenon, which has to be understood through interaction within two space-time frames.
\n
Local position has conjugation with the force (energy) carrying particle which itself is a carrier of space-time. Therefore, a local position exists only through interaction with the force-carrying particle, which does not obey Lorentz symmetry.
\n
Model (2) involves the exchange of interaction of energy portions in space-time instead of the curvature tensor of relativity. Inertia is not determined by mass itself because the mass of a particle has no independent existence.
\n
Model (2) involves the energy-momentum exchange interaction and, similar to Maxwell’s antisymmetric field tensor, describes antisymmetric energy distribution in the space-time field.
\n
Particle physics connects the formation of mass with the breaking of symmetry, but symmetry, as is known from Neother’s theorem, is associated with the conservation law. Therefore, breaking of symmetry has to be analyzed within the principles of energy conservation.
\n
The model of non-uniform conservation of energy (2) involves the commutation of space-time and energy-momentum ingredients that explains symmetry breaking in the distribution of energy within the asymmetric boundaries of space and time phases.
\n
It is obvious that non-uniform conservation of energy within an asymmetric space-time frame excludes the existence of continuous symmetry of particles-antiparticles, whereas continuous symmetry needs infinite energy resources to hold symmetry.
\n
Model (8) connects space-time position with the energy-momentum exchange relation and shows that this relation within space-time boundary-mapped frame cannot be subject to uncertainty because position as a spatial variable does not have existence, independent of time.
\n
\n\n
6. Principles of generation of mass and gravitation
\n
One of the main problems related to the generation of mass by spontaneous breakdown of continuous symmetry, given by the Higgs mechanism, is that this mechanism does not connect the generation of mass with the space-time locality of a particle and does not explain why background continuous symmetry has to be broken in an unnatural way. The mechanism of mass generation also has to explain why collision experiments produce more matter particles than antimatter particles.
\n
In this chapter, we will discuss how the non-uniform energy conservation concept is an alternative mechanism of mass generation. The non-uniform distribution of energy portions within asymmetric space and time phases requires generation of fields with different energetic properties (frequency and amplitude) which is the only way for carrying conservation of energy through these fields. The coupling of two fields with different energetic properties as energy consuming and energy restoring phases generates the non-virtual space-time frame, which appears to be the non-uniform conservation of energy through energy-mass exchange transformations (Eap/Es − 1).
\n
The background state of a space-time frame is the relation of virtual asymmetric space and time phases, which proceeds through the conversion of energy from one form to another (8), through the translation of asymmetric entities, such as ∆S/S1, ∆t/t1, carrying energy portions as virtual matter and antimatter particles.
\n
We can describe the non-uniform background energy-mass translation by conversion of light photons to electron/positron pairs, which is a well-known quantum mechanics translation event. Quantum mechanics states that during this translation, energy conservation is held by fluctuations, such as particles that borrow energy and return it after a very short time:
\n
\n\nγ\n/\nγ\n=\n\ne\n+\n\n/\n\ne\n−\n\n E5
\n
The energy-matter translation given by Eq. (5) does not count the time phase of energy conservation and the locality of the produced particles, while the translation between photons and leptons takes place in abstract space. Equation (5) could be the discrete translation of energy in the form of infinite fluctuations of the background quantum state. It is clear that in this case there is no natural way for breaking of the continuous symmetry of discrete fluctuations, forming time-independent infinite symmetry of matter-antimatter relations. Equation (5) does not reflect the borrowed time in the change of energy.
\n
Conservation of energy requires a certain finite frame for locality, therefore space and time cannot exist as separate variables. The formation of a particle within any time scale without locality in space phase leads to nonconservation of energy.
\n
On this basis, we replaced Eq. (5) with the relation:
\n
\n\nγ\n/\nγ\n=\n−\n\n\n\ne\n+\n\n/\n\ne\n−\n\n+\n\nν\ne\n\n/\n\n\nν\ne\n\n−\n\n\n\n\nE6
\n
The right side of Eq. (6) involves an additional identity in the form of neutrinos to cover the missing part of energy conservation in a time-dependent frame. Equation (6) represents the mechanism of energy conservation, which involves the decay of energy into asymmetric space and time field particles (2), characterized by different energy densities. Conversion of light photons from one form to another for conservation needs the generation of phase differences, which appears with the formation of e+/e− + νe/νe− pairs.
\n
The space field particles, comprising e−/e+ pairs, have more energy density, while time phase particles, comprising νe/νe− pairs, have energy portions of a high frequency. It is precisely for this reason that the mass for neutrinos is significantly less than that of electrons. The right-handed antineutrino and left-handed neutrino pair together with the electron/positron pair represents the distribution of energy within virtual space and time phases. Due to the locality within space, close to Planck’s size, the performance of virtual matter particles became time-dependent, and it attains a velocity less than the speed of light photons. Hence, the parity translation (6) became non-invariant.
\n
Generation of e−/e+ + νe/νe− particles (6) is the translation of the energy of photons to virtual space and time phase particles which could be specified as “empty space” particles. The “empty space” is the medium where e−/e+ + νe/νe− particles form a fluid with a continuum spectrum. In the absence of energy flux (Eap = 0), a loss of the space frame takes place with the translation of virtual particles back to photons. However, particles before giving the “borrowed’ energy back lose localization in space phase and lose some portion of the energy which has to go in parallel with the absorption of photons by e−/e+ pairs. This phenomenon is the main feature of energy nonconservation during the return of “borrowed” energy of quantum fluctuations. Generation of space phase and distribution of energy in the space field leads to the non-uniform conservation of energy in space by absorption of photons by e−/e+ pairs with the formation of pairs of heavy bosons.
\n
\n\n
7. The Higgs mechanism
\n
The question as to why particles need mass is the main question of fundamental physics. Based on the Standard Model, the generation of mass by particles is due to the spontaneous breaking of symmetry within pairs of particles-antiparticles in the universe. The Standard Model applies Higgs mechanism in order to explain the phenomenon of spontaneous symmetry breaking.
\n
In accordance with the Higgs mechanism, space is filled with a field, and when the weak force particles (electron, quarks) move through Higgs field, they gain mass. However, the Higgs field does not give mass to protons, which are generated from quarks. The Higgs mechanism does not explain why photons are not given a mass when they pass through the Higgs field.
\n
It is necessary to note that particle physics news involves hot discussions surrounding the discovery of Higgs bosons. The Higgs mechanism does not explain why field suddenly shifted matter-antimatter symmetry to a mass generation event. Many other questions also remain open, such as where the Higgs field came from and why the universe should contain the Higgs field for creating matter-antimatter asymmetry.
\n
Based on the non-uniform conservation of energy, we can explain why conversion of kinetic energy, produced from collision of matter-antimatter pairs, breaks the symmetry. Model (2) shows that conservation of energy gives associated mass which is localized in the space-time frame in order to eliminate singularity in energy conservation. From model (2), it also follows that the zero value of the field takes place at Eap = 0, which leads to ripples between space and time phases in the so-called Higgs Field.
\n
Model (2) shows that at Eap = 0 all energy is accumulated in the form of mass, and the space-time frame decays to virtual space and time ingredients. Virtual space and time ingredients annihilate each other as ripples of particles and antiparticles with the generation of gravitational energy accelerating to the background state with the longitudinal wave. The background space does not go to the zero value because in this case the energy of the universe will be infinite. At Eap = 0, the radioactive decay of the space-time frame produces heavy bosons W+, W− and Z. At minimum space, the energy accumulated in time phase generates location of W+, W− bosons in quarks with generation of space-time frame of matter.
\n
When all the available energy is consumed in space (Eap = 0), the background space (Planck scale) with the lowest valley of energy becomes the vacuum state and generates gravitational attraction toward all the ingredients of decay of space-time frame to the background state.
\n
Coupling of gravitational energy with virtual space and time leads to the regeneration of non-virtual space-time frame of matter.
\n
The two parts of space, carrying different contents of energy, have entanglement, but they have no symmetry and are not two identical, equal halves, which was suggested by the authors of the EP paper [6]. The widely separated regions of space carry non-uniform conservation of energy within the space-time frame; therefore, the entanglement of nonidentical pieces of space is due to the connection of energy within space and time phases regardless of space and time scales.
\n
In accordance with our concept of the non-uniform conservation of energy principle, the phenomenon called mass generation is the requirement of energy conservation. Based on model (2), generation of mass is not a spontaneous symmetry-breaking event; it is the requirement of energy conservation that is carried through a discrete non-uniform space-time frame. The space and time parameters work as particles and antiparticles carrying energy conservation through their integrated frame.
\n
Model (2) describes the conjugation of force (Eap) and matter (Es) particles, forming the space-time frame of a matter. On this basis, light energy can be observable only if it reflected from the space-time frame of matter. The force-carrying particle (Eap) generates its conjugated particle (Es) that has a mass, simultaneously conserving energy and momentum. The model shows that when the corresponding particle has no mass, the conservation of energy diverges to infinity.
\n
Model (2) may explain why photons do not attain mass when they pass through Higgs field. Model (2) comprises of massless (Eap) and mass-containing particles (Es). At Eap = 0, particles which form the so-called Higgs field have no space-time configuration. Assuming information that the Higgs boson may decay to a pair of photons, we can describe the generation of Higgs field particles and photons through Eqs. (7) and (8):
\n
\n\n\ne\n+\n\n/\n\nν\ne\n\n+\n\ne\n−\n\n/\n\n\nν\ne\n\n−\n\n=\n\ne\n+\n\n/\n\ne\n−\n\n+\n\nν\ne\n\n/\n\n\nν\ne\n\n−\n\n E7
\n
\n\n\ne\n+\n\n/\n\nν\ne\n\n+\n\ne\n−\n\n/\n\n\nν\ne\n\n−\n\n=\n−\n\ne\n+\n\n/\n\ne\n−\n\n+\n\nν\ne\n\n/\n\n\nν\ne\n\n−\n\n=\n2Y\n E8
\n
Scheme (8) describes the generation of light photons from dark matter. Due to the consumption of light photons for generation of space-time frame of observable matter, the conversion reaction (8) does not have the same velocity in both directions and is, therefore, not a time reversal invariant process.
\n
Now the question is how we can describe the mass of protons, which does not originate from Higgs bosons. By Standard Model, the mass of protons comes from binding energy-gluons.
\n
The coupling of energetic field with the virtual particles e+/e− + νe/νe− leads to the insertion of energy to the virtual particles with the generation of quarks and space-time frame:
\n
\n\n2Y\n+\n\ne\n+\n\n/\n\ne\n−\n\n+\n\nν\ne\n\n/\n\n\nν\ne\n\n−\n\n=\n\ne\n+\n\n/\n\nν\ne\n\n+\n\ne\n−\n\n/\n\n\nν\ne\n\n−\n\n\nE9
\n
The coupling reaction (9) maintains the conservation of energy and momentum within the boundary-mapped space-time frame.
\n
The virtual particles e+/e− + νe/νe− exist in the form of dark matter and became observable only after the generation of the space-time frame. Similarly, the photons, generated from decomposition of matter space-time frame, exist in the form of dark energy and become observable only after interaction with the space-time frame of matter.
\n
Therefore, matter and energy are observable only within interactions with the space-time frame. Interaction of virtual particles with the energy photons is such a coupling of virtual particles with themselves. These interactions follow the scheme, which is shown through the conversion (10):
\n
\n\n\nE10
\n
We may present the scheme (10) in the reverse order:
\n
\n\n\nE11
\n
Model (2) explains the invariance of time reversal transformation in scheme (10). The energy of space-time matter Es is always less than the energy of photon particles. The process moves in the direction of expansion of the space-time frame of observable matter.
\n
Scheme (11) in a similar way explains the generation of matter. Light photons transform to ingredients of matter particles, such as electron/positron and neutrino pairs. Due to the consumption of light energy during the coupling of photons with the ingredients of matter particles, the conversion of light photons is not invariant to the reversal of time.
\n
\n\n
8. The energy-mass equivalence
\n
In accordance with the theory of relativity, mass and energy are different manifestations of the same identity, and the equivalence of mass and energy is a consequence of the symmetries of space and time [17]. This statement of the theory of relativity does not explain when the difference between mass and energy disappears and when energy and mass became different entities.
\n
Based on model (2), the mass-energy equivalence is the consequence of energy conservation, which is carried through antisymmetric space-time phases. When there is no available energy to be conserved within space-time, the difference between energy and mass disappears. The difference between energy and mass appears when there is an energy (electromagnetic, kinetic) applied to space-time frame of a system. Production of energy in proton-proton collision experiments leads to the separation of mass from energy with the generation of a space-time frame of the produced particles.
\n
It is necessary to show that the energy-momentum exchange interaction, which generates mass, is similar to Lorentz’s theory of the generation of electron’s mass. Lorentz connected mass with the electromagnetic effect and suggested that “back reaction of electric and magnetic fields leads to the generation of mass” [18]. However, Lorentz did not explain the nature of back reaction of electric and magnetic fields. Lorentz’s formulation does not involve energy-momentum exchange interaction.
\n
Lorentz’s theory of electron mass is a very important approach for understanding the mass problem. Model (2) explains Lorentz’s statement on the nature of apparent and true masses [18]. Model (2) shows that the motion of any body, for example, an electron, takes place with the consumption of energy, which is imported to the space-time frame. Due to the correlation of the mass with the applied energy, we measure only the apparent mass but never the true mass.
\n
When Eap of model (2) is zero, space-time decays and moves back to the background state. In this case, the local energy portion responsible for the local state disappears. In accordance with model (2), when space-time frame undergoes decay (Eap = 0), the difference between space and time variables disappears which generates a condensate field where the space and time portion of energy are uniformly mixed. Separation of space and time variables from the background condensate and the formation of space-time frame consume energy, while merging them restores that energy at the initial state. Therefore, energy is conserved only through the non-uniform distribution within the boundary-mapped space-time frame and the energy-momentum exchange interaction within the space-time frame.
\n
At the background state, all available energy of the universe, accumulated within minimum space, leads to the separation of space and time portions of energy from condensate with the formation of space-time frame with asymmetric boundaries. Energy level in the non-uniform conservation stage is less than the energy of background condensate of uniform energy conservation stage.
\n
Background vacuum and black hole are the boundary conditions of space-time frame and energy conservation. Due to the exchange interaction, black hole space has a strong gravitational effect toward electromagnetic energy and consumes all the available portion of energy. Vacuum is the other extreme of space-time and has strong gravitational effect to the portion of energy consumed in space. Therefore, electromagnetism and gravitation are two phases which transform into each other, satisfying the non-uniform conservation of energy. On this basis, the phenomenon called mass in the form of inertia appears as the carrier of energy conservation within an asymmetric space-time frame.
\n
Due to the absence of space-time frame, a gravitational field in the form of a longitudinal wave does not react with the matter. On this basis, gravity has no discrete behavior, and there is no quantization of this field.
\n
It is necessary to note that the combination of electromagnetism and gravity is not enough to complete the unified theory. In accordance with the concept of conservation of energy and momentum within the space-time frame, a complete unified theory requires the combination of electromagnetism and gravity with the space-time frame.
\n
Therefore, our approach shows that description of space-time cannot be more fundamental than energy conservation, but the combination of space-time with the conservation of energy becomes a fundamental theory of reality.
\n
Model (2) does not describe a particle as an entity, which is localized in space and evolves in time, but it presents a particle and space-time as a resulting quantity produced from each other.
\n
Decomposition of a space-time frame (Eap = 0) leads to the loss of information which is why black hole radiation does not carry any information. Black hole radiation leads to the restoration of energy at the initial state and the starting of new information, carried by the new space-time frame.
\n
In Eq. (2), the Es in the denominator is the dark matter, but in the numerator is the dark energy. When Eap = 0, all the photon energy transforms to dark energy which disappears between dark energy and dark matter.
\n
The exchange interaction of space and time portions in space-time frame leads to the formation of electric and magnetic fields with the generation of time translational non-invariant electromagnetic energy. The Eap − Es parameter of the equation presents the vector potential of electromagnetism, which vanishes due to the consumption in space.
\n
Therefore, electromagnetic energy cannot exist without discrete space-time frame and exchange interactions. Light is observable only through the reflection from space-time frame, and without space-time frame energy is dark. Higgs field has no space-time frame, which is why it is a scalar field. Quantum excitation is the redistribution of energy portions between space and time phases.
\n
By Bose-Einstein statistics, two bosons with identical properties can be in the same place at the same time. Based on model (2) bosons have no space-time frame, which is why there is no difference between light bosons. Interaction of light bosons with the space-time frame and absorption of light with the growth of the matter space-time structure make light observable.
\n
Model (5) explains the phenomenon called “nonlocality.” The function Eap − Es/Es of model (2) which describes action-response parity is the origin of local action. At Eap = 0, a particle has no space-time frame and has no certain locality. When a particle has no space-time (Eap = 0), all particles are the non-distinguishable ingredients of antimatter “condensate.”
\n
At Eap − Es ˃ 0 a particle has its own space-time frame and, therefore, independent locality. The condition Eap = 0 eliminates the action-response behavior of a particle which loses spin and moves to the background state. Therefore, energy conservation comprises of two steps: the decomposition of matter to an energetic field and the reverse process of transfer of an energetic field to matter.
\n
In accordance with model (2), particles have space-time existence at positive energy state and have momentum in the opposite direction. The positive energy solution alone does not complete energy conservation. In accordance with our approach, the relationship between curvature of space-time and energy is the natural consequence of cyclic energy conservation within boundary-mapped space-time.
\n
In accordance with model (2), the positive and negative energy states are not symmetric. The negative energy state is the second portion of energy, conserved in the form of Higgs field. At the state of zero positive energy (Ea = 0), particles do not follow Pauli’s exclusion principle and, thus, have no local space-time position; in other words, all the particles occupy the same position.
\n
Dirac analyzed the relation of energy and momentum-using equations, which involves the sum of these parameters. Model (2) suggests a different approach and involves the ratio of the available portion of energy and the energy, which is consumed by momentum, which eliminates the divergence of energy to infinity.
\n
Now returning to Rovelli’s statement [12] on relation of space to the electromagnetic field, we may add that space-time itself through energy distribution is generated from an electromagnetic field and as a medium carries an electromagnetic field. Merging of energy quanta with the generated space-time leads to the expansion of space of an event.
\n
\n\n
9. Conclusion
\n
In this paper, we extended our analysis on the nature of space-time to give an input to the hot disputes on the generation of a unified theory by entanglement of two equal pieces of space through “Wormhole Bridge” which was the outcome of the ER and EPR papers. We suggest that the unification of the theory of relativity with quantum mechanics is possible only through the proper mathematical formulation of the law of conservation of energy within the space-time frame. In accordance with this approach, the conversion of energy from one form to another requires a non-separable space locality and time frame which generates a boundary-mapped space-time structure wherein the consumption of light photons generates identities, such as space and time particles, carrying distribution of energy within the emerging non-uniform space-time field.
\n
The non-uniform conservation of energy within the boundary-mapped space-time manifold leads to the generation of a deterministic dynamical law. This concept unifies all the interactions of nature within the asymmetric space-time manifold, carrying the non-uniform conservation of energy through coupling of energy-momentum conservation frames. It also describes the origin of mass, as the product of the non-uniform conservation of energy within the non-invariant energy-mass relation. We showed that gravity is materialized in space energy, while time at zero energy state (Eap = 0) in the form of ripples of space and time phases returns an event to the initial background state with restoration of a new elementary space-time frame. Based on the energy conservation model (2), at matter-antimatter symmetry, the difference between energy and momentum disappears which destroys the space-time frame of the universe.
\n
When energy is consumed by a space-time frame or by e−/v− + e+/v particles with the formation of quarks, the space-time frame returns to its origin after consumption of all the available portion of energy. Only energy, accumulated at background state, may separate e−/e+ + v/v dark field particle pairs and generate quarks. When the matter has no space-time frame, it is not observable. The dark matter and dark energy are “dark” due to the absence of space-time frame, and energy, which is produced from the decomposition of the space-time frame, is not observable. The dark energy becomes an electromagnetic energy when it interacts with the space-time frame.
