Summary of established and tentative lifestyle/environmental factors and their potential interactions with human leukocyte antigen (HLA) risk genes for multiple sclerosis (MS).
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More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
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In particular, it sheds more light on the current state of affairs of corporate governance mechanisms, codes, and their enforcement as well as novel issues arising. The ten constituent chapters contained herein are authored by seasoned academics with research interests in the areas of corporate governance, strategic management, and sustainable management practices. It provides up-to-date theoretical and empirical evidence of such corporate governance issues as corporate governance codes, corporate fraud, quality of earnings, strategic decision making, corporate social responsibility, sustainable management, and sustainable growth strategies. Irrespective of the diverse nature and span of the topics included, this edited volume is divided into three sections and structured to read as a unit.",isbn:"978-953-51-3554-8",printIsbn:"978-953-51-3553-1",pdfIsbn:"978-953-51-4649-0",doi:"10.5772/66270",price:119,priceEur:129,priceUsd:155,slug:"corporate-governance-and-strategic-decision-making",numberOfPages:226,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"1dabae48b0fee99d3d79f66f80ad095d",bookSignature:"Okechukwu Lawrence Emeagwali",publishedDate:"September 20th 2017",coverURL:"https://cdn.intechopen.com/books/images_new/5968.jpg",numberOfDownloads:20343,numberOfWosCitations:12,numberOfCrossrefCitations:34,numberOfCrossrefCitationsByBook:1,numberOfDimensionsCitations:57,numberOfDimensionsCitationsByBook:1,hasAltmetrics:1,numberOfTotalCitations:103,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 8th 2016",dateEndSecondStepPublish:"November 29th 2016",dateEndThirdStepPublish:"February 25th 2017",dateEndFourthStepPublish:"May 26th 2017",dateEndFifthStepPublish:"July 25th 2017",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"196317",title:"Associate Prof.",name:"Okechukwu Lawrence",middleName:null,surname:"Emeagwali",slug:"okechukwu-lawrence-emeagwali",fullName:"Okechukwu Lawrence Emeagwali",profilePictureURL:"https://mts.intechopen.com/storage/users/196317/images/system/196317.jpg",biography:"Dr. Okechukwu Lawrence Emeagwali holds a Ph.D. in Management (Strategy Focus) from Girne American University, Cyprus, where he is currently an Associate Professor of Strategic Management and Head of the Department of Business Management. Dr. Emeagwali is also the director of the faculty’s Center for Management Research (CMR), a member of the Strategic Management Society (SMS), and an active researcher within the field of strategic management. His current research interests focus on understanding the strategic and disruptive thinking patterns among upper echelons and top management teams. Dr. Emeagwali has authored and co-authored more than twenty publications in internationally refereed journals.",institutionString:"Girne American University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"Girne American University",institutionURL:null,country:{name:"Cyprus"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"447",title:"Sustainable Management Practices",slug:"business-management-and-economics-business-administration-sustainable-management-practices"}],chapters:[{id:"56244",title:"Corporate Governance",doi:"10.5772/intechopen.69704",slug:"corporate-governance",totalDownloads:1540,totalCrossrefCites:2,totalDimensionsCites:4,hasAltmetrics:0,abstract:"The following chapter identifies the meaning and main features of corporate governance, underlines the importance of an entity, which regulates and balances the interests of shareholders, stakeholders, and managers in order to realize a corporation’s long-run goals. Currently, all models of corporate governance can be divided by their characteristics into three types: Anglo-American, German, and Japanese; each of these models has some unique elements that are required by a particular country. The process of forming and development of corporate governance in transitional economies are described as well. As the accuracy of corporate government influences the wiliness of investors to sink their capital, it is crucial to understand the methods of corporate governance efficiency evaluation by international rating agencies. Moreover, the example of Enron Corporation’s failure shows the exceptional role of corporate governance in protecting and ensuring the rights of shareholders and stakeholders, solving the conflict between managers seeking higher bonuses and investors’ goals on stable future return and potential growth.",signatures:"Alla Mostepaniuk",downloadPdfUrl:"/chapter/pdf-download/56244",previewPdfUrl:"/chapter/pdf-preview/56244",authors:[{id:"202902",title:"Dr.",name:"Alla",surname:"Mostepaniuk",slug:"alla-mostepaniuk",fullName:"Alla Mostepaniuk"}],corrections:null},{id:"55244",title:"Corporate Governance and Fraud: Evolution and Considerations",doi:"10.5772/intechopen.68489",slug:"corporate-governance-and-fraud-evolution-and-considerations",totalDownloads:3106,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"There are many definitions of Corporate Governance, as a structure, as process, as policies, as mechanisms, but despite their differences of focus, they mainly addressed the sustainable economic growth and protection of shareholders and other stakeholder’s rights. The purpose here is to present the evolution of the main principles and frameworks as corporate and financial environment changes and set new challenges. Some important scandals that revealed the weaknesses of corporate governance frameworks are described to complement the comprehension of the object of it. It is detached the aspects simulated or ignored and the subsequent enforcement and monitoring response. Discussion about the new challenges, what corporate governance is supposed to provide and what it can promote, closes this chapter.",signatures:"Ana Paula Paulino da Costa",downloadPdfUrl:"/chapter/pdf-download/55244",previewPdfUrl:"/chapter/pdf-preview/55244",authors:[{id:"201677",title:"Dr.",name:"Ana Paula P.",surname:"Costa",slug:"ana-paula-p.-costa",fullName:"Ana Paula P. Costa"}],corrections:null},{id:"56123",title:"Corporate Governance Codes and Their Role in Improving Corporate Governance Practice",doi:"10.5772/intechopen.69707",slug:"corporate-governance-codes-and-their-role-in-improving-corporate-governance-practice",totalDownloads:3322,totalCrossrefCites:1,totalDimensionsCites:4,hasAltmetrics:0,abstract:"Good corporate governance (CG) is primarily the responsibility of every company, and both hard law and soft law should provide comprehensive corporate governance framework, thereby encouraging the introduction of high governance standards and best practices in the companies’ corporate governance system. The aim of this contribution is to broaden understanding on the role of codes of good governance in improving corporate governance practice on the case of Slovenia. The findings of research studies and analyses of the content of the Slovenian CG Code and its adoption in Slovenian companies show that the code has been playing an important role in developing corporate governance practice in Slovenia. Additionally, such analyses provide important cognitions on the adoption of the CG Code in Slovenian companies by revealing improvements in the governance practice and indicating those areas where changes are required. That is a way such monitoring and analyses should be done on the regular basis together with reporting on the monitoring results. This can considerably contribute to better understanding of the code’s recommendations among companies, promote debate and thus foster awareness of the underlying issues. Future analyses should address not only the statements on compliance but also how companies actually implement the code’s recommendations.",signatures:"Mojca Duh",downloadPdfUrl:"/chapter/pdf-download/56123",previewPdfUrl:"/chapter/pdf-preview/56123",authors:[{id:"202681",title:"Dr.",name:"Mojca",surname:"Duh",slug:"mojca-duh",fullName:"Mojca Duh"}],corrections:null},{id:"56867",title:"Strategic Decision Making and Its Importance in Small Corporations",doi:"10.5772/intechopen.68858",slug:"strategic-decision-making-and-its-importance-in-small-corporations",totalDownloads:2093,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The global economic crisis has sharply affected thousands of small corporations and declared bankruptcy. It is likely that in the form in which they are working now, they will not be able to survive the economic pressure of competitors. Effective policy‐making can be an important key to success. Analysis of the process of strategic decision making in small corporations is extensive research gap that we try to fill with the contribution. We put emphasis on strategic decisions, models of the strategic decision‐making factors affecting the profile of these processes and mechanisms that make use of small corporation managers in strategic decision making. The conclusions of the research are identified the most important aspects influencing and forming process of strategic decision making by managers of small corporations.",signatures:"Nadežda Jankelová",downloadPdfUrl:"/chapter/pdf-download/56867",previewPdfUrl:"/chapter/pdf-preview/56867",authors:[{id:"202315",title:"Dr.",name:"Nadežda",surname:"Jankelova",slug:"nadezda-jankelova",fullName:"Nadežda Jankelova"}],corrections:null},{id:"55548",title:"Taking Corporate Social Responsibility as Growth Strategy",doi:"10.5772/intechopen.69028",slug:"taking-corporate-social-responsibility-as-growth-strategy",totalDownloads:1631,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Corporate social responsibility (CSR) has been of great interest to many practitioners and researchers. Although this topic has been in hot discussion for the past few decades, many concerns and debates remain. In recent years, increasing evidence has demonstrated that there exists a positive relationship between CSR and firm performance, which negates conventional thought that CSR is an unavoidable additional cost to a firm. In fact, CSR can facilitate a positive value of a firm from the perspectives of marketing, innovation, management, and ownership. Thus, this chapter argues that CSR should not merely serve for the window‐dressing purpose, yet it should be incorporated into practical business operations and then become key corporate growth strategy as a firm grows in size.",signatures:"George Y. Wang",downloadPdfUrl:"/chapter/pdf-download/55548",previewPdfUrl:"/chapter/pdf-preview/55548",authors:[{id:"202778",title:"Prof.",name:"George Yungchih",surname:"Wang",slug:"george-yungchih-wang",fullName:"George Yungchih Wang"}],corrections:null},{id:"56639",title:"Creating Shared Value in the Context of Sustainability: The Communication Strategy of MNCs",doi:"10.5772/intechopen.70177",slug:"creating-shared-value-in-the-context-of-sustainability-the-communication-strategy-of-mncs",totalDownloads:1698,totalCrossrefCites:7,totalDimensionsCites:9,hasAltmetrics:1,abstract:"Creating shared value in the context of sustainability is a way to integrate stakeholders in business management. In addition, companies use a specific communication strategy to communicate the results of sustainable activities involving strategic stakeholders. In a sample of companies included in the Dow Jones Sustainability Index and Global Rep Track 100, we analyze the corporate social responsibility (CSR) strategy of these companies, how they integrate the Sustainable Development Goals, and how they create a dialogue with their stakeholders across different platforms. The study of the sample is performed by content analysis on identity values and their correspondence with the CSR values, and this study includes an analysis of activities that these companies develop communicating their impacts. The results show that companies have actively integrated their stakeholders into their business management. However, these companies incorporate the concept of value creation in a different manner, although their activities are oriented to the stakeholders as to the benefit of society.",signatures:"Belén López and Abel Monfort",downloadPdfUrl:"/chapter/pdf-download/56639",previewPdfUrl:"/chapter/pdf-preview/56639",authors:[{id:"201681",title:"Dr.",name:"Belen",surname:"Lopez",slug:"belen-lopez",fullName:"Belen Lopez"},{id:"203451",title:"Dr.",name:"Abel",surname:"Monfort",slug:"abel-monfort",fullName:"Abel Monfort"}],corrections:null},{id:"56214",title:"Strategic Corporate Performance Management: A Customer- Oriented Approach",doi:"10.5772/intechopen.69708",slug:"strategic-corporate-performance-management-a-customer-oriented-approach",totalDownloads:1437,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The contemporary world is characterized by enormous development of globalization on the basis of fast spread of information enabled by modern information technologies. The development of the last decades is very difficult to predict. Under these conditions, the society’s paradigm is changing as for the corporate economy management. The significance of non-financial indicators grows, they, in connection with the financial ones, can identify conditions much better and influence corporate performance indicators. An important role is played by the interdisciplinary holistic approach to corporate management, responding to rapid changes in production related to the individualization of the products according to customer requirements and shortening its life cycle. Under these conditions, the most important factor for market success becomes a customer, whose satisfaction and loyalty to the company must be measured to be able to create conditions for stable growth corporate performance. The great attention is also given to the theoretical basis on which corporate performance management is created. The most important part of customer-oriented management is data acquisition from the measurement of customer experience. The questionnaire survey was the basis for gaining of the primary data source for the customer’s satisfaction and loyalty measurements on the net promoter score (NPS) principle.",signatures:"Lilia Dvořáková and Olga Faltejsková",downloadPdfUrl:"/chapter/pdf-download/56214",previewPdfUrl:"/chapter/pdf-preview/56214",authors:[{id:"202939",title:"Prof.",name:"Lilia",surname:"Dvorakova",slug:"lilia-dvorakova",fullName:"Lilia Dvorakova"},{id:"202940",title:"Dr.",name:"Olga",surname:"Faltejskova",slug:"olga-faltejskova",fullName:"Olga Faltejskova"}],corrections:null},{id:"56008",title:"Gaining a Competitive Advantage through Green Human Resource