\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"4604",leadTitle:null,fullTitle:"Evolution of Ionizing Radiation Research",title:"Evolution of Ionizing Radiation Research",subtitle:null,reviewType:"peer-reviewed",abstract:"The industrial and medical applications of radiation have been augmented and scientific insight into mechanisms for radiation action notably progressed. In addition, the public concern about radiation risk has also grown extensively. Today the importance of risk communication among stakeholders involved in radiation-related issues is emphasized much more than any time in the past. Thus, the circumstances of radiation research have drastically changed, and the demand for a novel approach to radiation-related issues is increasing. It is thought that the publication of the book Evolution of Ionizing Radiation Research at this time would have enormous impacts on the society. The editor believes that technical experts would find a variety of new ideas and hints in this book that would be helpful to them to tackle ionizing radiation.",isbn:null,printIsbn:"978-953-51-2167-1",pdfIsbn:"978-953-51-5058-9",doi:"10.5772/59330",price:139,priceEur:155,priceUsd:179,slug:"evolution-of-ionizing-radiation-research",numberOfPages:316,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"eba92f773b60df7b8d34361670fad600",bookSignature:"Mitsuru Nenoi",publishedDate:"September 17th 2015",coverURL:"https://cdn.intechopen.com/books/images_new/4604.jpg",numberOfDownloads:29203,numberOfWosCitations:28,numberOfCrossrefCitations:29,numberOfCrossrefCitationsByBook:2,numberOfDimensionsCitations:49,numberOfDimensionsCitationsByBook:2,hasAltmetrics:1,numberOfTotalCitations:106,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 29th 2014",dateEndSecondStepPublish:"October 20th 2014",dateEndThirdStepPublish:"January 24th 2015",dateEndFourthStepPublish:"April 24th 2015",dateEndFifthStepPublish:"May 24th 2015",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"35416",title:"Dr.",name:"Mitsuru",middleName:null,surname:"Nenoi",slug:"mitsuru-nenoi",fullName:"Mitsuru Nenoi",profilePictureURL:"https://mts.intechopen.com/storage/users/35416/images/2328_n.jpg",biography:"Mitsuru Nenoi graduated from Kyoto University, Graduate School of Sciences, Japan in 1983, and started his career as a scientist at National Institute of Radiological Sciences (NIRS), Japan. He received a Ph.D from Kyoto University in 1992 for the study on induced accumulation of polyubiquitin gene transcripts after exposure to ultraviolet light and treatment with 12-O-Tetradecanoylphorbol 13-acetate. In 1991, he stayed at University of Cincinnati College of Medicine, USA as a visiting scientist, and was involved in the study of mechanisms for transcriptional regulation of small heat shock genes of Drosophila. Dr. Nenoi is now a Director, Radiation Risk Reduction Research Program, Research Center for Radiation Protection of NIRS. His research interest is radiation biology, especially on the mechanism for gene regulation after exposure to ionizing radiation.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"National Institute of Radiological Sciences",institutionURL:null,country:{name:"Japan"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1213",title:"Radiobiology",slug:"radiobiology"}],chapters:[{id:"48635",title:"Dynamics of p53 and Cancer",doi:"10.5772/60916",slug:"dynamics-of-p53-and-cancer",totalDownloads:1673,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Cancer is a multifactorial disease in which cell types lost their capability to regulate growth, proliferation, and cell death pathways, causing the uncontrolled proliferation of tumor cells. Cell death pathway is supported by the operation of the p53–Mdm2-negative feedback loop that has a central role to prevent the development of tumor cells. Under severe DNA damage, this loop takes the control of the apoptotic pathway and activates Bax, which, in turn, activates the caspase cascade to produce the death of the injured cell. However, events like Mdm2 overexpression or the suppression of caspase-9 gene can block the transmission of the death signal to the caspase cascade allowing the survival of the mutated cell. In this chapter, a mathematical model that explores the effect of Mdm2 overexpression and the suppression of caspase-9 on the control of death by the p53–Mdm2 loop is presented. From the model, two strategies for tumor cell survival are indentified, showing how mutations that affect the death pathway allow the survival of transformed cells. The model suggests that the combination of different simultaneous treatments against these mutations can be a suitable strategy against cancer.",signatures:"Antonio Bensussen and José Díaz",downloadPdfUrl:"/chapter/pdf-download/48635",previewPdfUrl:"/chapter/pdf-preview/48635",authors:[{id:"91955",title:"Dr.",name:"José",surname:"Díaz",slug:"jose-diaz",fullName:"José Díaz"},{id:"175665",title:"MSc.",name:"Antonio",surname:"Bensussen",slug:"antonio-bensussen",fullName:"Antonio Bensussen"}],corrections:null},{id:"49091",title:"On the Dynamical Approach of Quantitative Radiation Biology",doi:"10.5772/60859",slug:"on-the-dynamical-approach-of-quantitative-radiation-biology",totalDownloads:1768,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"A quantitative approach in radiation biology based on the clonogenic method and cell survival curves in various conditions are introduced. The cell survival curves seem to have universality with regard to its functional form; in other words, functional form of survival curve seems to be unchanged under various conditions including different species. Various factors affecting the radiosensitivity have been introduced to find macroscopic nature of living organisms. Mathematical models that describe cell survival curves have been presented for discussing the derivation of the mathematical