\n
\n\n',keywords:"Relativity, quantum mechanics, conservation of energy, origin of space-time",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/68843.pdf",chapterXML:"https://mts.intechopen.com/source/xml/68843.xml",downloadPdfUrl:"/chapter/pdf-download/68843",previewPdfUrl:"/chapter/pdf-preview/68843",totalDownloads:186,totalViews:0,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,dateSubmitted:"May 7th 2019",dateReviewed:"July 19th 2019",datePrePublished:"September 3rd 2019",datePublished:null,dateFinished:null,readingETA:"0",abstract:"We suggest a mathematical formulation which shows that gravity is the materialization of energy in space, which at zero energy input (Eap = 0) in the form of entanglement of virtual space and time phases returns an event to the initial background state with restoration of the original elementary space-time frame. Based on the suggested model, the matter-antimatter relation results from the non-uniform energy conservation principle while satisfying the conservation of energy within the boundary-mapped space-time frame. The suggested approach shows that the generation of mass is the requirement of energy conservation. The mathematic model of energy conservation involves the conjugation of the dynamic local state of space and time variables with the local energy-momentum relation, which at different energy inputs can operate at the small scale of quantum physics and the large scale of relativity. The suggested theory shows that commutation of local space-time position and energy-momentum exchange interaction is the only way for conservation of energy and momentum within a discrete space-time frame.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/68843",risUrl:"/chapter/ris/68843",book:{slug:"advances-in-quantum-communication-and-information"},signatures:"Agaddin Mamedov",authors:[{id:"219617",title:"Dr.",name:"Aghaddin",middleName:null,surname:"Mamedov",fullName:"Aghaddin Mamedov",slug:"aghaddin-mamedov",email:"amamedov@sabic.com",position:null,institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. The main principles of ER and EPR papers",level:"1"},{id:"sec_3",title:"3. Commutation of space-time with the principle of conservation of energy",level:"1"},{id:"sec_4",title:"4. Matter-antimatter asymmetry",level:"1"},{id:"sec_5",title:"5. Detailed features of the uncertainty principle of quantum mechanics",level:"1"},{id:"sec_6",title:"6. Principles of generation of mass and gravitation",level:"1"},{id:"sec_7",title:"7. The Higgs mechanism",level:"1"},{id:"sec_8",title:"8. The energy-mass equivalence",level:"1"},{id:"sec_9",title:"9. Conclusion",level:"1"}],chapterReferences:[{id:"B1",body:'[Crew B. Linking General Relativity and Quantum Mechanics with Wormholes. International science publisher. USA: Science Alert; 2016\n]'},{id:"B2",body:'[Maldacena J, Susskind L. Cool horizons for entangled black holes. arXiv: 1306.05332v2 [hep-th]. 2013\n]'},{id:"B3",body:'[Susskind L. Copenhagen vs Everett, Teleportation and ER=EPR. arXiv: 1604.02589 v2 [hep-th]. 2016\n]'},{id:"B4",body:'[Cole B. Wormholes Could Be the Key to Beating The Heisenberg’s Uncertainty Principle. USA, Science Alerts: International Science Publisher; 2016\n]'},{id:"B5",body:'[Grant A. Entanglement: Gravity’s Long-distance Connection. Science News. USA: Independent Publisher; 2015\n]'},{id:"B6",body:'[Einstein A, Rosen N. The particle problem in the general theory of relativity. Physical Review. 1935;1:48\n]'},{id:"B7",body:'[Einstein A, Podolsky B, Rosen N. Podolsky; “Can quantum-mechanical description of physical reality be considered complete?”. Physics Review. 1935;47(10):777-780\n]'},{id:"B8",body:'[Siegfried T. A new “Einstein” equation suggest wormholes hold key to quantum gravity. Science news. 16 Aug 2016\n]'},{id:"B9",body:'[Van Raamsdonk M. General Relative Gravity. 2010;42:2323-2329\n]'},{id:"B10",body:'[Cao CJ, Sean M, Carroll I, Michalakis S. Space from Hilbert Space: Recovering Geometry from Bulk Entanglement. arXiv: 1606.08444v3 [hep-th]. 2016\n]'},{id:"B11",body:'[Merali Z. Theoretical physics: The origins of space and time. Nature. 2013;500:516-519\n]'},{id:"B12",body:'[Rovelli C. Quantum Gravity. Cambridge Monographs on Mathematical Physics. Cambridge: University Press; 2007\n]'},{id:"B13",body:'[Smolin L. The Road to Quantum Gravity. New York: Basic Books; 2001\n]'},{id:"B14",body:'[Mamedov AK. Unification of dynamical laws through frequency based discrete space-time and symmetry principle. European Journal of Scientific Research. 2010;42(3):359-384\n]'},{id:"B15",body:'[Mamedov AK. The Concept of Mass Based on Accelerated Conservation of Energy Within Asymmetric Space-time Phases. Rijeka, Croatia: Intech; 2018\n]'},{id:"B16",body:'[Mamedov AK. Unification of quantum mechanics and relativity based on discrete conservation of energy. In: The Selected Topics of Quantum Mechanics. Rijeka, Croatia: InTech; 2014\n]'},{id:"B17",body:'[Wikipedia.org/mass-energy equivalence\n]'},{id:"B18",body:'[Lorentz HA. The Theory of Electrons and the Propagation of Light. Nobel Speech. Stockholm; 1902\n]'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Agaddin Mamedov",address:"amamedov@sabic.com",affiliation:'- Houston Technology Center, Sugar Land, Texas, USA
'}],corrections:null},book:{id:"8907",title:"Advances in Quantum Communication and Information",subtitle:null,fullTitle:"Advances in Quantum Communication and Information",slug:"advances-in-quantum-communication-and-information",publishedDate:"February 26th 2020",bookSignature:"Francisco Bulnes, Vasilios N. Stavrou, Oleg Morozov and Anton V. Bourdine",coverURL:"https://cdn.intechopen.com/books/images_new/8907.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"92918",title:"Dr.",name:"Francisco",middleName:null,surname:"Bulnes",slug:"francisco-bulnes",fullName:"Francisco Bulnes"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},chapters:[{id:"68940",title:"Introductory Chapter: Advanced Communication and Nano-Processing of Quantum Signals",slug:"introductory-chapter-advanced-communication-and-nano-processing-of-quantum-signals",totalDownloads:240,totalCrossrefCites:0,signatures:"Francisco Bulnes",authors:[{id:"92918",title:"Dr.",name:"Francisco",middleName:null,surname:"Bulnes",fullName:"Francisco Bulnes",slug:"francisco-bulnes"}]},{id:"67125",title:"A Novel Quantum Steganography Scheme Based on ASCII",slug:"a-novel-quantum-steganography-scheme-based-on-ascii",totalDownloads:381,totalCrossrefCites:0,signatures:"Ri-Gui Zhou and Jia Luo",authors:[null]},{id:"67463",title:"Quantum Algorithms for Fluid Simulations",slug:"quantum-algorithms-for-fluid-simulations",totalDownloads:940,totalCrossrefCites:2,signatures:"René Steijl",authors:[null]},{id:"67228",title:"Non-Gaussian Entanglement and Wigner Function",slug:"non-gaussian-entanglement-and-wigner-function",totalDownloads:259,totalCrossrefCites:1,signatures:"Mustapha Ziane and Morad El Baz",authors:[null]},{id:"68078",title:"Quantum Walks in Quasi-Periodic Photonics Lattices",slug:"quantum-walks-in-quasi-periodic-photonics-lattices",totalDownloads:426,totalCrossrefCites:1,signatures:"Dan Trung Nguyen, Daniel A. Nolan and Nicholas F. Borrelli",authors:[null]},{id:"70438",title:"Design of 4-Bit 4-Tap FIR Filter Based on Quantum-Dot Cellular Automata (QCA) Technology with a Realistic Clocking Scheme",slug:"design-of-4-bit-4-tap-fir-filter-based-on-quantum-dot-cellular-automata-qca-technology-with-a-realis",totalDownloads:250,totalCrossrefCites:0,signatures:"Ismail Gassoumi, Lamjed Touil, Bouraoui Ouni and Abdellatif Mtibaa",authors:[null]},{id:"67661",title:"DFT Study on Interaction of Estrone and Imidazolium-Based Hydrophobic Ionic Liquids",slug:"dft-study-on-interaction-of-estrone-and-imidazolium-based-hydrophobic-ionic-liquids",totalDownloads:184,totalCrossrefCites:0,signatures:"Sai Saravanan Ambi Venkataramanan and Ramalingam Anantharaj",authors:[null]},{id:"67792",title:"Schrödinger’s Cat and His Timeless (t = 0) Quantum World",slug:"schr-dinger-s-cat-and-his-timeless-t-0-quantum-world",totalDownloads:412,totalCrossrefCites:0,signatures:"Francis T.S. Yu",authors:[null]},{id:"70409",title:"What Is “Wrong” with Current Theoretical Physicists?",slug:"what-is-wrong-with-current-theoretical-physicists-",totalDownloads:225,totalCrossrefCites:0,signatures:"Francis T.S. Yu",authors:[null]},{id:"68843",title:"The Hot Disputes Related to the Generation of a Unified Theory Combining the Outcomes of ER and EPR Papers",slug:"the-hot-disputes-related-to-the-generation-of-a-unified-theory-combining-the-outcomes-of-er-and-epr-",totalDownloads:186,totalCrossrefCites:1,signatures:"Agaddin Mamedov",authors:[{id:"219617",title:"Dr.",name:"Aghaddin",middleName:null,surname:"Mamedov",fullName:"Aghaddin Mamedov",slug:"aghaddin-mamedov"}]}]},relatedBooks:[{type:"book",id:"8655",title:"Advances in Complex Analysis and Applications",subtitle:null,isOpenForSubmission:!1,hash:"6abcaa5b5cf98a51a769d1bce7e5ebe5",slug:"advances-in-complex-analysis-and-applications",bookSignature:"Francisco Bulnes and Olga Hachay",coverURL:"https://cdn.intechopen.com/books/images_new/8655.jpg",editedByType:"Edited by",editors:[{id:"92918",title:"Dr.",name:"Francisco",surname:"Bulnes",slug:"francisco-bulnes",fullName:"Francisco Bulnes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"},chapters:[{id:"73408",title:"Introductory Chapter: Frontiers and Future Developments of the Complex Analysis",slug:"introductory-chapter-frontiers-and-future-developments-of-the-complex-analysis",signatures:"Francisco Bulnes",authors:[{id:"92918",title:"Dr.",name:"Francisco",middleName:null,surname:"Bulnes",fullName:"Francisco Bulnes",slug:"francisco-bulnes"}]},{id:"69470",title:"Interference Pattern Representation on the Complex s-Plane",slug:"interference-pattern-representation-on-the-complex-s-plane",signatures:"José Trinidad Guillen Bonilla, Alex Guillen Bonilla, Mario Alberto García Ramírez, Gustavo Adolfo Vega Gómez, Héctor Guillen Bonilla, María Susana Ruiz Palacio, Martín Javier Martínez Silva and Verónica María Bettancourt Rodriguez",authors:[{id:"196421",title:"Dr.",name:"Héctor",middleName:null,surname:"Guillén-Bonilla",fullName:"Héctor Guillén-Bonilla",slug:"hector-guillen-bonilla"},{id:"196422",title:"Dr.",name:"Alex",middleName:null,surname:"Guillén-Bonilla",fullName:"Alex Guillén-Bonilla",slug:"alex-guillen-bonilla"},{id:"196424",title:"Dr.",name:"Verónica María",middleName:null,surname:"Rodríguez-Betancourtt",fullName:"Verónica María Rodríguez-Betancourtt",slug:"veronica-maria-rodriguez-betancourtt"},{id:"220284",title:"Ph.D.",name:"José Trinidad",middleName:null,surname:"Guillen Bonilla",fullName:"José Trinidad Guillen Bonilla",slug:"jose-trinidad-guillen-bonilla"},{id:"243297",title:"Prof.",name:"Mario Alberto",middleName:null,surname:"Garcia-Ramirez",fullName:"Mario Alberto Garcia-Ramirez",slug:"mario-alberto-garcia-ramirez"},{id:"272488",title:"Dr.",name:"Gustavo Adolfo",middleName:null,surname:"Vega Gómez",fullName:"Gustavo Adolfo Vega Gómez",slug:"gustavo-adolfo-vega-gomez"},{id:"272491",title:"Dr.",name:"María Susana",middleName:null,surname:"Ruiz-Palacios",fullName:"María Susana Ruiz-Palacios",slug:"maria-susana-ruiz-palacios"},{id:"272492",title:"Dr.",name:"Martin Javier",middleName:null,surname:"Martínez-Silva",fullName:"Martin Javier Martínez-Silva",slug:"martin-javier-martinez-silva"}]},{id:"72406",title:"Inverse Scattering Source Problems",slug:"inverse-scattering-source-problems",signatures:"Mozhgan “Nora” Entekhabi",authors:[{id:"199989",title:"Prof.",name:"Mozhgan (Nora)",middleName:null,surname:"Entekhabi",fullName:"Mozhgan (Nora) Entekhabi",slug:"mozhgan-(nora)-entekhabi"}]},{id:"72697",title:"Solution Methods of Large Complex-Valued Nonlinear System of Equations",slug:"solution-methods-of-large-complex-valued-nonlinear-system-of-equations",signatures:"Robson Pires",authors:[{id:"316573",title:"Prof.",name:"Robson",middleName:null,surname:"Pires",fullName:"Robson Pires",slug:"robson-pires"}]},{id:"72307",title:"Variable Exponent Spaces of Analytic Functions",slug:"variable-exponent-spaces-of-analytic-functions",signatures:"Gerardo A. Chacón and Gerardo R. Chacón",authors:[{id:"316794",title:"Dr.",name:"Gerardo R.",middleName:null,surname:"Chacón",fullName:"Gerardo R. Chacón",slug:"gerardo-r.-chacon"},{id:"316796",title:"Dr.",name:"Gerardo A.",middleName:null,surname:"Chacón",fullName:"Gerardo A. Chacón",slug:"gerardo-a.-chacon"}]},{id:"72743",title:"Integral Geometry and Cohomology in Field Theory on the Space-Time as Complex Riemannian Manifold",slug:"integral-geometry-and-cohomology-in-field-theory-on-the-space-time-as-complex-riemannian-manifold",signatures:"Francisco Bulnes",authors:[{id:"92918",title:"Dr.",name:"Francisco",middleName:null,surname:"Bulnes",fullName:"Francisco Bulnes",slug:"francisco-bulnes"}]},{id:"72271",title:"Extracting Coherent Structures in Near-Wall Turbulence Based on Wavelet Analysis",slug:"extracting-coherent-structures-in-near-wall-turbulence-based-on-wavelet-analysis",signatures:"Peng Du, Haibao Hu and Xiao Huang",authors:[{id:"316828",title:"Associate Prof.",name:"Peng",middleName:null,surname:"Du",fullName:"Peng Du",slug:"peng-du"},{id:"318312",title:"Prof.",name:"Haibao",middleName:null,surname:"Hu",fullName:"Haibao Hu",slug:"haibao-hu"},{id:"318322",title:"Dr.",name:"Xiao",middleName:null,surname:"Huang",fullName:"Xiao Huang",slug:"xiao-huang"}]},{id:"69225",title:"An Efficient Approach Based on the Near-Field Technique to Solve EMI Problems: Application to an AC/DC Flyback Converter",slug:"an-efficient-approach-based-on-the-near-field-technique-to-solve-emi-problems-application-to-an-ac-d",signatures:"Bessem Zitouna and Jaleleddine Ben Hadj Slama",authors:[{id:"310034",title:"Dr",name:"Zitouna",middleName:null,surname:"Bessem",fullName:"Zitouna Bessem",slug:"zitouna-bessem"},{id:"310038",title:"Prof.",name:"Ben Hadj Slama",middleName:null,surname:"Jaleleddine",fullName:"Ben Hadj Slama Jaleleddine",slug:"ben-hadj-slama-jaleleddine"}]},{id:"71419",title:"Mathematical Fundamentals of a Diagnostic Method by Long Nonlinear Waves for the Structured Media",slug:"mathematical-fundamentals-of-a-diagnostic-method-by-long-nonlinear-waves-for-the-structured-media",signatures:"Vyacheslav Vakhnenko, Dmitri Vengrovich and Alexandre Michtchenko",authors:[{id:"296741",title:"D.Sc.",name:"Vyacheslav",middleName:"O",surname:"Vakhnenko",fullName:"Vyacheslav Vakhnenko",slug:"vyacheslav-vakhnenko"},{id:"297433",title:"Dr.",name:"Dmitri",middleName:null,surname:"Vengrovich",fullName:"Dmitri Vengrovich",slug:"dmitri-vengrovich"},{id:"316043",title:"Dr.",name:"Alexandre",middleName:null,surname:"Michtchenko",fullName:"Alexandre Michtchenko",slug:"alexandre-michtchenko"}]}]}]},onlineFirst:{chapter:{type:"chapter",id:"71472",title:"Spasticity and Dystonia: A Brief Review",doi:"10.5772/intechopen.91780",slug:"spasticity-and-dystonia-a-brief-review",body:'1. Introduction
According to Lance and colleagues, spasticity is a “…motor disorder characterised by a velocity dependent increase in the tonic stretch reflex with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one component of the upper motor neuron syndrome…” [1]. Over time, the interest of clinicians on spasticity has increased more and more, topics ranging from pathophysiology to clinical relevance and treatment options [2, 3, 4, 5, 6, 7, 8].
However, in everyday management of patients’ spasticity symptoms, much more complex situation would be there, full of clinical problems. In fact, other positive and/or negative signs may be observed together with increased muscle tone and deep tendon reflexes. Abnormal cutaneous reflexes, spasms, co-contraction, Babinski reflex, and also dystonia, are described as positive phenomena, and weakness, fatigability, and reduced dexterity are considered negative ones. In clinical practice each problem that we have to treat may have different pathophysiological explanations [9]. A central nervous system lesion determines the upper motor neuron syndrome, induced by an interruption of descending pathways, which connect the highest centres to the spinal cord. Alternatively, reactivity of spinal cord circuits may be modified by a direct damage, through a different way to elaborate the input from peripheral afferents. It is important to differentiate immediate to delayed consequences of damage to the highest centres in the CNS. The delayed consequences lead to a rearrangement of reactivity in spinal cord circuits, in which it is considered a basis of spasticity. Moreover, spasticity may itself be modified by the consequences of paresis and immobilisation, i.e. development of contractures. Several pathophysiological mechanisms may explain the development of spasticity due to CNS lesions. These mainly include defective inhibition, such as postsynaptic inhibition of alpha motor neurons or presynaptic inhibition of 1a afferents. There is also a defective excitation of inhibitory interneurons underlying reciprocal inhibition, autogenetic inhibition, or recurrent inhibition [10].
Dystonia is defined as a neurological disorder characterised by sustained or intermittent muscle contractions, determining unusual movements and postures or both. Typically dystonic movements are patterned and twisting and may be tremulous. Often, dystonic movements may be started by voluntary action, worsening with typically an overflow muscle activation (Consensus 2013) [11]. Dystonia classification is based on clinical characteristics and aetiology. Indeed, except for hereditary forms, dystonic syndromes may be caused by birth-related or other physical trauma, infection, and poisoning or due to pharmacological treatments, particularly neuroleptics. The clinical characteristics include age at onset, temporal pattern, body distribution, and coexistence of other movement disorders. The etiologic characteristics are the presence or absence of nervous system pathology and the pattern of inheritance [11].
Focal dystonia is a neurologic movement disorder, due to an incorrect sensorimotor modulation, determining involuntary, excessive muscle contractions. Writer’s cramp is a specific type of focal dystonia that affects the fingers, hand, or forearm. Writer’s cramp is a task-specific dystonia, characterised by hands twisting into odd postures. A specific task induces this sign. Other skilled task-specific movements may induce focal hand dystonia, such as playing a musical instrument, typing, or sewing. Writer’s cramp is known also as musician’s cramp, focal hand dystonia, arm dystonia, finger dystonia, task-specific dystonia, and occupational cramp or dystonia.
Task-specific dystonia like writer’s cramp may appear in anyone. It usually appears between 30 and 50 years of age. Task-specific dystonia, particularly musician’s cramp, is more common in men.
Two types of writer’s cramp could be described:
Simple writer’s cramp, which appears only during writing. The abnormal postures spring up soon after you pick up a pen. So, it only affects the ability to write.
Dystonic writer’s cramp appears not only during writing but also during other activities with your hands, like shaving, dressing, or applying makeup.
Probably, repetitive movements determine a remapping of the brain’s sensorimotor areas. Bad posture of the hands while holding a pen or pencil associated with overuse seems to cause simple writer’s cramp. Dystonic writer’s cramp is less common than simple ones and may represent a symptom of generalised dystonia. In this case, the involuntary movements can appear also during other non-writing tasks, such as using a fork or handwashing. Rarely, writer’s cramp could be the early onset of a generalised dystonia, which is associated with the DYT1 gene [12].
1.1 Pathophysiology of spasticity and dystonia syndromes
Typically, spasticity is considered as a specific “pyramidal” sign; nevertheless, selective lesions of the primary motor cortex or corticospinal tract often induce hypotonia, deficit, or weakness in distal movements, without inducing spasticity [4]. Only the involvement of non-primary motor areas (premotor and supplementary areas) and the corticoreticulospinal fibres together with cortical lesions may induce spasticity. Corticoreticulospinal fibres sends through the dorsolateral reticulospinal tract descending just anteriorly to the corticospinal tract, a massive bilateral inhibitory projection to spinal motor neurons, which are located in the lateral funiculus of the spinal cord. So the fact that a selective lesion of the anterior limb or the genu of the internal capsula predominantly induces spasticity without an evident motor deficit and vice versa can be explained by the different courses of corticoreticular and corticospinal fibres in the internal capsula. Hence, a lesion involving the corticoreticulospinal fibres will lead to a decreased inhibition (or to an increased facilitation) of the spinal cord and ultimately to spasticity [13, 14]. Three fundamental phenomena occur after a lesion to the central motor pathways assigned to motor command execution:
Paresis: the quantitative lack of command directed to agonist muscles when attempting to generate force or movement.
Soft tissue contracture and contractile muscle property changes: shortened position induced by immobilisation due to paresis, causing soft tissue and muscle alterations. [13].
Muscle overactivity: as a consequence of corticospinal pathway lesion, which causes loss of motor command, brainstem descending pathways are activated. Most of these brainstem descending pathways tend to be constantly active, as a consequence a constant muscle activity is maintained. Releasing of growth factors locally is induced in the spinal cord level by the lack of regular descending excitation to the lower motor neurons. So these phenomena induce local sprouting from neighbouring interneurons, creating perfect conditions in order to synthetise new abnormal synapse network, leading to the creation of new abnormal reflex pathways [8, 9].
1.2 Spasticity
Among these changes, which gradually develop, spasticity represents the principal sign detectable. A simple definition of spasticity is an increase in velocity-dependent stretch reflexes [9, 10] which can be evoked at rest by muscle stretch or tendon taps.
Principal key points:
A tonic stretch reflex.
Mediated by type 1a fibre nerve, predominantly in the muscle spindle. Passive muscle stretch induces exciting of muscle spindle, which sends sensory input back to the spinal cord through monosynaptic way principally but also oligo- and polysynaptic reflexes, which at the end induce an efferent impulse to the muscle, causing contraction.
Velocity-dependent.
Length-dependent.
1.3 Spastic dystonia
The term “spastic dystonia” was coined by Denny-Brown in 1966 to define tonic-chronic muscle activity that is present in a spasticity pattern, during rest [15]. Thus, spastic dystonia could be described as a spontaneous overactivity at rest, not induced by a primary triggering factor [14, 15, 16]. It is easy to recognise it in patients with spastic paresis, as spastic dystonia causes specific bad postures in joints and body. For example, in the upper limb, the shoulder can stay internally rotated and adducted with a flexed and pronated elbow and flexed wrist and fingers. Equinovarus deformity represents a specific spastic dystonia in the lower limb, and it is characterised by plantar flexors and/or toe flexors, which may be painful and disabling during walking.
1.4 Spastic co-contraction
Spastic co-contraction is defined as an “unwanted, excessive, level of antagonistic muscle activity during voluntary command on an agonist muscle, which is aggravated by tonic stretch in the co-contracting muscle” [13]. Spastic co-contraction in spasticity pattern is a descending phenomenon, most probably due to misdirection of the supraspinal drive. It may be caused by loss of reciprocal inhibition during voluntary command [9, 10]. So, voluntary command of an agonist muscle is the first step, which induces spastic co-contraction. In patients with good or fairly good motor control, spastic co-contraction is certainly the most disabling form of muscle overactivity, because it obstacles muscle physiological muscle voluntary recruitment.
1.5 Clinical evaluation
1.5.1 Passive range of motion
For each movement evaluated, the corresponding muscles and joints are stretched at a very slow speed, in order to keep below the threshold for eliciting a stretch reflex. The angle at which soft tissue offers a maximum resistance is defined as the passive range of motion for that joint [17].
1.5.2 Angle of catch or clonus and spasticity grade
For each movement evaluated, the clinician should stretch the corresponding muscles and joints as fast as possible for the examiner. The spasticity grade is determined by the joint angle at which catch or clonus appears, according to Tardieu scale [18].
1.5.3 Active range of motion
For each passive movement evaluated at first, the clinician asks the patient to carry out an active movement at maximal range, until the active movement produced by the agonist muscles is contrasted by the passive resistance together with the spastic co-contraction of antagonist ones. This angle measure is the effective active range of motion [18].