Management",doi:"10.5772/intechopen.69703",slug:"gaining-a-competitive-advantage-through-green-human-resource-management",totalDownloads:2246,totalCrossrefCites:9,totalDimensionsCites:17,hasAltmetrics:0,abstract:"The practices of environmental protection and the prevention of environmental pollution have emerged as a result of recent environmental problems when the humans noticed that natural resources are limited. Environmental management practices have accelerated with the conscious acts of businesses on environmental issues since they have the greatest responsibility for environmental pollution. After the 2000s, businesses have started to prefer to be a part of the solution rather than being at the center of the problem and tended to green business and management practices. For improved environmental performance, sustainable competitive advantage, and environmental management, environmental consciousness should be taken into consideration in each and every human resource function ranging from recruitment to training of employees, from performance assessment to rewarding. In this sense, green human resources management (GHRM), allowing improved employee consciousness and commitment to environmental sustainability, has become an interesting issue. In the present study, green human resources management and practices are evaluated, significant issues are pointed out, and recommendations are made for future researchers who wish to work upon this subject.",signatures:"Ebru Aykan",downloadPdfUrl:"/chapter/pdf-download/56008",previewPdfUrl:"/chapter/pdf-preview/56008",authors:[{id:"202532",title:"Dr.",name:"Ebru",surname:"Aykan",slug:"ebru-aykan",fullName:"Ebru Aykan"}],corrections:null},{id:"55304",title:"Earnings Quality and Market Performance in LATAM Corporations: A Combined Agency and Cognitive Approach to Investors’ Perceptions of Managerial Information",doi:"10.5772/intechopen.68485",slug:"earnings-quality-and-market-performance-in-latam-corporations-a-combined-agency-and-cognitive-approa",totalDownloads:1222,totalCrossrefCites:2,totalDimensionsCites:4,hasAltmetrics:0,abstract:"This chapter studies the impact of financial reporting quality on firms’ market performance in a sample of LATAM corporations. We infer that, especially in contexts of high information asymmetry, investors are not able to effectively discern the quality of the information they are provided with and can therefore be misled in their investment decisions by managerial opportunism. Our theoretical framework is built upon a combined agency theory and cognitive approach. We thereby seek to provide a valuable method to better understand how investors could be making suboptimal choices as a consequence of managers’ opportunistic behaviour. Empirically, we use the Generalized Method of Moments (GMM) model, hypothesizing that a positive relationship should be observed between the opportunistic manipulation of earnings (that is, the misuse of accounting accruals) and the firm’s market performance (that is, the consequential behaviour of investors). Through this ‘pioneering’ methodology, applied to the relatively under-researched LATAM region, we find that: (1) Financial data are identifiably and consistently manipulated through discretionary accruals in these countries. (2) As manipulation increases, markets do tend to appear more attractive to investors. (3) The elasticity of the market reaction to this manipulation is higher in what we term ‘opaque’ countries.",signatures:"Paolo Saona, Alesia Slocum, Laura Muro and Gonzalo Moreno",downloadPdfUrl:"/chapter/pdf-download/55304",previewPdfUrl:"/chapter/pdf-preview/55304",authors:[{id:"201486",title:"Ph.D.",name:"Paolo",surname:"Saona Hoffmann",slug:"paolo-saona-hoffmann",fullName:"Paolo Saona Hoffmann"},{id:"202880",title:"Dr.",name:"Alesia",surname:"Slocum",slug:"alesia-slocum",fullName:"Alesia Slocum"},{id:"202881",title:"Dr.",name:"Laura",surname:"Muro",slug:"laura-muro",fullName:"Laura Muro"},{id:"202882",title:"Dr.",name:"Gonzalo",surname:"Moreno",slug:"gonzalo-moreno",fullName:"Gonzalo Moreno"}],corrections:null},{id:"56333",title:"Universities as Corporate Entities: The Role of Social Responsibility in Their Strategic Management",doi:"10.5772/intechopen.69931",slug:"universities-as-corporate-entities-the-role-of-social-responsibility-in-their-strategic-management",totalDownloads:2052,totalCrossrefCites:8,totalDimensionsCites:14,hasAltmetrics:1,abstract:"Universities, as educational institutions, play a vital role in the development and improvement of the society, contributing to the welfare of citizens. Considering the social responsibility of universities with a large number of stakeholders (students, institutions, government, employees, companies, local community, etc.), this chapter aims to examine how these institutions establish the mission, objectives and strategic actions oriented at meeting these expectations. In this line, university in its daily management is also considered a corporate entity, which set up strategic plans and practices, an essential process to achieve its success in the long term. The chapter explores the necessary steps for adjusting these strategic plans to the new challeng e of introducing a socially responsible orientation in their management.",signatures:"Elva L. Ramos‐Monge, Xavier Llinàs Audet and Jesús Barrena‐\nMartínez",downloadPdfUrl:"/chapter/pdf-download/56333",previewPdfUrl:"/chapter/pdf-preview/56333",authors:[{id:"197760",title:"Associate Prof.",name:"Jesus",surname:"Barrena-Martinez",slug:"jesus-barrena-martinez",fullName:"Jesus Barrena-Martinez"},{id:"202710",title:"Ph.D. Student",name:"Elva",surname:"Ramos-Monge",slug:"elva-ramos-monge",fullName:"Elva Ramos-Monge"},{id:"202711",title:"Prof.",name:"Xavier",surname:"Llinas-Audet",slug:"xavier-llinas-audet",fullName:"Xavier Llinas-Audet"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"7570",title:"Strategic Management",subtitle:"a Dynamic View",isOpenForSubmission:!1,hash:"f64ac900c22d892e48ff84a23668f124",slug:"strategic-management-a-dynamic-view",bookSignature:"Okechukwu Lawrence Emeagwali",coverURL:"https://cdn.intechopen.com/books/images_new/7570.jpg",editedByType:"Edited by",editors:[{id:"196317",title:"Associate Prof.",name:"Okechukwu Lawrence",surname:"Emeagwali",slug:"okechukwu-lawrence-emeagwali",fullName:"Okechukwu Lawrence Emeagwali"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10755",title:"Corporate Governance",subtitle:"Recent Advances and Perspectives",isOpenForSubmission:!1,hash:"ffe06d1d5c4bf0fc2e63511825fe1257",slug:"corporate-governance-recent-advances-and-perspectives",bookSignature:"Okechukwu Lawrence Emeagwali and Feyza Bhatti",coverURL:"https://cdn.intechopen.com/books/images_new/10755.jpg",editedByType:"Edited by",editors:[{id:"196317",title:"Associate Prof.",name:"Okechukwu Lawrence",surname:"Emeagwali",slug:"okechukwu-lawrence-emeagwali",fullName:"Okechukwu Lawrence Emeagwali"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9337",title:"Sustainable Management Practices",subtitle:null,isOpenForSubmission:!1,hash:"ef070ee744c15a1084cca5bb546816df",slug:"sustainable-management-practices",bookSignature:"Muddassar Sarfraz, Muhammad Ibrahim Adbullah, Abdul Rauf and Syed Ghulam Meran Shah",coverURL:"https://cdn.intechopen.com/books/images_new/9337.jpg",editedByType:"Edited by",editors:[{id:"260655",title:"Dr.",name:"Muddassar",surname:"Sarfraz",slug:"muddassar-sarfraz",fullName:"Muddassar Sarfraz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,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:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,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"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,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. 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The importance of pain management during dental procedures cannot be over-emphasized, but without proper anesthesia, the treatment plan may not be feasible or may result in potential harm to some of the patients. Anesthetic injections should be as painless as possible, especially in the palate which is the most sensitive area of the oral cavity for injection [1].
The conventional nasopalatine nerve block is commonly used to obtain anesthesia in the anterior portion of the palate. The painful nature of this approach, however, has led investigators to seek alternative methods to obtain an anesthesia. Labial infiltration of the maxillary central incisors can be considered an effective anesthetic substitute for procedures of the anterior palate. This chapter presents the anesthetic effect of a modified labial infiltration method for anesthetizing the nasopalatine nerve. The authors have reported this method of labial infiltration to be an effective alternative to the painful conventional nasopalatine nerve block to obtain efficient anesthesia of the anterior palate (p <0.001).
Anesthesia of the nasopalatine nerve is a mandatory prerequisite to perform surgical procedures on the soft and hard tissues of the anterior palate and for extraction of upper anterior teeth [1].The nasopalatine nerve passes through the Incisive fossa which is posteroinferior to anterior nasal spine and finally enters the oral cavity via the incisive foramen and innervates the anterior palate, maxillary central incisors and nasal floor (Figure 1). [1-3]
Diagram of the nasopalatine and surrounding nerves
Labial tissues are anaesthetized by labial infiltration. Obtaining anesthesia for the relevant palatal soft tissue is however, not possible this way and necessitates direct injection of an anesthetic agent in the palatal area (incisive papilla). Palatal soft tissues, especially in the vicinity of the hard palate, are tightly attached to the underlying bone. Injection in this area is thus, painful when the conventional method for injecting the anesthetic agent directly into or aside the incisive papilla is used [4].Therefore removal of maxillary teeth without a palatal injection is desirable.
In this technique two injections at two sites should be done.
Anesthesia of the maxillary hard and soft tissue of the labial area is obtained by injection of 1 cc of local anesthetic agent in the labial vestibule, with the syringe parallel to the long axis of the lateral incisor tooth and the needle bevel toward the bone. This is a nerve block because local anesthetic is deposited close to the main nerve trunk [2] (Figures 2, 3 and 4).With this injection the canine, lateral incisor, central incisors, hard and soft tissue of the alveolar area to the midline are anesthetized.
Diagram of the nasopalatine and surrounding nerves (from Gray’s Anatomy, 37th Ed.).
Nerve block (from Malamed 2013, 5th ed.)
The anesthesia of the maxillary hard and soft tissue of the labial area is obtained by injection of 1 cc of local anesthetic agent, with the syringe parallel to the long axis of the tooth. Orient the needle bevel toward the bone.
After 2-3 minutes and relative anesthesia of the labial area, infiltration of about 0.6 ml of the remaining solution is administered via a needle inserted superior to the apices of central incisors in the vicinity of the superior border of the base of the anterior nasal spine near the nasal floor at a 45 degree angle to the long axis of the central incisor, to obtain anesthesia in the anterior palate (Figure 5).
Needle inserted superior to the apices of central incisors in the vicinity of the superior border of the base of the anterior nasal spine near the nasal floor at a 45 degree angle to the long axis of the central incisor, to obtain anesthesia in the anterior palate.
Five to six minutes following the second injection, the extension and efficiency of anesthesia in the anterior palate is assessed by an explorer or periosteal elevator and if pain-free the nasopalatine nerve need not be injected from the palate and there is no need for another injection for extraction or dentoalveolar surgery. In the case of mild pain, severe pain, moderate pain or no anesthesia, a complementary injection in the palate is needed. The authors assessed this via a clinical trial that included 60 patients referring for the extraction of maxillary incisors and canine. They showed complete anesthesia of the anterior area of the palate in 76.7% of patients using this method; 23.3% needed a conventional nasopalatine nerve block to complement the effect of anesthesia prior to treatment. In controls we used the conventional technique.
The level of anesthesia obtained by our method in the anterior palate is satisfactory. The labial infiltration method resulted in total anesthesia in the majority of the cases. Failures may be the result of anatomic and physiologic variations. An eight minute wait or longer may be more effective than five minutes following the second injection. The amount of pain experienced by the patients during the injection in the labial infiltration approach is less than the conventional approach in most cases. [5]
The mental-incisive nerve block can be used where lower premolars and anterior teeth require treatment. In this chapter we present our method of mental-incisive nerve block for extraction of the lower premolars and anterior teeth or dentoalveolar surgery.
The authors reported a 95% success rate with the modified injection distal to the second lower premolar, while the success rate was 72.5% when the injection was done traditionally between lower premolars.
This modified mental-incisive nerve block with injection done distal to the second premolar is more successful than between premolars
The Inferior Alveolar Nerve Block (IANB) is the most important injection technique in dentistry. Unfortunately it also proves to be the most frustrating; with the highest percentage of clinical failure [6]. Potocnik and Bajrovic reported that even when a proper technique is employed, clinical studies show that IANB fails in approximately 30% to 45% of cases [7]. When dental treatment involved procedures on mandibular premolars and anterior teeth the incisive nerve block can be administered with greater success [6]. However, the injection technique for mental-incisive nerve block (MINB) may also influence the success rate.
The target is the mental foramen located on external surface of the body of the mandible below the first and second premolars where the IAN divides into terminal (incisive and mental) branches. The incisive branch continues forward in a bony canal or in a plexiform arrangement, giving off branches to the first premolar, canine and incisor teeth, and the associated labial gingiva. The lower central incisor teeth receive a bilateral innervation, fibers probably cross the midline within the periosteum to re-enter the bone via numerous canals in the labial cortical plate. The mental nerve passes upward, backward and outward to emerge from the mandible via the mental foramen between and just below the apices of the premolar teeth [8].
