Questionnaires to asses OHRQoL in adults
\r\n\tThis book aims to expose the recent advances in the research and development of chemical and biochemical processes to obtain bio-based chemical compounds and fuels from glycerol.
\r\n\r\n\tChapters dealing with the synthesis and characterization of catalysts (single and mixed hydroxides and oxides, supported catalysts, zeolites, heteropolyacids, pillared-clays, and metal-organic frameworks) and biocatalysts (novel microbial and fungi cultures, immobilized cells, immobilized enzymes, and nanobiocatalysts) to carry out the conversion of glycerol, as well as their testing in discontinuous and continuous stirred reactors, fixed-bed, fluidized-bed, trickle-bed, bubble column, airlift and membrane (bio)reactors are welcome.
\r\n\r\n\tThe book will comprise, but will not be limited to, the homogeneous and heterogeneous chemical reactions of glycerol such as dehydration, hydrogenolysis, partial oxidation, steam- and dry-reforming, glycerol to hydrocarbon fuels and aromatics, (trans)esterification, etherification, halogenation, ammoxidation, as well as supercritical, and photocatalytic processes.
\r\n\r\n\tAdditionally, we hope to cover the bioprocessing of glycerol, including microbial and fungal fermentation and enzymatic reactions to obtain C2-C4 alcohols, diols, hydrogen, methane, organic acids, dihydroxyacetone, biopolymers, and others.
\r\n\tThe book will also deal with the engineering aspects of glycerol processing, such as chemical equilibrium of glycerol reactions, reaction kinetics, (bio)reactor modeling, as well as process simulation and optimization of process variables and reactors.
Data about the impacts on people´s life caused by oral condition has been gathered recently in the last decades. Functional consequences of oral disease have been documented and also the emotional and social ones. It is accepted and recognized by dental community that oral health status can cause considerable pain and suffering, if oral symptoms remain untreated would be a major source of diminished quality of life; disturbing people´s food choices or their speech, or may lead to sleep deprivation, depression, and multiple adverse psychosocial outcomes. Influencing how people grow, enjoy life, chew, taste food and socialize, as well as their feelings of social well-being. There are so many oral affections that impact negatively on quality of life like caries, periodontal disease, tooth loss, cancer, dental injuries, dental fluorosis, and dental anomalies, craniofacial disorders among others. In fact not only dental disease but also treatment experience can negatively affect the oral health related quality of life. The relationship among these anomalies or conditions with quality of life are recently findings in literature in different populations. To evaluate these impacts different instruments have been developed for pediatric and adult population.
If there are complexities in defining disease, there are even more in defining health. Definitions have evolved over time. In the biomedical perspective, early definitions of health focused on the theme of the body’s ability to function; health was seen as a state of normal function that could be disrupted from time to time by disease. An example of such a definition of health is: "a state characterized by anatomic, physiologic, and psychological integrity; ability to perform personally, in family, work, and in community roles; ability to deal with physical, biologic, psychological, and social stress". Then, in 1948, the World Health Organization (WHO) proposed a definition that aimed higher, linking health to well-being, in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity". Although this definition is most accepted one it is also criticized as being vague, excessively broad, and unmeasurable.
This brought in a new conception of health, not as a state, but in dynamic terms, in other words, as "a resource for living". [1] The WHO in 1984 revised the concept of health and defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities". [2] Thus, health referred to the ability to maintain homeostasis and recover from illness. Mental, intellectual, emotional, and social health referred to a person’s ability to handle stress, to acquire skills, to maintain relationships, which are important for resources for resiliency and independent living. As seen the concept of health is wide and the way we define health also depends on individual perception, religious beliefs, cultural values, norms, and social class.
As in 1948 WHO expanded the definition of health to mean “a complete state of physical, mental, and social well-being, and not just the absence of infirmity”, oral health concept followed this change aiming not minimized oral health as having or not caries. So the concept of oral health (OH) has changed over time, going from a biologist approach, in which the oral cavity contributes to protect the body from infections by chewing and swallowing, to a social and psychological approaches, that take into account other roles of the oral cavity as the contribution that it has in self-esteem, communication and interaction and facial aesthetics. There is a concept of oral health defined by Dolan, who mention that OH means “a comfortable and functional dentition which allows individuals to continue in their desired social role.” [3]. This definition already includes the role of OH in the performance of daily activities of the individual. With this we see that oral health is not just a medical condition, but an aggregate of aspects such as the impact that pain may have in daily or the degree of disability or dysfunction. Nowadays the importance of the oral cavity is recognized, as vital part of the human body. It is conceptualized as not only the teeth but others structures as gums, supporting tissues, ligaments, bone, hard and soft palate, soft mucosal tissue tongue, lips, salivary glands, chewing muscles, jaws, and the temporomandibular joints.
Similarly, the Canadian Dental Association defines oral health as “a state of the oral and related tissues and structures that contributes positively to physical, mental and social well-being and enjoyment of life’s possibilities, by allowing the individual to speak, eat and socialize unhindered by pain, discomfort or embarrassment”. Oral Health and oral cavity should be viewed as a part of a complete body, we must see human beings and their activities and not teeth and tooth decay, thus to recognized the play that oral health has on daily life activities. Clearly, there is an interaction between how we experience quality of life and how we perceive our oral health.
The term “quality of life” (QoL) was first used by the British economist Arthur Cecil Pigou in 1920. Later, after World War II, this term was expanded into other areas such as sociology, politics [4] and health, among others. Within the area of health the concept of quality of life was introduced and initially applied in patients with neoplastic disease [5], having a peak in the 90s and essentially incorporating the patient’s perception. 4
The World Health Organization (WHO) in 1952 defined the concept of QoL, as “the proper and correct perception that a person has of itself in the cultural context and values on which it is embedded, in relation to its objectives, standards, hopes and concerns. [6]
This perception may be influenced by their physical, psychological, level of independence and social relationships. [7] Later it was considered good health and quality of life to “the absence of disease or defect and the sense of physical, mental and social well-being” or “personal sense of well-being and life satisfaction.” Another proposal definition in 2003 by Ventegodt is “to have a nice life and live a life of high quality.” [8] Later on it was postulated that “the quality of life has to do with the degree to which an individual can enjoy the possibilities of life”. This concept was proposed by the Centre for Health Promotion, University of Toronto. [9]
The variety of definitions and the lack of consensus lead us to think that the term quality of life is only understood on a personal level or as Campbell mentioned: “The QoL is a vague and ethereal concept, something that many people talk about but anybody knows clearly what it really means. [10]
On the other hand, all the above definitions are general definitions of quality of life and not quality of life related to health (HRQoL). Furthermore, it becomes evident that these terms within the medical field have been used interchangeably. Strictly research in the field of health should address processes or limit the scope of the study quality of life related to health, which refers to the effects that the sufferings directly or these treatments can occur in people. [11, 12] HRQoL is the quality of life that relates directly to the state of health of the individual. It is clear and recognized that HRQoL refers to something much broader than health.
The HRQoL assessment in a patient represents the impact that a disease and its subsequent treatment has on the patient’s perception of their well-being. One of the existing definitions consider HRQoL as “the subjective assessment of the influence of health status, health care and health promotion on an individual’s ability to maintain a level of functioning that allows him to perform activities that are important, and affect overall welfare.” [8]
Or, as Patrick and Erickson proposed, HRQoL is the “extent to which the value assigned to duration of life in terms of the perception of physical, psychological, social and diminishing opportunities limitations because of illness value is changed, its sequelae, treatment and / or health policy “. It has also been conceptualized as “the subjective perception, influenced by the current health status, ability to perform those activities important for the individual”.4
For this assessment it has been proposed that the most important dimensions of HRQoL are: social, physical and cognitive functioning, mobility and personal care and emotional wellbeing.
HRQoL is an important subjective component so it will depend on the relationship that each individual has with his life. This concept will vary and depend largely on the perception that people has about their physical, mental, social and spiritual state, largely depending on their own values, convictions and beliefs, as well as their personal cultural context and history. [13]
Given the above, to assess HRQoL should be considered the values in which each person lives, that is, the cultural context in which he is immersed, and in the individual expectations and achievements. Similarly, the perception of HRQoL is not equal over time because people change their expectations and aspirations adjusting them to different circumstances.
Clinicians interested in knowing the effects of interventions or treatments also find useful information on HRQoL, as it evaluates the final result of medical interventions at one point, not assessing only according to biological or physiological standards but at emotional and social functional level, it means to evaluate everything that a person represents.
Similarly, this information is also relevant to patients and family members making them aware of areas where their performance is affected by their health, identifying where they may need further help or therapy or supporting them to choose between various options of treatments. Moreover, it has been identified that the assessment of HRQoL in children can be used as a predictor of costs of health care and can help to identify risk groups or to evaluate health services. [14, 15].
Although oral health problems are rarely a matter of life and death they remain a major public health problem because of its prevalence and there are significant indications that oral health problems have social, economic and psychological consequences, this means that they have impact of quality of life.
Nowadays there is a growing interest in recognizing oral health as a component of quality of life, currently the dental research efforts are not only focus on rehabilitating oral-dental diseases, but in exploring the relationship between oral health status and quality of life, in order to evaluate it, improve it and maintain it. In fact, OHRQoL is an integral part of general health and well-being and is recognized by the WHO as an important segment of the Global Oral Health Program. [16]
Oral health-related quality of life was defined as a “self-report specifically pertaining to oral health–capturing both the functional, social and psychological impacts of oral disease” [17] There is another definition that conceptualizes OHRQoL mentioning that it “reflects people’s comfort when eating, sleeping and engaging in social interaction; their self-esteem; and their satisfaction with respect to their oral health”. Locker suggested that it is the result of an interaction between and among oral health conditions, social and contextual factors [18] and the rest of the body as Atchison mentioned. [19]
We must keep in mind that OHRQoL deals with conditions that vary in intensity and importance, some of them are life-threatening (e.g. oral cancers) some chronic (caries, periodontitis, etc.) some other dealing with aesthetics (fluorosis, dental anomalies, etc) and other are related to oral pain (pulpitis, dental treatments etc.).