1.5.4 Outcome measure
Tardieu score is a scale realised to measure spasticity that evaluates resistance to passive movement at both slow and fast speed. Individuals are evaluated both in in sit and supine position. There are two types of measures:
Quality of muscle reaction.
Angle of muscle reaction.
The quality of muscle reaction is scored as follows (range 0–4):
0. No resistance throughout the course of the passive movement.
1. Slight resistance throughout the course of the passive movement, followed by release.
2. Clear catch at precise angle, interrupting the passive movement, followed by release.
3. Fatigable clonus (<10 seconds when maintaining pressure) occurring at precise angle.
4. Infatigable clonus (>10 seconds when maintaining pressure) occurring at precise angle.
In order to consider joint angle, speed movement has to be defined:
Regarding the joint angle, modified Tardieu describes:
The angle of full ROM (R2) is defined at a very slow speed (V1). The angle of muscle reaction (R1) is detected when a catch or clonus appears during a quick stretch (V3) [19].
Ashworth scale, original version (1964), is a test which quantifies resistance to passive movement, with respect to a joint and with varying degrees of velocity. Scores range from 0 to 4:
0. No increase in tone.
1. Slight increase in tone giving a catch when the limb was moved in flexion or extension.
2. More marked increase in tone but limb easily flexed.
3. Considerable increase in tone, passive movement difficult.
4. Limb rigid, sometimes fixed in flexion or extension.
The modified Ashworth scale (Bohannon & Smith, 1987) is similar to the original one, except for a 1+ scoring category to indicate resistance through less than half of the movement [20].
2. Treatment options of spasticity
2.1 Indications for treatment
It’s demonstrated that burden of care is higher in neurological patients who developed spasticity than that of those without it, in particular regarding treatment costs, quality of life, caregiver burden, and the effects of comorbidities [21]. The treatment of muscle overactivity may be considered when the condition is disabling. Muscle overactivity usually impairs motor command, so this itself justifies the treatment. Moreover, independently from the aetiological context, it contributes to impair patient’s function [22]. Nevertheless, not all patients with muscle overactivity need a specific treatment. Treatment in spasticity should be carried out only after rigorous clinical analysis, in order to determine the severity of functional impairment. A multidisciplinary approach is necessary in order to obtain this specific assessment, being different according to patient’s clinical condition; it may include variably physician, physical therapist, occupational therapist, nurse, and/or caregiver [22]. In order to obtain an individual, task-oriented therapeutic strategy, it is necessary to analyse a list of personal measurable objectives, which may be different for each patient. The clinical follow-up is required in order to show the benefits as well as adverse events. Muscle spasticity, which usually is responsive to drug treatment, is not the only motor impairment in spastic paresis. It is necessary also that physiotherapy is associated to drug treatment, in order to obtain maximum gain in paresis. For example, stretch programmes can be used to treat soft tissue shortening. Therefore, before treatment, the following three questions must be answered:
Is muscle overactivity handicap an activity of daily living? Only after a detailed analysis of the functional impairment induced by spasticity, it is possible to carry out an appropriate treatment, which could be really effective to improve patient’s quality of life.
Is disability caused by muscle spasticity, or is it only a comorbidity? In the latter case, which components are involved? It is important to specify the quality of motor control and weakness. If motor impairment is induced or worsened by muscle overactivity, its treatment is to be considered mandatory, in order to be helpful to the patient [23].
Does muscle overactivity involve one specific muscle group, or does it spread to other? The correct therapeutic approach depends on the answer.
Pharmacological interventions for spasticity can be divided into two groups: those that act systemically and those that act locally [24] with the locally acting treatments tending to be more invasive, systemically acting drugs used as a first step [24]. If a systematic approach, which includes baclofen, tizanidine, or dantrolene, is not successful, local treatment is allowed [25], such as muscle botulinum toxin (BTX) injection or peripheral neurolytic blockade with alcohol or phenol [26]. Surgery is to be considered as the final treatment option; however, it is rarely used. If the principal aim is to inhibit neurotransmitter activity at one or more sites within the central nervous system, a systemic approach with specific drugs is to be evaluated. Targeted therapy could regard pre- or postsynaptic sites in spinal interneurons (at varying levels of the upper motor neuron pathway), alpha motor neurons, as well as primary sensory afferent neurons. So, the central nervous system is influenced by inhibitory effects of the neurotransmitters [27]. Oral administration needs high drug dose in order to cross the blood–brain barrier; therefore, side effects like dizziness could occur. In order to reduce the probability for these negative effects, it is possible to introduce some drugs directly into the cerebrospinal fluid, for example, by an intrathecal pump. For drugs used peripherally via injection directly to the nerve or muscle, systemic side effects are fewer.
2.2 Physical therapy
Physiotherapy is the basic treatment for all patients with spasticity [28, 29]. It may help limit muscle contractures and reduce overactivity for a short period. Physiotherapy together with drug treatment is fundamental to obtain the best functional gain, in order to help patients adapt to changes. In all cases, physiotherapy must be considered as complementary to drugs and surgery. In fact, stretching is considered an import goal in a physiotherapy session, as largely demonstrated [30]. Functional electrical stimulation allows spasticity reduction in antagonists of the stimulated muscles. An interesting use of electrical stimulation is the stimulation of hand and finger extensors during prehension training and mixing of overactive flexor inhibition with extensor activation [31]. Finally, it is important to educate patient in self-rehabilitation sessions comprehensive of stretching postures and active exercises, eventually assisted by caregivers and/or orthoses.
2.3 Oral drugs
Pharmacologic approaches emphasise oral drugs, neuromuscular blocks, and intrathecal agents. Usually, antispastic therapy is initiated with oral drugs, even though adverse side effects are frequently reported as a systematic effect [32]. Treatment decisions on specific pharmacologic approach are influenced by chronicity, severity, and localisation of spasticity. It was demonstrated that pharmacologic treatments are most effective if used early, in order to avoid muscle shortening and contracture development [33]. However, the time to treat is the first problem to resolve, in particular for drugs. Correctly, spasticity treatment is recommended when it induces a significant functional impairment, in particular regarding daily living activities, or clinical disability such as bad posture, motor capacity, or nursing. When spasticity is diffusely distributed above all in lower limbs, often observed as a consequence of spinal lesions, its treatment is firstly indicated, than in cerebral lesions.
The general goal of medical treatment is to decrease spinal reflex excitability by reducing the release of excitatory neurotransmitters or by potentiating the activity of inhibitory circuits. In clinical practice it is important to differentiate objectives in giving spasticity drugs. The technical objectives are focused to induce tone reduction, in order to increase range of motion or ameliorating joint position and promote rehabilitative procedures. Nevertheless, we also have functional therapeutic objectives regarding gait improvement, daily living activity, self-care, and spasm and pain reduction. When we evaluate the real effectiveness of different drug approaches, it is important to differentiate these therapeutic objectives. In order to achieve these therapeutic goals, most of the drugs currently used in spasticity influence the activity of the CNS neurotransmitters. Inhibitory neurotransmitters (GABA or glycine), as well as excitatory neurotransmitters (glutamate or the monoamines), are the main target. Diazepam, baclofen, tizanidine, and dantrolene represent the principal drugs more frequently used.
2.3.1 Diazepam
Diazepam, probably the first and oldest drug used in treating spasticity [34, 35], is a GABA-A receptor agonist. Its binding, to GABA-A receptors diffused in the brainstem and spinal cord, acts in increasing presynaptic inhibition. Consequently, reduction in the resistance to stretch is the principal clinical effect, showing an objectively increasing range of motion. Other clinical effects are also a reduction of deep tendon stretch reflexes and painful spasms [36]. Nevertheless, significant side effects are to be considered. The depressant effect of the drug on the CNS is the principal side effect, causing an influence on cognitive-level, consciousness status, leading to sedation, drowsiness, and attention or memory impairment. The same physiological mechanism explains weakness and motor discoordination caused by diazepam. Tolerance or dependency phenomena are often observed [37, 38]. Spasticity caused by spinal cord lesion, above all incomplete ones like in patients with multiple sclerosis (MS), is the principal indication to use diazepam, since the drug binding is mainly in the brainstem. Less literature are available for the use of diazepam in spasticity caused by cerebral accident, such as traumatic brain injuries, cerebral palsy, and stroke. In literature, a double-blind protocol is available showing the antispastic efficacy of diazepam, only in spinal cord lesions [39]. However, a possible strength and gait deterioration was also shown consistently in placebo-controlled studies.
2.3.2 Gabapentin
Gabapentin is approved as an antiepileptic drug. It is indicated also for postherpetic neuralgia treatment and as add-on therapy in partial seizures. GABA-B receptors are its target. Moreover, it is quietly safe. In a prospective, double-blind, placebo-controlled, crossover study, conducted on multiple sclerosis patients, a statistically significant reduction of spasticity was shown in gabapentin-treated patients compared to placebo [40]. The most efficient and safe dose range is still an open question. A dose range between 2700 and 3600 mg/day, as therapy for spasticity due to upper motor neuron syndrome, was found as efficient and safe. However, doses of 400 mg orally three times a day, in another double-blind, placebo-controlled crossover study, were shown to be effective in the treatment of spasticity and muscle painful cramps in patients with MS [41]. Nevertheless, considering the magnitude of the effect and the good tolerability of the drug, the evidence is on a weak recommendation for using gabapentin to reduce spasticity in MS [42].
2.3.3 Oral baclofen
Baclofen is another common drug diffusely used in spasticity. This drug is a GABA-B receptor agonist. Its physiological effect is a suppression of excitatory neurotransmitter release and, as a consequence, a potentiation of presynaptic inhibition. The main clinical effects are related mainly to the reduction in flexor-extensor spasms and mono- and polysynaptic reflexes. Obviously, related to its mechanism of action, this drug may induce dose-dependent side effects, quite similar to those seen with diazepam [43], although less frequent and less severe. However, sedation, confusion, dizziness, drowsiness, fatigue, and ataxia have been described as the common side effects observed in baclofen studies. Spasticity due to spinal cord lesions is the main indication to treat with baclofen. Unfortunately, in literature, there are very little studies focused on functional changes, so as a consequence, there is no evidence for effectiveness on functional activities such as gait, ambulation, or daily living activities. Moreover, also for oral baclofen, a weak recommendation for treatment of spasticity in MS has been shown [42]. It’s notable that there is no evidence of significant differences between diazepam, tizanidine, and oral baclofen, regarding therapeutic effects on spasticity [43, 44].
2.3.4 Tizanidine
Tizanidine, an imidazole derivative approved for the treatment of patients with spasticity [45], acts as an alpha-2 agonist, both in the spinal and supraspinal level. Presynaptic activity reduction of the excitatory interneurons represents the main physiological effect of this treatment. The coeruleo-spinal pathway, because of its involvement in the control of spinal cord activities, was shown as the main target in order to induce clinical effect during tizanidine treatment [46]. Consequently, reduction in tonic and stretch polysynaptic reflexes can be observed. Because of co-contraction reduction, which is observed, a possible effect on reciprocal inhibition is questionable. Possible side effects include sedation, dizziness, and dry mouth. Nevertheless, with respect to diazepam or baclofen, weakness is not reported as a great problem [47]. From the literature, the indications for its use are mainly in spasticity due to spinal cord lesions [48]. It has been particularly used in multiple sclerosis patients [49]. In spasticity caused by cerebral lesions, its efficacy is less well documented in literature. However, there are a certain number of reports regarding its antispastic efficacy, also in controlled studies vs. placebo. In the treatment of spasticity due to cerebral lesions, there are some evidences of its greater efficacy than diazepam [47]. However, there is very little information about the possible functional changes resulting from this treatment, i.e. quality of life and self-care. In fact, although it has been shown to have an antispastic effect, we do not know whether this will translate into long-term functional benefit for the patients. In clinical practice, tizanidine is usually well-tolerated. Drowsiness and dry mouth are the most common although are rare side effects. A range of 24–36 mg is normally the therapeutic dose (20% mean reduction in muscle tone), usually divided in three daily doses [50]. Like oral baclofen and diazepam, there is a consensus for a weak recommendation for the use of tizanidine [42].
2.3.5 Dantrolene
Among the oral dugs, dantrolene is the only one which acts outside the central nervous system [51]. It acts on the inhibition of calcium release from the sarcoplasmic reticulum, so, as a final effect, it reduces in muscle the excitation-coupling reaction between actin and myosin fibres. The documented clinical effects are a reduction of muscle tone and phasic reflexes, reduction of spasm, and an increased range of passive motion. Unfortunately, a frequent occurrence of side effects is described with this drug, such as gastrointestinal symptoms, weakness, and sedation although this is less than that seen with other treatments. Over all, a serious side effect with the use of dantrolene is hepatotoxicity, which occurs frequently [51]. In patients with spasticity due to cerebral lesions, dantrolene is the only drug with evidence of efficacy, so from a pure clinical point of view, this is very disappointing. In fact, dantrolene in approved in patients with stroke, cerebral palsy, traumatic brain injuries, and spinal cord lesions. As shown for baclofen, also for dantrolene, there are many evidences of efficacy and safety of its antispastic effect proven vs. placebo, but no studies focused on functional changes in activities of daily living. It’s notable that dantrolene is also used to prevent muscle stiffness and spasms caused by malignant hyperthermia (a rapid rise in body temperature and severe muscle contractions) that can occur during surgery with certain types of anaesthesia [52].
2.3.6 Cannabinoids
It is known, from many evidences, that the psychoactive ingredient in cannabis, delta-9-tetrahydrocannabinol (delta-9-THC), is able to treat muscle spasticity and pain. Two types of cannabinoid receptors can be described: CB1 and CB2. CB1s are located both in the central and peripheral neurons. CB1 and CB2 receptors are equally activated by delta-9-THC, a cannabinoid receptor agonist [53, 54]. On the contrary, cannabidiol, a natural cannabinoid, is inactive on the CB1 receptor. Some studies reported that cannabis extracts, containing approximately equal concentrations of delta-9-THC and cannabidiol administered through sublingual way, can significantly reduce spasticity. During the last years, several studies investigated and argued on the efficacy and safety of oral cannabinoid administration in MS patients as an add-on treatment for spasticity. A multicentre, double-blind, placebo-controlled trial showed that in MS spasticity treatment, cannabinoid may help to treat MS-related spasticity and pain [53]. However, according to the results from clinical trials, it is not allowed to use cannabinoids in MS as a general use. In a recent study, 630 MS patients affected by muscle spasticity were randomised to be treated with oral delta-9-THC, cannabis extract, or placebo for up to 12 months. The results showed a controversial effect; in fact, there was a small treatment effect on muscle spasticity and disability as functional independence measure, but patients’ sensation was that these drugs were helpful in treating their disease [54]. Adverse side effects are generally mild, in particular dry mouth, somnolence, dizziness, nausea, and rarely intoxication. However, there is a need of longer-term studies to evaluate other, well-known, adverse side effects of cannabinoid such as risks of lung cancer and other respiratory dysfunctions. A recent multicentre observational study confirmed the efficacy and safety of delta-9-THC in clinical practice, as an effective and safe option for patients with MS with moderate to severe spasticity resistant to common antispastic drugs [55]. In a recent consensus, a significant recommendation for the use of cannabinoids in spasticity emerged, particularly for oromucosal spray nabiximols, as treatment of spasticity in MS; the strength of the recommendation is strong [42].
2.4 Botulinum toxin
BTX type A is considered as the first-line treatment of multifocal muscle overactivity, thanks to its better efficacy and safety profile with respect to systemic approach with drugs. Different from baclofen or tizanidine, the efficacy of BTX type A has been demonstrated in self-care improvement (in particular for washing and dressing) and in active movements for the leg, with gait improvement if possible. Except for using kinematic analysis, no improvement was possibly shown in active movement or function in the upper limb. Pain was also reduced by BTX treatment as demonstrated in literature. Four forms of BTX are currently available in Europe: three type As (BOTOX®, Allergan; Dysport®, Ipsen-Pharma; Xeomin®, Merz) and one type B (Neurobloc®, Elan-Pharma). It is absolutely recommended to keep in mind that the units of these four toxins are different, being specific for each one. Injection sites are better detected, using electrical stimulation, as anatomical markers alone may induce to an inaccurate target. The use of ultrasound guidance, particularly in children, in identifying muscle site injection, is an interesting study object; however, this technique has not been evaluated with respect to electrical stimulation guidance for its efficiency. Generally, there are no immediate postinjection complications (except for a little pain as a side effect related to injection itself). Above all, during the first 3 weeks after each injection treatment, there would be a low risk of adverse events (swallowing disorders and botulism-like syndrome), so patients and caregivers must be warned as well as encouraged to eventually consult if necessary. The effects of treatment could be assessed 1–6 weeks after the injection, based on personalised goals decided before treatment. The effect of the toxin is not permanent, so repeated injections are often needed; nevertheless, a long-lasting effect is also observed. No repeated treatment is recommended without a specific assessment. When and if needed according to functional evaluation, a minimum delay of 2–3 months between injections must be respected, in order to reduce the risk of an immunologic reaction that may induce a permanent inefficacy of subsequent treatments. Each subsequent treatment should be planned after an accurate functional evaluation according to the pre-therapeutic identified goals and task, as well as tolerance. So, a review of the dose and treated muscles could be scheduled. If therapeutic effects continue to be evident, repeated injections can be planned [33, 56, 57, 58, 59, 60]. Physical therapy has to be considered after BOTOX injections. Regarding maximum doses, according to European Consensus, it should be considered:
It is notable that these dosages are identified relatively to acceptable side effects, in order to be safe. Moreover, each product could be effective with different doses for each patient, in terms of both efficacy and safety [61]. As well as the cannabinoid, there is a strong recommendation of the use of BTX to reduce muscle tone in spasticity do to multiple sclerosis [42].
2.5 Alcohol and phenol
Localised and loco-regional spasticity may effectively be treated by selective neurolysis. Coagulation and denaturing of proteins induced by phenol perineurally injected lead to cellular and axonal damage. Unfortunately, this chemical denervation is irreversible; moreover, the effects of phenol are not selective because also vascular and sensory structures can be destroyed [62]. In fact, the main recommendation choosing this approach is to identify preferably the nerves to be treated with a low sensory activity and a high motor predominance (i.e. obturator or musculocutaneous nerves, etc.). However, this focal treatment is usually not used as a first-line therapy, except in the case of particularly problematic overactivity affecting a big area under a single motor nerve control, for example, musculocutaneous nerve for biceps brachii muscle or obturator nerve for thigh adductor muscles. This may allow to use in the same patient BTX to treat other muscles, without the risk of an overdose. Electrical stimulation is used to identify a nerve, in order to perform injection on it. Firstly, a transient motor block may be a plan, in order to evaluate if chemical neurolysis might be significantly effective and safe. In fact, the efficacy and/or advantages eventually deriving from alcohol or phenol treatment could be evaluated before, in particular with respect to surgery (above all, tissue fibrosis induced by alcohol or phenol, which may hamper surgery approach). Advantages are the low cost and the long duration of effect. In clinical practice, 5–7% concentrations of phenol in aqueous solution are administered.
2.6 Intrathecal baclofen
Intrathecal baclofen (ITB) is a long-term treatment with continuous, intra-spinal administration via an implanted pump that reduces spasticity, especially in spinal injury patients and in multiple sclerosis [63, 64]. For this reason, ITB has become the first choice in intractable generalised spasticity, especially when oral administration fails to be effective. ITB efficacy in reducing spasticity was demonstrated by several studies [65]. Through direct infusion into the cerebrospinal fluid, the baclofen can be concentrated regionally, avoiding liver metabolism, so it is totally available for its therapeutic effects. In fact, with respect to oral baclofen administration, the ITB, bypassing the blood–brain barrier entirely, needs much lower dose in order to obtain the same CSF concentrations; it has been determined that the ITB dose is 100–1000 times smaller than the oral daily dose. Depending on the pump model, it is possible to modify infusion rate, according to the patient’s needs. In several studies ITB was shown as safe and effective in reducing spasticity. The complication rate was found to be low, and the efficacy was maintained over time [64]. A reduction in the Ashworth scale from 3 to 4 to 1 after ITB implantation was reported in several studies. Also spasm frequency significantly decreased. Some activities of daily living, in particular the ability to sit in a wheelchair and nursing care, improved after ITB implant. In some cases, authors showed that patients with less severe disability experienced an improvement in the ability to transfer, thanks to ITB effect [66]. Side effects, such as vertigo, nausea, nystagmus, dysmetria, mouth dryness, headache, amnesia, bladder, and sexual dysfunction, have been described in about 4% of patients and mainly are not life-threatening. As a red flag, it is notable that concerning gastrointestinal function, ITB could affect peristalsis, which could be severely slowed down to paralytic ileus. Nevertheless, constipation has previously been reported as an infrequent ITB-induced adverse effect, ranging from 3 to 10% of treated patients [67], rarely leading to death [68]. Therefore, recognition of constipation in patients treated with ITB is very important, not only because constipation is a possible side effect, being reported in some study, but also because it may be also a life-threatening complication. ITB has been used in patients with leg diffuse muscle overactivity. This type of treatment should be used above all in patients, in which muscle overactivity impaired posture, nursing, and personal independence or causes pain [63]. Several assessments are required before planning a definite pump implantation, performing drug test injection via lumbar puncture or via a temporary access device. Efficacy may be evaluated during the following 3–4 h. The first test dose is usually recommended up to 50 μg in adults, picking up gradually to a maximum dose of 150 μg, eventually reached after 3 days. A risk of overdose should be always evaluated, in particular regarding the effects on consciousness level and respiratory disorders. So, a specialised medical team is needed in order to monitor patient after and during the 4 h following the test. Only after the end of this test, if the treatment has been well-tolerated and effective, the team may make the decision to implant the pump. It is important to monitor the patient during the entire follow-up period, in order to prevent and/or detect collateral effects related to the procedure (displacement and/or obstruction of the catheter, infection, etc.), which may induce a serious withdrawal syndrome. ITB is often recommended for the treatment of spasticity, with a strong evidence of efficacy [42].
2.7 Surgery
Surgery may play an important role in the treatment of chronic muscle overactivity or for the after-effects induced by spasticity that become functional impairments (e.g. irreducible equinovarus foot), but it is not the first-line treatment. Because of its potential adverse events and its definite effects, surgical techniques should be reserved only in selected patients in order to reach different goals: hygiene, standing, transferring, walking, and the use of assistive devices. It involves neurosurgery and orthopaedic surgery. Surgical procedures may include one or more of the techniques described below. Peripheral neurotomy may include partial or segmental resection of a motor nerve, involving spastic muscles. In order to balance agonists and antagonists overlapping the muscle activity, a selective peripheral neurotomy is recommended to maintain a “functional” muscle tone. Collateral branches of the posterior tibial nerves and obturator nerves are commonly the main targets for the legs (e.g. ankle clonus, equinus, inversion of the foot). For the arms, neurotomy of the musculocutaneous, median, and ulnar nerves showed good results regarding efficacy and safety [69]. Other surgery techniques, such as rhizotomies, although used, have potential collateral effects and complications [70]. Musculoskeletal surgery, performed on the muscle or the tendon itself, aims to treat spasticity consequences, such as contracture and joint deformities. Tendon transfers (e.g. tibialis anterior) and lengthening are conservative treatments commonly proposed [69]. Tenotomy may be considered in the case of muscle contracture without active functional objectives [69]. Hip displacements and foot deformities induced by severe spasticity may be sometimes treated with osteotomies [69]. Arthrodesis may be the only solution to stabilise joints, notably ankle and foot joints in case of severe paresis associated with strong muscle overactivity and hypoesthesia [69].