In 24% of individuals the mental foramen is located distal to the root of the second premolar; in 20 to 25%, between the premolars roots, in 50% at the site of the second premolar root and in 1% to 2% anterior to the first premolar or mesial to the first molar.
However, the location of mental foramen varies in different people [8-13]; in 24% of individuals the mental foramen is located distal to the root of the second premolar; in 20 to 25%, between the premolars roots, in 50% at the area of the second premolar root and in 1% to 2% anterior to the first premolar or mesial to the first molar (Figure 6). [13] This variability in location may cause problems in obtaining anesthesia [8, 10, 13-15].
There are different methods for MINB; the authors compared 2 mental–incisive nerve block techniques for the extraction of lower premolars and anterior teeth bilaterally. One method was to inject between the first and second premolar so that the needle passed between the two premolars vertically. In the other method, the injection was performed distal to the second premolar.
This randomized double blind, split-mouth clinical study was done; in the case group, the needle penetrated the depth of the vestibule distal to the second premolar using a 27 gauge needle. Entry was from behind the patient at the ten O’ clock and the opposite side at the 2 O’ clock position. The needle entered the soft tissue about 5-8 mm supraperiosteal, with mouth half-open and lip and buccal tissues retracted. When standing behind the patient, the anatomical landmarks were the second premolar and buccal vestibule (Figure 7).
The injection administered distal to the second premolar. The syringe should be from posterior to anterior, from above to below and from lateral to medial while standing behind the patient.
In the control group an injection was done in the depth of buccal mucosa between two premolars at a depth of 5-6 mm using a 27 gauge needle with the mouth half open standing behind the patient (Figure 8). [16]
The injection administered in the depth of buccal mucosa between two premolars at a depth of 5-6 mm using a 27 gauge short needle with the mouth half open while standing behind the patient.
In both groups the local anesthetic solution was lidocaine 2% (1 cc) with epinephrine (1/80000). It is not necessary for the needle to enter the mental foramen. Data was statistically analyzed using the chi-square test. All patients had a lingual injection (0.5 cc) which was administered 5 mm distal to the tooth in the floor of the mouth.
The MINB with needle entrance distal to the second premolar from behind had a 95% success rate and MINB with needle entrance between premolars had a 72.5% success rate respectively (p<0.01). Thus, if the mental nerve block injection is administered with the needle entrance between premolars, the chance of failure is greater (R.R=5.5).
The MINB can be an alternative to the IANB when dental procedures requiring pulpal anesthesia on mandibular teeth anterior to the mental foramen (e.g. canine to canine or premolar to premolar) are treated. According to the result, we found that MINB with needle penetration distal to second premolar was more effective (95%) than injection between two premolars (72.5%). Al Yasser and Al Nwoku [15] showed that the mental foramen location on both sides of the mandible in 80% of cases is symmetrical and in 46.2% of cases the mental foramen is located between the longitudinal axes of the two premolars. Moiseiwitch [10] reported that anterior-posterior positions of mental foramens in most cases are symmetrical. In most studies on mental foramens in different cases, researchers reported that most mental foramens are in line with second premolars [11, 14]. What most scientists agree with is the presence of mental foramen in range of the long axis of the second premolar [10-12] with about 50% of cases at the level of the root of second premolar, between the two premolars in about 20% to 25% and posterior to the second premolar in about 24%, and in approximately 1% to 2% it lies as forward as the first premolar or as far back as the first molar [13]. This may be why the technique in which the needle penetrates mucosa distal to second premolar may yield the success rate of MINB higher. According to the results, the success rate of anesthesia administered distal to second premolar was 95% and with needle penetration between premolar was 72.5% [6, 9]. According to Malamed the correct position of the dentist is in front of the patient so that the syringe may be placed into the mouth below the patients line of sight and the thumb or index finger in the mucobuccal fold against the body of the mandible in the first molar area and moved slowly anteriorly until feeling the bone become irregular and somewhat concave [6] while in our technique there is no need to palpate the area and produce discomfort for patients. Mucosal penetration done from the distal of the second premolar hides the needle from the line of sight of the patient. When standing in front of the patient it is easier for the patient to see the needle whereas when standing behind the patient it is unlikely for him or her to visualize the needle. [17]
Mental-incisive nerve block injection distal to the second premolar from behind the patient was more successful than between premolars from the front.
This modified direct technique is easier and more practical than the conventional technique described by Malamed in the handbook of local anesthesia [18]; also it is easier to learn and teach dental students. We have used this technique in practice for many years with a high success rate (up to 98%).
A 27 gauge short or long needle is recommended.
The mouth should be open wide.
Placement of the syringe barrel at the first molar of the opposite side.
Needle penetration occurs at the point one centimeter above the occlusal plane of the mandibular molar and parallel to it just at the lateral border of pterygomandibular raphe. In this situation, the needle touches the medial aspect of the ramus at about a 90 angle. When entering the pterygomandibular space injury to the medial pterygoid muscle should be avoided. The pterygomandibular fold may serve as a landmark for the anterior border of the muscle. The needle pierces the mucous membrane lateral to the pterygomandibular fold and injury to the medial pterygoid muscle is avoided easily [18-21]
While slowly advancing, the needle contacts bone; then we withdraw the needle about 1 mm to prevent subperiosteal injection. If aspiration is negative, we slowly deposit 1.5 ml of anesthetic within 60 seconds; the remaining solution is deposited for lingual nerve anesthesia while withdrawing the needle. The average depth of needle penetration to bony contact depends on soft tissue thickness of the area on the medial aspect of the ramus. This will be approximately 8-10 mm or less, it is not necessary to advance the needle in the posterior direction at all or you will be far from the exact injection site. In this technique using the thumb or finger is not necessary, a dental mirror or Minnesota retractor can be used; however there is really no need to use these instruments. With this technique the inferior alveolar and lingual nerves are anesthetized. The long buccal nerve should be anesthetized separately for molar extraction (Figure 9).
The modified direct technique.
With regard to the high success rate of the technique and because of simplicity and easy learning curve by dental students it can be placed into the academic curriculum.
Multiple sclerosis (MS) is a central nervous system (CNS) immune-mediated disease characterized by demyelination and gliosis as a result of immune cell infiltration across the blood–brain barrier. The disease’s neurologic signs and symptoms are highly variable and dependent on the location of lesions in the CNS [1]. MS is the leading cause of non-traumatic disability in children. This disorder is a multifactorial, immune-mediated disease influenced by both genetic and environmental factors [2]. The prevalence of MS is expected to rise significantly in 2020, with an estimated 2.8 million people living with the disease worldwide in 2020, which is 30% more than in 2013, and it is more common in women than in men [3].
The exact cause of MS is unknown, but it is widely assumed that the disease is caused by complex gene–environment interactions [4, 5]. Genetic factors are important for characterizing pathogenetic mechanisms, and for elucidating the complex picture of disease initiation in the context of lifestyle and environmental factors Human leukocyte antigen (HLA) class I and II genes, which are the most strongly associated loci to MS. HLA class I and II genes encode for molecules that present antigens to CD4+ and CD8+ T lymphocytes [5]. In addition to genetic variants, lifestyle and environmental factors can be the important contributors to disease risk. Exposure to tobacco smoke and organic solvents, certain infections such as Epstein–Barr virus (EBV) infection, adolescent obesity, low levels of vitamin D and low exposure to sunlight, climate, and working night shifts are all risk factors (Figure 1), (Table 1). Use of oral tobacco, high coffee consumption, alcohol consumption, and serological evidence of cytomegalovirus (CMV) infection are all factors that may be associated with a lower risk (Table 1) [5, 6, 7, 8].
The pathogenesis of multiple sclerosis is influenced by both genetic and environmental factors. Gender,disease-modifier genes, disease susceptibility genes, and single nucleotide polymorphisms are among the genetic factors that play a significant role in MS prevalence and pathogenesis. Environmental factors, on the other hand, such as smoking, vitamin D deficiency, exposure to pollutants, alcohol, diet style, Epstein Barr infection, dysbiosis of the gut microbiota, lack of exercise, and stress, are strongly linked to MS susceptibility and progression.
Factor | OR | HLA gene interaction | Combined OR | Immune system implied |
---|---|---|---|---|
Smoking | ~1.5 | Yes | 14 | yes |
Oral tobacco | ~0.5 | ND | NA | yes |
EBV infection (seropositivity) | ~3.6 | Yes | ~16 | yes |
CMV infection (seropositivity) | ~0.7 | No | NA | yes |
Work shift | ~1.7 | No | NA | yes |
Adolescent obesity (BMI > 27) | ~2 | Yes | ~15 | Yes |
Vitamin D level < 50 nM | ~1.4 | No | NA | Yes |
Low sun exposure | ~2 | No | NA | Yes |
Alcohol | ~0.7–0.8 | No | NA | Yes |
Coffee | ~0.7 | No | NA | Yes |
Summary of established and tentative lifestyle/environmental factors and their potential interactions with human leukocyte antigen (HLA) risk genes for multiple sclerosis (MS).
OR, Odd ratio; HLA, Human Leukocyte Antigen; EBV, Epstein–Barr virus; CMV, cytomegalovirus; BMI, body mass index; ND, not determined, NA, not applicable.
MS risk and severity are influenced by a combination of genetic, environmental, and lifestyle/behavioral variables. This chapter explores the evidence regarding the impact of environmental and lifestyle factors such as sunshine and/or vitamin D, EBV infection, smoking and alcohol consumption, and other factors at various life stages, and addresses the issues in-depth and the impact of genetic variability on some.
Human leukocyte antigen (HLA) class I and II genes are particularly important disease risk modifiers: class II gene variants encode products that present antigens to CD4+ T lymphocytes, while class I products present antigens to CD8+ lymphocytes. The class II variant HLADRB1*15: 01 is a risk allele of MS (odds ratio (OR) ~3) and is carried by 25–30% of the population in northern Europe and the United States. The second most powerful MS gene, class I variant HLAA*02, is associated with a lower risk of MS (OR ~0.6). While the absence of HLAA*02 combined with the presence of DRB1*15: 01 has a combined OR of ~5 [5, 9, 10, 11, 12].
Several cohort studies suggest that the HLA genotype can influence environmental influences on MS risk. The harmful effects of childhood obesity [13], smoking [14, 15, 16], infectious mononucleosis, and solvent exposure [16] on MS risk are amplified in those who carry the HLA DRB1*15 allele and lack the protective HLA A*02 genotype. A recent study found a strong link between higher childhood body mass index (BMI) at age 10, smoking before the age of 20, and earlier menarche and MS. In a combined model that included the HLA DRB1*15:01 and HLA A*02:01 genotypes, the effects of these three risk factors remained similar [6]. Environmental risk factors have been shown to play an important role in the development of MS disease in genetically susceptible populations (class II HLA-DRB1*15:01 carriers) [17].
The mechanisms by which previous viral infections and viral reactivation may contribute to MS onset are still unknown. Epstein-Barr virus (EBV) is one of these viruses that has been linked to an increased risk of MS, as it has been discovered that people who have had clinically overt infectious mononucleosis (IM) have a more than twofold risk of developing MS [18, 19]. This organization has recently received funding. According to a longitudinal study, the risk of MS increased 32-fold after infection with EBV but not after infection with other viruses [20]. Supporting the link between EBV and MS, EBV-induced infectious mononucleosis, positivity for EBV nuclear antigen (EBNA)-1 IgG, or higher EBNA-1 titers have all been linked to an increased risk of MS (OR ~3.6) [21, 22]. Furthermore, there appears to be a critical time window for EBV infection, with infection occurring during adolescence or later implying an increased risk of developing MS, whereas this is not the case in childhood [23].
The genetic risk for elevated antiEBNA1 titers has been found to be positively correlated with the development of MS [24], which could be interpreted as additional evidence for EBV’s causality in MS. It has been reported that EBNA positivity interacts with both HLA-A*02 and HLA-DRB1*15 [25, 26]. Another study of MS cases and healthy non-MS controls who were seropositive for EBV found that HLA-A*A02-positive individuals had the lowest EBV viral load and HLA-DRB1*15-positive individuals had the highest. These findings support EBV’s causal role in MS, which is modulated by the HLA Class 1 genotype via changes in antigen presentation to T cells [27]. It has also been reported that an additive interaction of EBV status with HLA DRB1*15:01 modifies MS risk [28, 29]. People who tested positive for HLA-DRB1 *15, negative for HLA-A* 02, and had high EBNA-1 titers, had a 16-fold increased risk of MS compared to those who did not carry any of these factors, with a combined OR of ~16 [26].