form based on biological mechanism. Finally, the possibility that the structural change of chromosome affects the repair process is discussed.",signatures:"Noriyuki B. Ouchi",downloadPdfUrl:"/chapter/pdf-download/49091",previewPdfUrl:"/chapter/pdf-preview/49091",authors:[{id:"96736",title:"Dr.",name:"Noriyuki",surname:"Ouchi",slug:"noriyuki-ouchi",fullName:"Noriyuki Ouchi"}],corrections:null},{id:"48489",title:"Dietary Modification of Mouse Response to Total-Body-Irradiation",doi:"10.5772/60653",slug:"dietary-modification-of-mouse-response-to-total-body-irradiation",totalDownloads:1584,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Exposure to ionizing radiation (IR) could induce deleterious effects including cancer. Diet, as one of the major factors to influence susceptibility to many diseases, plays a critical role in maintaining human heath. It is known that unbalanced diet could result in health consequences, for example, high-calorie diet could lead to obesity, which could increase the risk of diabetes, heart disease, fatty liver, and some forms of cancer. Although the impact of diet on susceptibility to IR is thought to be big, the evidence is not clear due to lack of study. In this work, effects from dietary fat on modulation of mouse responses to total-body-irradiation (TBI) were studied. The mice were fed after weaning at postnatal age of 4 weeks with a standard diet (MB-1), a very high-fat diet (HFD32), and a very low-fat diet (CE-2 Low Fat), containing of 4.4%, 32.0%, and 0.4% of crude fat, respectively. A mouse model for radiation-induced adaptive response (AR) was applied to this work. The priming low-dose TBI at a dose of 0.5 Gy from X-rays was given at postnatal age of 6 weeks, and the challenge high dose of TBI was given at postnatal age of 8 weeks. The mouse response to low dose of TBI was evaluated by the efficacy of the priming low dose to rescue the animals from bone marrow death induced by the challenge high dose in the 30-day survival test. The mouse response to high dose of TBI was evaluated by comparing the LD50 in the 30-day survival test. In addition, dietary modulation of the residual (late) genotoxic effect from TBI was also evaluated by comparing the incidence of micronucleated erythrocytes in bone marrow using micronucleus test. Results showed that for the mice fed with the MB-1, a successful AR was demonstrated. While for the mice fed with either HFD32 or CE-2 Low Fat, no AR was observed, and all the animals died within 15 days after TBI with the challenge high dose at 7.5 Gy regardless the priming low dose at 0.5 Gy. When comparing the LD50 in the 30-day survival test, the LD50 values for the animals fed with the MB-1, HFD32 diet, and CE-2 Low Fat were 7.1 Gy, 6.0 Gy, and 6.2 Gy, respectively. As to the micronucleus test, for the mice fed with MB-1, the priming low dose at 0.5 Gy could significantly reduce the incidence of micronucleated erythrocytes in bone marrow that were caused by a challenge high dose at 4.0 Gy, while for the mice fed with either HFD32 or CE-2 Low Fat no such effect was observed. These findings indicated that under an unbalanced diet, namely, either of very high fat or of very low fat, alterations in mouse responses to TBI were induced. These findings confirmed that diet played a pivotal role in the response of the animals to radiation exposure, and suggested the possibility to modulate radiosensitivity through diet intervention in humans.",signatures:"Bing Wang, Kaoru Tanaka, Takanori Katsube, Kouichi Maruyama,\nYasuharu Ninomiya and Mitsuru Nenoi",downloadPdfUrl:"/chapter/pdf-download/48489",previewPdfUrl:"/chapter/pdf-preview/48489",authors:[{id:"35416",title:"Dr.",name:"Mitsuru",surname:"Nenoi",slug:"mitsuru-nenoi",fullName:"Mitsuru Nenoi"},{id:"91936",title:"Dr.",name:"Bing",surname:"Wang",slug:"bing-wang",fullName:"Bing Wang"},{id:"103129",title:"Ms.",name:"Kaoru",surname:"Tanaka",slug:"kaoru-tanaka",fullName:"Kaoru Tanaka"},{id:"103130",title:"Dr.",name:"Yasuharu",surname:"Ninomiya",slug:"yasuharu-ninomiya",fullName:"Yasuharu Ninomiya"},{id:"103131",title:"Dr.",name:"Kouichi",surname:"Maruyama",slug:"kouichi-maruyama",fullName:"Kouichi Maruyama"},{id:"173416",title:"Dr.",name:"Takanori",surname:"Katsube",slug:"takanori-katsube",fullName:"Takanori Katsube"}],corrections:null},{id:"48814",title:"The RadioP1 – An Integrative Web Resource for Radioresistant Prokaryotes",doi:"10.5772/60471",slug:"the-radiop1-an-integrative-web-resource-for-radioresistant-prokaryotes",totalDownloads:2591,totalCrossrefCites:3,totalDimensionsCites:4,hasAltmetrics:0,abstract:"The extremely radioresistant eubacterium Deinococcus radiodurans and the phenotypically related prokaryotes, whose genomes have been completely sequenced, are presently used as model species in several laboratories to study the lethal effects of DNA-damaging and protein-oxidizing agents, particularly the effects of ionizing radiation (IR). Unfortunately, providing relevant information about radioresistant prokaryotes (RP) in a neatly centralized and organized manner still remains a need. In this study, we designed RadioP1 Web resource (www.radiop.org.tn) to gather information about RP defined by the published literature with specific emphasis on (i) predicted genes that produce and protect against oxidative stress, (ii) predicted proteins involved in DNA repair mechanisms and (iii) potential uses of RP in biotechnology. RadioP1 allows the complete RP proteogenomes to be queried using various patterns in a user-friendly and interactive manner. The output data can be saved in plain text, Excel or HyperText Markup Language (HTML) formats for subsequent analyses. Moreover, RadioP1 provides for users a tool “START ANALYSIS”, including the previously described R-packages “drc” and “lethal”, to generate exponential or sigmoid survival curves with D10 and D50 values. Furthermore, when