3. Treatment options of dystonia
3.1 Indications of treatment
Treatment options of the management of dystonia include pharmacological therapies, injections, and surgical interventions. The main pharmacological therapies are anticholinergics (particularly trihexyphenidyl), baclofen, benzodiazepines (particularly clonazepam), and dopamine-related medications. However, medical therapy in dystonia is largely empiric and at times may seem anecdotal. Three main neurotransmitter systems are involved: cholinergic generally acting as antagonist at postsynaptic M1 receptor, GABAergic-like baclofen, and dopaminergic systems. Dopaminergic treatments can be divided into two: levodopa and dopamine reducing medications like presynaptic dopamine depleters such as tetrabenazine and postsynaptic dopamine-blocking agents, such as clozapine or neuroleptics. The therapeutic strategy, carried out by Fahn [71], is to “start low and go slow”: medications should be started at a low dose and upped slowly to the lowest effective dose, in order to reduce symptoms without side effects. The rate of titration may depend on age: every 3–4 days in children, compared to every 1 week in adults. A combination approach is used when monotherapy achieves a “good” dose, but symptom control is incomplete. The question is which medications should be started first?
3.2 Cholinergic system agents
In 1952, beneficial effects of trihexyphenidyl in writer’s cramp and “dystonia musculorum deformans” were first reported [72, 73]. The first open-label study of high-dose anticholinergics in dystonia using trihexyphenidyl and ethopropazine was conducted by Fahn [71]. Various forms of dystonia, both “primary and secondary,” can be treated with anticholinergics, except for tardive dystonia and Meige syndrome. Studies showed a good effect in 61% of the children and 38% of the adults, with mean trihexyphenidyl doses of 41 and 24 mg, respectively. More benefit was demonstrated in children, possibly due to better tolerability, and in patients who received treatment earlier, within 5 years of disease onset [74]. Several studies have demonstrated that anticholinergic drugs may be useful to treat various forms of dystonia including focal [75], cranial [76], and secondary dystonia including dystonia in cerebral palsy [74], after ischemic stroke [77], and in tardive dystonia [78]. Side effects can be divided into central ones, which include sedation, cognitive slowing, confusion, memory impairment, psychosis and chorea, and autonomic side effects, which include blurred vision, due to mydriasis, dry mouth, urinary retention, and constipation.
3.3 GABAergic system agents
Baclofen was reported to be useful in tardive dystonia [79]. Just in 1988, Greene published a retrospective open-label study, showing that 20% of 108 patients had benefits from baclofen at a mean daily dose of 82 mg [80]. Later, Greene and Fahn also reported beneficial effects of baclofen in 7 of 16 patients with idiopathic childhood dystonia [81]. ITB was tried initially for spasticity and later in dystonia [82]. In 1991 Narayan and colleagues showed the efficacy of ITB in axial dystonia not responding to other drugs [83] and subsequently in dystonic cerebral palsy with lower extremity involvement [84]. Albright reported the use of intraventricular baclofen in two patients with dystonic cerebral palsy, one of whom previously failed ITB therapy and the other has a complex spinal anatomy precluding the intrathecal procedure [85]. Nevertheless, baclofen is generally considered as a second-line agent, due to its significant side effects like drowsiness, dizziness, fatigue, and nausea. Regarding benzodiazepines, diazepam therapy was described in “dystonia musculorum deformans progressiva” and spasmodic torticollis [86]. In 1988, the benefit of clonazepam was shown by Greene in 16% of 115 patients with dystonia, also including secondary dystonia [80]. Also in acquired hemidystonia, as shown in a report of 33 patients, clonazepam and diazepam were found to be the most effective drugs. Clonazepam and diazepam are the two most commonly used drugs, partly due to their relatively long half-lives. The side effects of benzodiazepines include sedation, depression, nocturnal drooling, and behavioural disinhibition. Benzodiazepines are considered a second- or third-line agent.
3.4 Dopaminergic system agents
In 1976 Segawa firstly used levodopa as a treatment in dystonia, showing a dramatic response to low-dose levodopa in two patients affected by “hereditary progressive dystonia with marked diurnal fluctuations” [87], later named Segawa syndrome. In dystonia therapy, levodopa is used (1) as an aetiology-specific treatment in dopa responder dystonia and (2) as a symptomatic therapy in other forms of dystonia where the dramatic response to levodopa is unfortunately not replicated. Levodopa may also be used to treat dystonia symptoms which may complicate a parkinsonian syndrome [88]. In clinical practice, levodopa or dopamine agonists are rarely used to treat dystonia symptomatically. The side effects of levodopa include nausea, orthostatic hypotension, and psychosis. In 1972, Swash reported only a slight benefit of tetrabenazine in spasmodic torticollis [89]. In 1982, a double-blind crossover trial by Jankovic demonstrated an improvement in 11 of 12 patients [90]. Tetrabenazine has been used in various forms of dystonia; however, benefits are greater in tardive dystonia than that of the other forms [91]. Tetrabenazine is rarely used as a first-line agent, except in tardive dystonia [92].
4. Conclusions
Spasticity and dystonia syndromes and their consequences negatively impact the quality of life of patients, so management of symptoms represents an important care issue. The best choice of antispastic treatments depends not only on the level of spasticity but also on the outcome achievable, according to a task-oriented rehabilitation programme. In this respect, it is important to underline the importance of the individualised rehabilitative project, which can be carried out only through a multidisciplinary approach, in which all available options must be targeted to the real needs of the patients, keeping into account that the final goal is the reduction of disability and improvement of the quality of life. With advances in diagnosis and treatment, therapeutic strategies for the management of spasticity and dystonia symptoms, including pharmacological treatments, have evolved. Progresses in other areas such as BTX, neuromodulation, and disease-specific treatment have changed the way patients are treated. Nevertheless, dystonia remains a challenging field in both diagnostic and therapeutic aspects. Further understanding of its pathophysiology may shed light on more specific therapies. In conclusion, the management of spasticity and dystonia may include a proper diagnosis and classification with an evaluation of the aetiology underlying the pathological features and a clinical assessment of the functional impairment. For both conditions, therapeutic approaches, usually limited to symptomatic therapy, must then be tailored to the individual needs of the patient.
Conflict of interest
Vincenzo Cimino has received grants for congress participation from Biogen Idec, Merck Serono, Novartis, Roche, Sanofi Genzyme, and TEVA.
Clara Grazia Chisari has received grants for congress participation from Almirall, Biogen Idec, Merck Serono, Novartis, Roche, Sanofi Genzyme, and TEVA.
Francesco Patti has received honoraria for speaking activities by Almirall, Bayer Schering, Biogen Idec, Merck Serono, Novartis, Roche, Sanofi Genzyme, and TEVA; he also served as an advisory board member of the following companies: Bayer Schering, Biogen Idec, Merck Serono, Novartis, Roche, Sanofi Genzyme, and TEVA; he was also funded by Pfizer and FISM for epidemiological studies; he received grants for congress participation from Almirall, Bayer Schering, Biogen Idec, Merck Serono, Novartis, Roche, Sanofi Genzyme, and TEVA.
\n',keywords:"spasticity, dystonia, treatments, oral drugs, rehabilitation",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/71472.pdf",chapterXML:"https://mts.intechopen.com/source/xml/71472.xml",downloadPdfUrl:"/chapter/pdf-download/71472",previewPdfUrl:"/chapter/pdf-preview/71472",totalDownloads:260,totalViews:0,totalCrossrefCites:0,dateSubmitted:"September 11th 2019",dateReviewed:"February 17th 2020",datePrePublished:"September 11th 2020",datePublished:"September 30th 2020",dateFinished:null,readingETA:"0",abstract:"Spasticity and dystonia are two neurological conditions with a broad range of clinical manifestations that can emerge at any age. Although the spasticity and dystonia symptoms are caused by different pathophysiological mechanisms, both of them may cause functional impairment that contributes to a poor quality of life. Spasticity is characterised by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. It mostly occurs in disorders of the central nervous system (CNS) affecting the upper motor neurons, such as multiple sclerosis, amyotrophic lateral sclerosis, cerebrovascular diseases, cerebral palsy, traumatic brain injury, stroke, and spinal cord injury. Therapeutic options may combine, in various proportions, physical therapy, occupational therapy, self-rehabilitation, the use of orthoses and assistive devices, drug treatment, orthopaedic surgery, and neurosurgery. Dystonia is defined as a syndrome of involuntary movement that manifests as excessive muscle contractions that frequently cause twisting and repetitive movements or abnormal postures. It is often intensified or exacerbated by physical activity, and symptoms may progress into adjacent muscles. Dystonia has many different manifestations and causes, and many different treatment options are available. These options include physical and occupational therapy, oral medications, intramuscular injection of botulinum toxins, and neurosurgical interventions.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/71472",risUrl:"/chapter/ris/71472",signatures:"Vincenzo Cimino, Clara Grazia Chisari and Francesco Patti",book:{id:"8059",title:"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice",subtitle:null,fullTitle:"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice",slug:"neurostimulation-and-neuromodulation-in-contemporary-therapeutic-practice",publishedDate:"September 30th 2020",bookSignature:"Denis Larrivee and Seyed Mansoor Rayegani",coverURL:"https://cdn.intechopen.com/books/images_new/8059.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"206412",title:"Prof.",name:"Denis",middleName:null,surname:"Larrivee",slug:"denis-larrivee",fullName:"Denis Larrivee"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"311811",title:"Dr.",name:"Francesco",middleName:null,surname:"Patti",fullName:"Francesco Patti",slug:"francesco-patti",email:"fpatti@outlook.com",position:null,institution:{name:"University of Catania",institutionURL:null,country:{name:"Italy"}}},{id:"315142",title:"Dr.",name:"Vincenzo",middleName:null,surname:"Cimino",fullName:"Vincenzo Cimino",slug:"vincenzo-cimino",email:"vincenzo.cimino@irccsme.it",position:null,institution:{name:"Centro Neurolesi Bonino Pulejo",institutionURL:null,country:{name:"Italy"}}},{id:"315143",title:"Dr.",name:"Clara Grazia",middleName:null,surname:"Chisari",fullName:"Clara Grazia Chisari",slug:"clara-grazia-chisari",email:"clarachisari@yahoo.it",position:null,institution:{name:"University of Catania",institutionURL:null,country:{name:"Italy"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_1_2",title:"1.1 Pathophysiology of spasticity and dystonia syndromes",level:"2"},{id:"sec_2_2",title:"1.2 Spasticity",level:"2"},{id:"sec_3_2",title:"1.3 Spastic dystonia",level:"2"},{id:"sec_4_2",title:"1.4 Spastic co-contraction",level:"2"},{id:"sec_5_2",title:"1.5 Clinical evaluation",level:"2"},{id:"sec_5_3",title:"1.5.1 Passive range of motion",level:"3"},{id:"sec_6_3",title:"1.5.2 Angle of catch or clonus and spasticity grade",level:"3"},{id:"sec_7_3",title:"1.5.3 Active range of motion",level:"3"},{id:"sec_8_3",title:"1.5.4 Outcome measure",level:"3"},{id:"sec_11",title:"2. Treatment options of spasticity",level:"1"},{id:"sec_11_2",title:"2.1 Indications for treatment",level:"2"},{id:"sec_12_2",title:"2.2 Physical therapy",level:"2"},{id:"sec_13_2",title:"2.3 Oral drugs",level:"2"},{id:"sec_13_3",title:"2.3.1 Diazepam",level:"3"},{id:"sec_14_3",title:"2.3.2 Gabapentin",level:"3"},{id:"sec_15_3",title:"2.3.3 Oral baclofen",level:"3"},{id:"sec_16_3",title:"2.3.4 Tizanidine",level:"3"},{id:"sec_17_3",title:"2.3.5 Dantrolene",level:"3"},{id:"sec_18_3",title:"2.3.6 Cannabinoids",level:"3"},{id:"sec_20_2",title:"2.4 Botulinum toxin",level:"2"},{id:"sec_21_2",title:"2.5 Alcohol and phenol",level:"2"},{id:"sec_22_2",title:"2.6 Intrathecal baclofen",level:"2"},{id:"sec_23_2",title:"2.7 Surgery",level:"2"},{id:"sec_25",title:"3. Treatment options of dystonia",level:"1"},{id:"sec_25_2",title:"3.1 Indications of treatment",level:"2"},{id:"sec_26_2",title:"3.2 Cholinergic system agents",level:"2"},{id:"sec_27_2",title:"3.3 GABAergic system agents",level:"2"},{id:"sec_28_2",title:"3.4 Dopaminergic system agents",level:"2"},{id:"sec_30",title:"4. Conclusions",level:"1"},{id:"sec_34",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'[Lance JW. Symposium synopsis. In: Feldman RG, Young RR, Koella WP, editors. Spasticity: Disordered Motor Control. Chicago: Year Book Medical; 1980. pp. 485-494]'},{id:"B2",body:'[Cramer SC. Editorial comment – Spasticity after stroke: What’s the catch? Stroke. 2004;35:139-140]'},{id:"B3",body:'[Levin MF. On the nature and measurement of spasticity. Clinical Neurophysiology. 2005;116:1754-1755]'},{id:"B4",body:'[Sunnerhagen KS. Stop using the Ashworth scale for the assessment of spasticity. Journal of Neurology, Neurosurgery, and Psychiatry. 2010;81:2]'},{id:"B5",body:'[Lorentzen J, Grey MJ, Crone C, Mazevet D, Biering-Sorensen F, Nielsen JB. Distinguishing active from passive components of ankle plantar flexor stiffness in stroke, spinal cord injury and multiple sclerosis. Clinical Neurophysiology. 2010;121(11):1939-1951]'},{id:"B6",body:'[Gracies JM. Pathophysiology of spastic paresis. I: Paresis and soft tissue changes. Muscle & Nerve. 2005;31:535-551]'},{id:"B7",body:'[Pandyan AD, Gregoric M, Barnes MP, Wood D, van WF WF, Burridge J, et al. Spasticity: Clinical perceptions, neurological realities and meaningful measurement. Disability and Rehabilitation. 2005;27:2-6]'},{id:"B8",body:'[Sheean G, McGuire JR. Spastic hypertonia and movement disorders: Pathophysiology, clinical presentation, and quantification. The Journal of Injury, Function and Rehabilitation. 2009;1:827-833]'},{id:"B9",body:'[Sheean G. The pathophysiology of spasticity. European Journal of Neurology. 2002;3-9(Suppl 1):53-61]'},{id:"B10",body:'[Gracies JM, Fitzpatrick R, Wilson L, Burke D, Gandevia SC. Lycra garments designed for patients with upper limb spasticity: Mechanical effects in normal subjects. Archives of Physical Medicine and Rehabilitation. 1997;78(10):1066-1071]'},{id:"B11",body:'[Albanese A, Bhatia K, Bressman SB, et al. Phenomenology and classification of dystonia: A consensus update. Movement Disorders. 2013;28:863]'},{id:"B12",body:'[Goldman JG. Writer’s cramp. Toxicon. 2015;107(Pt A):98-104]'},{id:"B13",body:'[Mayer NH. Clinicophysiologic concepts of spasticity and motor dysfunction in adults with an upper motoneuron lesion. Muscle & Nerve. Supplement. 1997;6:S1-S13]'},{id:"B14",body:'[Mayer NH, Esquenazi A. Muscle overactivity and movement dysfunction in the upper motoneuron syndrome. Physical Medicine and Rehabilitation Clinics of North America. 2003;14(4):855-883]'},{id:"B15",body:'[Lorentzen J, Pradines M, Gracies JM, Bo NJ. On Denny-Brown’s ‘spasticdystonia’-what is it and what causes it? Clinical Neurophysiology. 2018;129(1):89-94]'},{id:"B16",body:'[Marinelli L, Currà A, Trompetto C, Capello E, Serrati C, Fattapposta F, et al. Spasticity and spastic dystonia: The two faces of velocity-dependent hypertonia. Journal of Electromyography and Kinesiology. 2017;37:84-89]'},{id:"B17",body:'[Bethoux F. Spasticity management after stroke. Physical Medicine and Rehabilitation Clinics of North America. 2015;26(4):625-639]'},{id:"B18",body:'[Morris SL, Williams G. A historical review of the evolution of the Tardieu scale. Brain Injury. 2018;32(5):665-669]'},{id:"B19",body:'[Ansari NN, Naghdi S, Hasson S, Azarsa MH, Azarnia S. The modified Tardieu scale for the measurement of elbow flexor spasticity in adult patients with hemiplegia. Brain Injury. 2008;22(13-14):1007-1012]'},{id:"B20",body:'[Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy. 1987;67(2):206-207]'},{id:"B21",body:'[Esquenazi A. The human and economic burden of poststroke spasticity and muscle overactivity. Journal of Clinical Outcomes Management. 2011;18(1):34-44]'},{id:"B22",body:'[Barnes MP. Management of spasticity. Age and Ageing. 1998;27(2):239-245]'},{id:"B23",body:'[Sheean G. Botulinum toxin treatment of adult spasticity: A benefit-risk assessment. Drug Safety. 2006;29(1):31-48]'},{id:"B24",body:'[Gormley ME, O’Brien CF, Yablon SA. A clinical overview of treatment decisions in the management of spasticity. Muscle and Nerve. Supplement. 1997;20(S6):S14-S20]'},{id:"B25",body:'[Bogey RA, Geis CC, Bryant PR, Moroz A, O’Neill BJ. Stroke and neurodegenerative disorders. 3. Stroke: Rehabilitation management. Archives of Physical Medicine and Rehabilitation. 2004;85(3):S15-S20. S34-S40]'},{id:"B26",body:'[Kocabas H, Salli A, Demir AH, Ozerbil OM. Comparison of phenol and alcohol neurolysis of tibial nerve motor branches to the gastrocnemius muscle for treatment of spastic foot after stroke: A randomized controlled pilot study. European Journal of Physical and Rehabilitation Medicine. 2010;46(1):5-10]'},{id:"B27",body:'[Gracies JM, Nance P, Elovic E, McGuire J, Simpson DM. Traditional pharmacological treatments for spasticity. Part II: General and regional treatments. Muscle & Nerve. 1997;20(S6):S92-S120]'},{id:"B28",body:'[Yelnik AP, Simon O, Parratte B, Gracies JM. How to clinically assess and treat muscle overactivity in spastic paresis. Journal of Rehabilitation Medicine. 2010;42:801-807]'},{id:"B29",body:'[Watanabe T. The role of therapy in spasticity management. American Journal of Physical Medicine & Rehabilitation. 2004;83:s45-s49]'},{id:"B30",body:'[Veerbeek JM, van Wegen E, van Peppen R, van der Wees PJ, Hendriks E, Rietberg M, et al. What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PLoS One. 2014;9:e87987]'},{id:"B31",body:'[He YL, Gao Y, Fan BY. Effectiveness of neuromuscular electrical stimulation combined with rehabilitation training for treatment of post-stroke limb spasticity. Medicine (Baltimore). 2019;98(39):e17261]'},{id:"B32",body:'[Pappalardo A, Castiglione A, Restivo DA, Calabrese A, Cimino V, Patti F. Pharmacologic management of spasticity in multiple sclerosis. Neurological Sciences. 2006;27:S310-S315]'},{id:"B33",body:'[Ks S, Olver J, Francisco GE. Assessing and treating functional impairment in poststroke spasticity. Neurology. 2013;80:s35-s44]'},{id:"B34",body:'[DeJak JJ, Lowry R. Use of diazepam (valium) for spasticity in spinal cord injury. Proceedings of Annual Clinical Spinal Cord Injury Conference. 1964;13:78-81]'},{id:"B35",body:'[Simpson CA. Use of diazepam for the relief of spasticity in multiple sclerosis. Annals of Physical Medicine. 1964;(Suppl):39-40]'},{id:"B36",body:'[Verrier M, Ashby P, MacLeod S. Diazepam effect on reflex activity in patients with complete spinal lesions and in those with other causes of spasticity. Archives of Physical Medicine and Rehabilitation. 1977;58(4):148-153]'},{id:"B37",body:'[Waldman HJ. Centrally acting skeletal muscle relaxants and associated drugs. Journal of Pain and Symptom Management. 1994;9(7):434-441]'},{id:"B38",body:'[Broderick CP, Radnitz CL, Bauman WA. Diazepam usage in veterans with spinal cord injury. The Journal of Spinal Cord Medicine. 1997;20(4):406-409]'},{id:"B39",body:'[Corbett M, Frankel HL, Michaelis L. A double blind, cross-over trial of valium in the treatment of spasticity. Paraplegia. 1972;10(1):19-22]'},{id:"B40",body:'[Cutter NC, Scott DD, Johnson JC, Whiteneck G. Gabapentin effect on spasticity in multiple sclerosis: A placebo-controlled, randomized trial. Archives of Physical Medicine and Rehabilitation. 2000;81:164-169]'},{id:"B41",body:'[Formica A, Verger K, Sol JM, Morralla C. Gabapentin for spasticity: A randomized, double-blind, placebo-controlled trial. Medicina Clínica (Barcelona). 2005;124:81-85]'},{id:"B42",body:'[Comi G, Solari A, Leocani L, Centonze D, Otero-Romero S. Italian consensus group on treatment of spasticity in multiple sclerosis. Italian consensus on treatment of spasticity in multiple sclerosis. European Journal of Neurology. 2019;25:445-453]'},{id:"B43",body:'[Cartlidge NE, Hudgson P, Weightman D. A comparison of baclofen and diazepam in the treatment of spasticity. Journal of the Neurological Sciences. 1974;23(1):17-24]'},{id:"B44",body:'[From A, Heltberg A. A double-blind trial with baclofen (Lioresal) and diazepam in spasticity due to multiple sclerosis. Acta Neurologica Scandinavica. 1975;51:158-166]'},{id:"B45",body:'[Bes A, Eyssette M, Pierrot-Deseilligny E, Rohmer F, Warter JM. A multi-Centre, double-blind trial of tizanidine, a new antispastic agent, in spasticity associated with hemiplegia. Current Medical Research and Opinion. 1988;10(10):709-718]'},{id:"B46",body:'[Coward DM. Tizanidine: neuropharmacology and mechanism of action. Neurology. 1994;44(11 Suppl 9):S6-S10]'},{id:"B47",body:'[Groves L, Shellenberger MK, Davis CS. Tizanidine treatment of spasticity: A meta-analysis of controlled, double-blind, comparative studies with baclofen and diazepam. Advances in Therapy. 1998;15(4):241-251]'},{id:"B48",body:'[Nance PW, Bugaresti J, Shellenberger K, Sheremata W, Martinez-Arizala A. Efficacy and safety of tizanidine in the treatment of spasticity in patients with spinal cord injury. North American Tizanidine Study Group. Neurology. 1994;44(11 Suppl 9):S44-S51. Discussion S51-S52]'},{id:"B49",body:'[Nance PW, Sheremata WA, Lynch SG, Vollmer T, Hudson S, Francis GS, et al. Relationship of the antispasticity effect of tizanidine to plasma concentration in patients with multiple sclerosis. Archives of Neurology. 1997;54(6):731-736]'},{id:"B50",body:'[Shakespeare DT, Boggild M, Young C. Anti-spasticity agents for multiple sclerosis. Cochrane Database of Systematic Reviews. 2003;4:CD001332]'},{id:"B51",body:'[Pinder RM, Brogden RN, Speight TM, Avery GS. Dantrolene sodium: A review of its pharmacological properties and therapeutic efficacy in spasticity. Drugs. 