The genetic risk for elevated antiEBNA1 titers is positively correlated with the development of MS, which could be further evidence for EBV causality in MS [24]. Infectious mononucleosis and increased EBNA1 antibody titers interact with HLA MS risk genetic variants [26]; and infectious mononucleosis interacts with HLA DRB1*15:01 [30] to increase the risk of MS in a pattern similar to smoking. Because HLA risk alleles encode molecules that regulate T cell adaptive immunity, the interaction with EBV infection measures may point to common pathogenetic pathways in MS [5].
Cytomegalovirus (CMV) is a herpes virus that is related to EBV. CMV infection is mostly asymptomatic. Multiple studies have found a negative correlation between CMV seropositivity and MS diagnosis (protective association) in both pediatric and adult populations, with an OR of ~0.7 [31, 32, 33, 34, 35]. While a few studies have failed to find a link between CMV seropositivity and MS risk [36, 37, 38],
CMV infection may have a potentially protective effect due to its ability to induce not only pro-inflammatory antiviral responses, but also several anti-inflammatory responses, such as decreased mononuclear cell proliferation, increased anti-inflammatory cytokine secretion, and decreased cell surface HLA class I and II expression [31]. CMV infection alters the phenotype and function of B cells in MS, modulating the influence of IFN and reducing the proinflammatory B cell profile, according to new research. These findings may help to explain the potential impact of this viral infection on MS [39].
Controversial findings regarding the relationship between HSV infection and MS risk [40, 41, 42]. According to a new study, HSV infection is modestly associated with MS risk, particularly in Whites, raising the possibility that the disparity between previous reports is due to the racial make-up of study populations [29]. This study also confirmed the link between HLADRB1 status, HSV infection, and the risk of MS. HSV infection was linked to an increased risk of MS only in HLA-DRB1*15:01 negative subjects [29, 32].
There are large number of studies on sun exposure/vitamin D, provoked by epidemiologic observations of a latitude-dependent difference in MS incidence and prevalence, despite being confounded by the distribution of the HLA DRB1*15:01 risk predisposing genotype in gradients [43, 44].
Because we rely on ultraviolet radiation (UVR) to convert vitamin D to an active metabolite, distinguishing the effect of UVR from that of vitamin D is difficult. Both of these exposures have been linked to a lower risk of MS, according to a recent and extensive review [45]. A higher level of UVR exposure is associated with a lower risk of MS [43, 46, 47]. Even after accounting for vitamin D levels, there was still a link between UVR exposure habits and the risk of MS [47], though this finding should be interpreted with caution because vitamin D levels were not measured prior to the preclinical phase. The physiological reason for UVR’s putative protective impact is still being researched. UVR exposure protects against MS even if vitamin D isn’t present. When tested in the animal model EAE [48], UVR exposure lowers peripheral inflammation in mice [49], with a T regulatory (Treg) cell activation and dampening effects on antigen-presenting dendritic cells [50, 51]. In these instances, cis-uronic acid production could be involved [52].
Increased vitamin D levels have been linked to a lower incidence of MS, particularly before the age of 20 [53], which is consistent with later results on supplementation and sun exposure [54, 55]. Furthermore, in the situation of minimal sunlight exposure, a diet rich in vitamin D containing fatty fish reduces MS risk [56]. In one study of vitamin D levels during pregnancy in humans using birth samples, no difference between MS cases and controls was found; despite large confidence intervals [57], which is consistent with studies on experimental autoimmune encephalomyelitis (EAE) in which only adolescent rats (not pregnancy or adult rats) showed an effect of vitamin D [58]. This discovery is not without controversy, as mothers with low vitamin D levels during the first trimester had a two-fold greater risk of MS in their offspring [59]. Variations in sampling timing, storing issues, or possible “inherited” behavior differences regarding sun exposure are all possible explanations for the disparate results. In Australia, epidemiologic studies of sun exposure found a link between low sun exposure in mothers during the first trimester and the risk of MS in their children [60]. Regardless, vitamin D and/or sun exposure appear to be significant during a temporal window of adolescence when vitamin supplementation may reduce MS risk to some extent. Vitamin D’s importance is also confirmed by genetic data, which shows that mutations around the CYP27B1 gene, which is involved in vitamin D metabolism, are linked to MS [61, 62]. In two case-control investigations, recent genomic data on a series of genes that regulate Vitamin D levels revealed significant effects. Because the distribution of these gene variants is random, it resembles a blinded clinical trial or Mendelian randomization in certain ways [63, 64]. In vitro investigations using the biggest MS risk gene, HLA DRB1*15:01, identified vitamin D as the first example of a gene–environment interaction [65], although this finding has not been replicated in humans [47].
It is still unclear whether vitamin D or sun exposure has a strong therapeutic effect once MS has been diagnosed. Despite the fact that vitamin D has been introduced to conventional therapy in multiple research, its value has yet to be determined. Importantly, high vitamin D levels are linked to reduced axonal injury as evaluated by cerebrospinal fluid (CSF), neurofilament light [66], and greater vitamin D levels were linked to lower MRI activity and delayed disease development during an interferon study [67, 68].
Vitamin D supplementation is thought to be non-toxic even at very high doses, so it seems reasonable to conduct large clinical trials in people at risk for MS, such as close relatives, or even to recommend supplementation at relatively high doses for all adolescents; vitamin D appears to play a role in a variety of diseases, not just MS. Because of the risk of skin cancer, it is more difficult to make sun exposure recommendations. Moderate exposure, on the other hand, is a good idea. Variations in the timing of sample, storage challenges, or possible “inherited” behavior variances towards sun exposure are all plausible causes for the lack of consensus on whether vitamin D supplementation is beneficial in individuals. Notably, epidemiologic studies of sun exposure in Australia found evidence of a link between low sun exposure in mothers and the development of MS. Many MS patients, on the other hand, are aware of the link between vitamin D and MS risk and take it, especially during the winter.
The link between air pollutant exposure and MS risk is unclear. Particulate matter (PM) exposure causes an inflammatory response in the lung, resulting in the release of inflammatory cytokines and elevated systemic levels. Long-term exposure to air pollution has been linked to neuroinflammation and blood–brain barrier damage. Studies examining exposure to particles with an aerodynamic diameter of less than10 μm (PM10) produced conflicting results [69, 70, 71]. Seasonal exposure to nitrogen dioxide during the cold season or ozone during the hot season has been linked to an increased risk of MS relapse, whereas exposure to benzene and carbon monoxide was not [72].
Cigarette smoking is a well-established risk factor for MS (OR of 1.5) [73, 74]; this finding result was later confirmed in a larger case-control study [75, 76], with a clear dose-response relationship [76, 77]; cumulative smoking is associated with an increase in risk [15, 75, 78, 79]. Elevated levels of cotinine in the serum or plasma ( ≥ 10 ng/ml) from patients before they developed MS were associated with a significantly increased risk of MS (OR of 1.5). The effect on the risk for MS by cotinine levels was significant in individuals younger than 26 years old with OR of 2.2 [80]. However, the age at which a person first began smoking had no effect on the association between smoking and MS risk [76]. Passive smoking exposure, including water pipe smoking, but not oral tobacco use in the form of moist snuff, has also been linked to an increased risk of MS [14, 81]. Also, children raised in environments associated with smoker parents had more than double the risk of a first MS episode when compared with unexposed children, this increase in risk was significantly associated with the longer duration of exposure [82]. In addition, children exposed to second-hand smoke and with HLA-DBR1*15 alleles have a higher risk of MS [83], implying that even minor lung irritation is significant [84]. If the association is due to nonspecific irritation, one might consider a factor such as air pollution as a trigger of CNS neuroinflammation, as long-term exposure to air pollutants has been confirmed as an environmental risk factor in MS [69]. On the other hand, smoking increases risk of developing neutralizing antibodies against some MS treatments, such as natalizumab and interferon β [85, 86].
Oral tobacco reduces the risk of developing MS in a dose-dependent manner [75, 87]. Nicotine may have such a protective effect due to its agonistic effect on the alpha 7 subunit of acetylcholine, expressed on the surface of CD4(+) T cells [88]. This finding lends credence to the idea that, despite nicotine’s apparent protective effects, it is lung inflammation that drives the increase in risk.
Smoking has a remarkable interaction with HLA risk genes associated with MS. In the Scandinavian population, carriers of the HLA DRB1*15:01 confer an OR of 3, and lack of HLA-A*02 confers an OR of ∼1.8, resulting in a combined OR of 5 among nonsmokers; however, among smokers, the combined OR is ∼14, much higher than the sum of the main effects associated with each factor [15]. In studies of passive smoke exposure, such a gene–environment interaction has been replicated [14]. These findings indicate a strong link between HLA genotypes and disease development [89].
Smoking also interacts with a non-HLA gene variant, the N-Acetyltransferase 1 (NAT1) gene (gene encoding the N-acetyltransferase 1 enzyme, which is important in the metabolism of aromatic amines present in cigarette smoke), as smokers with NAT1 single nucleotide polymorphisms are at a higher risk of developing MS [90]. As a result, the impact of smoking is highly dependent on genetic context [5, 7].
Female adolescent obesity has been linked to MS in large cohorts [91]. It has been found that adolescent obesity was associated with an OR of ∼2 in both males and females, despite the fact that adult body mass index (BMI) at diagnosis had no effect [13]. The link is highest with a BMI of > 27, but increased ORs can be seen at lower BMI levels as well. Obesity has been linked to a higher incidence of MS in children [91, 92]. It has been discovered that the critical period for adult MS appears to be during adolescence rather than at the age of ten [93]. A Norwegian/Italian study published results that were very comparable [94]. Furthermore, Mendelian randomization studies reveal that genetic determinants for high BMI are related to an increased risk of MS, despite several possible confounders and biases attributed to reverse causation, indicating that this lifestyle factor plays a causative role [64, 95].
In this scenario, there is also an interaction with MS HLA risk genes; specifically, DRB1*15:01 positive and HLA A*02 negative persons with a high BMI have an OR of ∼14 [13], indicating that biological pathways are shared and that obesity is a causal factor. Even however, the underlying mechanistic routes are still unknown. At the very least, we evaluate three non-exclusive and somewhat overlapping pathways: (1) Obesity is associated with “low-grade” inflammation, in which fat tissue produces higher quantities of proinflammatory mediators [96, 97]. Promotion of T helper (Th) 1-biased immune responses and decreased function of Treg cells have been described [98]; (2) In the presence of obesity, increased levels of leptin, a mediator connected to proinflammation, are observed [99]; (3) Obesity also leads to decreased bioavailability of vitamin D, in turn with options for a pro-inflammatory bias [100]. Any of the potential mechanisms may enhance the activation and functional proinflammatory bias of adaptive autoreactive immune cells, which may cause the neuroinflammatory bouts, a sequence of events that is supported by the HLA gene interaction; HLA genes encode the antigen-presenting molecules necessary for activation of T cells.
The observed interaction between EBV/IM and BMI, acting independently of the HLA DRB1*15:01 class II risk allele, where each of the two lifestyle/environmental factors results in ORs of 2, but approaches 14 when combined, strongly supports the relevance of obesity with regard to a putative immune attack on the CNS [101]. The causes for the interaction are still unknown. Obesity is linked to a less effective immune response to infections in general, so it’s possible that obesity will result in a less effective immune response to EBV [102, 103]. It’s also possible that a combined proinflammatory environment during obesity, as well as the as-yet-undefined effects of EBV linked to MS, are exacerbating the risk of neuroinflammation. Our argument is based on the fact that there is an interaction between EBV and obesity, two MS risk factors, in the development of MS, supporting the idea that both of them play a causal role in triggering onset.
Obesity data and MS may have a direct link with prevention in this scenario, especially for those who are at high risk for MS, such as children or other relatives of people with MS. It’s also relevant to the global obesity pandemic, and it could be one of the factors contributing to the rise in MS cases among women around the world.
A number of research have been carried out to look into the role of alcohol in MS. There was evidence indicating a dose-dependent inverse connection between MS and alcohol in two large case-control studies, with ORs in the range of 0.7–0.8 [104]. Low and moderate alcohol use has been demonstrated to lower innate inflammatory responses in humans [105, 106, 107], which is consistent with recent data that show alcohol consumption is negatively related to MS risk. In terms of MS risk, it has been discovered that the existence of DRB1*15:01 and non-drinking, as well as smoking and non-drinking, have interactions [108].
Although still significant, the relationship between non-drinking and smoking was less prominent among previous smokers than among current smokers. This finding may not come as a surprise, given the long-term negative impact of smoking on MS risk after quitting [76]. Interleukin-21 is a major immune modulator that may enhance autoimmune responses through various mechanisms such as the development and activation of helper T-17 and follicular helper T cells, as well as the suppression of regulatory T cells [109], which has been shown to be reduced by alcohol and its metabolite acetate. Interleukin-21 has been linked to the onset of a number of autoimmune illnesses and has also been linked to the severity and progression of MS [110, 111].