accessible, links to external databases are provided. Supplementary data will be included in the future when the sequences of other RP genomes will become available.",signatures:"Cherif Benhamda, Alia Benkahla, Slimane Ben Miled, Houria Ouled-\nHaddar, María del Carmen Montero-Calasanz, Maher Gtari, Ameur\nCherif, Benjamin Hofner, Kaïs Ghedira and Haïtham Sghaier",downloadPdfUrl:"/chapter/pdf-download/48814",previewPdfUrl:"/chapter/pdf-preview/48814",authors:[{id:"47210",title:null,name:"Haitham",surname:"Sghaier",slug:"haitham-sghaier",fullName:"Haitham Sghaier"},{id:"169553",title:"Dr.",name:"Alia",surname:"Benkahla",slug:"alia-benkahla",fullName:"Alia Benkahla"},{id:"173864",title:"MSc.",name:"Cherif",surname:"Ben Hamda",slug:"cherif-ben-hamda",fullName:"Cherif Ben Hamda"},{id:"173865",title:"Prof.",name:"Maher",surname:"Gtari",slug:"maher-gtari",fullName:"Maher Gtari"},{id:"173866",title:"Prof.",name:"Ameur",surname:"Cherif",slug:"ameur-cherif",fullName:"Ameur Cherif"},{id:"173867",title:"Dr.",name:"Kaïs",surname:"Ghedira",slug:"kais-ghedira",fullName:"Kaïs Ghedira"},{id:"175494",title:"Dr.",name:"Slimane",surname:"Ben Miled",slug:"slimane-ben-miled",fullName:"Slimane Ben Miled"},{id:"175495",title:"Dr.",name:"Houria",surname:"Ouled-Haddar",slug:"houria-ouled-haddar",fullName:"Houria Ouled-Haddar"},{id:"175496",title:"Dr.",name:"Benjamin",surname:"Hofner",slug:"benjamin-hofner",fullName:"Benjamin Hofner"},{id:"175686",title:"Dr.",name:"María",surname:"Del Carmen Montero-Calasanz",slug:"maria-del-carmen-montero-calasanz",fullName:"María Del Carmen Montero-Calasanz"}],corrections:null},{id:"49039",title:"Physical and Radiobiological Evaluation of Radiotherapy Treatment Plan",doi:"10.5772/60846",slug:"physical-and-radiobiological-evaluation-of-radiotherapy-treatment-plan",totalDownloads:4486,totalCrossrefCites:6,totalDimensionsCites:9,hasAltmetrics:0,abstract:"Radiation treatment planning plays an important role in modern radiation therapy; it could simulate to plan the geometric, radiobiological, and dosimetric aspects of the therapy using radiation transport simulations and optimization. In this chapter, we have reviewed several quantitative methods used for evaluating radiation treatment plans and discussed some important considering points. For the purpose of quantitative plan evaluation, we reviewed dosimetrical indexes like PITV, CI, TCI, HI, MHI, CN, COSI, and QF. Furthermore, radiobiological indexes like Niemierko’s EUD-based TCP and NTCP were included for the purpose of radiobiological outcome modeling. Additionally, we have reviewed dose tolerance for critical organs including RTOG clinical trial results, QUENTEC data, Emami data, and Milano clinical trial results. For the purpose of clinical evaluation of radiation-induced organ toxicity, we have reviewed RTOG and EORTC toxicity criteria. Several programs could help for the easy calculation and analysis of dosimetrical plan indexes and biological results. We have reviewed the recent trend in this field and proposed further clinical use of such programs. Along this line, we have proposed clinically optimized plan comparison protocols and indicated further directions of such studies.",signatures:"Suk Lee, Yuan Jie Cao and Chul Yong Kim",downloadPdfUrl:"/chapter/pdf-download/49039",previewPdfUrl:"/chapter/pdf-preview/49039",authors:[{id:"96630",title:"Prof.",name:"Suk",surname:"Lee",slug:"suk-lee",fullName:"Suk Lee"},{id:"175104",title:"Prof.",name:"Chul Yong",surname:"Kim",slug:"chul-yong-kim",fullName:"Chul Yong Kim"},{id:"175234",title:"Dr.",name:"Yuan Jie",surname:"Cao",slug:"yuan-jie-cao",fullName:"Yuan Jie Cao"}],corrections:null},{id:"48600",title:"Quality Control of Ionizing Radiation in Radiotherapy",doi:"10.5772/60421",slug:"quality-control-of-ionizing-radiation-in-radiotherapy",totalDownloads:1824,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This work includes the results of our research on the measurement of the dose delivered by an external beam in radiotherapy. The use of scintillating fibers in high-energy experiments produced rapid and reliable results and allows new dosimeters to be built and extends their use to measure the dose of an external beam of electrons, photons, and hadrons in radiotherapy.The chapter starts from the description of the radiation used in radiotherapy, presents the new approaches and then the tools used to perform the quality control of therapeutic beams, and finally shows the characteristics and differences compared to the traditional quality controls by using our results on the scintillating fibers used as a dosimeter. Some care should be taken into account during the collection and processing of data, for the treatment of some systematic errors in the method. In this chapter, we describe the procedure to be followed.",signatures:"Ernesto Lamanna, Bianco Cataldo, Giulia Marvaso, Marco D’Andrea\nand Lidia Strigari",downloadPdfUrl:"/chapter/pdf-download/48600",previewPdfUrl:"/chapter/pdf-preview/48600",authors:[{id:"99609",title:"Prof.",name:"Ernesto",surname:"Lamanna",slug:"ernesto-lamanna",fullName:"Ernesto Lamanna"},{id:"104912",title:"Dr.",name:"Lidia",surname:"Strigari",slug:"lidia-strigari",fullName:"Lidia Strigari"},{id:"176144",title:"Prof.",name:"Cataldo",surname:"Bianco",slug:"cataldo-bianco",fullName:"Cataldo Bianco"},{id:"176146",title:"Dr.",name:"Giulia",surname:"Marvaso",slug:"giulia-marvaso",fullName:"Giulia Marvaso"},{id:"176148",title:"Dr.",name:"Marco",surname:"D'Andrea",slug:"marco-d'andrea",fullName:"Marco D'Andrea"}],corrections:null},{id:"48785",title:"Linac Twins in Radiotherapy",doi:"10.5772/60427",slug:"linac-twins-in-radiotherapy",totalDownloads:3403,totalCrossrefCites:4,totalDimensionsCites:5,hasAltmetrics:1,abstract:"In a radiotherapy department having more than one linear accelerator, it is rather common to match the dose output of all machines. In