As HRQoL oral health related quality of life is highly subjective and has to be assessed within the framework of patients’ conditions, sociocultural environments and own experiences and states of mind: because OHRQoL is related to daily life and is unique to each individual, even patients with severe conditions can report having good quality of life. Furthermore, Quality of Life is by itself multi-faceted, showing variation over time for each individual. [20]
A long the time several oral conditions have been reported in literature as conditions having impact on OHRQoL. An example is
Some other common oral conditions, such as caries, periodontal disease, which are almost universal in prevalence, and which are chronic but with acute recurring episodes, also impact on QoL. In the same way other condition that might not be as common as the ones mentioned before but which prevalence cannot be considered low as dental fluorosis, craniofacial disorders and oral cancer which can be life treating.
There are several reports showing that
Another alteration that affects quality of life is
There is an association between the presence of malocclusion with worse OHRoQL. Particularly the one related to lack of space, facial pain has adversely effects of body image, social interaction and daily behavior of the individual. Given the fact that face and mouth appearance influence judgments of facial attractiveness, playing an important role in the development of social and occupational goals. Not only malocclusion but also its treatment has an effect on OHRQoL may also affect QoL through their effect on function and esthetics.
For instance, reports have been made demonstrating striking changes in self-concept and emotional health after
Another alteration that has an impacto n OHRQoL is severe
In Uganda, a study aiming to describe the OHRQoL in 12 years of age rural children showed that more than half of them reported oral impact “often” or “every day”. Authors concluded that the presence of caries experience or treatment were associated with higher impacts on quality of life. The socially significant fluorosis was associated with greater number of impacts, but not with higher total scores. Despite low levels of oral problems these children experienced impacts on quality of life due to oral problems. Finding that most responsible for these impacts is the presence of caries and fluorosis a lower level. Also
Also
Documented data, reported in Thailand, suggest that in ninety per cent of pre-adolescents have an impact related to oral health, 74% of 35–44-year olds had daily performances affected by their oral state; 46% reported their emotional stability was affected. Earlier, end points such as recurrence rates and survival were used to evaluate the efficacy of various therapeutic measures in head and neck cancer while patient’s quality of life was usually ignored. Presently, the multitudinal impact of maxillofacial tumors on a patient’s life has been recognized, which led various researchers to investigate the quality of life of those patients. However, studies evaluating the quality of life of patients with maxillectomy defects and the effect of prosthodontic therapy with obturator prostheses on their quality of life remain rare. A obturator prosthesis is a highly positive and non-invasive approach to improve the quality of life of patients with maxillectomy defects. [25]
Andiappan and cols. performed a meta-analysis and revealed that those receiving treatment for malocclusion and in individuals without malocclusion have significantly better OHRQoL compared to those with such condition [26]
Recent studies of the impact on OHRQoL on children’s under general anesthesia treatment have shown significant improvement in oral health and psychological, social and overall wellbeing as well as a positive impact on the family.
Besides clinical conditions, there are other factors that contributed in the impact on OHRQoL as lower family income and sex. In general, women reported a greater impact on OHRQoL than men, although no differences are observed between clinical conditions present in each gender. Differences in the perception of OHRQoL between the genders may be caused by individual and subjective concepts related to beauty and personal esthetic standards, imposed by the social demands and personal needs [27].
As aforementioned, in the literature has been identified OHRQoL as a multidimensional construct containing physical, social and psychological domains. [28] The clinical indexes do not evaluate these aspects, they only measure the presence and severity of illness, and give scarce consideration to the functionality of the oral cavity as a whole, or to the impact of the symptoms on the patients’ quality of life. So the clinical indexes that are commonly used to establish the presence and severity of pathological conditions should be complemented with indicators of social and emotional aspects related to the individual experience and subjective perception of changes in the patients’ physical, mental, and social health. [29]
Over the years several socio-dental indicators have been developed, since Cohen and Jago first advocated the development of sociodental indicators. These indicators range from single item to composite inventories or scoring systems, covering the aforementioned OHRQoL domains. So since the 70´s, several authors have been given the task to develop and test instruments that may assess the functional, emotional and social effects of oral abnormalities.
All these questionnaires around the world have been developed to measure the impact of oral disease on quality of life which comprising different domains including: pain and inability to perform normal functions of the mouth, sleep disturbances, loss of school days, degree of emotional and social wellbeing. These questionnaires could also potentially be a valuable outcome for evaluating oral health promotion programs and/or service initiatives. 30
The SIDD developed in the early 1980s, was one of first socio-dental indicators. Created under a model that defines dental health status in socio-dental terms; the clinical indicators are largely determined by vulnerability whilst the social elements are more directly linked with the degree of social and psychological impact arising from dental diseases. The indicator was tested on large randomly selected samples of industrial workers in Warrington, in the North of England and skilled manual workers and their wives in the South of England.
It was developed as a component of a much broader socio-dental model of dental disease and health behavior so that both the clinical and socio-psychological aspects could be considered within an integrated framework. The model assumes that an individual\'s present oral health status and treatment needs are influenced by an interplay of three \'dimensions\' of background and behavioural factors, namely vulnerability, motivational and preventive dimensions. The score for each individual was constructed from responses to questions relating to those five categories. A total impact score is derived by adding the number of categories. A score of 1 is given to the impact category if a positive response has been given to any of the questions in the category. Two total impact scores were used, one including (total score 0-5) and one excluding discomfort (totaL score 0-4) to see the difference if this relatively common problem was excluded.
The GOHAI is one of the most commonly used scales in assessment of OHRQoL it was developed by Kathryn Atchison and Dolan in 1990 in the USA for use with elderly populations. It is compounded by 12-items developed with three months’ time reference, with five (six in the original) Likert scale options, scoring as ‘often’, always’, ‘seldom ’or ‘sometimes’ and ‘never’ reflecting the aspects that are considered to have an impact upon the quality of life of the older population. Nonetheless it was created for geriatric populations some author have used it with younger adult populations, which is reflected in the interchangeable us of the names Geriatric or General Oral Health Assessment Index. It was developed to evaluate three dimensions of OHRQoL including physical functions like eating, chewing, speech, swallowing; psychosocial functions like worry, limitations and discomfort with social contacts, dissatisfaction with appearance; and self-consciousness about oral health, pain or discomfort including the use of medication or discomfort from the mouth. The GOHAI score is determined by summing the final score of each of the12 items.
The GOHAI gives a greater weight to functional limitations or pain and discomfort. According to the research of Hassel et al., the GOHAI seems to be more appropriate when focusing on subjective oral health with minor clinical changes and immediate clinical aspects. [33]
This questionnarie has been tested on a variety of sample of subjects, of different ages, races and the reliability testes show that this instrument is acceptable in all samples tested thus far. It has also been translated and validated to a wide range of languages.
This instrument was developed by Ronald Strauss. It consist in twenty-five items that have been placed in non-apparent order and respondents are offered three ordinal response choices (good effect, bad effect, no effect) about whether teeth or dentures have had an effect on various aspects of life. A response of “good effect” was seen as likely to be most socially acceptable and the potential for response bias in the positive direction exists. While “good effect” and “bad effect” response categories have meaning independently, they may be combined in the estimation of dental impact. Dental impact is noted for an item if teeth are seen to have an effect on that aspect of life, whether that effect is positive or negative. Responses of “no effect” are seen as indication of no dental impact. The four subscales and component items were:
Eating Subscale: Eating, Chewing and Biting, Enjoyment of eating, Food choice, Tasting
Health/Well-Being Subscale: Feeling comfortable, Enjoyment of life, General happiness, General health, Appetite, Weight, Living a long life
Social Relations Subscale: Facial appearance to other people, Facial appearance (to self), Smiling and laughing, Moods, Speech, Breath, Confidence around others, Attendance at activities, Success at work
Romance Subscale: Social Life, Romantic relationships, Having sex appeal, Kissing,
Developed by Leao & Sheiham in 1996. The Dental Impact on Daily Living (DIDL) is a socio-dental measure which assesses five dimensions of quality of life comfort, appearance, pain, daily activities, eating. Comfort, related to complaints such as bleeding gums and food packing; Appearance, consisting of self-image; Pain; Performance, the ability to carry out daily activities and to interact with people; and Eating restriction, relating to difficulties in biting and chewing. The measure consists of a questionnaire of 36 items, which assesses the oral impacts on daily living, and a scale, which is a graphical representation of a method developed by Leao to assess the importance respondents attribute to the different dimensions involved. Items are summed into a score for each dimension. To compute the score, coded responses within each dimension were summed and divided by the number of items, resulting in a dimension score (For example, Appearance has four questions. The score for this dimension would be the sum of coded responses for all four questions divided by four). Impacts were coded as ‘+1’ for positive impacts, 0 for impacts not totally negatives and ‘-1’ for negative impacts. To construct a final score, questions within each category are summed and divided by the number of items, giving a score for each dimension. Before adding the different dimensions, they receive the respective weight attributed on the scale, otherwise it would be assumed that they were equally important. Then the five dimensions are finally added to give a final score.