1977;13(1):3-23]'},{id:"B52",body:'[Krause T, Gerbershagen MU, Fiege M, Weisshorn R, Wappler F. Dantrolene—A review of its pharmacology, therapeutic use and new developments. Anaesthesia. 2004;59(4):364-373]'},{id:"B53",body:'[Vaney C, Heinzel-Gutenbrunner M, Jobin P, et al. Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: A randomized, double-blind, placebo-controlled, crossover study. Multiple Sclerosis. 2004;10:339-340]'},{id:"B54",body:'[Zajicek JP, Sanders HP, Wright DE, et al. Cannabinoids in multiple sclerosis (CAMS) study: Safety and efficacy data for 12 months follow up. Journal of Neurology, Neurosurgery, and Psychiatry. 2005;76:1664-1669]'},{id:"B55",body:'[Patti F, Messina S, Solaro C, Amato MP, Bergamaschi R, Bonavita S, et al. Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity. Journal of Neurology, Neurosurgery, and Psychiatry. 2016;87(9):944-951]'},{id:"B56",body:'[Turner-Stokes L, Ward A. Botulinum toxin in the management of spasticity in adults. Clinical Medicine. 2002;2:128-130]'},{id:"B57",body:'[Suputtitada A, Suwanwela NC. the lowest effective dose of botulinum a toxin in adult patients with upper limb spasticity. Disability and Rehabilitation. 2005;27:176-184]'},{id:"B58",body:'[Gracies JM, Brashear A, Jech R, Mcallister P, Banach M, Valkovic P, et al. Safety and efficacy of abobotulinumtoxinA for hemiparesis in adults with upper limb spasticity after stroke or traumatic brain injury: A double-blind randomised controlled trial. Lancet Neurology. 2015;14:992-1001]'},{id:"B59",body:'[Turner-Stokes L, Fhedoroff K, Jacinto J, Maisonobe P. Results from the upper limb international spasticity study-II (ULIS-II): A large, international, prospective cohort study investigating practice and goal attainment following treatment with botulinum toxin A in real-life clinical management. BMJ Open. 2013;3:e002771]'},{id:"B60",body:'[Esquenazi A, Moon D, Wikoff A, Sale P. Hemiparetic gait and changes in functional performance due to OnabotulinumtoxinA injection to lower limb muscles. Toxicon. 2015;107:109-113]'},{id:"B61",body:'[Wissel J, Ward AB, Erztgaard P, Bensmail D, Hecht MJ, Lejeune TM, et al. European consensus table on the use of botulinum toxin type a in adult spasticity. Journal of Rehabilitation Medicine. 2009;41(1):13-25]'},{id:"B62",body:'[Carda S, Molteni F. Selective neuromuscular blocks and chemoneurolysis in the localized treatment of spasticity. European Journal of Medical Physics. 2004;40:123-130]'},{id:"B63",body:'[Penn RD, Savoy SM, Corcos D, et al. Intrathecal baclofen for severe spinal spasticity. The New England Journal of Medicine. 1989;320:1517-1521]'},{id:"B64",body:'[Middel B, Kuipers-Upmeijer H, Bouma J, et al. Effect of intrathecal baclofen delivered by an implanted programmable pump on health related quality of life in patients with severe spasticity. Journal of Neurology, Neurosurgery, and Psychiatry. 1997;63:204-209]'},{id:"B65",body:'[Coffey RJ, Cahill D, Steers W, et al. Intrathecal baclofen for intractable spasticity of spinal origin: Results of a long-term multicentre study. Journal of Neurosurgery. 1993;78:226-232]'},{id:"B66",body:'[Ben Smail D, Peskine A, Roche N, et al. Intrathecal baclofen for treatment of spasticity of multiple sclerosis patients. Multiple Sclerosis. 2006;12:101-103]'},{id:"B67",body:'[Kofler M, Matzak H, Saltuari L. The impact of intrathecal baclofen on gastrointestinal function. Brain Injury. 2002;16:825-836]'},{id:"B68",body:'[Patti F, Pappalardo A, Lo Fermo S, Cimino V, Castiglione A, Zappia M. Life-threatening constipation induced by intrathecal baclofen therapy. European Neurology. 2008;60(2):95-96]'},{id:"B69",body:'[Chambers HG. The surgical treatment of spasticity. Muscle and Nerve. Supplement. 1997;6:S121-S128]'},{id:"B70",body:'[Farmer JP, Sabbagh AJ. Selective dorsal rhizotomies in the treatment of spasticity related to cerebral palsy. Child’s Nervous System. 2007;23:991-1002]'},{id:"B71",body:'[Fahn S. High dosage anticholinergic therapy in dystonia. Neurology. 1983;33:1255-1261]'},{id:"B72",body:'[Ravina A. A case of writer’s cramp cured by trihexyphenidyl. Bulletins et Mémoires de la Société Médicale des Hôpitaux de Paris. 1952;68:581-582]'},{id:"B73",body:'[Corner BD. Dystonia musculorum deformans in siblings; treated with artane (trihexyphenidyl). Proceedings of the Royal Society of Medicine. 1952;45:451-452]'},{id:"B74",body:'[Burke RE, Fahn S, Marsden CD. Torsion dystonia: A double-blind, prospective trial of high-dosage trihexyphenidyl. Neurology. 1986;36:160-164]'},{id:"B75",body:'[Lang AE, Sheehy MP, Marsden CD. Anticholinergics in adult-onset focal dystonia. The Canadian Journal of Neurological Sciences. 1982;9:313-319]'},{id:"B76",body:'[Nutt JG, Hammerstad JP, de Garmo P, Carter J. Cranial dystonia: Double-blind crossover study of anticholinergics. Neurology. 1984;34:215-217]'},{id:"B77",body:'[Vogels OJ, Maassen B, Rotteveel JJ, Merx JL. Focal dystonia and speech impairment responding to anticholinergic therapy. Pediatric Neurology. 1994;11:346-348]'},{id:"B78",body:'[Kang UJ, Burke RE, Fahn S. Natural history and treatment of tardive dystonia. Movement Disorders. 1986;1:193-208]'},{id:"B79",body:'[Rosse RB, Allen A, Lux WE. Baclofen treatment in a patient with tardive dystonia. The Journal of Clinical Psychiatry. 1986;47:474-475]'},{id:"B80",body:'[Greene P, Shale H, Fahn S. Analysis of open-label trials in torsion dystonia using high dosages of anticholinergics and other drugs. Movement Disorders. 1988;3:46-60]'},{id:"B81",body:'[Greene PE, Fahn S. Baclofen in the treatment of idiopathic dystonia in children. Movement Disorders. 1992;7:48-52]'},{id:"B82",body:'[Bonouvrie L, Becher J, Soudant D, Buizer A, van Ouwerkerk W, Vles G, et al. The effect of intrathecal baclofen treatment on activities of daily life in children and young adults with cerebral palsy and progressive neurological disorders. European Journal of Paediatric Neurology. 2016;20:538-544]'},{id:"B83",body:'[Narayan RK, Loubser PG, Jankovic J, Donovan WH, Bontke CF. Intrathecal baclofen for intractable axial dystonia. Neurology. 1991;41:1141-1142]'},{id:"B84",body:'[Butler C, Campbell S. Evidence of the effects of intrathecal baclofen for spastic and dystonic cerebral palsy. AACPDM treatment outcomes committee review panel. Developmental Medicine and Child Neurology. 2000;42:634-645]'},{id:"B85",body:'[Albright AL. Intraventricular baclofen infusion for dystonia. Report of two cases. Journal of Neurosurgery. 2006;105:71-74]'},{id:"B86",body:'[Bianchine JR, Bianchine JW. Treatment of spasmodic torticollis with diazepam. Southern Medical Journal. 1971;64:893-894]'},{id:"B87",body:'[Segawa M, Hosaka A, Miyagawa F, Nomura Y, Imai H. Hereditary progressive dystonia with marked diurnal fluctuation. Advances in Neurology. 1976;14:215-233]'},{id:"B88",body:'[Termsarasab P, Yang AC, Frucht SJ. Intermediate phenotypes of ATP1A3 mutations: Phenotype-genotype correlations. Tremor and Other Hyperkinetic Movements. 2015;5:336]'},{id:"B89",body:'[Swash M, Roberts AH, Zakko H, Heathfield KW. Treatment of involuntary movement disorders with tetrabenazine. Journal of Neurology, Neurosurgery, and Psychiatry. 1972;35:186-191]'},{id:"B90",body:'[Jankovic J. Treatment of hyperkinetic movement disorders with tetrabenazine: A double-blind crossover study. Annals of Neurology. 1982;11:41-47]'},{id:"B91",body:'[Jankovic J, Orman J. Tetrabenazine therapy of dystonia, chorea, tics, and other dyskinesias. Neurology. 1988;38:391-394]'},{id:"B92",body:'[Chen JJ, Ondo WG, Dashtipour K, Swope DM. Tetrabenazine for the treatment of hyperkinetic movement disorders: A review of the literature. Clinical Therapeutics. 2012;34:1487-1504]'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Vincenzo Cimino",address:null,affiliation:'- Centro Neurolesi “Bonino Pulejo”, IRCSS, Italy
'},{corresp:null,contributorFullName:"Clara Grazia Chisari",address:null,affiliation:'- Department “G.F. Ingrassia”, Section of Neuroscience, University of Catania, Italy
'},{corresp:"yes",contributorFullName:"Francesco Patti",address:"fpatti@outlook.com",affiliation:'- Department “G.F. Ingrassia”, Section of Neuroscience, University of Catania, Italy
'}],corrections:null},book:{id:"8059",title:"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice",subtitle:null,fullTitle:"Neurostimulation and Neuromodulation in Contemporary Therapeutic Practice",slug:"neurostimulation-and-neuromodulation-in-contemporary-therapeutic-practice",publishedDate:"September 30th 2020",bookSignature:"Denis Larrivee and Seyed Mansoor Rayegani",coverURL:"https://cdn.intechopen.com/books/images_new/8059.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"206412",title:"Prof.",name:"Denis",middleName:null,surname:"Larrivee",slug:"denis-larrivee",fullName:"Denis Larrivee"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},profile:{item:{id:"168063",title:"MSc.",name:"Bart",middleName:null,surname:"Kerre",email:"bart.kerre@student.kuleuven.be",fullName:"Bart Kerre",slug:"bart-kerre",position:null,biography:null,institutionString:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",totalCites:0,totalChapterViews:"0",outsideEditionCount:0,totalAuthoredChapters:"1",totalEditedBooks:"0",personalWebsiteURL:null,twitterURL:null,linkedinURL:null,institution:null},booksEdited:[],chaptersAuthored:[{title:"Stability of Organic Matter in Anthropic Soils: A Spectroscopic Approach",slug:"stability-of-organic-matter-in-anthropic-soils-a-spectroscopic-approach",abstract:null,signatures:"M.C. Hernandez-Soriano, A. Sevilla-Perea, B. Kerré and M.D. Mingorance",authors:[{id:"116131",title:"Dr.",name:"Maria C.",surname:"Hernandez Soriano",fullName:"Maria C. Hernandez Soriano",slug:"maria-c.-hernandez-soriano",email:"maria.HernandezSoriano@ees.kuleuven.be"},{id:"161090",title:"MSc.",name:"Ana",surname:"Sevilla-Perea",fullName:"Ana Sevilla-Perea",slug:"ana-sevilla-perea",email:"ana.sevilla@iact.ugr-csic.es"},{id:"161091",title:"Dr.",name:"Maria D.",surname:"Mingorance",fullName:"Maria D. Mingorance",slug:"maria-d.-mingorance",email:"mdmingorance@iact.ugr-csic.es"},{id:"168063",title:"MSc.",name:"Bart",surname:"Kerre",fullName:"Bart Kerre",slug:"bart-kerre",email:"bart.kerre@student.kuleuven.be"}],book:{title:"Soil Processes and Current Trends in Quality Assessment",slug:"soil-processes-and-current-trends-in-quality-assessment",productType:{id:"1",title:"Edited Volume"}}}],collaborators:[{id:"56222",title:"Prof.",name:"Zueng-Sang",surname:"Chen",slug:"zueng-sang-chen",fullName:"Zueng-Sang Chen",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:"Curriculum Vitae\r\nZueng-Sang CHEN\r\nUpdated on Oct 3, 2010\r\n\r\nAssociate Dean\r\nCollege of Bioresources and Agriculture \r\nNational Taiwan University\r\n1, Sect. 4th, Roosevelt road, Taipei 10617, Taiwan.\r\nTel: (college office) (+886-2) 3366-4205) \r\nFax: (college office) (+886-2) 2391-9626\r\nE-mail: soilchen@ntu.edu.tw \r\n\r\nDistinguished Professor\r\nPedology and soil environmental quality\r\nSoil Survey and Remediation Laboratory\r\nDepartment of Agricultural Chemistry\r\nNational Taiwan University\r\n1, Sect. 4th, Roosevelt road, Taipei 10617, Taiwan.\r\nTel: (Office) (+886-2) 2369-8349 (or 3366-2117) \r\nFax: (Office) (+886-2) 2392-4335\r\nE-mail: soilchen@ntu.edu.tw \r\nLab. Website: http://Lab.ac.ntu.edu.tw/soilsc/ \r\n\r\nMain Contributions \r\nHe have published more than 37 International SCI papers, 68 local journal papers, 117 international conference full paper, 61 local workshop full papers, 37 book chapters, and 62 technical reports in his career. \r\n\r\nHe contributed to East and Southeastern Federation of Soil Science Society (ESAFS) as a President for 2 years in 2002-2003, and also as a chairman and well organized the 6th ESAFS International Conference held in November 2003, at Taipei, Taiwan. \r\n\r\nHe served as a part time Soil and Fertilizer Consultant of Food Fertilizer Technology Center for the Asian and Pacific Region (FFTC/ASPAC), for 12 years from 1999 to 2010. He organized more than 10 International workshops or symposiums to maintain the quality of soil resources of the Asia and Pacific region and also to improve the crop productivities and crop quality. \r\n\r\nHis researches especially focus on the technologies of management of agricultural resources, composting, soil and environmental quality, newly developed innovative technologies on soil-crop inventory on heavy metals in the Asian region. \r\n\r\nHe have edited and published 3 technical books, 40 technical bulletin of FFTC and 40 Extension Bulletin of FFTC on Soil and Fertilizer Technology for Asian and Pacific region from 1996 to now. \r\n\r\nHe attended almost all the ESAFS conferences since 1990 and as a representative of Chinese Society of Soil and Fertilizer Sciences (CSSFS) to attend the business meeting of ESAFS and make a valuable contribution on the promotion of the communication and operation processing of the country members of ESAFS. \r\n\r\nHe almost was invited as one of the keynote speakers or speaker of session during the ESAFS conferences held in this region.\r\n\r\nHe initiated to develop the “Asian Soil database and Information Center†in 2008. \r\n\r\nPosition\r\nDirector, Agricultural Exhibition Center of National Taiwan University. (August, 2008-July, 2011).\r\n\r\nAssociate Dean, College of Bioresources and Agriculture, National Taiwan University. (August, 2007 to July, 2011).\r\n\r\nDistinguished Professor, pedology and soil environmental quality, Department of Agricultural Chemistry, National Taiwan University. (August 2007 to July 2010).\r\n\r\nHead of Department, Department of Agricultural Chemistry, National Taiwan University. (August, 2004 to July, 2007). http://www.ac.ntu.edu.tw \r\n\r\nProfessor of pedology and soil environmental quality, Department of Agricultural Chemistry, National Taiwan University. (August, 1989 to July 31, 2007).\r\n\r\nSoil and Fertilizer Consultant, Food and Fertilizer Technology Center for the Asian and Pacific Region (FFTC/ASPAC) http://www.fftc.agnet.org (12 years, March 1999 to February 2011). FFTC is located at Taipei, Taiwan\r\n\r\nInternational Honorable Scientists, RDA, Korea (2004-2006) and International Honorable Green Technology advisor, RDA, Korea (2010-2012)\r\n\r\nAssociate editor, Journal of Food, Agriculture, and Environment (www.world-food.net, 5 years, Jan 01, 2006-Dec 31, 2010). WFL Publisher is located at Helsinki, Finland.\r\n\r\nAssociate Professor, Department of Agricultural Chemistry, National Taiwan University. (August, 1985 to July, 1989)\r\n\r\nNationality: Taiwan \r\n\r\nEducation\r\nPh.D. Graduate Institute of Agricultural Chemistry, Div. of Soils and Plant Nutrition, Taiwan, ROC, June, 1984.\r\n\r\nResaerch and Teaching Distinguished Awards\r\nDistinguished Social Service Award (2009), National Taiwan University\r\n\r\nDistinguished Teaching Professor Award (2004, Top 1%), National Taiwan University\r\n\r\nDistinguished Agricultural Experts Award (2007), KIWANI International-Taiwan Branch\r\n\r\nDistinguished Science Achievement Award (1998), Agricultural Association of China.\r\n\r\nDistinguished Science Achievement Award (1997), Chinese Society of Agricultural Chemistry.\r\n\r\nScience Research Award (1984-2010, 26 times), National Science Council, Taiwan.\r\n\r\nOutstanding Teaching Professor Award (2001-2002, 2010), Natioanl Taiwan University (Top 5% of all faculty members) \r\n\r\nVisiting Professor in 1996\r\nDepartment of Soil Science, North Carolina State University, Raleigh, NC. USA, 1996.\r\n\r\nDepartment of Crop and Soil Environmental Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA., USA. 1996. \r\n\r\nHonorable Presidents of Societies \r\nPresident, East and Southeastern Asian Federation of Soil Science Society (ESAFS) (2002-2003)\r\n\r\nPresident, The Chinese Society of Soil and Fertilizer Sciences (CSSFS) (2002-2006)\r\n\r\nPresident, Taiwan Association of Soil and Groundwater Environmental Protection (2003-2007)\r\n\r\nPresident, The Agricultural Chemical Society of Taiwan (ACST) (2005-2007) \r\n\r\nField of Experts \r\nSoil Morphology, pedogenic processes, and classification\r\n\r\nSoil remediation techniques on cultivated soils contaminated by heavy metals, especially on phytoremediation of trace elements.. \r\n\r\nEnhancing the methodology to establish the criteria and guidelines of soil quality, especially for heavy metals in soils.\r\n\r\nSoil nutrient dynamics of subtropical forest Ecosystem\r\n\r\nResearch\r\nSignificant Findings\r\nDemonstrated the soil morphological characteristics, properties, pedogenic processes and classification of different Soils Orders in Taiwan.\r\n\r\nDemonstrated the data base system and background concentrations of heavy metals in soils-plants system or polluted soils.\r\n\r\nEvaluated the remediation techniques tested in cultivated soils contaminated by heavy metals (cadmium and lead) and make recommendations for EPA.\r\n\r\nPhytoremediation of trace elements in Taiwan rural soils.\r\n\r\nEnhancing the methodology to establish the criteria and guidelines of soil quality, especially for heavy metals in soils.\r\n\r\nSoil nutrient dynamics of subtropical forest Ecosystem in south Taiwan. \r\n\r\nFuture Research Plans\r\nEvaluate the soil remediation technique for soil and sediment contaminated with heavy metals (cadmium, lead, copper, and zinc) or organic materials, especially on phytoremediation of trace elements.\r\n\r\nEvaluate the guidelines of soil quality or criteria in different land uses.\r\n\r\nEnhancing the understanding of genetic processes of cultivated soils (rice-growing soils) and high mountains forest soils, especially on the volcanic soils (Andisols), Ultisols, and Spodosols.\r\n\r\nSoil nutrient balance of agricultural long tern ecologyical site in Taiwan\r\n\r\nInternational Committee Members\r\nInternational Council Meeting Members of International Union of Soil Science (IUSS) (1998-2008)\r\n\r\nInternational Business Meeting Members of East and Southeastern Asian Federation of Soil Science Society (ESAFS) (1995-2009)\r\n\r\nInternational Steering and Auditing Committee Member on International Society for Biogeochemistry of Trace Elements (1997-2005)\r\n\r\nInternational Steering Committee Members on Soil Contamination Research in Asia and the Pacific (SCRAP) Network (1996-1999)\r\n\r\nInternational Organizing Committee Members on National Soil Reference Collections and Databases (NASREC) (ISRIC) (1996-1999)\r\n\r\nWho’s Who Award\r\nVIP members in 2006 MADISON Who’s Who of Executives and Professionals\r\n\r\nMADISON Who’s Who in 2005/2006\r\n\r\nMADISON Who’s Who in 2006/2007\r\n\r\n500 Distinguished Professors & Scholors of the BWW Society/IAPGS (Bibliotheque World Wide, 2004)\r\n\r\n500 GREAT MINDS of the Early 21st Century (Bibliotheque World Wide, 2002)\r\n\r\nMARQUIS Who’s Who in the World (1999 to 2009), 16th to 26th Edition, Marquis Who’s Who. \r\n\r\nProfile in Excellence: 500 Biographies of Inspiration, Dedication and Accomplishment (Bibliotheque World Wide, 2003)\r\n\r\nOutstanding People of the 20th Century Incorporating the Outstanding Achievement Awards (International Biographical Centre, England, 2000)\r\n\r\nThe ASIA 500 Leaders for the New Century (Barons Who’s Who, 2000)\r\n\r\nFive Hundred Leaders of Influence (The American Biographical Institute, 1999)\r\n\r\nServices to review paper submitted in the International Journals\r\nAnalytica Chimica ACTA\r\nAustralian J Soil Research\r\nAnnuals of Tropical Ecology\r\nAnalytica Chimica Acta\r\nArchieves of Environmental contamination and Toxicology (AECT)\r\nChemosphere\r\nCatena\r\nCompost Science & Utilization\r\nDesalination\r\nEnvironmental Science and Technology (ES&T)\r\nGeoderma\r\nGeomorphology\r\nForest Ecology and Management (FE&M)\r\nInternational Journal of Environment and Pollution\r\nInternational Journal of Environmental Analytical Chemistry\r\nInternational Journal of Phytoremediation\r\nEnvironmental Pollution\r\nJournal of Environmental Engineering\r\nJournal Scientia Agricola.\r\nJournal of Environmental Science (Chinese Academy Sciences)\r\nJournal of Environmental Management\r\nPaddy and Water Environment Journal\r\nPedosphere\r\nSoil Science\r\nSoil Science Society of America Journal (SSSAJ)\r\nTalanta\r\nToxicology and Industrial Health\r\nWater, Air, and Soil Pollution",institutionString:null,institution:{name:"National Chung Cheng University",institutionURL:null,country:{name:"Taiwan"}}},{id:"62015",title:"Mr.",name:"Horng-Yuh",surname:"Guo",slug:"horng-yuh-guo",fullName:"Horng-Yuh Guo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"77653",title:"Dr.",name:"Agnieszka",surname:"Rutkowska",slug:"agnieszka-rutkowska",fullName:"Agnieszka Rutkowska",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Institute of Soil Science and Plant Cultivation",institutionURL:null,country:{name:"Poland"}}},{id:"77736",title:"Dr",name:null,surname:"Han",slug:"han",fullName:"Han",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"79674",title:"Dr.",name:"Rui",surname:"Guo",slug:"rui-guo",fullName:"Rui Guo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Institute of Environment and Sustainable Development in Agriculture",institutionURL:null,country:{name:"China"}}},{id:"117438",title:"Dr.",name:"WeiPing",surname:"Hao",slug:"weiping-hao",fullName:"WeiPing Hao",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Institute of Environment and Sustainable Development in Agriculture",institutionURL:null,country:{name:"China"}}},{id:"117439",title:"Dr.",name:"DaoZhi",surname:"Gong",slug:"daozhi-gong",fullName:"DaoZhi Gong",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Institute of Environment and Sustainable Development in Agriculture",institutionURL:null,country:{name:"China"}}},{id:"117440",title:"Dr.",name:"XiuLi",surname:"Zhong",slug:"xiuli-zhong",fullName:"XiuLi Zhong",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Institute of Environment and Sustainable Development in Agriculture",institutionURL:null,country:{name:"China"}}},{id:"155825",title:"Dr.",name:"FengXue",surname:"Gu",slug:"fengxue-gu",fullName:"FengXue Gu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"156225",title:"Ph.D.",name:"Chun-Chih",surname:"Tsui",slug:"chun-chih-tsui",fullName:"Chun-Chih Tsui",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Taiwan University",institutionURL:null,country:{name:"Taiwan"}}}]},generic:{page:{slug:"partnerships",title:"Partnerships",intro:"IntechOpen has always supported new and evolving ideas in scholarly publishing. We understand the community we serve, but to provide an even better service for our IntechOpen Authors and Academic Editors, we have partnered with leading companies and associations in the scientific field and beyond.