particular, the recently developed flattening filter free mode requires new investigations regarding the feasibility of matching and the consequences for quality assurance and workload. This refers also to the beam model of the radiotherapy treatment planning system. Our results show that matching is possible not only for flat beams but also for flattening filter free mode. Therefore, the machines can substitute each other in the case of breakdown or service without new treatment planning even in the case of complex intensity-modulated radiotherapy or volumetric-modulated arc therapy. The quality assurance is reduced to only one data set for both the linear accelerators and the radiotherapy treatment planning system.",signatures:"Marius Treutwein, Petra M. Härtl, Christian Gröger, Zaira Katsilieri\nand Barbara Dobler",downloadPdfUrl:"/chapter/pdf-download/48785",previewPdfUrl:"/chapter/pdf-preview/48785",authors:[{id:"173624",title:"Mr.",name:"Marius",surname:"Treutwein",slug:"marius-treutwein",fullName:"Marius Treutwein"},{id:"173699",title:"MSc.",name:"Petra M.",surname:"Härtl",slug:"petra-m.-hartl",fullName:"Petra M. Härtl"},{id:"173700",title:"Dr.",name:"Christian",surname:"Gröger",slug:"christian-groger",fullName:"Christian Gröger"},{id:"173701",title:"MSc.",name:"Zaira",surname:"Katsilieri",slug:"zaira-katsilieri",fullName:"Zaira Katsilieri"},{id:"173702",title:"Dr.",name:"Barbara",surname:"Dobler",slug:"barbara-dobler",fullName:"Barbara Dobler"}],corrections:null},{id:"48796",title:"Ionizing Radiation Detectors",doi:"10.5772/60914",slug:"ionizing-radiation-detectors",totalDownloads:3948,totalCrossrefCites:1,totalDimensionsCites:4,hasAltmetrics:1,abstract:"Ionizing radiation has always been present in the natural environment. However, this radiation is not easily detected and since it also possesses high ionizing power and penetration strength, it constitutes a risk to human health when it is found outside of its acceptable limits. The adverse effects of ionizing radiation on human health need to be systematically monitored in order to prevent damage, overexposure, or even death. The detection of the radiation depends on its particular interaction with a sensitive material, and different types of detectors, in different physical states (solid, liquid or gas), are used to measure selective types of ionizing radiation. New materials such as organic semiconductors, for instance, are being targeted for research and as potential candidates for new perspectives on ionizing radiation sensing.",signatures:"Marcia Dutra R. Silva",downloadPdfUrl:"/chapter/pdf-download/48796",previewPdfUrl:"/chapter/pdf-preview/48796",authors:[{id:"173533",title:"Dr.",name:"Marcia",surname:"Silva",slug:"marcia-silva",fullName:"Marcia Silva"}],corrections:null},{id:"48737",title:"Ionizing Radiations in Entomology",doi:"10.5772/60409",slug:"ionizing-radiations-in-entomology",totalDownloads:2033,totalCrossrefCites:1,totalDimensionsCites:5,hasAltmetrics:0,abstract:"Radiation in the form of particles (α or β particles and neutrons) or electromagnetic waves (gamma or X-rays) can induce biological effects in insect cells like in other living cells. Ionization and chemical damages to organic molecules can be caused directly (mostly by particulate types of radiation) or indirectly by free radicals. Radioinduced ions and radicals, most of them coming from water radiolysis, may react with neighboring molecules to produce secondary DNA radicals or even chain reactions, particularly in lipids, and most of the significant biological effects results from damage to DNA. Currently, more than 300 species of arthropods, mostly of economic importance, have already been subjected to irradiation studies for basic research, pest control applications, and disinfestation of commodities (quarantine and phytosanitary purposes). This chapter focused on insect sterilization and disinfestation by ionizing radiations in view of the socioeconomic impacts. The release of insects that are sterile after exposure to radiation aiming to control or eradicate pest populations revealed to be a revolutionary tactic in the area-wide management of pests, and many successful cases with the application of the sterile insect technique can be found around the globe. The use of ionizing radiations to inhibit the spread of quarantine insects represents an important alternative postharvest control, and the development of generic radiation treatments has resulted in a significant increase in the international use of phytosanitary irradiation for trade in horticultural products and other commodities",signatures:"Valter Arthur, Andre Machi and Thiago Mastrangelo",downloadPdfUrl:"/chapter/pdf-download/48737",previewPdfUrl:"/chapter/pdf-preview/48737",authors:[{id:"100407",title:"Dr.",name:"Valter",surname:"Arthur",slug:"valter-arthur",fullName:"Valter Arthur"},{id:"173841",title:"Dr.",name:"Thiago",surname:"Mastrangelo",slug:"thiago-mastrangelo",fullName:"Thiago Mastrangelo"},{id:"173842",title:"MSc.",name:"Andre",surname:"Machi",slug:"andre-machi",fullName:"Andre Machi"}],corrections:null},{id:"48950",title:"Ionizing Radiation Disinfestation Treatments against Pest Insects",doi:"10.5772/60923",slug:"ionizing-radiation-disinfestation-treatments-against-pest-insects",totalDownloads:2123,totalCrossrefCites:3,totalDimensionsCites:6,hasAltmetrics:0,abstract:"Pesticides are often considered a suitable solution for controlling pests. However, the use of chemicals is very costly, and their residues have always the potential to pollute soil, air, and ground water and also pose significant risks to the natural ecosystems and nontarget organisms. Considering all these, irradiation could offer substantial and charming option for eliminating the export commodity fumigation uses for the undesirable effects of chemicals. Gamma rays, high-energy electrons, and X-rays are among the