One aspect to be highlighted in DIDL is the degree of flexibility offered in terms of aggregating and disaggregating data (either individual items, dimension scores or total score). Although criticized, a total score reproduces the total impact subjects are experiencing, and since dimensions sometimes may not impact separately, it appears important to have this view of the individual as a whole. Another point to be stressed is that in the total score generated by DIDL, weights attributed to dimensions (by each respondent) are personal. That is, the importance attributed to a dimension by a given individual is directly associated with his or her own impacts on that dimension. [36]
Developed by Cornell et al. in 1997, they included 56 questions divided 4 domains: oral health, nutrition, self-rated oral health, overall quality of life. It is part of a larger home-based interview, the Oral Health Quality of Life Interview (OHQOLI)*. In addition to the OH-QoL, OHQOLI includes self-report assessments of oral health and functional status (SROH), a Nutrition Quality of Life Index (NutQoL), and an interview version of the Quality of Life Inventory (QOLI). [37] The final OHQOLI interview has 40 SROH items, 15 OH-QoL items, and 9 NutQoL items. The OH-QoL items are distributed among the related SROH items. Thus, the subjective well-being items appear immediately following the related objective functional status items in the questionnaire. The overall format of the OHQOLI is designed for interviewer administration.
The OHIP, developed by Slade & Spencer is the most widely used OHRQoL questionnaire. It is based on Locker\'s adaptation of the World Health Organisation\'s classification of impairments, disabilities and handicaps (Locker, 1988). The OHIP contains 49 assessing seven dimensions of impacts of oral conditions on people’s OHRQoL including functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability and handicap.
A short version, OHIP-14, was later developed based on a subset of 2 questions for each of the 7 dimensions. [39] It is patient-centered, gives a greater weight to psychological and behavioral outcomes, is better at detecting psychosocial impacts among individuals and groups, and better meets the main criteria for the measurement of OHRQoL.[33] The OHIP 14 responses, “never”, “hardly ever”, “occasionally”, “fairly often”, and “very often”, were codified from 0 to 4, respectively. Each of the 14 questions was assigned a score of 0 if the response was “never,” and a score of 1 if the response was “hardly ever”, “occasionally”, “fairly often,” or “very often,” dichotomizing responses into no impact versus some impact. The scores assigned to the responses to the 14 questions are added to obtain values between 0 and 14. [40]
There also exist the OHIP-aesthetic which is a modified short form of the OHIP derived (OHIP-conceptual) that is most favorable in discriminating dental aesthetics, showing to be reliable and most sensitive to the dental aesthetics intervention-tooth whitening. [41]
The OIDP aims to provide an alternative sociodental indicator which focuses on measuring the serious oral impacts on the person\'s ability to perform daily activities. It is one of many self-reported inventories to assess OHRQoL in terms of adverse impacts that oral conditions can have on everyday life experiences.
Theoretical framework of consequences of oral impacts
The theoretical framework of OIDP is presented in Figure 1. This is a modified model from the WHO International Classification of Impairments, Disabilities and Handicaps amended for dentistry by Locker. [42] In this modification different levels of consequence variables were established. The first level refers to the oral status, including oral impairments, which most clinical indices attempt to measure. The second level, "the intermediate impacts", includes the possible earliest negative impacts caused by oral health status: pain, discomfort or functional limitation. Dissatisfaction with appearance was added in this level since studies indicated that it was a major dimension of oral health outcomes. In addition, functional limitation may cause pain, discomfort or dissatisfaction with appearance and vice versa. The third level, or the "ultimate impacts" represents impacts on ability to perform daily activities which consists of physical, psychological and social performances. Any of the dimensions in the second level may impact on performance ability. This third level is equivalent to disability and handicap dimensions in the WHO model. The OIDP concentrates only on the measurement of "ultimate" oral impacts, thus covering the fields of disability and handicap.
The OIDP has been demonstrated to have appropriate psychometric properties when applied in population based cross-sectional surveys of elderly in Norway 43, Sweden 44, Greece and UK, Tanzania, Bosnia 45, Brazil, Thailand, among others. Studies have shown that OIDP is associated in the expected direction with self-reported oral health and clinical indicators and that personal-, socio-demographic-, and health care service related factors modify those relationships.
There are other questionnaires adapted to specific conditions/domains as the Orthognathic QOL Questionnaire, SOOQ for orthodontic surgery, OHRQOL for Dental Hygiene, The prosthetic quality of life (PQL), Quality of Life with Implant-Prostheses’ (QoLIP-10)
The PQL, created by Javier Montero and collaborators, is compounded by 11 items and can be applied in epidemiological studies or clinical trials with no special cost as regards the time required for exploration. It has a bipolar design of the responses of the items of the PQL that allows both negative and positive impacts to be recorded, such that the assessment of the physical, psychological and social well-being deriving from the use of dental prostheses, condition that makes it more complete than questionnaires limited to evaluating the presence of negative impact. Responses: Yes, a lot (1),Yes, slightly (2), It’s more or less the same (3), I think it’s worse (4), It’s much worse (5).
Preciado and colaborators designed this instrumet of the 10-item scale that gather information on global oral satisfaction, socio-demographic, health-behavioural, clinical and prosthetic-related data. This questionnaire has shown to be reliable and valid. The factor analysis confirmed the existence of three dimensions and meaningful inter-correlations among the 10 items. The QoLIP-10 index confirmed its psychometric capacity for assessing the OHRQoL of implant overdenture and hybrid prosthesis wearers. Authors suggest that this instrument may be recommended for determining the influence of implant-retained overdentures and hybrid prostheses on the well-being of future patients.
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
\n\t\t\t\t | \n\t\t\tSIDD | \n\t\t\tEnglish | \n\t\t\t1980 | \n\t\t\t\n\t\t |
\n\t\t\t\t | \n\t\t\tSIP | \n\t\t\tEnglish | \n\t\t\t1985 | \n\t\t\t\n\t\t |
\n\t\t\t\t | \n\t\t\tGOHAI | \n\t\t\tEnglish | \n\t\t\t1990 | \n\t\t\tFrench [48], German [49], Mandarin Chinese [50], Arabic [51], Swedish [52], Malay [53], Arabic [54], Turkey [55], Hindi [56] Spanish [57], Portuguese [58] | \n\t\t
\n\t\t\t\t | \n\t\t\tDIP | \n\t\t\tEnglish | \n\t\t\t1993 | \n\t\t\t\n\t\t |
\n\t\t\t\t | \n\t\t\tOHIP | \n\t\t\tEnglish | \n\t\t\t1994 | \n\t\t\tKorean, Chinese. Swedish, Portuguese, Japanese, Hungarian, Dutch, German, Hebrew, Croatian, Slovenian, Sinhalese, Persian, Italian | \n\t\t
\n\t\t\t\t | \n\t\t\tDDIDL | \n\t\t\tEnglish | \n\t\t\t1996 | \n\t\t\t\n\t\t |
\n\t\t\t\t | \n\t\t\tOIDP | \n\t\t\tEnglish | \n\t\t\t2011 | \n\t\t\tPortugues, Greece, Thai, Kannada [59], Swedish, Bosnian, Norwegian | \n\t\t
OIDP abreviado | \n\t\t\t\n\t\t\t | 2012 | \n\t\t\tIndia [60], Albanian | \n\t\t|
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\tEnglish | \n\t\t\t2007 | \n\t\t\t\n\t\t |
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\tEnglish | \n\t\t\t2013 | \n\t\t\t\n\t\t |
Questionnaires to asses OHRQoL in adults
During the past decade, several instruments have been developed to detect the impact of oral health on children´s quality of life.
In 2002, Jokovic et al. developed the Child Perceptions Questionnaire (CPQ), which is one of the first instruments used to evaluate OHRQoL in children. In addition to the CPQ, there is a Parent’s Perceptions Questionnaire (P-CPQ) [62] and a Family Impact Scale (FIS) [63], which is compound a battery of instruments that provide information at different levels and perspectives for OHRQoL in children.
The CPQ has two versions, one is the CPQ11-14 for children from 11 to 14 years of age; the other, which is the CPQ 8-10, is for children aged 8 to 10 years. Both aim to evaluate the impact of oral and orofacial conditions in children at a functional, emotional, and social level.
The CPQ11–14 was constructed using a systematic multistage process based on the theory of measurement and scale development. It is one of the most used instruments which is composed of 37 items divided into four domains or subscales: oral symptoms (n=6), functional limitations (n=9), emotional well-being (n=9) and social well-being (n=13). The questions ask about the frequency of events in the previous three months in relation to the child\'s oral/oro-facial condition. The response options are: \'Never\'=0; \'Once/twice\'=1; \'Sometimes\'=2; \'Often\'=3; \'Everyday/almost every day\'=4. The questionnaire also contains global ratings of the child\'s oral health and the extent to which the oral/oro-facial condition affected his/her overall well-being. They are worded as follows: "Would you say that the health of your teeth, lips, jaws and mouth is..." and "How much does the condition of your teeth, lips, jaws or mouth affect your life overall?" A 5-point response format ranging from \'Excellent\'=0 to \'Poor\'=4 and from \'Not at all\'=0 to \'Very much\'=4, respectively, is offered for these ratings.
The CPQ11–14 performs well as a discriminative measure, being able to distinguish between the three groups. Jokovic and co-workers developed short-forms versions of the CPQ11-14 using two different approaches. This resulted in developed two short versions to facilitate the administration of the questionnaire in clinical settings (16-item short-form) and in epidemiological surveys involving general populations (8-item short-form). Important to mention is that if an 8-item version could be used as an overall scale scores but not analysis is possible at the level of the individual domains. The number of items per domain is insufficient for this purpose. [64]
The CPQ8-10 contains 29 questions. The first two relate to demographic information; the next two pertain to global items; and the remaining twenty-five are divided into four domains: oral symptoms (OS), functional limitation (FL), emotional well-being (EW), and social well-being (SW). The questionnaire registers problems occurring during a prior four-week period. The responses are recorded in a Likert scale from 0 to 4, where 0=never; 1=once or twice; 2=sometimes; 3=often; and 4=every day or almost every day. The maximum score is 100, and the minimum is 0. For the global question concerning the general perception of oral health, the possible responses are 0=very good, 1=good, 2=OK, 3=poor. Regarding the second global question: How much does oral health affect daily living? With a scale as follows: 0=not at all, 1=a little bit, 2=some, 3=a lot.