",metaTitle:"Partnerships",metaDescription:"IntechOpen was built by scientists, for scientists. We understand the community we serve, but to bring an even better service to the table for IntechOpen Authors and Academic Editors, we partnered with the leading companies and associations in the industry and beyond.",metaKeywords:null,canonicalURL:"/page/partnerships",contentRaw:'[{"type":"htmlEditorComponent","content":"ALPSP
\\n\\n\\n\\t- The Association of Learned and Professional Society Publishers (ALPSP) is the largest association of scholarly and professional publishers in the world. Its mission is to connect, inform, develop and represent the international scholarly and professional publishing community. IntechOpen has been a member of ALPSP since 2016 and has consequently stayed informed about industry trends through connecting with peers and developing jointly.
\\n
\\n\\nOASPA
\\n\\n\\n\\t- The Open Access Scholarly Publishers Association (OASPA) was established in 2008 to represent the interests of Open Access (OA) publishers globally in all scientific, technical and scholarly disciplines. Its mission is carried out through exchange of information, the setting of standards, advancing models, advocacy, education, and the promotion of innovation.
\\n
\\n\\nSTM
\\n\\n\\n\\t- The International Association of Scientific, Technical and Medical Publishers (STM) is the leading global trade association for academic and professional publishers. As a member, IntechOpen has not only made a commitment to STM's Ethical Principles.
\\n
\\n\\nCOPE
\\n\\n\\n\\t- The Committee on Publication Ethics (COPE) provides advice to editors and publishers on all aspects of publication ethics and, in particular, how to handle cases of misconduct in research and publication. IntechOpen has been a member of COPE since 2013 and adheres to the COPE Code of Conduct and Best Practice Guidelines, ensuring that we maintain the highest ethical standards.
\\n
\\n\\nCreative Commons
\\n\\n\\n\\t- Creative Commons (CC) is a nonprofit organization that enables the sharing and use of creativity and knowledge through free legal tools. IntechOpen uses the CC BY 3.0 license for chapters, meaning Authors retain copyright and their work can be reused and adapted as long as the source is properly cited and Authors are acknowledged.
\\n
\\n\\nCrossref
\\n\\n\\n\\t- Crossref is the official Digital Object Identifier (DOI) Registration Agency for scholarly and professional publications with a goal of making scholarly communications more effective. IntechOpen deposits metadata and registers DOIs for all content using the Crossref System. IntechOpen also deposits its references and uses the Crossref Cited-by service that enables researchers to track citation statistics.
\\n
\\n\\nAltmetric and Dimensions from Digital Science
\\n\\n\\n\\t- Digital Science is a technology company serving the needs of scientific and research communities at key points along the full cycle of research. They support innovative businesses and technologies that make all parts of the research process more open, efficient and effective. IntechOpen integrates tools such as Altmetric to enable our researchers to track and measure the activity around their academic research and Dimensions, to ease access to the most relevant information and better understand and analyze the global research landscape.
\\n
\\n\\nCLOCKSS
\\n\\n\\n\\t- CLOCKSS preserves scholarly publications in original formats, ensuring that they always remain available and openly accessible to everyone.
\\n
\\n\\nCounter
\\n\\n\\n\\t- COUNTER provides the Code of Practice that enables publishers and vendors to report usage of their electronic resources in a consistent way. This enables libraries to compare data received from different publishers and vendors.
\\n
\\n\\nDORA
\\n\\n\\n\\t- DORA is a worldwide initiative covering all scholarly disciplines which recognizes the need to improve the ways in which the outputs of scholarly research are evaluated and seeks to develop and promote best practice. To date it has been signed by over 1500 organizations and around 14,700 individuals.
\\n
\\n\\niThenticate
\\n\\n\\n\\t- iThenticate is the leading provider of professional plagiarism detection and prevention technology and is used worldwide by scholarly publishers and research institutions to ensure the originality of written work before publication. IntechOpen uses the iThenticate plagiarism software to ensure content originality and the research integrity of our published work.
\\n
\\n\\nEnago
\\n\\n\\n\\t- IntechOpen collaborates with Enago, through its sister brand, Ulatus, one of the world’s leading providers of book translation services. Their services are designed to convey the essence of your work to readers from across the globe in the language they understand.
\\n\\t- IntechOpen Authors that wish to use this service will receive a 20% discount on all translation services. To find out more information or obtain a quote, please visit https://www.enago.com/intech
\\n
\\n\\nSPi Global
\\n\\n\\n\\t- SPi Global is the market leader in technology-driven solutions for the extraction, enrichment and transformation of content assets. IntechOpen publishing services are designed to meet the unique needs of Authors. As part of our commitment to that objective, we have an ongoing partnership agreement for production solutions.
\\n
\\n\\nAmazon
\\n\\n\\n\\t- Amazon is the world’s largest online retailer and cloud services provider. IntechOpen books have been available on Amazon since 2017, guaranteeing more visibility for our Authors and Academic Editors.
\\n
\\n\\nDHL
\\n\\n\\n\\t- IntechOpen has partnered with DHL since 2011 to ensure the fastest delivery of Print on Demand books.
\\n
\\n"}]'},components:[{type:"htmlEditorComponent",content:'ALPSP
\n\n\n\t- The Association of Learned and Professional Society Publishers (ALPSP) is the largest association of scholarly and professional publishers in the world. Its mission is to connect, inform, develop and represent the international scholarly and professional publishing community. IntechOpen has been a member of ALPSP since 2016 and has consequently stayed informed about industry trends through connecting with peers and developing jointly.
\n
\n\nOASPA
\n\n\n\t- The Open Access Scholarly Publishers Association (OASPA) was established in 2008 to represent the interests of Open Access (OA) publishers globally in all scientific, technical and scholarly disciplines. Its mission is carried out through exchange of information, the setting of standards, advancing models, advocacy, education, and the promotion of innovation.
\n
\n\nSTM
\n\n\n\t- The International Association of Scientific, Technical and Medical Publishers (STM) is the leading global trade association for academic and professional publishers. As a member, IntechOpen has not only made a commitment to STM's Ethical Principles.
\n
\n\nCOPE
\n\n\n\t- The Committee on Publication Ethics (COPE) provides advice to editors and publishers on all aspects of publication ethics and, in particular, how to handle cases of misconduct in research and publication. IntechOpen has been a member of COPE since 2013 and adheres to the COPE Code of Conduct and Best Practice Guidelines, ensuring that we maintain the highest ethical standards.
\n
\n\nCreative Commons
\n\n\n\t- Creative Commons (CC) is a nonprofit organization that enables the sharing and use of creativity and knowledge through free legal tools. IntechOpen uses the CC BY 3.0 license for chapters, meaning Authors retain copyright and their work can be reused and adapted as long as the source is properly cited and Authors are acknowledged.
\n
\n\nCrossref
\n\n\n\t- Crossref is the official Digital Object Identifier (DOI) Registration Agency for scholarly and professional publications with a goal of making scholarly communications more effective. IntechOpen deposits metadata and registers DOIs for all content using the Crossref System. IntechOpen also deposits its references and uses the Crossref Cited-by service that enables researchers to track citation statistics.
\n
\n\nAltmetric and Dimensions from Digital Science
\n\n\n\t- Digital Science is a technology company serving the needs of scientific and research communities at key points along the full cycle of research. They support innovative businesses and technologies that make all parts of the research process more open, efficient and effective. IntechOpen integrates tools such as Altmetric to enable our researchers to track and measure the activity around their academic research and Dimensions, to ease access to the most relevant information and better understand and analyze the global research landscape.
\n
\n\nCLOCKSS
\n\n\n\t- CLOCKSS preserves scholarly publications in original formats, ensuring that they always remain available and openly accessible to everyone.
\n
\n\nCounter
\n\n\n\t- COUNTER provides the Code of Practice that enables publishers and vendors to report usage of their electronic resources in a consistent way. This enables libraries to compare data received from different publishers and vendors.
\n
\n\nDORA
\n\n\n\t- DORA is a worldwide initiative covering all scholarly disciplines which recognizes the need to improve the ways in which the outputs of scholarly research are evaluated and seeks to develop and promote best practice. To date it has been signed by over 1500 organizations and around 14,700 individuals.
\n
\n\niThenticate
\n\n\n\t- iThenticate is the leading provider of professional plagiarism detection and prevention technology and is used worldwide by scholarly publishers and research institutions to ensure the originality of written work before publication. IntechOpen uses the iThenticate plagiarism software to ensure content originality and the research integrity of our published work.
\n
\n\nEnago
\n\n\n\t- IntechOpen collaborates with Enago, through its sister brand, Ulatus, one of the world’s leading providers of book translation services. Their services are designed to convey the essence of your work to readers from across the globe in the language they understand.
\n\t- IntechOpen Authors that wish to use this service will receive a 20% discount on all translation services. To find out more information or obtain a quote, please visit https://www.enago.com/intech
\n
\n\nSPi Global
\n\n\n\t- SPi Global is the market leader in technology-driven solutions for the extraction, enrichment and transformation of content assets. IntechOpen publishing services are designed to meet the unique needs of Authors. As part of our commitment to that objective, we have an ongoing partnership agreement for production solutions.
\n
\n\nAmazon
\n\n\n\t- Amazon is the world’s largest online retailer and cloud services provider. IntechOpen books have been available on Amazon since 2017, guaranteeing more visibility for our Authors and Academic Editors.
\n
\n\nDHL
\n\n\n\t- IntechOpen has partnered with DHL since 2011 to ensure the fastest delivery of Print on Demand books.
\n
\n'}]},successStories:{items:[]},authorsAndEditors:{filterParams:{sort:"featured,name"},profiles:[{id:"6700",title:"Dr.",name:"Abbass A.",middleName:null,surname:"Hashim",slug:"abbass-a.-hashim",fullName:"Abbass A. Hashim",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/6700/images/1864_n.jpg",biography:"Currently I am carrying out research in several areas of interest, mainly covering work on chemical and bio-sensors, semiconductor thin film device fabrication and characterisation.\nAt the moment I have very strong interest in radiation environmental pollution and bacteriology treatment. The teams of researchers are working very hard to bring novel results in this field. I am also a member of the team in charge for the supervision of Ph.D. students in the fields of development of silicon based planar waveguide sensor devices, study of inelastic electron tunnelling in planar tunnelling nanostructures for sensing applications and development of organotellurium(IV) compounds for semiconductor applications. I am a specialist in data analysis techniques and nanosurface structure. I have served as the editor for many books, been a member of the editorial board in science journals, have published many papers and hold many patents.",institutionString:null,institution:{name:"Sheffield Hallam University",country:{name:"United Kingdom"}}},{id:"54525",title:"Prof.",name:"Abdul Latif",middleName:null,surname:"Ahmad",slug:"abdul-latif-ahmad",fullName:"Abdul Latif Ahmad",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"20567",title:"Prof.",name:"Ado",middleName:null,surname:"Jorio",slug:"ado-jorio",fullName:"Ado Jorio",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidade Federal de Minas Gerais",country:{name:"Brazil"}}},{id:"47940",title:"Dr.",name:"Alberto",middleName:null,surname:"Mantovani",slug:"alberto-mantovani",fullName:"Alberto Mantovani",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"12392",title:"Mr.",name:"Alex",middleName:null,surname:"Lazinica",slug:"alex-lazinica",fullName:"Alex Lazinica",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/12392/images/7282_n.png",biography:"Alex Lazinica is the founder and CEO of IntechOpen. After obtaining a Master's degree in Mechanical Engineering, he continued his PhD studies in Robotics at the Vienna University of Technology. Here he worked as a robotic researcher with the university's Intelligent Manufacturing Systems Group as well as a guest researcher at various European universities, including the Swiss Federal Institute of Technology Lausanne (EPFL). During this time he published more than 20 scientific papers, gave presentations, served as a reviewer for major robotic journals and conferences and most importantly he co-founded and built the International Journal of Advanced Robotic Systems- world's first Open Access journal in the field of robotics. Starting this journal was a pivotal point in his career, since it was a pathway to founding IntechOpen - Open Access publisher focused on addressing academic researchers needs. Alex is a personification of IntechOpen key values being trusted, open and entrepreneurial. Today his focus is on defining the growth and development strategy for the company.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"19816",title:"Prof.",name:"Alexander",middleName:null,surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/19816/images/1607_n.jpg",biography:"Alexander I. Kokorin: born: 1947, Moscow; DSc., PhD; Principal Research Fellow (Research Professor) of Department of Kinetics and Catalysis, N. Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow.\r\nArea of research interests: physical chemistry of complex-organized molecular and nanosized systems, including polymer-metal complexes; the surface of doped oxide semiconductors. He is an expert in structural, absorptive, catalytic and photocatalytic properties, in structural organization and dynamic features of ionic liquids, in magnetic interactions between paramagnetic centers. The author or co-author of 3 books, over 200 articles and reviews in scientific journals and books. He is an actual member of the International EPR/ESR Society, European Society on Quantum Solar Energy Conversion, Moscow House of Scientists, of the Board of Moscow Physical Society.",institutionString:null,institution:{name:"Semenov Institute of Chemical Physics",country:{name:"Russia"}}},{id:"62389",title:"PhD.",name:"Ali Demir",middleName:null,surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62389/images/3413_n.jpg",biography:"Dr. Ali Demir Sezer has a Ph.D. from Pharmaceutical Biotechnology at the Faculty of Pharmacy, University of Marmara (Turkey). He is the member of many Pharmaceutical Associations and acts as a reviewer of scientific journals and European projects under different research areas such as: drug delivery systems, nanotechnology and pharmaceutical biotechnology. Dr. Sezer is the author of many scientific publications in peer-reviewed journals and poster communications. Focus of his research activity is drug delivery, physico-chemical characterization and biological evaluation of biopolymers micro and nanoparticles as modified drug delivery system, and colloidal drug carriers (liposomes, nanoparticles etc.).",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"61051",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"100762",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"St David's Medical Center",country:{name:"United States of America"}}},{id:"107416",title:"Dr.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Texas Cardiac Arrhythmia",country:{name:"United States of America"}}},{id:"64434",title:"Dr.",name:"Angkoon",middleName:null,surname:"Phinyomark",slug:"angkoon-phinyomark",fullName:"Angkoon Phinyomark",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/64434/images/2619_n.jpg",biography:"My name is Angkoon Phinyomark. I received a B.Eng. degree in Computer Engineering with First Class Honors in 2008 from Prince of Songkla University, Songkhla, Thailand, where I received a Ph.D. degree in Electrical Engineering. My research interests are primarily in the area of biomedical signal processing and classification notably EMG (electromyography signal), EOG (electrooculography signal), and EEG (electroencephalography signal), image analysis notably breast cancer analysis and optical coherence tomography, and rehabilitation engineering. I became a student member of IEEE in 2008. During October 2011-March 2012, I had worked at School of Computer Science and Electronic Engineering, University of Essex, Colchester, Essex, United Kingdom. In addition, during a B.Eng. I had been a visiting research student at Faculty of Computer Science, University of Murcia, Murcia, Spain for three months.\n\nI have published over 40 papers during 5 years in refereed journals, books, and conference proceedings in the areas of electro-physiological signals processing and classification, notably EMG and EOG signals, fractal analysis, wavelet analysis, texture analysis, feature extraction and machine learning algorithms, and assistive and rehabilitative devices. I have several computer programming language certificates, i.e. Sun Certified Programmer for the Java 2 Platform 1.4 (SCJP), Microsoft Certified Professional Developer, Web Developer (MCPD), Microsoft Certified Technology Specialist, .NET Framework 2.0 Web (MCTS). I am a Reviewer for several refereed journals and international conferences, such as IEEE Transactions on Biomedical Engineering, IEEE Transactions on Industrial Electronics, Optic Letters, Measurement Science Review, and also a member of the International Advisory Committee for 2012 IEEE Business Engineering and Industrial Applications and 2012 IEEE Symposium on Business, Engineering and Industrial Applications.",institutionString:null,institution:{name:"Joseph Fourier University",country:{name:"France"}}},{id:"55578",title:"Dr.",name:"Antonio",middleName:null,surname:"Jurado-Navas",slug:"antonio-jurado-navas",fullName:"Antonio Jurado-Navas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/55578/images/4574_n.png",biography:"Antonio Jurado-Navas received the M.S. degree (2002) and the Ph.D. degree (2009) in Telecommunication Engineering, both from the University of Málaga (Spain). He first worked as a consultant at Vodafone-Spain. From 2004 to 2011, he was a Research Assistant with the Communications Engineering Department at the University of Málaga. In 2011, he became an Assistant Professor in the same department. From 2012 to 2015, he was with Ericsson Spain, where he was working on geo-location\ntools for third generation mobile networks. Since 2015, he is a Marie-Curie fellow at the Denmark Technical University. His current research interests include the areas of mobile communication systems and channel modeling in addition to atmospheric optical communications, adaptive optics and statistics",institutionString:null,institution:{name:"University of Malaga",country:{name:"Spain"}}}],filtersByRegion:[{group:"region",caption:"North America",value:1,count:5775},{group:"region",caption:"Middle and South America",value:2,count:5239},{group:"region",caption:"Africa",value:3,count:1721},{group:"region",caption:"Asia",value:4,count:10411},{group:"region",caption:"Australia and Oceania",value:5,count:897},{group:"region",caption:"Europe",value:6,count:15810}],offset:12,limit:12,total:118378},chapterEmbeded:{data:{}},editorApplication:{success:null,errors:{}},ofsBooks:{filterParams:{topicId:"6"},books:[{type:"book",id:"8977",title:"Protein Kinase - New Opportunities, Challenges and Future Perspectives",subtitle:null,isOpenForSubmission:!0,hash:"6d200cc031706a565b554fdb1c478901",slug:null,bookSignature:"Dr. Rajesh Kumar Singh",coverURL:"https://cdn.intechopen.com/books/images_new/8977.jpg",editedByType:null,editors:[{id:"329385",title:"Dr.",name:"Rajesh",surname:"Singh",slug:"rajesh-singh",fullName:"Rajesh Singh"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9659",title:"Fibroblasts - Advances in Cancer, Autoimmunity and Inflammation",subtitle:null,isOpenForSubmission:!0,hash:"926fa6446f6befbd363fc74971a56de2",slug:null,bookSignature:"Ph.D. Mojca Frank Bertoncelj and Ms. Katja Lakota",coverURL:"https://cdn.intechopen.com/books/images_new/9659.jpg",editedByType:null,editors:[{id:"328755",title:"Ph.D.",name:"Mojca",surname:"Frank Bertoncelj",slug:"mojca-frank-bertoncelj",fullName:"Mojca Frank Bertoncelj"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10741",title:"Synthetic Genomics - From Natural to Synthetic Genomes",subtitle:null,isOpenForSubmission:!0,hash:"eb1cebd0b9c4e7e87427003ff7196f57",slug:null,bookSignature:"Dr. Miguel Fernández-Niño and Dr. Luis H. Reyes",coverURL:"https://cdn.intechopen.com/books/images_new/10741.jpg",editedByType:null,editors:[{id:"158295",title:"Dr.",name:"Miguel",surname:"Fernández-Niño",slug:"miguel-fernandez-nino",fullName:"Miguel Fernández-Niño"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10797",title:"Cell Culture",subtitle:null,isOpenForSubmission:!0,hash:"2c628f4757f9639a4450728d839a7842",slug:null,bookSignature:"Prof. Xianquan Zhan",coverURL:"https://cdn.intechopen.com/books/images_new/10797.jpg",editedByType:null,editors:[{id:"223233",title:"Prof.",name:"Xianquan",surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10799",title:"Phenolic Compounds",subtitle:null,isOpenForSubmission:!0,hash:"339199f254d2987ef3167eef74fb8a38",slug:null,bookSignature:"Prof. Farid A. Badria",coverURL:"https://cdn.intechopen.com/books/images_new/10799.jpg",editedByType:null,editors:[{id:"41865",title:"Prof.",name:"Farid A.",surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10800",title:"Ligase",subtitle:null,isOpenForSubmission:!0,hash:"1f10ff112edb1fec24379dac85ef3b5b",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/10800.