ionizing radiation sources utilized practically in sterile insect releasing programs using “self-contained” and “non-self-contained or panoramic” irradiators. When applying radiation sources, dosimetry should be adjusted to ensure quarantine security for large groups of insect pests. Because of growing concerns related to health problems and environmental pollutions, chemical sanitizing treatments are faced with a lot of regulatory restrictions, so irradiation reveals best choice for this purpose. The sterile insect technique (SIT) may have indispensable consideration for integrated pest management (IPM) of many important insect pests, including agricultural, veterinary, and medicinal importance. On the other hand, to overcome the obstacles of SIT treatments, genetic engineering techniques were supposed to ease the development of transgenic insects for sustainable tactics to control pest populations. Thus, genetic means should be an integral part of SIT treatments in controlling important pest populations.",signatures:"Abdurrahman Ayvaz and Semih Yilmaz",downloadPdfUrl:"/chapter/pdf-download/48950",previewPdfUrl:"/chapter/pdf-preview/48950",authors:[{id:"173542",title:"Prof.",name:"Abdurrahman",surname:"Ayvaz",slug:"abdurrahman-ayvaz",fullName:"Abdurrahman Ayvaz"},{id:"173806",title:"Dr.",name:"Semih",surname:"Yılmaz",slug:"semih-yilmaz",fullName:"Semih Yılmaz"}],corrections:null},{id:"48894",title:"Gamma Radiation as a Recycling Tool for Waste Materials Used in Concrete",doi:"10.5772/60435",slug:"gamma-radiation-as-a-recycling-tool-for-waste-materials-used-in-concrete",totalDownloads:2344,totalCrossrefCites:4,totalDimensionsCites:8,hasAltmetrics:1,abstract:"Over the course of the last 50 years, a large number of major technological advances have contributed to the development of higher-strength, high-performance materials that provide excellent benefits. Nevertheless, in most cases, after a very short useful life, these products become waste material and contribute to environmental degradation. This situation has created an environmental crisis that has reached global proportions. In efforts to combat this issue and to promote sustainable development and reduce environmental pollution, some investigations have focused on recycling using innovative and clean technologies, such as gamma radiation, as an alternative to conventional mechanical and chemical recycling procedures. In this context, the reuse and recycling of waste materials and the use of gamma radiation are useful tools for improving the mechanical properties of concrete; for example, the compressive strength and modulus of elasticity are improved by the addition of waste particles and application of gamma radiation. In this chapter, we propose the use of gamma radiation as a method for modifying waste materials; for instance, polyethylene terephthalate plastic bottles, automotive tire rubber, and the cellulose in Tetra Pak containers, and their reuse to enhance the properties of concrete.",signatures:"Gonzalo Martínez-Barrera, Liliana Ivette Ávila-Córdoba, Miguel\nMartínez-López, Eduardo Sadot Herrera-Sosa, Enrique Vigueras-\nSantiago, Carlos Eduardo Barrera-Díaz, Fernando Ureña-Nuñez and\nNelly González-Rivas",downloadPdfUrl:"/chapter/pdf-download/48894",previewPdfUrl:"/chapter/pdf-preview/48894",authors:[{id:"102080",title:"Dr.",name:"Gonzalo",surname:"Martínez-Barrera",slug:"gonzalo-martinez-barrera",fullName:"Gonzalo Martínez-Barrera"},{id:"110214",title:"Dr.",name:"Fernando",surname:"Ureña-Nuñez",slug:"fernando-urena-nunez",fullName:"Fernando Ureña-Nuñez"},{id:"177864",title:"Dr.",name:"Liliana Ivette",surname:"Ávila-Córdoba",slug:"liliana-ivette-avila-cordoba",fullName:"Liliana Ivette Ávila-Córdoba"},{id:"177865",title:"Dr.",name:"Miguel",surname:"Martínez-López",slug:"miguel-martinez-lopez",fullName:"Miguel Martínez-López"},{id:"177866",title:"Dr.",name:"Eduardo",surname:"Sadot Herrera-Sosa",slug:"eduardo-sadot-herrera-sosa",fullName:"Eduardo Sadot Herrera-Sosa"},{id:"177867",title:"Dr.",name:"Enrique",surname:"Vigueras-Santiago",slug:"enrique-vigueras-santiago",fullName:"Enrique Vigueras-Santiago"},{id:"177868",title:"Dr.",name:"Carlos Eduardo",surname:"Barrera-Díaz",slug:"carlos-eduardo-barrera-diaz",fullName:"Carlos Eduardo Barrera-Díaz"},{id:"177869",title:"Dr.",name:"Nelly",surname:"González-Rivas",slug:"nelly-gonzalez-rivas",fullName:"Nelly González-Rivas"}],corrections:null},{id:"48823",title:"Ionizing Radiation Used in Drug Sterilization, Characterization of Radical Intermediates by Electron Spin Resonance (ESR) Analyses",doi:"10.5772/61052",slug:"ionizing-radiation-used-in-drug-sterilization-characterization-of-radical-intermediates-by-electron-",totalDownloads:1427,totalCrossrefCites:4,totalDimensionsCites:5,hasAltmetrics:0,abstract:"In this study, the feasibility of radiation sterilization of drugs/drug raw materials is investigated by using Electron Spin Resonance (ESR) spectroscopy. Experimental data and their theoretical correspondings are presented for Sulfanilamide (SA), Sulfafurazole (SFZ), Sulfatiazole (STZ), Sulfacetamide Sodium (SS), Sulfamethazine (SMH), Butylated Hydroxyanisole (BHA), and Albendazole (ALB). Unirradiated samples exhibited no ESR signal whereas the irradiated samples showed ESR spectra consisting of different number of resonance lines indicating that radiolytic intermediates were produced upon irradiation. Increase in the absorbed dose did not create any pattern change in the ESR spectra of these samples. The results of ESR microwave power studies indicated that saturation is observed to be faster for the studies held below room temperatures. Low radiation yield (G=0.1-0.5) calculated by ESR data for the gamma-irradiated samples showed that these materials can not be used as sensitive dosimetric materials. No significant differences were observed between FT-IR spectra of the unirradiated