Recently Foster and cols. suggested that these two questionnaires to be acceptable to be used in younger age group, since 5 years of age. They proposed to use a single questionnaire, CPQ8-10 or the short CPQ11-14, to evaluated OHRQoL in children from 5 to 14 years of age [66], thus facilitating the use in prospective studies following children through different life stages.
The P-CPQ has 31 items distributed into 4 subscales: 6 oral symptoms (OS), 8 functional limitations (FL), 7 emotional wellbeing (EWB) and 10 social wellbeing (SWB). The questions refer only to the frequency of events in the previous 3 months. The items have 5 Likert response options: \'never=0\', \'once or twice=1\', \'sometimes=2\', \'often=3\', \'every day or almost every day=4\'. A \'don\'t know\' response also was permitted and scored as 0. Global ratings of the child\'s oral health and impact of the oral condition on his or her overall wellbeing were obtained from the parents/caregivers. The global ratings had a 5-point response format from \'excellent=0\' to \'poor=4\' for oral health and \'not at all=0\' to \'very much=4\' for wellbeing. The P-CPQ score is calculated by summing the response codes to all 31 items and dividing this sum by the number of items for which a valid response is obtained. The P-CPQ was developed for use with younger children and provides a measure of a child’s OHRQoL. Where both parental and child reports are used, the P-CPQ can be regarded as complementing the latter, thus providing a comprehensive profile of a child’s health and well-being.
The FIS is included in the P-CPQ and consists of 14 items that attempted to capture the effect of a child’s oral or oro-facial condition on four domains: related to parental and family activities with 5 questions, parental emotions (4questions), family conflict (4 questions) and family finances (1 question). The questions ask about the frequency of events in the previous 3 months. Response options for the four domains and the respective scores were: ‘Never’ (scoring 0); ‘Once or twice’ (1); ‘Sometimes’ (2); ‘Often’ (3); and ‘Everyday’ or ‘Almost every day’ (4). A ‘Don’t know’ (DK) response was also allowed. The FIS scores are computed by summing all of the item scores. Scores for each of the four domains can also be computed. The final score could vary from 0 to 56, for which a higher score denoted a greater degree of the impact of child’s oral conditions on the functioning of parents-caregivers and the family as a whole.
In 2013 Thomson and cols developed the short form of the P-CPQ [67] obtaining a 16-and 8-item short-form versions of the P-CPQ and FIS-8 short forms that were developed using data from two New Zealand pre/post-test interventional studies. The internal reliability, validity and responsiveness of the short-form versions were acceptable. [68]
The C-OIDP index is specifically designed to show the final impact of a number of oral health related conditions which can affect child’s daily life. it is a short and enjoyable questionnaire, and relatively quick to administer. The modification of the OIDP included adjusting the language, changing the sequence of questions, simplifying index scales and shortening the recall period. When the index had been validated, pictures of performances were developed and tested in order to make the interview more practical. It was developed and tested among 11–12 year old Thai children. Eight activities are considered: eating, speaking, cleaning teeth, relaxing, emotion, and smiling, studying, and social contact.
The 0–5 scale was changed into 0–3 scale on the computer, by grouping together scores of 1 and 2, and scores of 4 and 5.
The index score is based on the score for each of these eight daily activities. The score for each activity is obtained by multiplying the frequency value by the severity value; the maximum score is therefore 3x3=9. Thus, the score scale for each activity is between 0 and 9. The total score is calculated by adding the scores for all activities, divided by the maximum score possible (8x9=72) and multiplying by 100. The index score ranges therefore between 0-100.
The C-OIDP has two modes of the same questionnaire: bone is interviewer-administered and the other is self-administered, and the latter is used in this validation for adolescents. Both modes have been shown to produce similar results.
The COHIP consists of 34 questions grouped into five domains measuring: oral health, functional well-being, socio-emotional well-being, school performance and self-image. This instrument was designed to measure self-reported OHRQoL in children 8-15 years of age, using both positive and negative questions. It was created by an international study and was simultaneously validated in the U.S.A., Great Britain, Spain, Portugal, China, France and Holland in 2007. Data reported suggest that this instrument has an acceptable validity and reliability (Cronbach’s alpha 0.91, 0.84 CCI) to be applied in population of 8 to 15 years.
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t|
\n\t\t\t\t | \n\t\t\tChild Perception Questionnaire 11-14 | \n\t\t\tEnglish | \n\t\t\tCPQ11-14\n\t\t\t | \n\t\t\t2005 | \n\t\t\tÁrabic, [73] Portugués [74], Chinese, [75] German [76], Italian, Cambodian [77], Danish [78] | \n\t\t
CPQ11-14 Short form | \n\t\t\tEnglish | \n\t\t\t\n\t\t\t | 2006 | \n\t\t\tPortuges, Arabic 79 | \n\t\t|
Child Perception Questionnaire 8-10 | \n\t\t\tEnglish | \n\t\t\tCPQ8-10\n\t\t\t | \n\t\t\t2004 | \n\t\t\tSpanish [80] Portugués, Danés, Bosnian | \n\t\t|
Family Impact Scale | \n\t\t\tEnglish | \n\t\t\tFIS | \n\t\t\t2007 | \n\t\t\tChinese, Portugués [81] | \n\t\t|
Parental-Caregiver Perceptions Questionnaire | \n\t\t\tEnglish | \n\t\t\tP-CPQ | \n\t\t\t2003 | \n\t\t\tChinese, Peruvian Spanish [82] | \n\t\t|
\n\t\t\t\t | \n\t\t\tEnglish | \n\t\t\tChild-OIDP | \n\t\t\t2008 | \n\t\t\tSpanish [83] Canarain Portugues, Swahilli, Malayan, French, Hebrew [84] \n\t\t\t | \n\t\t|
\n\t\t\t\t | \n\t\t\tEnglish | \n\t\t\t\n\t\t\t | 2012 | \n\t\t\tIndial [9] Albanian | \n\t\t|
\n\t\t\t\t | \n\t\t\tEnglish | \n\t\t\tCOHIP29\n\t\t\t | \n\t\t\t2008 | \n\t\t\tSpanish Persian [85] Corean [86] | \n\t\t|
\n\t\t\t\t | \n\t\t\tEnglish | \n\t\t\tECOHIS27\n\t\t\t | \n\t\t\t\n\t\t\t | Turkey [87], Persian [88] Chinese [89]. French [90] Lituan [91], Portugues [92] | \n\t\t|
\n\t\t\t\t | \n\t\t\tEnglish | \n\t\t\tSOHO-5 | \n\t\t\t2013 | \n\t\t\tPortugues | \n\t\t
Questionnaires to asses OHRQoL in children
It was designed to evaluate OHRQoL of children of preschool age and younger. The ECOHIS consists of 13 questions relevant to preschool-age children. The survey questionnaire relies on parental ratings of the 13 items grouped in two main parts: the child impact section and the family impact section. The child impact section covers four domains: child symptoms (1 item), child functions (4 items), child psychology (2 items), and child self-image and social interaction (2 items). The family impact section covers two domains: parental distress (2 items) and family function (2 items). Each question asks about the frequency of an oral health-related problem and is scored on a scale from 0–5, as follows: never (score 0), hardly ever (score 1), occasionally (score 2), often (score 3), very often (score 4), don’t know (score 5).
As dental caries is a chronic disease that can affect children from a very young age and it is important to measure its impacts on quality of life, as they may affect the psychological, social and educational development of the first self-reported OHRQoL measure among 5 year-old children. All inter-item correlations were positive and none was very high, and all item-total correlation coefficients were above the recommended level of 0.2
Cronbach’s alpha was 0.74. Despite the positive initial results, the assessment of this questionnaire should be an on-going process, by extending psychometric testing to properties not evaluated so far, and assessing its applicability and performance in other populations.
Multiple definitions have been postulated to conceptualize HRQoL and OHRQoL and in spite of there are different concepts we can see in every single one that quality of life refers to something much broader than health than physical status, it promotes to see a human being and his environment.
Important to mention that the assessments in the area of health are usually performed by the “professional” and although this is deemed appropriate, they often do not reflect the complex set of feelings that patient has about having or not having good health and quality of life. Therefore, relevant information about the quality of life is of practical importance for various actors in the health sector such as the health policy makers, health services researchers, epidemiologists, health program evaluators, who should underpin and complement their decisions based on this information. The evaluation of these concepts should not substitute clinical ones; rather those should complement them so to take into account the patient’s own perception of their health, expectations, desires and needs. In this sense it is accepted and recognized by dental community that oral health status can cause considerable pain and suffering, dentists should not be only focus on physical status but in subjective evaluations about how people feel and how much they are satisfied or affected with their own oral condition.
The evaluation of OHRQoL promotes a shift from traditional dental criteria assessment and care that focus on a person´s social and emotional experience and physical functioning in defining appropriate treatment goals and outcomes.