Due to preexisting detrimental effects on CNS by the MS process, individuals may experience decreased alcohol tolerance and so restrict their alcohol consumption before the beginning of MS. Alcohol intake, on the other hand, has been linked to an increased risk of various autoimmune illnesses that do not directly damage the CNS [112, 113, 114]. Furthermore, alcohol use throughout adolescence was linked to a decreased incidence of MS [115] in a recent Danish case–control study.
To summarize, non-drinkers have a higher risk of developing MS than drinkers, and non-drinking combines with DRB1*15:01 and smoking to raise disease risk. Alcohol use has been shown to have negative effects on other disease conditions, and a greater understanding of the mechanisms behind our findings may aid in the development of new approaches to guard against MS without using alcohol.
Only a few studies have looked at the effects of coffee consumption on the risk and severity of MS, in contrast to the intense interest in the effects of smoking. Two independent population-based case-control studies recently looked into the link between coffee consumption and MS risk. The risk of MS was significantly lowered in individuals who reported drinking more than 900 mL of coffee per day (OR 0.70) [116]. In a case–control research with 93 cases and 186 controls, of which 92 were hospital controls and 94 were population controls, persons who took coffee before the age of 15 years had a higher risk of MS; however, there was no link between MS risk and coffee consumption beyond that age [117]. Increased coffee consumption was linked to an increased incidence of MS in a hospital-based case–control research with 210 incident cases and 210 individually matched controls. The inverse relationship between coffee drinking and the beginning of chronic diseases such as cardiovascular disease, diabetes, Parkinson’s disease, and various malignancies has led the US Dietary Guidelines Advisory Committee to suggest moderate coffee consumption as part of a healthy diet [118]. Coffee drinking could play a role in MS through a number of different processes. Caffeine therapy protects against experimental autoimmune encephalomyelitis by increasing the number of adenosine 1A receptors [119, 120]. In addition, caffeine administration of human monocytoid cells in vitro boosted the expression of adenosine 1A receptors while lowering pro-inflammatory cytokine output [121]. Although this study was cross-sectional, a causal relationship could not be verified, coffee drinking has also been linked to a slower progression of disability in relapsing onset MS [122]. More research is needed to determine whether the findings are due to caffeine or another molecule in coffee, to longitudinally assess the association between coffee consumption and MS disease activity, and to evaluate the mechanisms by which coffee may act, which could lead to new therapeutic targets.
The experimental findings regarding immune system modulation by salt concentration have been validated. In vitro studies suggest that lower intracellular sodium concentrations and sodium intake may have immune-protective effects [123, 124, 125]. While a large epidemiological study aimed at determining the relationship between dietary sodium intake and MS found that neither baseline energy-adjusted sodium levels nor cumulative longitudinal sodium intake was associated with an increased risk of developing MS [126, 127]. Other studies sought to determine the effect of salt consumption on the ongoing disease process, as it has been reported that individuals with MS who consumed a lot of salt had a lot more relapses and magnetic resonance imaging (MRI) evidenced disease activity than those who ate less salt [128]. On the contrary, studies that looked at patients’ sodium urine excretion levels found no correlation with conversion to clinically definite MS, nor with clinical or MRI outcomes over a five-year period [127]. The same results have been shown in the pediatric MS population [129, 130].
The relationship between polyunsaturated fatty acids (PUFAs) and MS has been investigated. Several studies [56, 131, 132] found that a higher intake of total PUFA at baseline was associated with a lower risk of MS. Clinical trials, on the other hand, have found no effect of a low-fat diet on relapse rate or MRI activity [133]. Furthermore, omega-3 supplementation had no effect on disease activity [134]. A higher saturated fat intake was associated with higher relapse risk in children with MS, whereas vegetable intake may be an independent protective factor [135].
In experimental MS models, the effects of various dietary changes have been studied (i.e., experimental autoimmune encephalomyelitis [EAE]). When compared to mice fed a normal diet, mice fed a high-fat diet showed increased gene expression of renin–angiotensin aldosterone system (RAAS) brain components, which coincided with increased vascular endothelial permeability, recruitment of inflammatory cells, upregulation of adhesion molecules, more severe exacerbations, and higher mean disease scores. The use of captopril which acts as an angiotensin-converting enzyme (ACE) inhibitor improves the outcomes of EAE disease [136]. A high-fat diet has also been linked to increased brain inflammation, decreased protective neurotrophic factors, and decreased neural plasticity, all of which impair learning and memory functions [137]. The EAE RAAS studies have proposed cardiovascular health as a potential link between dietary changes and MS outcomes by indicating a high-fat diet as a factor in MS [138].
The relationship between shift work (night work) and MS has been studied. Shift work during adolescence (before the age of 20 years) has been shown to increase the risk of MS (OR ∼1.7). Other studies [139, 140, 141] have confirmed these findings. These findings highlight the importance of melatonin in the disease. Shift work consequences, such as circadian disruption and sleep restriction, have been linked to disturbed melatonin secretion and increased proinflammatory responses, and may thus be part of the mechanism underlying the association [139, 142]. Avoiding night shift work, especially in people at high risk of MS, is another modifiable lifestyle factor that may help prevent the disease [5].
The composition and abundance of microbes in the intestinal microbiota are risk factors for the development of MS. MS in humans can be caused by changes in certain microbial populations in the gastrointestinal tract. Furthermore, the gut microbiota promotes an anti-inflammatory and protective environment capable of inhibiting the growth of pathogenic microorganisms that cause a variety of diseases [143, 144]. Furthermore, many factors, such as diet, obesity, antibiotic use, cigarette smoking, and stress, influence the gut microbiota and may influence the risk and/or course of MS [144]. The gut microbiota appears to be crucial in the pathogenesis of MS. It appears to be involved in immune system modulation, changes the integrity and function of biological barriers (blood−brain barrier), has a direct effect on several types of central nervous system-resident cells, and causes autoimmune demyelination [144, 145].
The influence of lifestyle/environmental factors on MS is becoming clearer. Combining genetics and environmental factors has aided the understanding of MS; factors interacting with MS risk genes, primarily HLA risk genes, can be argued to share etiologic pathways underlying the disease, as well as their effect on the immune system. This is true for adolescent obesity, tobacco use, and EBV infection. The understanding method is still in its early stages, but the vast majority of recognized factors may be related to immune system impacts, comparable to hereditary predisposing factors, implying that the peripheral immune system plays a critical role in MS. Factors that cause disease are increasingly being incorporated into practical health treatment and even prevention, particularly for people at high risk of MS, especially if the disease runs in the family.
Acknowledgment to our student Massa Zahdeh (
The authors declare no conflict of interest.
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The tobamoviruses are highly stable plant viruses that could cause severe disease symptoms. The well-known tobamovirus Cucumber green mottle mosaic virus (CGMMV) has recently caused severe damages in the cucumber, melon, and watermelon cucurbitaceous crops, worldwide. Similarly, a recent widespread of the newly identified tobamoviruses, Tomato mottle mosaic virus (ToMMV) and Tomato brown rugose fruit virus (ToBRFV), has reduced the solanaceous crop production. The primary route of tobamoviral infection is through mechanical means. These viruses adhere to agricultural facilities, contaminate the soil, infect seeds, and spread via beneficial pollinators and irrigation water. Mechanical plant injury suffices to initiate viral infection. Practicing hygiene by plant growers and in nurseries is currently the main strategy for mitigation of tobamoviral infection. Promoting the production of solanaceous vegetable crops genetically resistant to ToMMV and ToBRFV infection is a promising approach. However, CGMMV-resistant sources of cucurbitaceous vegetable crops are scarce. Conferring resistance to rootstocks and cross-protection strategies are newly implemented approaches that could alleviate tobamovirus disease spread in both solanaceous and cucurbitaceous crops.",book:{id:"8814",slug:"plant-diseases-current-threats-and-management-trends",title:"Plant Diseases",fullTitle:"Plant Diseases - Current Threats and Management Trends"},signatures:"Elisheva Smith and Aviv Dombrovsky",authors:null},{id:"68107",doi:"10.5772/intechopen.87958",title:"Plant Metabolites in Plant Defense Against Pathogens",slug:"plant-metabolites-in-plant-defense-against-pathogens",totalDownloads:1404,totalCrossrefCites:4,totalDimensionsCites:11,abstract:"Medicinal plants are widely used worldwide to treat various diseases. Its widespread use is due in part to the cultural acceptance of traditional medicine in different regions of the world, as well as its effectiveness in treating various diseases. Many of its active substances or secondary metabolites are formed to a response of various situations that generate stress in their habitat, such as sudden changes in environmental temperature, humidity, rain, drought, and infections by phytopathogens (fungi, bacteria, viruses, nematodes, protozoa). The production of these secondary metabolites is a mechanism of defense of plants. In this context, the objective of this chapter is to study the secondary metabolites of medicinal plants that could have a promising application in the control of different phytopathogens in crops of agricultural and economic interest.",book:{id:"8814",slug:"plant-diseases-current-threats-and-management-trends",title:"Plant Diseases",fullTitle:"Plant Diseases - Current Threats and Management Trends"},signatures:"Xóchitl S. Ramírez-Gómez, Sandra N. Jiménez-García, Vicente Beltrán Campos and Ma. Lourdes García Campos",authors:null},{id:"67930",doi:"10.5772/intechopen.87055",title:"Impact of Climate Change on Plant Diseases and IPM Strategies",slug:"impact-of-climate-change-on-plant-diseases-and-ipm-strategies",totalDownloads:1991,totalCrossrefCites:7,totalDimensionsCites:10,abstract:"There has been a remarkable scientific output on the topic of how climate change is likely to affect plant diseases. Climate change influences the occurrence, prevalence, and severity of plant diseases. Projected atmospheric and climate change will thus affect the interaction between crops and pathogens in multiple ways. This will also affect disease management with regard to timing, preference, and efficacy of chemical, physical, and biological measures of control and their utilization within integrated pest management (IPM) strategies. Prediction of future requirements in disease management is of great interest for agro-industries, extension services, and practical farmers. A comprehensive analysis of potential climate change effects on disease control is difficult because current knowledge is limited and fragmented and due to the complexity of future risks for plant disease management, particularly if new crops are introduced in an area. Uncertainty in models of plant disease development under climate change calls for a diversity of management strategies, from more participatory approaches to interdisciplinary science. Involvement of stakeholders and scientists from outside plant pathology shows the importance of trade-offs. All these efforts and integrations will produce effective crop protection strategies using novel technologies as appropriate tools to adapt to altered climatic conditions.",book:{id:"8814",slug:"plant-diseases-current-threats-and-management-trends",title:"Plant Diseases",fullTitle:"Plant Diseases - Current Threats and Management Trends"},signatures:"Sahar Abdou Zayan",authors:null},{id:"62605",doi:"10.5772/intechopen.75837",title:"The Biology of Thecaphora frezii Smut and Its Effects on Argentine Peanut Production",slug:"the-biology-of-thecaphora-frezii-smut-and-its-effects-on-argentine-peanut-production",totalDownloads:1117,totalCrossrefCites:7,totalDimensionsCites:9,abstract:"Thecaphora frezii was first reported in 1962 in wild peanut from Aquidauana, Mato Grosso do Sul, Brazil. In Argentina, it was first detected in 1995 in commercial crops from the central-northern area of Córdoba province. The fungus can survive in the soil as teliospores. When peanut gynophore penetrates the soil, their exudates disrupt telial dormancy; T. frezii penetrates and colonizes the tissues and replaces the cells with teliospores. Since its first report, peanut smut prevalence has gradually increased in peanut areas to reach a 100% in 2012. Currently, it is the most important peanut disease in Argentina, not only for its destructive power on crop but also for its quick spread throughout the growing region of Córdoba and the lack of effective tools for its management. It is important for additional research to find effective agronomical practice that reaches high control efficiencies. The collaboration of all those involved in Argentinian peanut production systems is necessary for the management of peanut smut to be