and irradiated samples and this result is considered to be in agreement with the relatively small G value derived from ESR studies. The decay rates of the ESR peak heights of the samples irradiated at different doses and stored at normal and stability conditions were found to be independent of the irradiation doses. The contributing radical species were determined to decay with different decay characteristics and the decay rates but decaying faster at stability conditions. The discrimination of the samples irradiated at even a low absorbed dose from unirradiated samples was possible for a long storage time after irradiation. Cooling the sample temperature down to room temperature did not create any pattern change in the ESR spectra of irradiated samples except slight reversible increases in the peak heights and at high temperatures irreversible decreases in the peaks heights were observed. Annealing studies indicated that the decay rates of the radical species at high temperatures were higher than the decay rates at low temperatures and the decay activation energies for the radical species were calculated by using Arrhenius plots. Spectrum simulation calculations were also performed and it was concluded that, the molecular ionic fragments and ionic radicals were the main responsible units from the resonance lines of ESR spectra of the gamma-irradiated sulfanomides such as SA, SFZ, STZ, SS, and SMH. Besides these two radical species, some other radical types were also likely produced after irradiation in STZ, SS, and SMH. Besides these two radical species, some other radical types were also likely produced after irradiation in STZ, SS and SMH. As for BHA and ALB, again two other type radical species were believed to produce upon irradiation. Basing on the derived experimental and theoretical data it was concluded that SA, SFZ, STZ, SS, SMH, BHA, and ALB could be safely sterilized by gamma radiation up to permitted drug sterilization radiation doses without causing high amount of molecular damages upon irradiation, and ESR spectroscopy could be used as a potential technique in monitoring the radiosterilization of the drugs, drug raw materials, and drug delivery systems containg present samples as active ingredient.",signatures:"Şeyda Çolak",downloadPdfUrl:"/chapter/pdf-download/48823",previewPdfUrl:"/chapter/pdf-preview/48823",authors:[{id:"173296",title:"Associate Prof.",name:"Şeyda",surname:"Çolak",slug:"seyda-colak",fullName:"Şeyda Çolak"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"1562",title:"Current Topics in Ionizing Radiation Research",subtitle:null,isOpenForSubmission:!1,hash:"b1443bb4589a4088326076be6ff30f13",slug:"current-topics-in-ionizing-radiation-research",bookSignature:"Mitsuru Nenoi",coverURL:"https://cdn.intechopen.com/books/images_new/1562.jpg",editedByType:"Edited by",editors:[{id:"35416",title:"Dr.",name:"Mitsuru",surname:"Nenoi",slug:"mitsuru-nenoi",fullName:"Mitsuru Nenoi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7373",title:"Nuclear Medicine Physics",subtitle:null,isOpenForSubmission:!1,hash:"4aaee2e9fd29a290d04e9041b003462b",slug:"nuclear-medicine-physics",bookSignature:"Aamir Shahzad and Sajid Bashir",coverURL:"https://cdn.intechopen.com/books/images_new/7373.jpg",editedByType:"Edited by",editors:[{id:"288354",title:"Dr.",name:"Aamir",surname:"Shahzad",slug:"aamir-shahzad",fullName:"Aamir Shahzad"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7769",title:"Medical Isotopes",subtitle:null,isOpenForSubmission:!1,hash:"f8d3c5a6c9a42398e56b4e82264753f7",slug:"medical-isotopes",bookSignature:"Syed Ali Raza Naqvi and Muhammad Babar Imrani",coverURL:"https://cdn.intechopen.com/books/images_new/7769.jpg",editedByType:"Edited by",editors:[{id:"259190",title:"Dr.",name:"Syed Ali Raza",surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7668",title:"Ionizing and Non-ionizing Radiation",subtitle:null,isOpenForSubmission:!1,hash:"c8569365b35dd693c9979360bb34550c",slug:"ionizing-and-non-ionizing-radiation",bookSignature:"Otolorin Adelaja Osibote",coverURL:"https://cdn.intechopen.com/books/images_new/7668.jpg",editedByType:"Edited by",editors:[{id:"245068",title:"D.Sc.",name:"Adelaja",surname:"Osibote",slug:"adelaja-osibote",fullName:"Adelaja Osibote"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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Kumavath and Pratap Deverapalli",dateSubmitted:"October 10th 2012",dateReviewed:"March 18th 2013",datePrePublished:null,datePublished:"October 2nd 2013",book:{id:"3547",title:"Applied Bioremediation",subtitle:"Active and Passive Approaches",fullTitle:"Applied Bioremediation - Active and Passive Approaches",slug:"applied-bioremediation-active-and-passive-approaches",publishedDate:"October 2nd 2013",bookSignature:"Yogesh B. 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\r\n\tMale circumcision is a procedure that has been practiced since the dawn of human culture more than six thousand years ago. It is performed for both medical and non-medical reasons. Despite being a simple procedure, it may lead to a myriad of minor and even crippling complications, if not done properly, such as iatrogenic injury of the glans or the urethra. Several techniques have been used to perform circumcision including the classic open technique, clamp technique, and laser /electrocautery technique with various safety outcomes. Overtime time, there has been an ongoing debate over the pros and cons of cultural circumcision with a significant dichotomy between the opinions of the experts in the field.
\r\n\r\n\tThe main purpose of this book will aim to present a comprehensive overview of the historic background of circumcision in males and the debate over female circumcision. It is intended to be an addition to a description of the different procedural techniques of circumcision highlighting their potential complications.