Pain is an unpleasant sensation that can range from slight discomfort to excruciating agony and can be linked to actual or potential tissue damage [1]. It is a multimodal and biopsychosocial event with an individual objective and subjective occurrences, resulting in significantly diverse perceptions of pain between the individuals. One of the most common reasons for a patient to visit an endodontist is dental pain. Managing dental pain and anxiety during and after treatment is still a difficult task, which depends on the clinician’s skill and knowledge [2].
In symptomatic pulp tissue diagnosed with irreversible pulpitis, extracellular levels of Substance P are elevated. When comparing pulp tissue diagnosed with irreversible pulpitis to clinically normal pulp tissue, an 8-fold rise in Substance P was found [3]. As a result, irreversible pulpitis is linked to high peptidergic system activation. It is generally known that root canal preparation causes inflammation in the periapical tissues, explaining why root canal therapy causes post-treatment pain (such as symptomatic apical periodontitis). SP is released in the periodontal ligaments as a result of varied canal preparation approaches, which was found to be quite interesting. However, the amount of released SP differs among procedures. Inflammation in the periapical tissues could be triggered by an elevation in SP [4]. This might thus be considered a key mediator of neurogenic inflammation and related hyperalgesia, and hence a prospective target for therapeutics targeted at regulating pain and minimizing the harmful effects of tissue injury [5].
When a carious lesion gets close to the pulp, the pulp’s inflammatory alterations get worse. An acute exacerbation of chronic inflammation occurs at this stage, with an influx of neutrophils and the release of inflammatory mediators (prostaglandins and interleukins), proinflammatory neuropeptides and mediators (substance P, Bradykinin, and calcitonin gene related peptide) [6]. These mediators can increase pain perception and neuronal excitability by stimulating peripheral nociceptors within the pulp of the affected tooth. This causes moderate-to-severe discomfort. Conventional procedures may not provide sufficient anesthesia. As a result, endodontists must achieve profound anesthesia in order to alleviate the pain [7].
The use of local anesthetic agents in pain management plays a vital role. It is the safest and most effective medications to prevent and manage pain during dental treatment [8]. Today’s availability of a variety of local anesthetic agents allows dentists to choose an anesthetic with specific properties such as time of onset and duration, hemostatic control, and degree of cardiac side effects that are suited for each individual patient and dental operation [9]. 2 percent lignocaine (Xylotox, Adcock Ingram; Xylesthesin, 3 M) with 1:80000 adrenaline content, 3 percent mepivacaine (Carbocaine) without a vasoconstrictor and 4 percent articaine (Ubistesin 3 M) with either 1:100000 or 1:200000 adrenaline concentration is currently the most commonly used local anesthetic agents in general dentistry [10]. Each local anesthetic has its own maximum recommended dose (MDR) measured in mg/kg body weight. Unfortunately, the literature7 shows that the mg/kg MDR for each drug ranges from 4.4 mg/kg 8 to 6.6 mg/kg [11, 12].
When dealing with a tooth that has been diagnosed with irreversible pulpitis or “Hot” tooth, it’s critical to determine whether enough local anesthetic has been attained. Subjective and objective testing has historically been used to validate successive inferior alveolar nerve block (IANB). Signs such as lip numbness, probing the gingiva surrounding the tooth to be treated, and so forth are examples of subjective tests [13]. Patients should not suffer discomfort throughout therapy if they respond favorably to the subjective results. These approaches, however, are not confirmatory test for detecting pulpal anesthesia.
While it’s possible that the operator’s inability to deposit anesthetic solution close to the targeted nerve would result in an insufficient blockade in both normal and non-inflamed states, it’s also possible that a partial blockade would suffice in neurons that inflammatory mediators did not sensitize. It’s crucial to understand the nerve supply to the anesthetized tissue and the anatomy of the injection site and any changes [14].
During a local infiltration at the root apex, however, the cortical bone of the body of the mandible can effectively block the anesthetic. The maxillary cortical bone is often thinner. Anesthetic diffusion is more easily achieved through this bone. Therefore, infiltration anesthesia, which is routinely used in the maxilla, would be less affected by anatomic variance. Block anesthesia is advised in the mandible because it is more predictable. Still, it demands a deeper awareness of the deep anatomy of the jaw and is more technique sensitive, which is why anesthetic failures in the mandible are more common. Inadequate local anesthetic has also been linked to accessory innervation of the mandibular teeth from various sources. The nerve to the mylohyoid muscle, in particular, has been linked to the transport of afferent fibers from the mandibular teeth [14]. The clinician has many alternatives for overcoming accessory innervations from the mylohyoid nerve, including using a blocking technique that deposits anesthetic solution higher in the pterygomandibular space.
The pH of the anesthetic solution determines the ratio of RN to RNH+. According to the Henderson–Hasselbalch equation, there are equal amounts of half-charged and half-uncharged molecules when the acid dissociation constant Pka equals the pH of the solution. In a cartridge of local anesthetic solution, both charged (RNH+) and uncharged (RN) molecules exist in equilibrium. The deionized lipid-soluble (RH) form penetrates the neuronal membrane and takes up H+. RNH+ within the nerve, resulting in RNH+, which enters the sodium channel and blocks conduction. To produce anesthesia, the body buffers the pH-injected anesthetic solution to the physiological pH [15].
This becomes potentially critical since inflammation-induced tissue acidosis can cause local anesthetics to get “ion trapped.” According to this theory, the low tissue pH causes a higher proportion of the local anesthetic to be held in the charged acid form of the molecule, preventing it from passing through cell membranes. This theory has been proposed as a primary cause of local anesthetic failures in situations like endodontic pain [16].
Local anesthetic failures may be exacerbated by central sensitization. Increased sensitivity may enhance incoming sensory nerve impulses. There is a significant response to peripheral stimuli in central sensitization, and as a result, the IANB may allow adequate signaling to occur, leading to the experience of pain [16].
According to this hypothesis, the nerves on the exterior of the nerve bundle supply the molar teeth, while the nerves on the inside supply the anterior teeth. Even if the anesthetic solution is placed in the right location, it may not disperse enough into the nerve trunk to reach all nerves and cause a sufficient block. This concept may only apply to the increased failure rates associated with IANB in the anterior teeth, not the posterior teeth [17].
The Tetrodoxin resistant channels (TTXr) family of sodium channels have been demonstrated to be resistant to the effects of local anesthesia. Anesthetic failures in a hot tooth are caused by increased expression of sodium channels in the pulp. The TTXr channels are resistant to lidocaine, resulting in insufficient anesthetic [18]. TTXr channels are expressed on nociceptors, and their activation with Prostaglandin E2 is relatively resistant to lidocaine. Because they are less susceptible to lidocaine, sodium channels that are resistant to TTX. As the concentration of lidocaine rises, the sodium channels get blocked [19].
Inflamed tissue nerves have a lower excitability threshold and an altered resting potential. Lower excitability thresholds are responsible for impulse transmission [20].
Anxiety in the patient may also play a role in the local anesthetic failure. Clinicians who have worked with anxious patients know that they have a lower pain threshold and are more likely to complain about an unpleasant dental experience. The sight of a needle and the sound of the dental handpiece are frequently reported as causes of anxiety in patients. Furthermore, patients may be particularly apprehensive about root canal therapy.
Inflammation has several additional consequences on the physiology of local tissues. Inflammatory mediators cause peripheral vasodilation, which increases the rate of systemic absorption, lowering the concentration of local anesthetics. Local anesthetics, in most circumstances, need formulation with vasoconstrictor drugs. Thus, this is a potentially relevant mechanism. Although regional variations in blood flow occur in inflamed dental pulp, little is known regarding inflammation-induced vascular alterations in periradicular tissue [21]. Furthermore, this vasodilation is likely to be confined and not seen at distant injection sites. As a result, compared to nerve block anesthesia, this concept may be more useful in understanding issues with infiltration anesthesia.
Inflammation alters the production of many proteins in nociceptors, resulting in a rise in neuropeptides such substance P and calcitonin gene-related peptide. These neuropeptides have an essential role to perform have a role in regulating pulpal inflammation. Furthermore, tissue damage can change the composition, distribution, and activity of sodium channels expressed on the nociceptors. Inflammation’s effect on these sodium channels might substantially impact local anesthetic failures [22].
Tachyphylaxis is a condition in which a receptor agonist medication causes a reduction in responsiveness to a subsequent dose of the drug. Because local anesthetics are frequently used in conjunction with vasoconstrictors, the medication may remain in the tissue long enough to trigger tachyphylaxis at the sodium channel. This has been suggested as a factor in decreased anesthetic efficacy, particularly after many administrations [21].
Contrary to popular belief, most moderate-duration anesthetics are equally efficient in inducing deep pulpal anesthetic for root canal treatment. Understanding the anatomical, local, and psychological aspects of each patient against the type of anesthetic utilized is critical to success. Most dentists prefer to employ a combination of anesthetics and a vasoconstrictor. When some types of anesthetic drugs are used, it is possible that the patients would experience more pain. Because of the acidic nature of local anesthetics, lower pH values are considered to produce a burning sensation during injection [23].
The injection location might influence injection discomfort. According to one study, maxillary buccal injections with plain 2% lidocaine Was found to be considerably less discomfort than 2% lidocaine with 1:80000 epinephrine. However, using the same anesthetic drugs, no difference in injection discomfort was recorded at the palatal location [12]. The type of anesthetic solution has little effect on injection discomfort when a location with less connective tissue (such as the palatal site in the maxilla) is injected. Faster injection speed leads to increased drug distribution. It has been proposed that a speed of injection exposes a larger portion of a nerve to the anesthetic solution, resulting in a higher rate of local anesthesia success. The rapid injections, on the other hand, produced more pain and discomfort during the procedure [23, 24, 25].