successful.",book:{id:"6642",slug:"advances-in-plant-pathology",title:"Advances in Plant Pathology",fullTitle:"Advances in Plant Pathology"},signatures:"Luis Ignacio Cazón, Juan Andrés Paredes and Alejandro Mario Rago",authors:[{id:"232647",title:"M.Sc.",name:"Luis Ignacio",middleName:null,surname:"Cazón",slug:"luis-ignacio-cazon",fullName:"Luis Ignacio Cazón"},{id:"240515",title:"MSc.",name:"Juan Andrés",middleName:null,surname:"Paredes",slug:"juan-andres-paredes",fullName:"Juan Andrés Paredes"},{id:"240517",title:"MSc.",name:"Alejandro Mario",middleName:null,surname:"Rago",slug:"alejandro-mario-rago",fullName:"Alejandro Mario Rago"}]}],mostDownloadedChaptersLast30Days:[{id:"53686",title:"Major and Emerging Fungal Diseases of Citrus in the Mediterranean Region",slug:"major-and-emerging-fungal-diseases-of-citrus-in-the-mediterranean-region",totalDownloads:3195,totalCrossrefCites:3,totalDimensionsCites:9,abstract:"This chapter deals with major endemic and emerging fungal diseases of citrus as well as with exotic fungal pathogens potentially harmful for citrus industry in the Mediterranean region, with particular emphasis on diseases reported in Italy and Maghreb countries. The aim is to provide an update of both the taxonomy of the causal agents and their ecology based on a molecular approach, as a preliminary step towards developing or upgrading integrated and sustainable disease management strategies. Potential or actual problems related to the intensification of new plantings, introduction of new citrus cultivars and substitution of sour orange with other rootstocks, globalization of commerce and climate changes are discussed. Fungal pathogens causing vascular, foliar, fruit, trunk and root diseases in commercial citrus orchards are reported, including Plenodomus tracheiphilus, Colletotrichum spp., Alternaria spp., Mycosphaerellaceae, Botryosphaeriaceae, Guignardia citricarpa and lignicolous basidiomycetes. Diseases caused by Phytophthora spp. (oomycetes) are also included as these pathogens have many biological, ecological and epidemiological features in common with the true fungi (eumycetes).",book:{id:"5606",slug:"citrus-pathology",title:"Citrus Pathology",fullTitle:"Citrus Pathology"},signatures:"Khaled Khanchouch, Antonella Pane, Ali Chriki and Santa Olga\nCacciola",authors:[{id:"193916",title:"M.Sc.",name:"Khaled",middleName:null,surname:"Khanchouch",slug:"khaled-khanchouch",fullName:"Khaled Khanchouch"},{id:"193918",title:"Dr.",name:"Santa Olga",middleName:null,surname:"Cacciola",slug:"santa-olga-cacciola",fullName:"Santa Olga Cacciola"},{id:"196942",title:"Dr.",name:"Antonella",middleName:null,surname:"Pane",slug:"antonella-pane",fullName:"Antonella Pane"},{id:"196943",title:"Prof.",name:"Ali",middleName:null,surname:"Chriki",slug:"ali-chriki",fullName:"Ali Chriki"}]},{id:"67930",title:"Impact of Climate Change on Plant Diseases and IPM Strategies",slug:"impact-of-climate-change-on-plant-diseases-and-ipm-strategies",totalDownloads:1988,totalCrossrefCites:7,totalDimensionsCites:10,abstract:"There has been a remarkable scientific output on the topic of how climate change is likely to affect plant diseases. Climate change influences the occurrence, prevalence, and severity of plant diseases. Projected atmospheric and climate change will thus affect the interaction between crops and pathogens in multiple ways. This will also affect disease management with regard to timing, preference, and efficacy of chemical, physical, and biological measures of control and their utilization within integrated pest management (IPM) strategies. Prediction of future requirements in disease management is of great interest for agro-industries, extension services, and practical farmers. A comprehensive analysis of potential climate change effects on disease control is difficult because current knowledge is limited and fragmented and due to the complexity of future risks for plant disease management, particularly if new crops are introduced in an area. Uncertainty in models of plant disease development under climate change calls for a diversity of management strategies, from more participatory approaches to interdisciplinary science. Involvement of stakeholders and scientists from outside plant pathology shows the importance of trade-offs. All these efforts and integrations will produce effective crop protection strategies using novel technologies as appropriate tools to adapt to altered climatic conditions.",book:{id:"8814",slug:"plant-diseases-current-threats-and-management-trends",title:"Plant Diseases",fullTitle:"Plant Diseases - Current Threats and Management Trends"},signatures:"Sahar Abdou Zayan",authors:null},{id:"74757",title:"The Trends in the Evaluation of Fusarium Wilt of Chickpea",slug:"the-trends-in-the-evaluation-of-fusarium-wilt-of-chickpea",totalDownloads:734,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Chickpea (Cicer arietinum L.) is one of the important annual legume crops, cultivated throughout the India since ancient time. It is also grown in many countries of the world. The crop has been facing numerous biotic and abiotic constraints. Among biotic constraint crop affected adversely by diseases, caused by many pathogens. Ever since 1918 when for the first time wilt disease of chickpea was reported and Fusarium oxysporum f. sp. ciceri was the causal organism many strategies have been adopted to control the wilt disease. The controlling methods included conventional as well as modern one. However, more and more emphasis was given on biological control agents such as AM fungi and Trichoderma. The role of AM fungi have been evaluated for controlling the wilt disease similarly role of Trichoderma is thoroughly established biological control agent against Fusarium wilt. With the advent of modern tools and techniques developing markers, resistant varieties, all such sources enable us to reduce the effect of pathogens. Here an attempted has been made to acknowledge the trend of disease management and evaluation strategies of Fusarium wilt of chickpea for getting better yields of the crop.",book:{id:"10113",slug:"diagnostics-of-plant-diseases",title:"Diagnostics of Plant Diseases",fullTitle:"Diagnostics of Plant Diseases"},signatures:"Chandan Singh and Deepak Vyas",authors:[{id:"315463",title:"Mr.",name:"Chandan",middleName:null,surname:"Singh",slug:"chandan-singh",fullName:"Chandan Singh"},{id:"338974",title:"Prof.",name:"Deepak",middleName:null,surname:"Vyas",slug:"deepak-vyas",fullName:"Deepak Vyas"}]},{id:"60615",title:"Leaf Curl Disease: A Significant Constraint in the Production of Tomato in India",slug:"leaf-curl-disease-a-significant-constraint-in-the-production-of-tomato-in-india",totalDownloads:1457,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"Tomato (Lycopersicon esculentum Mill.) is one of the most economically important vegetable crops in the world. Among the major biotic constraints, virus-associated Tomato leaf curl disease (ToLCD) is a major limiting factor affecting its cultivation and yield. Different symptoms associated with disease are reported such as leaf curling, puckering of leaves, vein yellowing, stunting, excessive branching, from pale yellowing to deep yellowing, and small leaves. The genus Begomovirus is a circular single-stranded DNA virus which is exclusively being transmitted by whitefly (Bemisia tabaci) in a persistent circulative manner. Most of the begomovirus species are monopartite (having DNA-A molecule only), except few species, which are bipartite (having DNA-A and DNA-B as the genomic component). No absolute effective control measures of the disease could be developed so far, except resistance, management of insect vectors, and altering the dates of sowing to avoid peaks of insect vector population. This chapter reports an account of history, symptoms, transmission, genome organization, distribution, and management of Tomato leaf curl disease.",book:{id:"6642",slug:"advances-in-plant-pathology",title:"Advances in Plant Pathology",fullTitle:"Advances in Plant Pathology"},signatures:"Pradeep Kumar and Manish Kumar",authors:[{id:"234558",title:"Dr.",name:"Manish",middleName:null,surname:"Kumar",slug:"manish-kumar",fullName:"Manish Kumar"},{id:"239750",title:"Ph.D. Student",name:"Pradeep",middleName:null,surname:"Kumar",slug:"pradeep-kumar",fullName:"Pradeep Kumar"}]},{id:"68015",title:"Sisal Bole Rot: An Important but Neglected Disease",slug:"sisal-bole-rot-an-important-but-neglected-disease",totalDownloads:988,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Sisal (Agave sisalana) is one of the main sources of hard natural fibre and raw materials for the industry, medicine and handicrafts. Sisal yields a coarse and strong fibre that is increasingly being used in composite materials for automobiles, furniture, construction and plastic and paper products. Extracts of sisal contain substances with anti-inflammatory, antimicrobial and anthelmintic activities. Sisal is adapted to warm environments with low rainfall and is an excellent option for cultivation in semiarid conditions, where other crops cannot be grown. The world’s largest sisal producers are Brazil, Tanzania, China, Kenya and Madagascar. Sisal is a labour-intensive crop with great socio-economical importance as it is cultivated in poor areas employing familiar labour. Sisal bole rot is the main disease of sisal, responsible for substantial losses in producing countries. The disease is caused by certain species of the genus Aspergillus, especially the ones belonging in the section Nigri. The main symptoms are yellowing of the aerial parts and the red-coloured rot of the bole, which causes the plant to die. In this review we are going to address the taxonomy of the causal agents, disease diagnosis and epidemiology and disease management, with emphasis on biological control.",book:{id:"8814",slug:"plant-diseases-current-threats-and-management-trends",title:"Plant Diseases",fullTitle:"Plant Diseases - Current Threats and Management Trends"},signatures:"Valter Cruz-Magalhães, Jackeline Pereira Andrade, Yasmim Freitas Figueiredo, Phellippe Arthur Santos Marbach and Jorge Teodoro de Souza",authors:null}],onlineFirstChaptersFilter:{topicId:"367",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:141,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:123,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:22,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403",scope:"Artificial Intelligence (AI) is a rapidly developing multidisciplinary research area that aims to solve increasingly complex problems. In today's highly integrated world, AI promises to become a robust and powerful means for obtaining solutions to previously unsolvable problems. This Series is intended for researchers and students alike interested in this fascinating field and its many applications.",coverUrl:"https://cdn.intechopen.com/series/covers/14.jpg",latestPublicationDate:"July 5th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:9,editor:{id:"218714",title:"Prof.",name:"Andries",middleName:null,surname:"Engelbrecht",slug:"andries-engelbrecht",fullName:"Andries Engelbrecht",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNR8QAO/Profile_Picture_1622640468300",biography:"Andries Engelbrecht received the Masters and PhD degrees in Computer Science from the University of Stellenbosch, South Africa, in 1994 and 1999 respectively. He is currently appointed as the Voigt Chair in Data Science in the Department of Industrial Engineering, with a joint appointment as Professor in the Computer Science Division, Stellenbosch University. Prior to his appointment at Stellenbosch University, he has been at the University of Pretoria, Department of Computer Science (1998-2018), where he was appointed as South Africa Research Chair in Artifical Intelligence (2007-2018), the head of the Department of Computer Science (2008-2017), and Director of the Institute for Big Data and Data Science (2017-2018). In addition to a number of research articles, he has written two books, Computational Intelligence: An Introduction and Fundamentals of Computational Swarm Intelligence.",institutionString:null,institution:{name:"Stellenbosch University",institutionURL:null,country:{name:"South Africa"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:6,paginationItems:[{id:"22",title:"Applied Intelligence",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",isOpenForSubmission:!0,editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",slug:"carlos-travieso-gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",biography:"Carlos M. Travieso-González received his MSc degree in Telecommunication Engineering at Polytechnic University of Catalonia (UPC), Spain in 1997, and his Ph.D. degree in 2002 at the University of Las Palmas de Gran Canaria (ULPGC-Spain). He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. He won the “Catedra Telefonica” Awards in Modality of Knowledge Transfer, 2017, 2018, and 2019 editions, and awards in Modality of COVID Research in 2020.