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10801",title:"Uric Acid",subtitle:null,isOpenForSubmission:!0,hash:"d947ab87019e69ab11aa597edbacc018",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/10801.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10837",title:"Peroxisomes",subtitle:null,isOpenForSubmission:!0,hash:"0014b09d4b35bb4d7f52ca0b3641cda1",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/10837.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10838",title:"Ion Channels",subtitle:null,isOpenForSubmission:!0,hash:"048017b227b3bdfd0d33a49bac63c915",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/10838.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10840",title:"Benzimidazole",subtitle:null,isOpenForSubmission:!0,hash:"9fe810233f92a9c454c624aec634316f",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/10840.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10841",title:"Hydrolases",subtitle:null,isOpenForSubmission:!0,hash:"64617cf21bf1e47170bb2bcf31b1fc37",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/10841.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],filtersByTopic:[{group:"topic",caption:"Agricultural and Biological Sciences",value:5,count:18},{group:"topic",caption:"Biochemistry, Genetics and Molecular Biology",value:6,count:5},{group:"topic",caption:"Business, Management and Economics",value:7,count:2},{group:"topic",caption:"Chemistry",value:8,count:8},{group:"topic",caption:"Computer and Information Science",value:9,count:6},{group:"topic",caption:"Earth and Planetary Sciences",value:10,count:7},{group:"topic",caption:"Engineering",value:11,count:20},{group:"topic",caption:"Environmental Sciences",value:12,count:2},{group:"topic",caption:"Immunology and Microbiology",value:13,count:4},{group:"topic",caption:"Materials Science",value:14,count:5},{group:"topic",caption:"Mathematics",value:15,count:1},{group:"topic",caption:"Medicine",value:16,count:25},{group:"topic",caption:"Neuroscience",value:18,count:2},{group:"topic",caption:"Pharmacology, Toxicology and Pharmaceutical Science",value:19,count:3},{group:"topic",caption:"Physics",value:20,count:3},{group:"topic",caption:"Psychology",value:21,count:4},{group:"topic",caption:"Robotics",value:22,count:1},{group:"topic",caption:"Social Sciences",value:23,count:3},{group:"topic",caption:"Technology",value:24,count:1},{group:"topic",caption:"Veterinary Medicine and Science",value:25,count:1}],offset:12,limit:12,total:11},popularBooks:{featuredBooks:[{type:"book",id:"9521",title:"Antimicrobial Resistance",subtitle:"A One Health Perspective",isOpenForSubmission:!1,hash:"30949e78832e1afba5606634b52056ab",slug:"antimicrobial-resistance-a-one-health-perspective",bookSignature:"Mihai Mareș, Swee Hua Erin Lim, Kok-Song Lai and Romeo-Teodor Cristina",coverURL:"https://cdn.intechopen.com/books/images_new/9521.jpg",editors:[{id:"88785",title:"Prof.",name:"Mihai",middleName:null,surname:"Mares",slug:"mihai-mares",fullName:"Mihai Mares"}],equalEditorOne:{id:"190224",title:"Dr.",name:"Swee Hua Erin",middleName:null,surname:"Lim",slug:"swee-hua-erin-lim",fullName:"Swee Hua Erin Lim",profilePictureURL:"https://mts.intechopen.com/storage/users/190224/images/system/190224.png",biography:"Dr. Erin Lim is presently working as an Assistant Professor in the Division of Health Sciences, Abu Dhabi Women\\'s College, Higher Colleges of Technology in Abu Dhabi, United Arab Emirates and is affiliated as an Associate Professor to Perdana University-Royal College of Surgeons in Ireland, Selangor, Malaysia. She obtained her Ph.D. from Universiti Putra Malaysia in 2010 with a National Science Fellowship awarded from the Ministry of Science, Technology and Innovation Malaysia and has been actively involved in research ever since. Her main research interests include analysis of carriage and transmission of multidrug resistant bacteria in non-conventional settings, besides an interest in natural products for antimicrobial testing. She is heavily involved in the elucidation of mechanisms of reversal of resistance in bacteria in addition to investigating the immunological analyses of diseases, development of vaccination and treatment models in animals. She hopes her work will support the discovery of therapeutics in the clinical setting and assist in the combat against the burden of antibiotic resistance.",institutionString:"Abu Dhabi Women’s College",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Perdana University",institutionURL:null,country:{name:"Malaysia"}}},equalEditorTwo:{id:"221544",title:"Dr.",name:"Kok-Song",middleName:null,surname:"Lai",slug:"kok-song-lai",fullName:"Kok-Song Lai",profilePictureURL:"https://mts.intechopen.com/storage/users/221544/images/system/221544.jpeg",biography:"Dr. Lai Kok Song is an Assistant Professor in the Division of Health Sciences, Abu Dhabi Women\\'s College, Higher Colleges of Technology in Abu Dhabi, United Arab Emirates. He obtained his Ph.D. in Biological Sciences from Nara Institute of Science and Technology, Japan in 2012. Prior to his academic appointment, Dr. Lai worked as a Senior Scientist at the Ministry of Science, Technology and Innovation, Malaysia. His current research areas include antimicrobial resistance and plant-pathogen interaction. His particular interest lies in the study of the antimicrobial mechanism via membrane disruption of essential oils against multi-drug resistance bacteria through various biochemical, molecular and proteomic approaches. Ultimately, he hopes to uncover and determine novel biomarkers related to antibiotic resistance that can be developed into new therapeutic strategies.",institutionString:"Higher Colleges of Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"8",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Higher Colleges of Technology",institutionURL:null,country:{name:"United Arab Emirates"}}},equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10020",title:"Operations Management",subtitle:"Emerging Trend in the Digital Era",isOpenForSubmission:!1,hash:"526f0dbdc7e4d85b82ce8383ab894b4c",slug:"operations-management-emerging-trend-in-the-digital-era",bookSignature:"Antonella Petrillo, Fabio De Felice, Germano Lambert-Torres and Erik Bonaldi",coverURL:"https://cdn.intechopen.com/books/images_new/10020.jpg",editors:[{id:"181603",title:"Dr.",name:"Antonella",middleName:null,surname:"Petrillo",slug:"antonella-petrillo",fullName:"Antonella Petrillo"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9560",title:"Creativity",subtitle:"A Force to Innovation",isOpenForSubmission:!1,hash:"58f740bc17807d5d88d647c525857b11",slug:"creativity-a-force-to-innovation",bookSignature:"Pooja Jain",coverURL:"https://cdn.intechopen.com/books/images_new/9560.jpg",editors:[{id:"316765",title:"Dr.",name:"Pooja",middleName:null,surname:"Jain",slug:"pooja-jain",fullName:"Pooja Jain"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10192",title:"Background and Management of Muscular Atrophy",subtitle:null,isOpenForSubmission:!1,hash:"eca24028d89912b5efea56e179dff089",slug:"background-and-management-of-muscular-atrophy",bookSignature:"Julianna Cseri",coverURL:"https://cdn.intechopen.com/books/images_new/10192.jpg",editors:[{id:"135579",title:"Dr.",name:"Julianna",middleName:null,surname:"Cseri",slug:"julianna-cseri",fullName:"Julianna Cseri"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9243",title:"Coastal Environments",subtitle:null,isOpenForSubmission:!1,hash:"8e05e5f631e935eef366980f2e28295d",slug:"coastal-environments",bookSignature:"Yuanzhi Zhang and X. San Liang",coverURL:"https://cdn.intechopen.com/books/images_new/9243.jpg",editors:[{id:"77597",title:"Prof.",name:"Yuanzhi",middleName:null,surname:"Zhang",slug:"yuanzhi-zhang",fullName:"Yuanzhi Zhang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9385",title:"Renewable Energy",subtitle:"Technologies and Applications",isOpenForSubmission:!1,hash:"a6b446d19166f17f313008e6c056f3d8",slug:"renewable-energy-technologies-and-applications",bookSignature:"Tolga Taner, Archana Tiwari and Taha Selim Ustun",coverURL:"https://cdn.intechopen.com/books/images_new/9385.jpg",editors:[{id:"197240",title:"Associate Prof.",name:"Tolga",middleName:null,surname:"Taner",slug:"tolga-taner",fullName:"Tolga Taner"}],equalEditorOne:{id:"186791",title:"Dr.",name:"Archana",middleName:null,surname:"Tiwari",slug:"archana-tiwari",fullName:"Archana Tiwari",profilePictureURL:"https://mts.intechopen.com/storage/users/186791/images/system/186791.jpg",biography:"Dr. Archana Tiwari is Associate Professor at Amity University, India. Her research interests include renewable sources of energy from microalgae and further utilizing the residual biomass for the generation of value-added products, bioremediation through microalgae and microbial consortium, antioxidative enzymes and stress, and nutraceuticals from microalgae. She has been working on algal biotechnology for the last two decades. She has published her research in many international journals and has authored many books and chapters with renowned publishing houses. She has also delivered talks as an invited speaker at many national and international conferences. Dr. Tiwari is the recipient of several awards including Researcher of the Year and Distinguished Scientist.",institutionString:"Amity University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Amity University",institutionURL:null,country:{name:"India"}}},equalEditorTwo:{id:"197609",title:"Prof.",name:"Taha Selim",middleName:null,surname:"Ustun",slug:"taha-selim-ustun",fullName:"Taha Selim Ustun",profilePictureURL:"https://mts.intechopen.com/storage/users/197609/images/system/197609.jpeg",biography:"Dr. Taha Selim Ustun received a Ph.D. in Electrical Engineering from Victoria University, Melbourne, Australia. He is a researcher with the Fukushima Renewable Energy Institute, AIST (FREA), where he leads the Smart Grid Cybersecurity Laboratory. Prior to that, he was a faculty member with the School of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA, USA. His current research interests include power systems protection, communication in power networks, distributed generation, microgrids, electric vehicle integration, and cybersecurity in smart grids. He serves on the editorial boards of IEEE Access, IEEE Transactions on Industrial Informatics, Energies, Electronics, Electricity, World Electric Vehicle and Information journals. Dr. Ustun is a member of the IEEE 2004 and 2800, IEC Renewable Energy Management WG 8, and IEC TC 57 WG17. He has been invited to run specialist courses in Africa, India, and China. He has delivered talks for the Qatar Foundation, the World Energy Council, the Waterloo Global Science Initiative, and the European Union Energy Initiative (EUEI). His research has attracted funding from prestigious programs in Japan, Australia, the European Union, and North America.",institutionString:"Fukushima Renewable Energy Institute, AIST (FREA)",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"National Institute of Advanced Industrial Science and Technology",institutionURL:null,country:{name:"Japan"}}},equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8985",title:"Natural Resources Management and Biological Sciences",subtitle:null,isOpenForSubmission:!1,hash:"5c2e219a6c021a40b5a20c041dea88c4",slug:"natural-resources-management-and-biological-sciences",bookSignature:"Edward R. Rhodes and Humood Naser",coverURL:"https://cdn.intechopen.com/books/images_new/8985.jpg",editors:[{id:"280886",title:"Prof.",name:"Edward R",middleName:null,surname:"Rhodes",slug:"edward-r-rhodes",fullName:"Edward R Rhodes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10065",title:"Wavelet Theory",subtitle:null,isOpenForSubmission:!1,hash:"d8868e332169597ba2182d9b004d60de",slug:"wavelet-theory",bookSignature:"Somayeh Mohammady",coverURL:"https://cdn.intechopen.com/books/images_new/10065.jpg",editors:[{id:"109280",title:"Dr.",name:"Somayeh",middleName:null,surname:"Mohammady",slug:"somayeh-mohammady",fullName:"Somayeh Mohammady"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9644",title:"Glaciers and the Polar Environment",subtitle:null,isOpenForSubmission:!1,hash:"e8cfdc161794e3753ced54e6ff30873b",slug:"glaciers-and-the-polar-environment",bookSignature:"Masaki Kanao, Danilo Godone and Niccolò Dematteis",coverURL:"https://cdn.intechopen.com/books/images_new/9644.jpg",editors:[{id:"51959",title:"Dr.",name:"Masaki",middleName:null,surname:"Kanao",slug:"masaki-kanao",fullName:"Masaki Kanao"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9550",title:"Entrepreneurship",subtitle:"Contemporary Issues",isOpenForSubmission:!1,hash:"9b4ac1ee5b743abf6f88495452b1e5e7",slug:"entrepreneurship-contemporary-issues",bookSignature:"Mladen Turuk",coverURL:"https://cdn.intechopen.com/books/images_new/9550.jpg",editors:[{id:"319755",title:"Prof.",name:"Mladen",middleName:null,surname:"Turuk",slug:"mladen-turuk",fullName:"Mladen Turuk"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9027",title:"Human Blood Group Systems and Haemoglobinopathies",subtitle:null,isOpenForSubmission:!1,hash:"d00d8e40b11cfb2547d1122866531c7e",slug:"human-blood-group-systems-and-haemoglobinopathies",bookSignature:"Osaro Erhabor and Anjana Munshi",coverURL:"https://cdn.intechopen.com/books/images_new/9027.jpg",editors:[{id:"35140",title:null,name:"Osaro",middleName:null,surname:"Erhabor",slug:"osaro-erhabor",fullName:"Osaro Erhabor"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8558",title:"Aerodynamics",subtitle:null,isOpenForSubmission:!1,hash:"db7263fc198dfb539073ba0260a7f1aa",slug:"aerodynamics",bookSignature:"Mofid Gorji-Bandpy and Aly-Mousaad Aly",coverURL:"https://cdn.intechopen.com/books/images_new/8558.jpg",editors:[{id:"35542",title:"Prof.",name:"Mofid",middleName:null,surname:"Gorji-Bandpy",slug:"mofid-gorji-bandpy",fullName:"Mofid Gorji-Bandpy"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],offset:12,limit:12,total:5249},hotBookTopics:{hotBooks:[],offset:0,limit:12,total:null},publish:{},publishingProposal:{success:null,errors:{}},books:{featuredBooks:[{type:"book",id:"9521",title:"Antimicrobial Resistance",subtitle:"A One Health Perspective",isOpenForSubmission:!1,hash:"30949e78832e1afba5606634b52056ab",slug:"antimicrobial-resistance-a-one-health-perspective",bookSignature:"Mihai Mareș, Swee Hua Erin Lim, Kok-Song Lai and Romeo-Teodor Cristina",coverURL:"https://cdn.intechopen.com/books/images_new/9521.jpg",editors:[{id:"88785",title:"Prof.",name:"Mihai",middleName:null,surname:"Mares",slug:"mihai-mares",fullName:"Mihai Mares"}],equalEditorOne:{id:"190224",title:"Dr.",name:"Swee Hua Erin",middleName:null,surname:"Lim",slug:"swee-hua-erin-lim",fullName:"Swee Hua Erin Lim",profilePictureURL:"https://mts.intechopen.com/storage/users/190224/images/system/190224.png",biography:"Dr. Erin Lim is presently working as an Assistant Professor in the Division of Health Sciences, Abu Dhabi Women\\'s College, Higher Colleges of Technology in Abu Dhabi, United Arab Emirates and is affiliated as an Associate Professor to Perdana University-Royal College of Surgeons in Ireland, Selangor, Malaysia. She obtained her Ph.D. from Universiti Putra Malaysia in 2010 with a National Science Fellowship awarded from the Ministry of Science, Technology and Innovation Malaysia and has been actively involved in research ever since. Her main research interests include analysis of carriage and transmission of multidrug resistant bacteria in non-conventional settings, besides an interest in natural products for antimicrobial testing. She is heavily involved in the elucidation of mechanisms of reversal of resistance in bacteria in addition to investigating the immunological analyses of diseases, development of vaccination and treatment models in animals. She hopes her work will support the discovery of therapeutics in the clinical setting and assist in the combat against the burden of antibiotic resistance.",institutionString:"Abu Dhabi Women’s College",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Perdana University",institutionURL:null,country:{name:"Malaysia"}}},equalEditorTwo:{id:"221544",title:"Dr.",name:"Kok-Song",middleName:null,surname:"Lai",slug:"kok-song-lai",fullName:"Kok-Song Lai",profilePictureURL:"https://mts.intechopen.com/storage/users/221544/images/system/221544.jpeg",biography:"Dr. Lai Kok Song is an Assistant Professor in the Division of Health Sciences, Abu Dhabi Women\\'s College, Higher Colleges of Technology in Abu Dhabi, United Arab Emirates. He obtained his Ph.D. in Biological Sciences from Nara Institute of Science and Technology, Japan in 2012. Prior to his academic appointment, Dr. Lai worked as a Senior Scientist at the Ministry of Science, Technology and Innovation, Malaysia. His current research areas include antimicrobial resistance and plant-pathogen interaction. His particular interest lies in the study of the antimicrobial mechanism via membrane disruption of essential oils against multi-drug resistance bacteria through various biochemical, molecular and proteomic approaches. Ultimately, he hopes to uncover and determine novel biomarkers related to antibiotic resistance that can be developed into new therapeutic strategies.",institutionString:"Higher Colleges of Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"8",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Higher Colleges of Technology",institutionURL:null,country:{name:"United Arab Emirates"}}},equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10020",title:"Operations Management",subtitle:"Emerging Trend in the Digital Era",isOpenForSubmission:!1,hash:"526f0dbdc7e4d85b82ce8383ab894b4c",slug:"operations-management-emerging-trend-in-the-digital-era",bookSignature:"Antonella Petrillo, Fabio De Felice, Germano Lambert-Torres and Erik Bonaldi",coverURL:"https://cdn.intechopen.com/books/images_new/10020.jpg",editors:[{id:"181603",title:"Dr.",name:"Antonella",middleName:null,surname:"Petrillo",slug:"antonella-petrillo",fullName:"Antonella Petrillo"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9560",title:"Creativity",subtitle:"A Force to Innovation",isOpenForSubmission:!1,hash:"58f740bc17807d5d88d647c525857b11",slug:"creativity-a-force-to-innovation",bookSignature:"Pooja Jain",coverURL:"https://cdn.intechopen.com/books/images_new/9560.jpg",editors:[{id:"316765",title:"Dr.",name:"Pooja",middleName:null,surname:"Jain",slug:"pooja-jain",fullName:"Pooja Jain"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10192",title:"Background and Management of Muscular Atrophy",subtitle:null,isOpenForSubmission:!1,hash:"eca24028d89912b5efea56e179dff089",slug:"background-and-management-of-muscular-atrophy",bookSignature:"Julianna Cseri",coverURL:"https://cdn.intechopen.com/books/images_new/10192.jpg",editors:[{id:"135579",title:"Dr.",name:"Julianna",middleName:null,surname:"Cseri",slug:"julianna-cseri",fullName:"Julianna Cseri"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9243",title:"Coastal Environments",subtitle:null,isOpenForSubmission:!1,hash:"8e05e5f631e935eef366980f2e28295d",slug:"coastal-environments",bookSignature:"Yuanzhi Zhang and X. San Liang",coverURL:"https://cdn.intechopen.com/books/images_new/9243.jpg",editors:[{id:"77597",title:"Prof.",name:"Yuanzhi",middleName:null,surname:"Zhang",slug:"yuanzhi-zhang",fullName:"Yuanzhi Zhang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9385",title:"Renewable Energy",subtitle:"Technologies and Applications",isOpenForSubmission:!1,hash:"a6b446d19166f17f313008e6c056f3d8",slug:"renewable-energy-technologies-and-applications",bookSignature:"Tolga Taner, Archana Tiwari and Taha Selim Ustun",coverURL:"https://cdn.intechopen.com/books/images_new/9385.jpg",editors:[{id:"197240",title:"Associate Prof.",name:"Tolga",middleName:null,surname:"Taner",slug:"tolga-taner",fullName:"Tolga Taner"}],equalEditorOne:{id:"186791",title:"Dr.",name:"Archana",middleName:null,surname:"Tiwari",slug:"archana-tiwari",fullName:"Archana Tiwari",profilePictureURL:"https://mts.intechopen.com/storage/users/186791/images/system/186791.jpg",biography:"Dr. Archana Tiwari is Associate Professor at Amity University, India. Her research interests include renewable sources of energy from microalgae and further utilizing the residual biomass for the generation of value-added products, bioremediation through microalgae and microbial consortium, antioxidative enzymes and stress, and nutraceuticals from microalgae. She has been working on algal biotechnology for the last two decades. She has published her research in many international journals and has authored many books and chapters with renowned publishing houses. She has also delivered talks as an invited speaker at many national and international conferences. Dr. Tiwari is the recipient of several awards including Researcher of the Year and Distinguished Scientist.",institutionString:"Amity University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Amity University",institutionURL:null,country:{name:"India"}}},equalEditorTwo:{id:"197609",title:"Prof.",name:"Taha Selim",middleName:null,surname:"Ustun",slug:"taha-selim-ustun",fullName:"Taha Selim Ustun",profilePictureURL:"https://mts.intechopen.com/storage/users/197609/images/system/197609.jpeg",biography:"Dr. Taha Selim Ustun received a Ph.D. in Electrical Engineering from Victoria University, Melbourne, Australia. He is a researcher with the Fukushima Renewable Energy Institute, AIST (FREA), where he leads the Smart Grid Cybersecurity Laboratory. Prior to that, he was a faculty member with the School