In individuals with symptomatic irreversible pulpitis, the degree of preoperative pain might impact anesthetic success. The activation of nociceptors during inflammation might be one reason for the lower success rate of inflamed pulp. The peripheral and central pain pathways are altered and modulated by the barrage of painful stimuli, as well as tissue destruction. Another reason for failure is that nerves from inflamed tissue have reduced excitability thresholds and altered resting potentials [26].
Inflamed pulps may have more tetrodotoxin-resistant sodium channels, which are resistant to local anesthetics. Prostaglandins, which can influence tetrodotoxin-resistant receptors and reduce nerve responses to anesthetic drugs, have also risen considerably in inflamed pulps [27]. As a result, premedication with nonsteroidal anti-inflammatory medicines (NSAIDs) and corticosteroids to increase anesthetic success appear to be a viable option. However, the findings of such research do not agree on the effectiveness of premedication on anesthetic success [28, 29]. However, if the patient does not have spontaneous pain, pre-treatment with particular types of NSAIDs may improve the effectiveness of anesthesia when treating irreversible pulpitis [30]. Premedication with corticosteroids before anesthesia with an inferior alveolar nerve block (IANB) injection resulted in a considerably better success rate.
Genetics may play a role in predisposing specific individuals to problems such as discomfort, delayed healing, and abscess development. A range of genetic variations influences pain perception and behavior. Pain becomes significantly more common in women, and various explanations have been proposed, including hormonal and genetically driven sex variations in brain neurochemistry [27].
Intraligamentary anesthesia is a technique wherein local anesthetic solution administered via the periodontal ligament to reach the pulpal nerve supply. The use of conventional or customized syringes can be used for this technique. At the mesiobuccal aspect, the needle is placed as deeply between the root surface and alveolar bone at a 30° angle to the long axis of the tooth. The needle can be placed with the bevel pointing in either direction, and 0.2 ml of the solution should be injected per root using back pressure. For 5 to 10 seconds, the needle is held in place [31]. The anesthetic action begins almost immediately and lasts for around 15–20 minutes [32].
In comparison to other anesthetic techniques, Intraligamentary anesthesia allows for a substantial reduction in the overall volume of anesthetic solution and vasoconstrictor supplement. At the same time, the unintentional intravascular application is avoided [33]. Furthermore, the effectiveness of Intraligamentary anesthesia is limited in cases of severe marginal periodontitis or teeth with a sclerotic periodontal gap, and alternate anesthetic methods such as inferior alveolar nerve block can be advised [32].
Intraosseous Anesthesia is more invasive and necessitates the use of specialist equipment, such as a perforator (e.g., Stabident, X-Tip). The gingiva must first be sedated for the perforator to penetrate without discomfort. A slow-speed handpiece is used to move the perforator into the anesthetic gingiva and bone until the cancellous bone is felt like a sharp dip. The perforator is then withdrawn, and a small 27-gauge needle is introduced through the perforation, injecting approximately 1 mL of solution over 2 minutes. It’s one of the most effective supplemental methods available [34]. The intraosseous injection permits the local anesthetic solution to be injected directly into the cancellous bone adjacent to the tooth that has to be sedated [35]. The intraosseous anesthetic onset of anesthesia is immediate and lasts for around 15 to 30 minutes, and was found to be more efficient than intraligamentary anesthesia [36].
After a failed IANB, buccal infiltration has been utilized as a supplemental anesthetic for anesthetizing mandibular molar teeth, especially in symptomatic irreversible pulpitis. A mandibular buccal infiltration injection of 4% articaine with 1:100,000 epinephrine as an additional injection to improve the effectiveness of the IANB injection has recently been investigated. The usage of the articaine solution was shown to be better than the lidocaine solution in asymptomatic individuals (88 percent vs. 71 percent, respectively) [37]. Only 58% anesthesia was achievable with buccal infiltration injection when used as a supplement to the IANB in case of symptomatic irreversible pulpitis [38].
Intrapulpal anesthesia is one of the supplementary anesthesia that is beneficial, especially in a hot tooth. The most crucial aspect of this technique is to pump the fluid into the pulp forcefully. If the physician does not feel pressure or resistance to injection, the solution is not reaching the pulp and is most likely running out of the pulp chamber and back into the access cavity [39]. However, this type of anesthesia is excruciating and should only be used as the last option during endodontic therapy. Intrapulpal anesthesia has the drawback of having a limited duration of effect. As a result, it’s critical to remove the pulp from all of the root canals as soon as possible after injection to avoid repeated injection [40]. It is necessary that the patient should be informed that the type of anesthesia will cause moderate to severe discomfort in the beginning.
Buffered local anesthesia technique to one of the techniques to improve the efficiency of the local anesthetics. Alkalinization accelerates the dissociation of the LA molecule, increasing in the uncharged base form that penetrates the nerve membrane and acts in the intraneuronal location. The addition of sodium bicarbonate is the most frequent technique for buffering LAs. The addition of sodium bicarbonate to local anesthetics reacts to form sodium chloride water and carbon dioxide. Alkalinization with sodium bicarbonate raise the pH of the solution. Carbon dioxide produces an independent anesthetic effect by changing the local anesthetic inside the nerve direct depressant effect of carbon dioxide on the nerve axon [41]. 50 mEq is the maximum dose of sodium bicarbonate. 20 ml of 1 or 2% lignocaine is recommended to be added with 2 ml of 8.4 percent sodium bicarbonate. The ratio of lignocaine to bicarbonate should be between 5:1 and 10:1 for best effects. If the bicarbonate level exceeds this ratio, precipitation may occur. In individuals with metabolic acidosis and hypocalcemia, this method is contraindicated [15].
Pain being the most common symptom, every effort should be made to manage it during and after root canal treatment and should be informed priorly the type of anesthesia administered to the patient. Although various anesthetic agents and techniques are available, the choice of them is specific and customized to each patient and their preoperative status and clinical condition. So, ultimately, the clinician should critically decide on a specific agent or a technique for the clinical condition of the patient. It is necessary to provide appropriate pulpal anesthesia when treating teeth with irreversible pulpitis.
The authors declare no conflict of interest.
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In this chapter, you understand the details of ageing processes and associated physiological changes.",book:{id:"6381",slug:"gerontology",title:"Gerontology",fullTitle:"Gerontology"},signatures:"Shilpa Amarya, Kalyani Singh and Manisha Sabharwal",authors:[{id:"226573",title:"Ph.D.",name:"Shilpa",middleName:null,surname:"Amarya",slug:"shilpa-amarya",fullName:"Shilpa Amarya"},{id:"226593",title:"Dr.",name:"Kalyani",middleName:null,surname:"Singh",slug:"kalyani-singh",fullName:"Kalyani Singh"},{id:"243264",title:"Dr.",name:"Manisha",middleName:null,surname:"Sabharwal",slug:"manisha-sabharwal",fullName:"Manisha Sabharwal"}]},{id:"56330",doi:"10.5772/intechopen.69932",title:"Russian Scientific Trends on Specific Language Impairment in Childhood",slug:"russian-scientific-trends-on-specific-language-impairment-in-childhood",totalDownloads:1941,totalCrossrefCites:0,totalDimensionsCites:23,abstract:"In Russia, there are many decades of experience in the scientific study of the problem of impaired language development in children. Today, the term “Systemic speech-and-language underdevelopment (SLU)” has firmly established in Russian science and practice, implying a complex developmental disorder of speech and language in children with a primary normal hearing and a conserved intellect, in which the main components of the language system are violated: vocabulary, grammar, phonetics, and, as a consequence, dialogic and monologic speech. Traditionally, a differentiated level-by-level analysis of the speech and language abilities of children is used. The variability of the manifestations and severity of speech-and-language disorders were initially systematized and characterized in four levels of underdevelopment: from the complete absence of phrase speech to the availability of simple and complex sentences with lexico-grammatical errors. Effective algorithms of speech therapist work with SLU are introduced. The effectiveness of the application of these models and algorithms on the material of various language groups is proved.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Tatiana Tumanova and Tatiana Filicheva",authors:[{id:"204529",title:"Dr.",name:"Tatiana Volodarovna",middleName:null,surname:"Tumanova",slug:"tatiana-volodarovna-tumanova",fullName:"Tatiana Volodarovna Tumanova"},{id:"208704",title:"Dr.",name:"Tatiana Borisovna",middleName:null,surname:"Filicheva",slug:"tatiana-borisovna-filicheva",fullName:"Tatiana Borisovna Filicheva"}]},{id:"36452",doi:"10.5772/38931",title:"Qualitative Research Methods in Psychology",slug:"qualitative-research-methods-in-psychology",totalDownloads:35854,totalCrossrefCites:13,totalDimensionsCites:18,abstract:null,book:{id:"1997",slug:"psychology-selected-papers",title:"Psychology",fullTitle:"Psychology - Selected Papers"},signatures:"Deborah Biggerstaff",authors:[{id:"123274",title:"Dr.",name:"Deborah",middleName:null,surname:"Biggerstaff",slug:"deborah-biggerstaff",fullName:"Deborah Biggerstaff"}]},{id:"56560",doi:"10.5772/intechopen.70235",title:"The Role of Speech and Language Therapist in Autism Spectrum Disorders Intervention – An Inclusive Approach",slug:"the-role-of-speech-and-language-therapist-in-autism-spectrum-disorders-intervention-an-inclusive-app",totalDownloads:2342,totalCrossrefCites:2,totalDimensionsCites:16,abstract:"The chapter describes the possibilities of involving a speech-language therapist in the assessment of the pragmatic level of communication in autism spectrum disorders (ASD), where one of the most frequently impaired areas is communication pragmatics. These difficulties lead to a disruption of social interaction, which might be one of the obstacles to speech-language intervention in these children. The text is based on an originally developed testing material aimed at selected pragmatic-oriented communication situations relating to everyday activities and real life. Based on a comparison of domestic and international resources in this area, as well as mediated and own empirical experience, our assessment approach is based on the conclusion that pragmatics can be understood in different contexts and perspectives. The text presents the results of a partial survey comparing the performance of children with ASD and children with typical development. The assessment focused on the children’s election of the correct picture of a pair of pictures that represent usual communication and social situations. The results of the research suggest fewer incorrect responses in children with ASD and in different areas compared with children with typical development. However, the results of a qualitative analysis indicate a necessity to expand the assessment of communication pragmatics by adding an individually specific qualitative analysis of children’s performance.