\n\nPublic References:\nResearcher ID http://www.researcherid.com/rid/N-5967-2014\nORCID https://orcid.org/0000-0002-4621-2768 \nScopus Author ID https://www.scopus.com/authid/detail.uri?authorId=6602376272\nScholar Google https://scholar.google.es/citations?user=G1ks9nIAAAAJ&hl=en \nResearchGate https://www.researchgate.net/profile/Carlos_Travieso",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"23",title:"Computational Neuroscience",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",isOpenForSubmission:!0,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null},{id:"24",title:"Computer Vision",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",isOpenForSubmission:!0,editor:{id:"294154",title:"Prof.",name:"George",middleName:null,surname:"Papakostas",slug:"george-papakostas",fullName:"George Papakostas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hYaGbQAK/Profile_Picture_1624519712088",biography:"George A. Papakostas has received a diploma in Electrical and Computer Engineering in 1999 and the M.Sc. and Ph.D. degrees in Electrical and Computer Engineering in 2002 and 2007, respectively, from the Democritus University of Thrace (DUTH), Greece. Dr. Papakostas serves as a Tenured Full Professor at the Department of Computer Science, International Hellenic University, Greece. Dr. Papakostas has 10 years of experience in large-scale systems design as a senior software engineer and technical manager, and 20 years of research experience in the field of Artificial Intelligence. Currently, he is the Head of the “Visual Computing” division of HUman-MAchines INteraction Laboratory (HUMAIN-Lab) and the Director of the MPhil program “Advanced Technologies in Informatics and Computers” hosted by the Department of Computer Science, International Hellenic University. He has (co)authored more than 150 publications in indexed journals, international conferences and book chapters, 1 book (in Greek), 3 edited books, and 5 journal special issues. His publications have more than 2100 citations with h-index 27 (GoogleScholar). His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. Dr Ventura also holds the positions of Affiliated Professor at Virginia Commonwealth University (Richmond, USA) and Distinguished Adjunct Professor at King Abdulaziz University (Jeddah, Saudi Arabia). Additionally, he is deputy director of the Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI) and heads the Knowledge Discovery and Intelligent Systems Research Laboratory. He has published more than ten books and over 300 articles in journals and scientific conferences. Currently, his work has received over 18,000 citations according to Google Scholar, including more than 2200 citations in 2020. In the last five years, he has published more than 60 papers in international journals indexed in the JCR (around 70% of them belonging to first quartile journals) and he has edited some Springer books “Supervised Descriptive Pattern Mining” (2018), “Multiple Instance Learning - Foundations and Algorithms” (2016), and “Pattern Mining with Evolutionary Algorithms” (2016). He has also been involved in more than 20 research projects supported by the Spanish and Andalusian governments and the European Union. He currently belongs to the editorial board of PeerJ Computer Science, Information Fusion and Engineering Applications of Artificial Intelligence journals, being also associate editor of Applied Computational Intelligence and Soft Computing and IEEE Transactions on Cybernetics. Finally, he is editor-in-chief of Progress in Artificial Intelligence. He is a Senior Member of the IEEE Computer, the IEEE Computational Intelligence, and the IEEE Systems, Man, and Cybernetics Societies, and the Association of Computing Machinery (ACM). Finally, his main research interests include data science, computational intelligence, and their applications.",institutionString:null,institution:{name:"University of Córdoba",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"26",title:"Machine Learning and Data Mining",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",isOpenForSubmission:!0,editor:{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. 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He is the author of several scientific articles, book chapters, and books.",institutionString:"University of Hassan II Casablanca",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"7",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"University of Hassan II Casablanca",institutionURL:null,country:{name:"Morocco"}}},equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7060",title:"Gingival Disease",subtitle:"A Professional Approach for Treatment and Prevention",coverURL:"https://cdn.intechopen.com/books/images_new/7060.jpg",slug:"gingival-disease-a-professional-approach-for-treatment-and-prevention",publishedDate:"October 23rd 2019",editedByType:"Edited by",bookSignature:"Alaa Eddin Omar Al Ostwani",hash:"b81d39988cba3a3cf746c1616912cf41",volumeInSeries:4,fullTitle:"Gingival Disease - A Professional Approach for Treatment and Prevention",editors:[{id:"240870",title:"Ph.D.",name:"Alaa Eddin Omar",middleName:null,surname:"Al Ostwani",slug:"alaa-eddin-omar-al-ostwani",fullName:"Alaa Eddin Omar Al Ostwani",profilePictureURL:"https://mts.intechopen.com/storage/users/240870/images/system/240870.jpeg",institutionString:"International University for Science and Technology.",institution:{name:"Islamic University of Science and Technology",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7572",title:"Trauma in Dentistry",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7572.jpg",slug:"trauma-in-dentistry",publishedDate:"July 3rd 2019",editedByType:"Edited by",bookSignature:"Serdar Gözler",hash:"7cb94732cfb315f8d1e70ebf500eb8a9",volumeInSeries:3,fullTitle:"Trauma in Dentistry",editors:[{id:"204606",title:"Dr.",name:"Serdar",middleName:null,surname:"Gözler",slug:"serdar-gozler",fullName:"Serdar Gözler",profilePictureURL:"https://mts.intechopen.com/storage/users/204606/images/system/204606.jpeg",institutionString:"Istanbul Aydin University",institution:{name:"Istanbul Aydın University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7139",title:"Current Approaches in Orthodontics",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7139.jpg",slug:"current-approaches-in-orthodontics",publishedDate:"April 10th 2019",editedByType:"Edited by",bookSignature:"Belma Işık Aslan and Fatma Deniz Uzuner",hash:"2c77384eeb748cf05a898d65b9dcb48a",volumeInSeries:2,fullTitle:"Current Approaches in Orthodontics",editors:[{id:"42847",title:"Dr.",name:"Belma",middleName:null,surname:"Işik Aslan",slug:"belma-isik-aslan",fullName:"Belma Işik Aslan",profilePictureURL:"https://mts.intechopen.com/storage/users/42847/images/system/42847.jpg",institutionString:"Gazi University Dentistry Faculty Department of Orthodontics",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"6668",title:"Dental Caries",subtitle:"Diagnosis, Prevention and Management",coverURL:"https://cdn.intechopen.com/books/images_new/6668.jpg",slug:"dental-caries-diagnosis-prevention-and-management",publishedDate:"September 19th 2018",editedByType:"Edited by",bookSignature:"Zühre Akarslan",hash:"b0f7667770a391f772726c3013c1b9ba",volumeInSeries:1,fullTitle:"Dental Caries - Diagnosis, Prevention and Management",editors:[{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",institutionString:"Gazi University",institution:{name:"Gazi University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Prosthodontics and Implant Dentistry",value:2,count:3},{group:"subseries",caption:"Oral Health",value:1,count:6}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:3},{group:"publicationYear",caption:"2020",value:2020,count:2},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:229,paginationItems:[{id:"318170",title:"Dr.",name:"Aneesa",middleName:null,surname:"Moolla",slug:"aneesa-moolla",fullName:"Aneesa Moolla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/318170/images/system/318170.png",biography:"Dr. Aneesa Moolla has extensive experience in the diverse fields of health care having previously worked in dental private practice, at the Red Cross Flying Doctors association, and in healthcare corporate settings. She is now a lecturer at the University of Witwatersrand, South Africa, and a principal researcher at the Health Economics and Epidemiology Research Office (HE2RO), South Africa. Dr. Moolla holds a Ph.D. in Psychology with her research being focused on mental health and resilience. In her professional work capacity, her research has further expanded into the fields of early childhood development, mental health, the HIV and TB care cascades, as well as COVID. She is also a UNESCO-trained International Bioethics Facilitator.",institutionString:"University of the Witwatersrand",institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"419588",title:"Ph.D.",name:"Sergio",middleName:"Alexandre",surname:"Gehrke",slug:"sergio-gehrke",fullName:"Sergio Gehrke",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038WgMKQA0/Profile_Picture_2022-06-02T11:44:20.jpg",biography:"Dr. Sergio Alexandre Gehrke is a doctorate holder in two fields. The first is a Ph.D. in Cellular and Molecular Biology from the Pontificia Catholic University, Porto Alegre, Brazil, in 2010 and the other is an International Ph.D. in Bioengineering from the Universidad Miguel Hernandez, Elche/Alicante, Spain, obtained in 2020. In 2018, he completed a postdoctoral fellowship in Materials Engineering in the NUCLEMAT of the Pontificia Catholic University, Porto Alegre, Brazil. He is currently the Director of the Postgraduate Program in Implantology of the Bioface/UCAM/PgO (Montevideo, Uruguay), Director of the Cathedra of Biotechnology of the Catholic University of Murcia (Murcia, Spain), an Extraordinary Full Professor of the Catholic University of Murcia (Murcia, Spain) as well as the Director of the private center of research Biotecnos – Technology and Science (Montevideo, Uruguay). Applied biomaterials, cellular and molecular biology, and dental implants are among his research interests. He has published several original papers in renowned journals. In addition, he is also a Collaborating Professor in several Postgraduate programs at different universities all over the world.",institutionString:null,institution:{name:"Universidad Católica San Antonio de Murcia",country:{name:"Spain"}}},{id:"342152",title:"Dr.",name:"Santo",middleName:null,surname:"Grace Umesh",slug:"santo-grace-umesh",fullName:"Santo Grace Umesh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/342152/images/16311_n.jpg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"333647",title:"Dr.",name:"Shreya",middleName:null,surname:"Kishore",slug:"shreya-kishore",fullName:"Shreya Kishore",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333647/images/14701_n.jpg",biography:"Dr. Shreya Kishore completed her Bachelor in Dental Surgery in Chettinad Dental College and Research Institute, Chennai, and her Master of Dental Surgery (Orthodontics) in Saveetha Dental College, Chennai. She is also Invisalign certified. She’s working as a Senior Lecturer in the Department of Orthodontics, SRM Dental College since November 2019. She is actively involved in teaching orthodontics to the undergraduates and the postgraduates. Her clinical research topics include new orthodontic brackets, fixed appliances and TADs. She’s published 4 articles in well renowned indexed journals and has a published patency of her own. Her private practice is currently limited to orthodontics and works as a consultant in various clinics.",institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"323731",title:"Prof.",name:"Deepak M.",middleName:"Macchindra",surname:"Vikhe",slug:"deepak-m.-vikhe",fullName:"Deepak M. Vikhe",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/323731/images/13613_n.jpg",biography:"Dr Deepak M.Vikhe .\n\n\t\n\tDr Deepak M.Vikhe , completed his Masters & PhD in Prosthodontics from Rural Dental College, Loni securing third rank in the Pravara Institute of Medical Sciences Deemed University. He was awarded Dr.G.C.DAS Memorial Award for Research on Implants at 39th IPS conference Dubai (U A E).He has two patents under his name. He has received Dr.Saraswati medal award for best research for implant study in 2017.He has received Fully funded scholarship to Spain ,university of Santiago de Compostela. He has completed fellowship in Implantlogy from Noble Biocare. \nHe has attended various conferences and CDE programmes and has national publications to his credit. His field of interest is in Implant supported prosthesis. Presently he is working as a associate professor in the Dept of Prosthodontics, Rural Dental College, Loni and maintains a successful private practice specialising in Implantology at Rahata.\n\nEmail: drdeepak_mvikhe@yahoo.com..................",institutionString:null,institution:{name:"Pravara Institute of Medical Sciences",country:{name:"India"}}},{id:"204110",title:"Dr.",name:"Ahmed A.",middleName:null,surname:"Madfa",slug:"ahmed-a.-madfa",fullName:"Ahmed A. Madfa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204110/images/system/204110.jpg",biography:"Dr. Madfa is currently Associate Professor of Endodontics at Thamar University and a visiting lecturer at Sana'a University and University of Sciences and Technology. He has more than 6 years of experience in teaching. His research interests include root canal morphology, functionally graded concept, dental biomaterials, epidemiology and dental education, biomimetic restoration, finite element analysis and endodontic regeneration. Dr. Madfa has numerous international publications, full articles, two patents, a book and a book chapter. Furthermore, he won 14 international scientific awards. Furthermore, he is involved in many academic activities ranging from editorial board member, reviewer for many international journals and postgraduate students' supervisor. Besides, I deliver many courses and training workshops at various scientific events. Dr. Madfa also regularly attends international conferences and holds administrative positions (Deputy Dean of the Faculty for Students’ & Academic Affairs and Deputy Head of Research Unit).",institutionString:"Thamar University",institution:null},{id:"210472",title:"Dr.",name:"Nermin",middleName:"Mohammed Ahmed",surname:"Yussif",slug:"nermin-yussif",fullName:"Nermin Yussif",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210472/images/system/210472.jpg",biography:"Dr. Nermin Mohammed Ahmed Yussif is working at the Faculty of dentistry, University for October university for modern sciences and arts (MSA). Her areas of expertise include: periodontology, dental laserology, oral implantology, periodontal plastic surgeries, oral mesotherapy, nutrition, dental pharmacology. She is an editor and reviewer in numerous international journals.",institutionString:"MSA University",institution:null},{id:"204606",title:"Dr.",name:"Serdar",middleName:null,surname:"Gözler",slug:"serdar-gozler",fullName:"Serdar Gözler",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204606/images/system/204606.jpeg",biography:"Dr. Serdar Gözler has completed his undergraduate studies at the Marmara University Faculty of Dentistry in 1978, followed by an assistantship in the Prosthesis Department of Dicle University Faculty of Dentistry. Starting his PhD work on non-resilient overdentures with Assoc. Prof. Hüsnü Yavuzyılmaz, he continued his studies with Prof. Dr. Gürbüz Öztürk of Istanbul University Faculty of Dentistry Department of Prosthodontics, this time on Gnatology. He attended training programs on occlusion, neurology, neurophysiology, EMG, radiology and biostatistics. In 1982, he presented his PhD thesis \\Gerber and Lauritzen Occlusion Analysis Techniques: Diagnosis Values,\\ at Istanbul University School of Dentistry, Department of Prosthodontics. As he was also working with Prof. Senih Çalıkkocaoğlu on The Physiology of Chewing at the same time, Gözler has written a chapter in Çalıkkocaoğlu\\'s book \\Complete Prostheses\\ entitled \\The Place of Neuromuscular Mechanism in Prosthetic Dentistry.