",isbn:"978-1-80355-907-0",printIsbn:"978-1-80355-906-3",pdfIsbn:"978-1-80355-908-7",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"d4761c03b5694edec9f7fc48092549ce",bookSignature:"Dr. Ahmad Zaghal and Dr. Ali El Safadi",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11729.jpg",keywords:"History Of Circumcision, Male Circumcision, Female Circumcision, Indications, Contraindications, Peri-Procedural Preparation, Analgesia, Clamp, Meatal Stenosis, Iatrogenic Injury, Adhesions, Buried Penis",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 25th 2022",dateEndSecondStepPublish:"April 29th 2022",dateEndThirdStepPublish:"June 28th 2022",dateEndFourthStepPublish:"September 16th 2022",dateEndFifthStepPublish:"November 15th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"4 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Pediatric surgeon and clinical educator, member of Royal College of Surgeons of England, European Pediatric Surgeon’s Association, British Association of Pediatric Endoscopic Surgeons, American College of Surgeons, International Society for Pediatric Wound Care.",coeditorOneBiosketch:"Obstetrics and Gynecology trainee and clinical researcher.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"240621",title:"Dr.",name:"Ahmad",middleName:null,surname:"Zaghal",slug:"ahmad-zaghal",fullName:"Ahmad Zaghal",profilePictureURL:"https://mts.intechopen.com/storage/users/240621/images/system/240621.jpg",biography:"Ahmad Zaghal, MD, MSc (Clin Ed), FACS, FEBPS, FHEA, graduated from the general surgery-residency program at The American University of Beirut-Medical Center (AUBMC), Lebanon, in 2012. He then completed a two-year fellowship in Pediatric Surgery at the University of Iowa-Hospitals and Clinics, USA. Then he joined Chelsea and Westminster Hospital, UK, for another year of fellowship in pediatric surgery. Dr. Zaghal is board certified by the European Board of Pediatric Surgery.\nDr. Zaghal has been a pediatric surgeon and assistant professor of surgery at AUBMC since 2017. He has special interests in minimally invasive and neonatal surgery, and medical education. He is a fellow of the Higher Education Academy. Dr. Zaghal has published several articles in peer-reviewed journals and authored several chapters in general and pediatric surgery.",institutionString:"American University of Beirut",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"American University of Beirut",institutionURL:null,country:{name:"Lebanon"}}}],coeditorOne:{id:"450673",title:"Dr.",name:"Ali",middleName:null,surname:"El Safadi",slug:"ali-el-safadi",fullName:"Ali El Safadi",profilePictureURL:"https://intech-files.s3.amazonaws.com/a043Y00000rTNkyQAG/Co1_Profile_Picture__c%202021-12-20%2012%3A56%3A08.218",biography:null,institutionString:"American University of Beirut Medical Center",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"American University of Beirut Medical Center",institutionURL:null,country:{name:"Lebanon"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"184402",firstName:"Romina",lastName:"Rovan",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/184402/images/4747_n.jpg",email:"romina.r@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. 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It is also considered an important stroke severity marker, being associated with a higher risk of mortality, poor functional prognosis, and augmented risk of vascular dementia. This syndrome is a real challenge not only for the patients or their relatives but also for the specialists (neurologists, speech therapists, psychologists, and physiotherapists) involved in the diagnosis and treatment of those patients.
\nThe assessment of aphasias in clinical practice is based on classical analysis of oral production and comprehension. The language disturbances are frequently combined into aphasic syndromes (nonfluent/fluent aphasias), which are constituents of different vascular syndromes, being accompanied by motor deficit of the right limbs or visual deficit (hemianopia). The main determinant of the type of vascular aphasia is the infarct location (especially left middle cerebral artery territory). Recent studies at the hyperacute stage of ischemic stroke have observed features of aphasia, have reanalyzed its neuroanatomy using new imaging techniques, and have shown that aphasias have a parallel course to that of cortico-subcortical hypoperfusion. Thus, the reversal of hypoperfusion, following recanalization (spontaneous or secondary to thrombolysis or thrombectomy), is associated with resolution of aphasia. Speech therapy is needed as soon as permitted by clinical condition. Unfortunately, pharmacotherapy remains to be evaluated. Other studies examined the potential interest of new treatment, such as transcranial magnetic stimulation.
\nThis chapter is meant to clarify different aspects regarding the definition, classification, diagnosis criteria, and therapeutically strategies for the most common vascular aphasic syndromes due to ischemic stroke.
\nIn the field of neurolinguistics, there are two words, often misused as synonyms: “language” and “speech,” although each one of these terms describes different functions regarding distinct processes and involving distinct neural networks [1].
\n\n
The language system consists of five domains [1]:
\n
\n
\n
\n
\n
Speech results from the extremely coordinated rapid motor functions, thereby requiring the combination of phonation (voicing), resonance (nasality), articulation, fluency, and prosody. It is responsible for the actual act of vocal expression of language. The most important neural structures involved in the regulation of speech are represented by the cortical systems, the basal ganglia, the cerebellum, and the corticobulbar tracts, via the nuclei of the trigeminal, facial, glossopharyngeal, vagal, accessory (spinal), hypoglossal, and phrenic nerves. All these structures maintain the control and coordination between all the muscles involved in speaking: oral, lingual, palatal, pharyngeal, laryngeal, and respiratory muscles [1].
\nAphasia represents an acquired central disorder of language that impairs a person’s ability to understand or/and produce spoken language, often associated with impairment in reading (alexia) and writing (agraphia). Aphasia may supplementary affect the person’s ability to use musical notation, mathematical operations, etc.; in consequence, the aphasic may present difficulties to generate and use symbol systems. Aphasia is different from a peripheral (sensory-motor) disorder of language that may mimic aphasia (such as weakness of the muscles of articulation). In the same time, it is an acquired phenomenon that appears after the language has already been learned [1, 2, 3, 4].
\nNowadays, in the era of functional neuroimaging, using a variety of complex techniques, organization of the language network has been partially understood. The outward production of language is the effect of neural activation in huge network including different regions in the cortex, basal ganglia, cerebellum, and brainstem. An overlap in that network or with other networks of specialization determines the huge clinical spectrum following an acquired injury. One lesion in an area can produce numerous signs, and injuries concerning distinct areas can result in similar deficits [1].