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Kateřina Vitásková and Lucie Kytnarová",authors:[{id:"203061",title:"Associate Prof.",name:"Kateřina",middleName:null,surname:"Vitásková",slug:"katerina-vitaskova",fullName:"Kateřina Vitásková"},{id:"212035",title:"MSc.",name:"Lucie",middleName:null,surname:"Kytnarová",slug:"lucie-kytnarova",fullName:"Lucie Kytnarová"}]}],mostDownloadedChaptersLast30Days:[{id:"73271",title:"Social Media and Its Effects on Beauty",slug:"social-media-and-its-effects-on-beauty",totalDownloads:2991,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Beauty is concerned with physical and mental health as both are intimately related. Short-term decisions to alter one’s body structure irrespective of genetic, environmental, occupational and nutritional needs can leave medium- and long-term effects. This chapter analyzes the role of social media and its effects on the standards of beauty. The researchers have summarized the literature on how social media plays a role in affecting beauty trends, body image and self-esteem concerns. There is support that social media affects individuals negatively, in pushing them to engage in life threatening beauty trends due to social compliance and acceptance in society. The aim was to review social networking sites’ impact on perception of standards of beauty and newer unrealistic trends gaining popularity that could alter opinions and also cause harm to individuals in the long run. This is an emerging area of research that is of high importance to the physical and mental health in the beauty, health and hospitality industry with the latter being manifested in depression, anxiety and fear of non-acceptability and being seen as a social gauche.",book:{id:"7811",slug:"beauty-cosmetic-science-cultural-issues-and-creative-developments",title:"Beauty",fullTitle:"Beauty - Cosmetic Science, Cultural Issues and Creative Developments"},signatures:"Mavis Henriques and Debasis Patnaik",authors:[{id:"320016",title:"Ph.D. Student",name:"Mavis",middleName:"Lilian",surname:"Henriques",slug:"mavis-henriques",fullName:"Mavis Henriques"},{id:"320978",title:"Dr.",name:"Debasis",middleName:null,surname:"Patnaik",slug:"debasis-patnaik",fullName:"Debasis Patnaik"}]},{id:"60564",title:"Ageing Process and Physiological Changes",slug:"ageing-process-and-physiological-changes",totalDownloads:6884,totalCrossrefCites:16,totalDimensionsCites:31,abstract:"Ageing is a natural process. Everyone must undergo this phase of life at his or her own time and pace. In the broader sense, ageing reflects all the changes taking place over the course of life. These changes start from birth—one grows, develops and attains maturity. To the young, ageing is exciting. Middle age is the time when people notice the age-related changes like greying of hair, wrinkled skin and a fair amount of physical decline. Even the healthiest, aesthetically fit cannot escape these changes. Slow and steady physical impairment and functional disability are noticed resulting in increased dependency in the period of old age. According to World Health Organization, ageing is a course of biological reality which starts at conception and ends with death. It has its own dynamics, much beyond human control. However, this process of ageing is also subject to the constructions by which each society makes sense of old age. In most of the developed countries, the age of 60 is considered equivalent to retirement age and it is said to be the beginning of old age. In this chapter, you understand the details of ageing processes and associated physiological changes.",book:{id:"6381",slug:"gerontology",title:"Gerontology",fullTitle:"Gerontology"},signatures:"Shilpa Amarya, Kalyani Singh and Manisha Sabharwal",authors:[{id:"226573",title:"Ph.D.",name:"Shilpa",middleName:null,surname:"Amarya",slug:"shilpa-amarya",fullName:"Shilpa Amarya"},{id:"226593",title:"Dr.",name:"Kalyani",middleName:null,surname:"Singh",slug:"kalyani-singh",fullName:"Kalyani Singh"},{id:"243264",title:"Dr.",name:"Manisha",middleName:null,surname:"Sabharwal",slug:"manisha-sabharwal",fullName:"Manisha Sabharwal"}]},{id:"27237",title:"Emotional Intelligence",slug:"emotional-intelligence",totalDownloads:5728,totalCrossrefCites:6,totalDimensionsCites:9,abstract:null,book:{id:"679",slug:"emotional-intelligence-new-perspectives-and-applications",title:"Emotional Intelligence",fullTitle:"Emotional Intelligence - New Perspectives and Applications"},signatures:"Adrian Furnham",authors:[{id:"85492",title:"Prof.",name:"Adrian",middleName:null,surname:"Furnham",slug:"adrian-furnham",fullName:"Adrian Furnham"}]},{id:"70731",title:"Theoretical Perspective of Traditional Counseling",slug:"theoretical-perspective-of-traditional-counseling",totalDownloads:1582,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"This chapter discusses the theoretical perspective of traditional counseling from an African context. Traditional counseling involves a broad perspective that enhances learning for transformation and integration of sociocultural values that are peculiar to each human society. A cursory review of the literature suggests that the concept of traditional counseling is rooted in traditional systems of knowledge and sociocultural customs and practices, and it promotes a collective approach to problem identification, resolution, and management. The traditional counseling process centers on four aspects: traditional counselor, client, family, and community. The key elements that inform the theoretical framework of traditional counseling from an African perspective are: cultural context, collective belief system, and initiation rituals Traditional systems of knowledge deemed essential for each generation are passed on successively to the next generation by elderly people who do not only have the necessary wisdom and experience, but are also adorned with social competences and skills.",book:{id:"9136",slug:"counseling-and-therapy",title:"Counseling and Therapy",fullTitle:"Counseling and Therapy"},signatures:"Hector Chiboola",authors:[{id:"314172",title:"Prof.",name:"Hector",middleName:null,surname:"Chiboola",slug:"hector-chiboola",fullName:"Hector Chiboola"}]},{id:"55388",title:"Beauty, Body Image, and the Media",slug:"beauty-body-image-and-the-media",totalDownloads:7678,totalCrossrefCites:5,totalDimensionsCites:12,abstract:"This chapter analyses the role of the mass media in people’s perceptions of beauty. We summarize the research literature on the mass media, both traditional media and online social media, and how they appear to interact with psychological factors to impact appearance concerns and body image disturbances. There is a strong support for the idea that traditional forms of media (e.g. magazines and music videos) affect perceptions of beauty and appearance concerns by leading women to internalize a very slender body type as ideal or beautiful. Rather than simply being passive recipients of unrealistic beauty ideals communicated to them via the media, a great number of individuals actually seek out idealized images in the media. Finally, we review what is known about the role of social media in impacting society’s perception of beauty and notions of idealized physical forms. Social media are more interactive than traditional media and the effects of self‐presentation strategies on perceptions of beauty have just begun to be studied. This is an emerging area of research that is of high relevance to researchers and clinicians interested in body image and appearance concerns.",book:{id:"5925",slug:"perception-of-beauty",title:"Perception of Beauty",fullTitle:"Perception of Beauty"},signatures:"Jennifer S. Mills, Amy Shannon and Jacqueline Hogue",authors:[{id:"202110",title:"Dr.",name:"Jennifer S.",middleName:null,surname:"Mills",slug:"jennifer-s.-mills",fullName:"Jennifer S. Mills"}]}],onlineFirstChaptersFilter:{topicId:"21",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82260",title:"Psychometric Analysis of an Instrument to Study Retention in Engineering",slug:"psychometric-analysis-of-an-instrument-to-study-retention-in-engineering",totalDownloads:4,totalDimensionsCites:0,doi:"10.5772/intechopen.105443",abstract:"Although engineering programs admit highly qualified students with strong academic credentials, retention in engineering remains lower than most other programs of study. Addressing retention by modeling student success shows promise. Instruments incorporating noncognitive attributes have proven to be more accurate than those using only cognitive variables in predicting student success. The Student Attitudinal Success Instrument (SASI-I), a survey assessing nine specific noncognitive constructs, was developed based largely on existing, validated instruments. It was designed to collect data on affective (noncognitive) characteristics for incoming engineering students (a) that can be collected prior to the first year and (b) for which higher education institutions may have an influence during students’ first year of study. This chapter will focus on the psychometric analysis of this instrument. Three years of data from incoming first-year engineering students were collected and analyzed. This work was conducted toward investigating the following research questions: Do the scale scores of the instrument demonstrate evidence of reliability and validity, and what is the normative taxonomy of the scale scores of first-year engineering students across multiple years? Further, to what extent did the overall affective characteristics change over the first year of study?",book:{id:"11441",title:"Psychometrics - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/11441.jpg"},signatures:"Kenneth J. Reid"},{id:"82112",title:"Comparative Senescence and Lifespan",slug:"comparative-senescence-and-lifespan",totalDownloads:9,totalDimensionsCites:0,doi:"10.5772/intechopen.105137",abstract:"The word senescence is derived from the Latin word “senex” (meaning old). In biology, senescence is a process by which a cell ages and permanently stops dividing. Senescence is a natural universal phenomenon affecting all living organisms (e.g., humans, animals, and plants). It is the process of growing old (aging). The underlying mechanisms of senescence and aging at the cellular level are not fully understood. Senescence is a multifactorial process that can be induced by several stimuli including cellular stress, DNA damage, telomere shortening, and oncogene activation. The most popular theory to explain aging is the free radical theory. Senescence plays a role in the development