of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA, USA. His current research interests include power systems protection, communication in power networks, distributed generation, microgrids, electric vehicle integration, and cybersecurity in smart grids. He serves on the editorial boards of IEEE Access, IEEE Transactions on Industrial Informatics, Energies, Electronics, Electricity, World Electric Vehicle and Information journals. Dr. Ustun is a member of the IEEE 2004 and 2800, IEC Renewable Energy Management WG 8, and IEC TC 57 WG17. He has been invited to run specialist courses in Africa, India, and China. He has delivered talks for the Qatar Foundation, the World Energy Council, the Waterloo Global Science Initiative, and the European Union Energy Initiative (EUEI). His research has attracted funding from prestigious programs in Japan, Australia, the European Union, and North America.",institutionString:"Fukushima Renewable Energy Institute, AIST (FREA)",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"National Institute of Advanced Industrial Science and Technology",institutionURL:null,country:{name:"Japan"}}},equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8985",title:"Natural Resources Management and Biological Sciences",subtitle:null,isOpenForSubmission:!1,hash:"5c2e219a6c021a40b5a20c041dea88c4",slug:"natural-resources-management-and-biological-sciences",bookSignature:"Edward R. Rhodes and Humood Naser",coverURL:"https://cdn.intechopen.com/books/images_new/8985.jpg",editors:[{id:"280886",title:"Prof.",name:"Edward R",middleName:null,surname:"Rhodes",slug:"edward-r-rhodes",fullName:"Edward R Rhodes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10065",title:"Wavelet Theory",subtitle:null,isOpenForSubmission:!1,hash:"d8868e332169597ba2182d9b004d60de",slug:"wavelet-theory",bookSignature:"Somayeh Mohammady",coverURL:"https://cdn.intechopen.com/books/images_new/10065.jpg",editors:[{id:"109280",title:"Dr.",name:"Somayeh",middleName:null,surname:"Mohammady",slug:"somayeh-mohammady",fullName:"Somayeh Mohammady"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9644",title:"Glaciers and the Polar Environment",subtitle:null,isOpenForSubmission:!1,hash:"e8cfdc161794e3753ced54e6ff30873b",slug:"glaciers-and-the-polar-environment",bookSignature:"Masaki Kanao, Danilo Godone and Niccolò Dematteis",coverURL:"https://cdn.intechopen.com/books/images_new/9644.jpg",editors:[{id:"51959",title:"Dr.",name:"Masaki",middleName:null,surname:"Kanao",slug:"masaki-kanao",fullName:"Masaki Kanao"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9550",title:"Entrepreneurship",subtitle:"Contemporary Issues",isOpenForSubmission:!1,hash:"9b4ac1ee5b743abf6f88495452b1e5e7",slug:"entrepreneurship-contemporary-issues",bookSignature:"Mladen Turuk",coverURL:"https://cdn.intechopen.com/books/images_new/9550.jpg",editors:[{id:"319755",title:"Prof.",name:"Mladen",middleName:null,surname:"Turuk",slug:"mladen-turuk",fullName:"Mladen Turuk"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],latestBooks:[{type:"book",id:"9243",title:"Coastal Environments",subtitle:null,isOpenForSubmission:!1,hash:"8e05e5f631e935eef366980f2e28295d",slug:"coastal-environments",bookSignature:"Yuanzhi Zhang and X. San Liang",coverURL:"https://cdn.intechopen.com/books/images_new/9243.jpg",editedByType:"Edited by",editors:[{id:"77597",title:"Prof.",name:"Yuanzhi",middleName:null,surname:"Zhang",slug:"yuanzhi-zhang",fullName:"Yuanzhi Zhang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10020",title:"Operations Management",subtitle:"Emerging Trend in the Digital Era",isOpenForSubmission:!1,hash:"526f0dbdc7e4d85b82ce8383ab894b4c",slug:"operations-management-emerging-trend-in-the-digital-era",bookSignature:"Antonella Petrillo, Fabio De Felice, Germano Lambert-Torres and Erik Bonaldi",coverURL:"https://cdn.intechopen.com/books/images_new/10020.jpg",editedByType:"Edited by",editors:[{id:"181603",title:"Dr.",name:"Antonella",middleName:null,surname:"Petrillo",slug:"antonella-petrillo",fullName:"Antonella Petrillo"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9521",title:"Antimicrobial Resistance",subtitle:"A One Health Perspective",isOpenForSubmission:!1,hash:"30949e78832e1afba5606634b52056ab",slug:"antimicrobial-resistance-a-one-health-perspective",bookSignature:"Mihai Mareș, Swee Hua Erin Lim, Kok-Song Lai and Romeo-Teodor Cristina",coverURL:"https://cdn.intechopen.com/books/images_new/9521.jpg",editedByType:"Edited by",editors:[{id:"88785",title:"Prof.",name:"Mihai",middleName:null,surname:"Mares",slug:"mihai-mares",fullName:"Mihai Mares"}],equalEditorOne:{id:"190224",title:"Dr.",name:"Swee Hua Erin",middleName:null,surname:"Lim",slug:"swee-hua-erin-lim",fullName:"Swee Hua Erin Lim",profilePictureURL:"https://mts.intechopen.com/storage/users/190224/images/system/190224.png",biography:"Dr. Erin Lim is presently working as an Assistant Professor in the Division of Health Sciences, Abu Dhabi Women\\'s College, Higher Colleges of Technology in Abu Dhabi, United Arab Emirates and is affiliated as an Associate Professor to Perdana University-Royal College of Surgeons in Ireland, Selangor, Malaysia. She obtained her Ph.D. from Universiti Putra Malaysia in 2010 with a National Science Fellowship awarded from the Ministry of Science, Technology and Innovation Malaysia and has been actively involved in research ever since. Her main research interests include analysis of carriage and transmission of multidrug resistant bacteria in non-conventional settings, besides an interest in natural products for antimicrobial testing. She is heavily involved in the elucidation of mechanisms of reversal of resistance in bacteria in addition to investigating the immunological analyses of diseases, development of vaccination and treatment models in animals. She hopes her work will support the discovery of therapeutics in the clinical setting and assist in the combat against the burden of antibiotic resistance.",institutionString:"Abu Dhabi Women’s College",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Perdana University",institutionURL:null,country:{name:"Malaysia"}}},equalEditorTwo:{id:"221544",title:"Dr.",name:"Kok-Song",middleName:null,surname:"Lai",slug:"kok-song-lai",fullName:"Kok-Song Lai",profilePictureURL:"https://mts.intechopen.com/storage/users/221544/images/system/221544.jpeg",biography:"Dr. Lai Kok Song is an Assistant Professor in the Division of Health Sciences, Abu Dhabi Women\\'s College, Higher Colleges of Technology in Abu Dhabi, United Arab Emirates. He obtained his Ph.D. in Biological Sciences from Nara Institute of Science and Technology, Japan in 2012. Prior to his academic appointment, Dr. Lai worked as a Senior Scientist at the Ministry of Science, Technology and Innovation, Malaysia. His current research areas include antimicrobial resistance and plant-pathogen interaction. His particular interest lies in the study of the antimicrobial mechanism via membrane disruption of essential oils against multi-drug resistance bacteria through various biochemical, molecular and proteomic approaches. Ultimately, he hopes to uncover and determine novel biomarkers related to antibiotic resistance that can be developed into new therapeutic strategies.",institutionString:"Higher Colleges of Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"8",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Higher Colleges of Technology",institutionURL:null,country:{name:"United Arab Emirates"}}},equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9560",title:"Creativity",subtitle:"A Force to Innovation",isOpenForSubmission:!1,hash:"58f740bc17807d5d88d647c525857b11",slug:"creativity-a-force-to-innovation",bookSignature:"Pooja Jain",coverURL:"https://cdn.intechopen.com/books/images_new/9560.jpg",editedByType:"Edited by",editors:[{id:"316765",title:"Dr.",name:"Pooja",middleName:null,surname:"Jain",slug:"pooja-jain",fullName:"Pooja Jain"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9669",title:"Recent Advances in Rice Research",subtitle:null,isOpenForSubmission:!1,hash:"12b06cc73e89af1e104399321cc16a75",slug:"recent-advances-in-rice-research",bookSignature:"Mahmood-ur- Rahman Ansari",coverURL:"https://cdn.intechopen.com/books/images_new/9669.jpg",editedByType:"Edited by",editors:[{id:"185476",title:"Dr.",name:"Mahmood-Ur-",middleName:null,surname:"Rahman Ansari",slug:"mahmood-ur-rahman-ansari",fullName:"Mahmood-Ur- Rahman Ansari"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10192",title:"Background and Management of Muscular Atrophy",subtitle:null,isOpenForSubmission:!1,hash:"eca24028d89912b5efea56e179dff089",slug:"background-and-management-of-muscular-atrophy",bookSignature:"Julianna Cseri",coverURL:"https://cdn.intechopen.com/books/images_new/10192.jpg",editedByType:"Edited by",editors:[{id:"135579",title:"Dr.",name:"Julianna",middleName:null,surname:"Cseri",slug:"julianna-cseri",fullName:"Julianna Cseri"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9550",title:"Entrepreneurship",subtitle:"Contemporary Issues",isOpenForSubmission:!1,hash:"9b4ac1ee5b743abf6f88495452b1e5e7",slug:"entrepreneurship-contemporary-issues",bookSignature:"Mladen Turuk",coverURL:"https://cdn.intechopen.com/books/images_new/9550.jpg",editedByType:"Edited by",editors:[{id:"319755",title:"Prof.",name:"Mladen",middleName:null,surname:"Turuk",slug:"mladen-turuk",fullName:"Mladen Turuk"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10065",title:"Wavelet Theory",subtitle:null,isOpenForSubmission:!1,hash:"d8868e332169597ba2182d9b004d60de",slug:"wavelet-theory",bookSignature:"Somayeh Mohammady",coverURL:"https://cdn.intechopen.com/books/images_new/10065.jpg",editedByType:"Edited by",editors:[{id:"109280",title:"Dr.",name:"Somayeh",middleName:null,surname:"Mohammady",slug:"somayeh-mohammady",fullName:"Somayeh Mohammady"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9313",title:"Clay Science and Technology",subtitle:null,isOpenForSubmission:!1,hash:"6fa7e70396ff10620e032bb6cfa6fb72",slug:"clay-science-and-technology",bookSignature:"Gustavo Morari Do Nascimento",coverURL:"https://cdn.intechopen.com/books/images_new/9313.jpg",editedByType:"Edited by",editors:[{id:"7153",title:"Prof.",name:"Gustavo",middleName:null,surname:"Morari Do Nascimento",slug:"gustavo-morari-do-nascimento",fullName:"Gustavo Morari Do Nascimento"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9888",title:"Nuclear Power Plants",subtitle:"The Processes from the Cradle to the Grave",isOpenForSubmission:!1,hash:"c2c8773e586f62155ab8221ebb72a849",slug:"nuclear-power-plants-the-processes-from-the-cradle-to-the-grave",bookSignature:"Nasser Awwad",coverURL:"https://cdn.intechopen.com/books/images_new/9888.jpg",editedByType:"Edited by",editors:[{id:"145209",title:"Prof.",name:"Nasser",middleName:"S",surname:"Awwad",slug:"nasser-awwad",fullName:"Nasser Awwad"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"994",title:"Traumatology",slug:"traumatology",parent:{title:"Critical Care Medicine",slug:"critical-care-medicine"},numberOfBooks:5,numberOfAuthorsAndEditors:132,numberOfWosCitations:55,numberOfCrossrefCitations:44,numberOfDimensionsCitations:101,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicSlug:"traumatology",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"9066",title:"Wound Healing",subtitle:null,isOpenForSubmission:!1,hash:"a293ecd8c2655a402321dc30e0ffbf9a",slug:"wound-healing",bookSignature:"Muhammad Ahmad",coverURL:"https://cdn.intechopen.com/books/images_new/9066.jpg",editedByType:"Edited by",editors:[{id:"204257",title:"Dr.",name:"Muhammad",middleName:null,surname:"Ahmad",slug:"muhammad-ahmad",fullName:"Muhammad Ahmad"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7046",title:"Wound Healing",subtitle:"Current Perspectives",isOpenForSubmission:!1,hash:"fa7b870ad29ce1dfcf6faeafdc060309",slug:"wound-healing-current-perspectives",bookSignature:"Kamil Hakan Dogan",coverURL:"https://cdn.intechopen.com/books/images_new/7046.jpg",editedByType:"Edited by",editors:[{id:"30612",title:"Prof.",name:"Kamil Hakan",middleName:null,surname:"Dogan",slug:"kamil-hakan-dogan",fullName:"Kamil Hakan Dogan"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6662",title:"Trauma Surgery",subtitle:null,isOpenForSubmission:!1,hash:"9721b9ac98bf237058cafd0a0303bdbc",slug:"trauma-surgery",bookSignature:"Ozgur Karcioglu and Hakan Topacoglu",coverURL:"https://cdn.intechopen.com/books/images_new/6662.jpg",editedByType:"Edited by",editors:[{id:"221195",title:"Dr.",name:"Ozgur",middleName:null,surname:"Karcioglu",slug:"ozgur-karcioglu",fullName:"Ozgur Karcioglu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6069",title:"Essentials of Spinal Cord Injury Medicine",subtitle:null,isOpenForSubmission:!1,hash:"f0a49e24ebfbb9ed7d02f7daab9b30f6",slug:"essentials-of-spinal-cord-injury-medicine",bookSignature:"Yannis Dionyssiotis",coverURL:"https://cdn.intechopen.com/books/images_new/6069.jpg",editedByType:"Edited by",editors:[{id:"76883",title:"PhD.",name:"Yannis",middleName:null,surname:"Dionyssiotis",slug:"yannis-dionyssiotis",fullName:"Yannis Dionyssiotis"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5290",title:"Wound Healing",subtitle:"New insights into Ancient Challenges",isOpenForSubmission:!1,hash:"a6c479ab3fea0a9b7051d2a8478c91c3",slug:"wound-healing-new-insights-into-ancient-challenges",bookSignature:"Vlad Adrian Alexandrescu",coverURL:"https://cdn.intechopen.com/books/images_new/5290.jpg",editedByType:"Edited by",editors:[{id:"66358",title:"Ph.D.",name:"Vlad",middleName:"Adrian",surname:"Alexandrescu",slug:"vlad-alexandrescu",fullName:"Vlad Alexandrescu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:5,mostCitedChapters:[{id:"50983",doi:"10.5772/63961",title:"Antimicrobial Dressings for Improving Wound Healing",slug:"antimicrobial-dressings-for-improving-wound-healing",totalDownloads:3705,totalCrossrefCites:5,totalDimensionsCites:21,book:{slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Omar Sarheed, Asif Ahmed, Douha Shouqair and Joshua Boateng",authors:[{id:"183108",title:"Dr.",name:"Joshua",middleName:null,surname:"Boateng",slug:"joshua-boateng",fullName:"Joshua Boateng"},{id:"183399",title:"Dr.",name:"Omar",middleName:null,surname:"Sarheed",slug:"omar-sarheed",fullName:"Omar Sarheed"},{id:"188082",title:"Mr.",name:"Asif",middleName:null,surname:"Ahmed",slug:"asif-ahmed",fullName:"Asif Ahmed"},{id:"188083",title:"Ms.",name:"Douha",middleName:null,surname:"Shouqair",slug:"douha-shouqair",fullName:"Douha Shouqair"}]},{id:"51825",doi:"10.5772/64611",title:"Roles of Matrix Metalloproteinases in Cutaneous Wound Healing",slug:"roles-of-matrix-metalloproteinases-in-cutaneous-wound-healing",totalDownloads:2740,totalCrossrefCites:8,totalDimensionsCites:14,book:{slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Trung T. Nguyen, Shahriar Mobashery and Mayland Chang",authors:[{id:"183405",title:"Prof.",name:"Mayland",middleName:null,surname:"Chang",slug:"mayland-chang",fullName:"Mayland Chang"},{id:"191152",title:"Mr.",name:"Trung",middleName:null,surname:"Nguyen",slug:"trung-nguyen",fullName:"Trung Nguyen"},{id:"191153",title:"Prof.",name:"Shahriar",middleName:null,surname:"Mobashery",slug:"shahriar-mobashery",fullName:"Shahriar Mobashery"}]},{id:"63675",doi:"10.5772/intechopen.81208",title:"Wound Healing: Contributions from Plant Secondary Metabolite Antioxidants",slug:"wound-healing-contributions-from-plant-secondary-metabolite-antioxidants",totalDownloads:685,totalCrossrefCites:1,totalDimensionsCites:6,book:{slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Victor Y.A. Barku",authors:[{id:"261027",title:"Prof.",name:"Victor Y. A.",middleName:null,surname:"Barku",slug:"victor-y.-a.-barku",fullName:"Victor Y. A. Barku"}]}],mostDownloadedChaptersLast30Days:[{id:"60520",title:"Maxillofacial Fractures: From Diagnosis to Treatment",slug:"maxillofacial-fractures-from-diagnosis-to-treatment",totalDownloads:1791,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"trauma-surgery",title:"Trauma Surgery",fullTitle:"Trauma Surgery"},signatures:"Mohammad Esmaeelinejad",authors:[{id:"172188",title:"Dr.",name:"Mohammad",middleName:null,surname:"Esmaeelinejad",slug:"mohammad-esmaeelinejad",fullName:"Mohammad Esmaeelinejad"}]},{id:"51825",title:"Roles of Matrix Metalloproteinases in Cutaneous Wound Healing",slug:"roles-of-matrix-metalloproteinases-in-cutaneous-wound-healing",totalDownloads:2743,totalCrossrefCites:8,totalDimensionsCites:15,book:{slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Trung T. Nguyen, Shahriar Mobashery and Mayland Chang",authors:[{id:"183405",title:"Prof.",name:"Mayland",middleName:null,surname:"Chang",slug:"mayland-chang",fullName:"Mayland Chang"},{id:"191152",title:"Mr.",name:"Trung",middleName:null,surname:"Nguyen",slug:"trung-nguyen",fullName:"Trung Nguyen"},{id:"191153",title:"Prof.",name:"Shahriar",middleName:null,surname:"Mobashery",slug:"shahriar-mobashery",fullName:"Shahriar Mobashery"}]},{id:"51223",title:"Medicinal Plants and Natural Products with Demonstrated Wound Healing Properties",slug:"medicinal-plants-and-natural-products-with-demonstrated-wound-healing-properties",totalDownloads:2807,totalCrossrefCites:1,totalDimensionsCites:3,book:{slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Christian Agyare, Emelia Oppong Bekoe, Yaw Duah Boakye,\nSusanna Oteng Dapaah, Theresa Appiah and Samuel Oppong\nBekoe",authors:[{id:"182058",title:"Dr.",name:"Christian",middleName:null,surname:"Agyare",slug:"christian-agyare",fullName:"Christian Agyare"},{id:"186987",title:"Dr.",name:"Yaw Duah",middleName:null,surname:"Boakye",slug:"yaw-duah-boakye",fullName:"Yaw Duah Boakye"},{id:"186988",title:"Ms.",name:"Susanna Oteng",middleName:null,surname:"Dapaah",slug:"susanna-oteng-dapaah",fullName:"Susanna Oteng Dapaah"},{id:"186989",title:"MSc.",name:"Theresa",middleName:null,surname:"Appiah",slug:"theresa-appiah",fullName:"Theresa Appiah"},{id:"186990",title:"Dr.",name:"Samuel Oppong",middleName:null,surname:"Bekoe",slug:"samuel-oppong-bekoe",fullName:"Samuel Oppong Bekoe"},{id:"186992",title:"Dr.",name:"Emelia Oppong",middleName:null,surname:"Bekoe",slug:"emelia-oppong-bekoe",fullName:"Emelia Oppong Bekoe"}]},{id:"63086",title:"Medicinal Plants in Wound Healing",slug:"medicinal-plants-in-wound-healing",totalDownloads:1701,totalCrossrefCites:0,totalDimensionsCites:2,book:{slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Mohammad Reza Farahpour",authors:[{id:"253340",title:"Prof.",name:"Mohammadreza",middleName:null,surname:"Farahpour",slug:"mohammadreza-farahpour",fullName:"Mohammadreza Farahpour"}]},{id:"62998",title:"Biomarkers of Wound Healing",slug:"biomarkers-of-wound-healing",totalDownloads:890,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Christian Agyare, Newman Osafo and Yaw Duah Boakye",authors:[{id:"182058",title:"Dr.",name:"Christian",middleName:null,surname:"Agyare",slug:"christian-agyare",fullName:"Christian Agyare"},{id:"196452",title:"Dr.",name:"Newman",middleName:null,surname:"Osafo",slug:"newman-osafo",fullName:"Newman Osafo"},{id:"252789",title:"Dr.",name:"Yaw Duah",middleName:null,surname:"Boakye",slug:"yaw-duah-boakye",fullName:"Yaw Duah Boakye"}]},{id:"63082",title:"Abdominal Trauma",slug:"abdominal-trauma",totalDownloads:631,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"trauma-surgery",title:"Trauma Surgery",fullTitle:"Trauma Surgery"},signatures:"Göksu Afacan",authors:[{id:"236854",title:"M.D.",name:"Göksu",middleName:null,surname:"Afacan",slug:"goksu-afacan",fullName:"Göksu Afacan"}]},{id:"63308",title:"Autologous Platelet-Rich Plasma and Mesenchymal Stem Cells for the Treatment of Chronic Wounds",slug:"autologous-platelet-rich-plasma-and-mesenchymal-stem-cells-for-the-treatment-of-chronic-wounds",totalDownloads:1153,totalCrossrefCites:1,totalDimensionsCites:3,book:{slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Peter A. Everts",authors:[{id:"256306",title:"Ph.D.",name:"Peter A.",middleName:null,surname:"Everts",slug:"peter-a.-everts",fullName:"Peter A. Everts"}]},{id:"66286",title:"From Tissue Repair to Tissue Regeneration",slug:"from-tissue-repair-to-tissue-regeneration",totalDownloads:1052,totalCrossrefCites:2,totalDimensionsCites:2,book:{slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Aragona Salvatore Emanuele, Mereghetti Giada, Ferrari Alessio and\nGiorgio Ciprandi",authors:[{id:"247667",title:"Prof.",name:"Emanuele Salvatore",middleName:null,surname:"Aragona",slug:"emanuele-salvatore-aragona",fullName:"Emanuele Salvatore Aragona"}]},{id:"71904",title:"Modulation of Inflammatory Dynamics by Insulin to Promote Wound Recovery of Diabetic Ulcers",slug:"modulation-of-inflammatory-dynamics-by-insulin-to-promote-wound-recovery-of-diabetic-ulcers",totalDownloads:274,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"wound-healing",title:"Wound Healing",fullTitle:"Wound Healing"},signatures:"Pawandeep Kaur and Diptiman Choudhury",authors:null},{id:"51068",title:"A Potential Mechanism for Diabetic Wound Healing: Cutaneous Environmental Disorders",slug:"a-potential-mechanism-for-diabetic-wound-healing-cutaneous-environmental-disorders",totalDownloads:1432,totalCrossrefCites:0,totalDimensionsCites:0,book:{slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Junna Ye, Ting Xie, Yiwen Niu, Liang Qiao, Ming Tian, Chun Qing\nand Shuliang Lu",authors:[{id:"182332",title:"Dr.",name:"Junna",middleName:null,surname:"Ye",slug:"junna-ye",fullName:"Junna Ye"}]}],onlineFirstChaptersFilter:{topicSlug:"traumatology",limit:3,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[{type:"book",id:"10176",title:"Microgrids and Local Energy Systems",subtitle:null,isOpenForSubmission:!0,hash:"c32b4a5351a88f263074b0d0ca813a9c",slug:null,bookSignature:"Prof. Nick Jenkins",coverURL:"https://cdn.intechopen.com/books/images_new/10176.jpg",editedByType:null,editors:[{id:"55219",title:"Prof.",name:"Nick",middleName:null,surname:"Jenkins",slug:"nick-jenkins",fullName:"Nick Jenkins"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter"}}],offset:8,limit:8,total:1},route:{name:"profile.detail",path:"/profiles/168063/bart-kerre",hash:"",query:{},params:{id:"168063",slug:"bart-kerre"},fullPath:"/profiles/168063/bart-kerre",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()