\\ The book was published five times since by the Istanbul University Publications. Having presented in various conferences about occlusion analysis until 1998, Dr. Gözler has also decided to use the T-Scan II occlusion analysis method. Having been personally trained by Dr. Robert Kerstein on this method, Dr. Gözler has been lecturing on the T-Scan Occlusion Analysis Method in conferences both in Turkey and abroad. Dr. Gözler has various articles and presentations on Digital Occlusion Analysis methods. He is now Head of the TMD Clinic at Prosthodontic Department of Faculty of Dentistry , Istanbul Aydın University , Turkey.",institutionString:"Istanbul Aydin University",institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"256417",title:"Associate Prof.",name:"Sanaz",middleName:null,surname:"Sadry",slug:"sanaz-sadry",fullName:"Sanaz Sadry",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256417/images/8106_n.jpg",biography:null,institutionString:null,institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"240870",title:"Ph.D.",name:"Alaa Eddin Omar",middleName:null,surname:"Al Ostwani",slug:"alaa-eddin-omar-al-ostwani",fullName:"Alaa Eddin Omar Al Ostwani",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/240870/images/system/240870.jpeg",biography:"Dr. Al Ostwani Alaa Eddin Omar received his Master in dentistry from Damascus University in 2010, and his Ph.D. in Pediatric Dentistry from Damascus University in 2014. Dr. Al Ostwani is an assistant professor and faculty member at IUST University since 2014. \nDuring his academic experience, he has received several awards including the scientific research award from the Union of Arab Universities, the Syrian gold medal and the international gold medal for invention and creativity. Dr. Al Ostwani is a Member of the International Association of Dental Traumatology and the Syrian Society for Research and Preventive Dentistry since 2017. He is also a Member of the Reviewer Board of International Journal of Dental Medicine (IJDM), and the Indian Journal of Conservative and Endodontics since 2016.",institutionString:"International University for Science and Technology.",institution:{name:"Islamic University of Science and Technology",country:{name:"India"}}},{id:"42847",title:"Dr.",name:"Belma",middleName:null,surname:"Işik Aslan",slug:"belma-isik-aslan",fullName:"Belma Işik Aslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/42847/images/system/42847.jpg",biography:"Dr. Belma IşIk Aslan was born in 1976 in Ankara-TURKEY. After graduating from TED Ankara College in 1994, she attended to Gazi University, Faculty of Dentistry in Ankara. She completed her PhD in orthodontic education at Gazi University between 1999-2005. Dr. Işık Aslan stayed at the Providence Hospital Craniofacial Institude and Reconstructive Surgery in Michigan, USA for three months as an observer. She worked as a specialist doctor at Gazi University, Dentistry Faculty, Department of Orthodontics between 2005-2014. She was appointed as associate professor in January, 2014 and as professor in 2021. Dr. Işık Aslan still works as an instructor at the same faculty. She has published a total of 35 articles, 10 book chapters, 39 conference proceedings both internationally and nationally. Also she was the academic editor of the international book 'Current Advances in Orthodontics'. She is a member of the Turkish Orthodontic Society and Turkish Cleft Lip and Palate Society. She is married and has 2 children. Her knowledge of English is at an advanced level.",institutionString:"Gazi University Dentistry Faculty Department of Orthodontics",institution:null},{id:"202198",title:"Dr.",name:"Buket",middleName:null,surname:"Aybar",slug:"buket-aybar",fullName:"Buket Aybar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202198/images/6955_n.jpg",biography:"Buket Aybar, DDS, PhD, was born in 1971. She graduated from Istanbul University, Faculty of Dentistry, in 1992 and completed her PhD degree on Oral and Maxillofacial Surgery in Istanbul University in 1997.\r\nDr. Aybar is currently a full-time professor in Istanbul University, Faculty of Dentistry Department of Oral and Maxillofacial Surgery. She has teaching responsibilities in graduate and postgraduate programs. Her clinical practice includes mainly dentoalveolar surgery.\r\nHer topics of interest are biomaterials science and cell culture studies. She has many articles in international and national scientific journals and chapters in books; she also has participated in several scientific projects supported by Istanbul University Research fund.",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"178412",title:"Associate Prof.",name:"Guhan",middleName:null,surname:"Dergin",slug:"guhan-dergin",fullName:"Guhan Dergin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178412/images/6954_n.jpg",biography:"Assoc. Prof. Dr. Gühan Dergin was born in 1973 in Izmit. He graduated from Marmara University Faculty of Dentistry in 1999. He completed his specialty of OMFS surgery in Marmara University Faculty of Dentistry and obtained his PhD degree in 2006. In 2005, he was invited as a visiting doctor in the Oral and Maxillofacial Surgery Department of the University of North Carolina, USA, where he went on a scholarship. Dr. Dergin still continues his academic career as an associate professor in Marmara University Faculty of Dentistry. He has many articles in international and national scientific journals and chapters in books.",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"178414",title:"Prof.",name:"Yusuf",middleName:null,surname:"Emes",slug:"yusuf-emes",fullName:"Yusuf Emes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178414/images/6953_n.jpg",biography:"Born in Istanbul in 1974, Dr. Emes graduated from Istanbul University Faculty of Dentistry in 1997 and completed his PhD degree in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery in 2005. He has papers published in international and national scientific journals, including research articles on implantology, oroantral fistulas, odontogenic cysts, and temporomandibular disorders. Dr. Emes is currently working as a full-time academic staff in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery.",institutionString:null,institution:{name:"Istanbul University",country:{name:"Turkey"}}},{id:"192229",title:"Ph.D.",name:"Ana Luiza",middleName:null,surname:"De Carvalho Felippini",slug:"ana-luiza-de-carvalho-felippini",fullName:"Ana Luiza De Carvalho Felippini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192229/images/system/192229.jpg",biography:null,institutionString:"University of São Paulo",institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"256851",title:"Prof.",name:"Ayşe",middleName:null,surname:"Gülşen",slug:"ayse-gulsen",fullName:"Ayşe Gülşen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256851/images/9696_n.jpg",biography:"Dr. Ayşe Gülşen graduated in 1990 from Faculty of Dentistry, University of Ankara and did a postgraduate program at University of Gazi. \nShe worked as an observer and research assistant in Craniofacial Surgery Departments in New York, Providence Hospital in Michigan and Chang Gung Memorial Hospital in Taiwan. \nShe works as Craniofacial Orthodontist in Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, University of Gazi, Ankara Turkey since 2004.",institutionString:"Orthodontist, Assoc Prof in the Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, University of Gazi",institution:null},{id:"255366",title:"Prof.",name:"Tosun",middleName:null,surname:"Tosun",slug:"tosun-tosun",fullName:"Tosun Tosun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255366/images/7347_n.jpg",biography:"Graduated at the Faculty of Dentistry, University of Istanbul, Turkey in 1989;\nVisitor Assistant at the University of Padua, Italy and Branemark Osseointegration Center of Treviso, Italy between 1993-94;\nPhD thesis on oral implantology in University of Istanbul and was awarded the academic title “Dr.med.dent.”, 1997;\nHe was awarded the academic title “Doç.Dr.” (Associated Professor) in 2003;\nProficiency in Botulinum Toxin Applications, Reading-UK in 2009;\nMastership, RWTH Certificate in Laser Therapy in Dentistry, AALZ-Aachen University, Germany 2009-11;\nMaster of Science (MSc) in Laser Dentistry, University of Genoa, Italy 2013-14.\n\nDr.Tosun worked as Research Assistant in the Department of Oral Implantology, Faculty of Dentistry, University of Istanbul between 1990-2002. \nHe worked part-time as Consultant surgeon in Harvard Medical International Hospitals and John Hopkins Medicine, Istanbul between years 2007-09.\u2028He was contract Professor in the Department of Surgical and Diagnostic Sciences (DI.S.C.), Medical School, University of Genova, Italy between years 2011-16. \nSince 2015 he is visiting Professor at Medical School, University of Plovdiv, Bulgaria. \nCurrently he is Associated Prof.Dr. at the Dental School, Oral Surgery Dept., Istanbul Aydin University and since 2003 he works in his own private clinic in Istanbul, Turkey.\u2028\nDr.Tosun is reviewer in journal ‘Laser in Medical Sciences’, reviewer in journal ‘Folia Medica\\', a Fellow of the International Team for Implantology, Clinical Lecturer of DGZI German Association of Oral Implantology, Expert Lecturer of Laser&Health Academy, Country Representative of World Federation for Laser Dentistry, member of European Federation of Periodontology, member of Academy of Laser Dentistry. Dr.Tosun presents papers in international and national congresses and has scientific publications in international and national journals. He speaks english, spanish, italian and french.",institutionString:null,institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"260116",title:"Dr.",name:"Mehmet",middleName:null,surname:"Yaltirik",slug:"mehmet-yaltirik",fullName:"Mehmet Yaltirik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/260116/images/7413_n.jpg",biography:"Birth Date 25.09.1965\r\nBirth Place Adana- Turkey\r\nSex Male\r\nMarrial Status Bachelor\r\nDriving License Acquired\r\nMother Tongue Turkish\r\n\r\nAddress:\r\nWork:University of Istanbul,Faculty of Dentistry, Department of Oral Surgery and Oral Medicine 34093 Capa,Istanbul- TURKIYE",institutionString:null,institution:{name:"Istanbul University",country:{name:"Turkey"}}},{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",biography:"Zühre Akarslan was born in 1977 in Cyprus. She graduated from Gazi University Faculty of Dentistry, Ankara, Turkey in 2000. \r\nLater she received her Ph.D. degree from the Oral Diagnosis and Radiology Department; which was recently renamed as Oral and Dentomaxillofacial Radiology, from the same university. \r\nShe is working as a full-time Associate Professor and is a lecturer and an academic researcher. \r\nHer expertise areas are dental caries, cancer, dental fear and anxiety, gag reflex in dentistry, oral medicine, and dentomaxillofacial radiology.",institutionString:"Gazi University",institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"272237",title:"Dr.",name:"Pinar",middleName:"Kiymet",surname:"Karataban",slug:"pinar-karataban",fullName:"Pinar Karataban",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272237/images/8911_n.png",biography:"Assist.Prof.Dr.Pınar Kıymet Karataban, DDS PhD \n\nDr.Pınar Kıymet Karataban was born in Istanbul in 1975. After her graduation from Marmara University Faculty of Dentistry in 1998 she started her PhD in Paediatric Dentistry focused on children with special needs; mainly children with Cerebral Palsy. She finished her pHD thesis entitled \\'Investigation of occlusion via cast analysis and evaluation of dental caries prevalance, periodontal status and muscle dysfunctions in children with cerebral palsy” in 2008. She got her Assist. Proffessor degree in Istanbul Aydın University Paediatric Dentistry Department in 2015-2018. ın 2019 she started her new career in Bahcesehir University, Istanbul as Head of Department of Pediatric Dentistry. In 2020 she was accepted to BAU International University, Batumi as Professor of Pediatric Dentistry. She’s a lecturer in the same university meanwhile working part-time in private practice in Ege Dental Studio (https://www.egedisklinigi.com/) a multidisciplinary dental clinic in Istanbul. Her main interests are paleodontology, ancient and contemporary dentistry, oral microbiology, cerebral palsy and special care dentistry. She has national and international publications, scientific reports and is a member of IAPO (International Association for Paleodontology), IADH (International Association of Disability and Oral Health) and EAPD (European Association of Pediatric Dentistry).",institutionString:null,institution:null},{id:"172009",title:"Dr.",name:"Fatma Deniz",middleName:null,surname:"Uzuner",slug:"fatma-deniz-uzuner",fullName:"Fatma Deniz Uzuner",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/172009/images/7122_n.jpg",biography:"Dr. Deniz Uzuner was born in 1969 in Kocaeli-TURKEY. After graduating from TED Ankara College in 1986, she attended the Hacettepe University, Faculty of Dentistry in Ankara. \nIn 1993 she attended the Gazi University, Faculty of Dentistry, Department of Orthodontics for her PhD education. After finishing the PhD education, she worked as orthodontist in Ankara Dental Hospital under the Turkish Government, Ministry of Health and in a special Orthodontic Clinic till 2011. Between 2011 and 2016, Dr. Deniz Uzuner worked as a specialist in the Department of Orthodontics, Faculty of Dentistry, Gazi University in Ankara/Turkey. In 2016, she was appointed associate professor. Dr. Deniz Uzuner has authored 23 Journal Papers, 3 Book Chapters and has had 39 oral/poster presentations. She is a member of the Turkish Orthodontic Society. 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Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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