of several age-related chronic diseases in humans (e.g., ischemic heart disease, osteoporosis, and cancer). Lifespan is a biological characteristic of every species. The lifespan of living organisms ranges from few hours (with mayfly) to potential eternity (with jellyfish and hydra). The maximum theoretical lifespan in humans is around 120 years. The lifespan in humans is influenced by multiple factors including genetic, epigenetic, lifestyle, environmental, metabolic, and endocrine factors. There are several ways to potentially extend the lifespan of humans and eventually surpass the maximum theoretical lifespan of 120 years. The tools that can be proposed include lifestyle, reduction of several life-threatening diseases and disabilities, hormonal replacement, antioxidants, autophagy inducers, senolytic drugs, stem cell therapy, and gene therapy.",book:{id:"10935",title:"Mechanisms and Management of Senescence",coverURL:"https://cdn.intechopen.com/books/images_new/10935.jpg"},signatures:"Hassan M. Heshmati"},{id:"81748",title:"Emotional Creativity",slug:"emotional-creativity",totalDownloads:5,totalDimensionsCites:0,doi:"10.5772/intechopen.104544",abstract:"Creativity encompasses and is influenced by several emotions. Emotional creativity is a critical component in the creative process. It is the ability to create something new through the influence of emotions evoked from the personal or experiences of others. Creative works inspired by emotions are often original and greeted with Euphoria. This chapter demonstrates how different emotions inspire different forms and levels of creativity with examples of notable artists who experienced emotional creativity. This chapter discusses research linking emotions to creativity and the explanations of how the identification and regulation of emotions, which are often referred to as emotional intelligence, make a difference in whether creativity becomes useful, helpful, or hurtful. The dark side of creativity, which occurs when creativity becomes hurtful instead of helpful, and research into its causes is also discussed in this chapter. An example of a notable figure in the twentieth century, i.e., Adolf Hitler who masterminded World War II, is used to demonstrate how emotions played a role in this phenomenon. A conclusion alluding to the fact that creativity or creative outcomes are not necessarily bad but the application of creative work and the ability to identify emotions and regulate or control the emotions to drive creative performance validates emotional creativeness.",book:{id:"11303",title:"Creativity",coverURL:"https://cdn.intechopen.com/books/images_new/11303.jpg"},signatures:"Cynthia Naa Anyimah Botchway"},{id:"82097",title:"Including Religion in Rational-Emotive Behavior Counseling",slug:"including-religion-in-rational-emotive-behavior-counseling",totalDownloads:6,totalDimensionsCites:0,doi:"10.5772/intechopen.104980",abstract:"Cognitive-behavioral therapies (CBT) have been disseminated worldwide. This therapeutic approach is being considered some of the best empirically supported treatments for a large variety of psychological disorders. The core tenet of CBT is to restore mental health and promote psychological well-being by focusing on cognitive dysfunctional patterns that cause emotional distress and maladaptive behaviors. First, a general view of the basic principles and origins of cognitive-behavior therapies constitute the basis on which the chapter is built. Thereafter, a more in-depth discussion on specific forms of CBT, namely cognitive therapy (CT) and rational-emotive behavior therapy (REBT) provides further support for the integration of religion and psychological intervention. Next, a thorough analysis of the theoretical premises of this integration and the ways in which religious beliefs and psychological mechanisms merge in practice is provided. Finally, the REBT conceptualization, techniques, and strategies are illustrated in a practical situation; here, the relationship between religious beliefs and practices on the one hand, and irrational beliefs, dysfunctional emotions, and maladaptive behaviors, on the other hand, is easy to observe. The example provided aptly illustrates the many ways in which REBT can incorporate religious principles, beliefs, and practices; all of them, advocating for the harmonious relationship between Christian values and REBT.",book:{id:"11305",title:"Counseling and Therapy - Recent Developments in Theories and Concepts",coverURL:"https://cdn.intechopen.com/books/images_new/11305.jpg"},signatures:"Adrian Opre and Bianca Macavei"},{id:"82075",title:"Sexuality and Disability",slug:"sexuality-and-disability",totalDownloads:10,totalDimensionsCites:0,doi:"10.5772/intechopen.104325",abstract:"Sexuality and disability is an important topic in our global society. Dismantling myths about sexuality and disability is considered a final frontier for people with disabilities. Dismantling myths about sexuality and disability is vital to the overall health and well-being of people with disabilities. A major aspect of the dismantling process is to acknowledge that sexuality is a significant quality of life determinant for all human beings. This chapter provides information that will promote a healthier and more accurate view of Sexuality and Disability. Dismantling this last frontier involves providing the readership with relevant historical information; information about psychosocial factors and attitudes that influence sexuality; and information about ethical practice guidelines. Information pertaining to sexuality training, specific provider competencies and how select disabilities and chronic illness impact sexuality is also covered in the chapter.",book:{id:"11267",title:"Human Sexuality",coverURL:"https://cdn.intechopen.com/books/images_new/11267.jpg"},signatures:"Danita H. Stapleton, Sekeria V. Bossie, Angela L. Hall and Lovett O. Lowery"},{id:"81962",title:"Gender and Modern-Day Slavery: Aggression and Violence in the Context of a Nigerian Focus",slug:"gender-and-modern-day-slavery-aggression-and-violence-in-the-context-of-a-nigerian-focus",totalDownloads:16,totalDimensionsCites:0,doi:"10.5772/intechopen.104727",abstract:"This chapter explored the various forms of gender-based modern-day slavery in Nigeria. Such modern slaveries as baby factories (unlawful maternity and orphanages where children are sold and their mothers serve as ‘economic-slaves, sex-slaves, procreation-slaves, and money-ritual-slaves’), peonage (debt bondage), and early forced marriage were found to be common and on the increase in Nigeria and fundamentally precipitated by patriarchy. The predictors and risk factors of these slavery typologies were supported by the tenets of feminist and political economy theories, which formed the framework. A patriarchal society engenders inequalities, alienation, subjugation, aggression, violence, deprivations, and frustration, with women on the receiving end, when compared to men. The female population is largely the victim, while most perpetrators are males. The new, emerging trend in slavery enterprise are typically organised and largely motivated by women’s vulnerabilities and powerlessness, with dehumanising and destructive consequences. Arising from this is the conclusion that certain cultural practices and socioeconomic forces intertwine with poverty, lack of qualitative education, and other exclusions to expose women and girls to servitudes. The problem requires robust intersectoral approaches—that is, coordinated intervention, programmes, and collaborative efforts between governments and local authorities and institutions—to (re)solve.",book:{id:"11440",title:"Aggression and Violent Behaviour",coverURL:"https://cdn.intechopen.com/books/images_new/11440.jpg"},signatures:"Mary Juachi Eteng and Macpherson Uchenna Nnam"}],onlineFirstChaptersTotal:50},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:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:320,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:133,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:107,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:19,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:16,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{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"}}}},{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"}}}}]},series:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"July 5th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:32,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. 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Singh",profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8018",title:"Extracellular Matrix",subtitle:"Developments and Therapeutics",coverURL:"https://cdn.intechopen.com/books/images_new/8018.jpg",slug:"extracellular-matrix-developments-and-therapeutics",publishedDate:"October 27th 2021",editedByType:"Edited by",bookSignature:"Rama Sashank Madhurapantula, Joseph Orgel P.R.O. and Zvi Loewy",hash:"c85e82851e80b40282ff9be99ddf2046",volumeInSeries:23,fullTitle:"Extracellular Matrix - Developments and Therapeutics",editors:[{id:"212416",title:"Dr.",name:"Rama Sashank",middleName:null,surname:"Madhurapantula",slug:"rama-sashank-madhurapantula",fullName:"Rama Sashank Madhurapantula",profilePictureURL:"https://mts.intechopen.com/storage/users/212416/images/system/212416.jpg",institutionString:"Illinois Institute of Technology",institution:{name:"Illinois Institute of Technology",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9759",title:"Vitamin E in Health and Disease",subtitle:"Interactions, Diseases and Health Aspects",coverURL:"https://cdn.intechopen.com/books/images_new/9759.jpg",slug:"vitamin-e-in-health-and-disease-interactions-diseases-and-health-aspects",publishedDate:"October 6th 2021",editedByType:"Edited by",bookSignature:"Pınar Erkekoglu and Júlia Scherer Santos",hash:"6c3ddcc13626110de289b57f2516ac8f",volumeInSeries:22,fullTitle:"Vitamin E in Health and Disease - Interactions, Diseases and Health Aspects",editors:[{id:"109978",title:"Prof.",name:"Pınar",middleName:null,surname:"Erkekoğlu",slug:"pinar-erkekoglu",fullName:"Pınar Erkekoğlu",profilePictureURL:"https://mts.intechopen.com/storage/users/109978/images/system/109978.jpg",institutionString:"Hacettepe University",institution:{name:"Hacettepe University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Proteomics",value:18,count:4},{group:"subseries",caption:"Metabolism",value:17,count:6},{group:"subseries",caption:"Cell and Molecular Biology",value:14,count:9},{group:"subseries",caption:"Chemical Biology",value:15,count:13}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:8},{group:"publicationYear",caption:"2021",value:2021,count:7},{group:"publicationYear",caption:"2020",value:2020,count:12},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:2}],authors:{paginationCount:148,paginationItems:[{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:null},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:"Polytechnic University of Timişoara",institution:{name:"Polytechnic University of Timişoara",country:{name:"Romania"}}},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:null},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. 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