\nFunctional neuroimaging studies mentioned that the “language network” is strikingly similar across different language tasks and across different healthy people:
Aphasia is caused by a localized brain damage. Using a combination of different neuroimaging techniques, it has been suggested that
Anterior areas | \nPosterior areas | \n
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| \n\n
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Recent studies [2], using MRI, noted the following correlations between different linguistic disturbances and cerebral lesions due to ischemic strokes:
\n\n
| \n\n
| \n
The assessment of aphasias in clinical practice is based on the analysis of six different language domains, which are represented by oral production (expressive language), comprehension (language understanding), repetition, naming, reading, and writing (Figure 1) [1, 2, 3, 4, 5, 6].
\nThe assessment of aphasias in clinical practice is based on the classical analysis of oral production (fluency), comprehension, and repetition.
It refers to modifications of fluency, prosody and volume, and presence of deviations at various linguistic levels [1, 2, 3, 4, 5, 6, 7].
\nFluency is represented by the flow of speech (number of words per minute: wpm) and effort (smoothness).
\nThe main deviations at different linguistic levels of oral production are as follows:
\n
\n
\n
\n
Other deviations are represented by oral production restricted to a few stereotyped utterances (e.g., “tan tan”), jargon aphasia (associating frequently multiple phonemic and verbal deviations leading to neologisms), echolalia, and the “conduit d’approche” (i.e., numerous attempts to correct phonemic deformations by successive approximations).
\nThere are two types of aphasias: nonfluent (Broca’s aphasia, transcortical motor aphasia, and global aphasia) and fluent (Wernicke’s aphasia, transcortical sensory aphasia, and conduction aphasia). On the one hand, a nonfluent spontaneous speech presents less than 50 wpm, augmented effort, dysprosodia, sometimes hypophonia, dysarthria, few paraphasias (especially phonological paraphasias), substantive words in excess, and short sentences. On the other hand, a fluent speech presents a normal of words per minute (100–200 wpm), with a normal effort, normal prosody and volume, no deviation at sound level (correct articulation of a sound), many paraphasias (including verbal paraphasias), relatively lack of substantive words, and normal sentences (including 5–8 wps) [1, 2, 3, 4, 5, 6, 7].
\nIt analyses comprehension at the linguistic levels of word and syntax [1, 2, 3, 4, 5, 6, 7]. Oral comprehension is formally examined by (a) asking the aphasic to point an object, a body part, etc. and (b) presenting different verbal commands with augmenting complexity. Impaired oral comprehension is usually underdiagnosed in clinical practice. We should think at this language disturbance when a patient does not behave according to the examiner’s tasks, especially during object pointing on verbal command and tasks using sentences of progressive complexity. The shortened Token Test is the test usually used to exam if the comprehension is impaired (adjusted score <29) and to differentiate Broca from global aphasia (adjusted score <17) [2, 6].
\nWhen testing repetition, it is essential to use different types of items (short-long verbal information and meaningful-meaningless utterances) [1, 2, 3, 4, 5, 6, 7].
\nAphasias with impaired repetition ability (perisylvian aphasias) differ from this point of view from transcortical (extrasylvian) aphasias, with normal repetition (even if oral comprehension is severely impaired in transcortical sensory aphasia).
\nWhile testing naming, different types should be included: objects, body parts, actions, and colors (“What is this?”) [5, 6, 7]. If we want to assess the understanding ability of the patient, we have to exam pointing (“Show me, please, where the…is!”), which is the opposite of naming [5, 6].
\nWhile testing reading, we should focus on two aspects: (a) the mechanisms of reading (the conversion of visual signs-graphemes into phonemes) and (b) reading comprehension (using written commands, etc.) [5, 6, 7].
\nWe should exam spontaneous writing, writing by dictation, and copying at different levels of the writing language: letters, syllables, words, sentences, and texts [5, 6, 7].
\nThe different language disturbances observed are frequently combined into aphasic syndromes (nonfluent/fluent aphasias) [1, 2, 5, 7].
\nAn experimented examiner can diagnose the aphasic syndrome based on analysis of six language domains (oral production, etc.).
\nHowever, clinical examination can produce two kinds of errors: (a) underestimation of oral comprehension deficit and (b) misdiagnose of verbal stereotypies with jargon aphasia.
\nThese errors are not found in the case of assessment of aphasias using an aphasia battery test:
Boston Diagnostic Aphasia Examination (BDAE) [8]
Western Aphasia Battery (WAB) [9]
Montreal-Toulouse Language Assessment Battery [10]
Minnesota Test for Differential Diagnosis of Aphasia [6]
Multilingual Aphasia Examination [6]
Bilingual Aphasia Test [6]
Each test provides well-defined cut-off scores, so the description of the aphasic syndrome is more precise than that obtained on clinical grounds [2].
\nBilingual Aphasia Test (BAT) [6] was realized to exam each of the languages of a bilingual or polyglot aphasic in an equivalent way. The test is available in dozens of different pairs of languages. Thus, the various versions of the BAT are linguistically equivalent tests [6].
\nThe main determinants of the type of aphasias are
Types of aphasic syndromes (nonfluent/fluent aphasias) [1, 2, 8] are:
Broca’s aphasia
Wernicke’s aphasia
Conduction aphasia
Transcortical aphasias:
Transcortical motor aphasia
Transcortical sensory aphasia
Mixed transcortical aphasia
Global aphasias
Anomic plus aphasias
The global aphasia (24–38%) and anomic plus aphasia (20%) are more frequent in acute ischemic stroke; Broca (10–15%), Wernicke (15%), and transcortical motor aphasias (15–20%) present an intermediate frequency, and other aphasias are rare [1, 2, 5].
\nAbout 10% of aphasias remain unclassifiable, especially in patients with a previous ischemic stroke (atypical aphasias: mixed aphasias, thalamic aphasias, and capsulo-striatal aphasias) [2, 12, 13, 14].
\n\n
Assessment of oral production (spontaneous speech)
Fluency
When there is no aphasic mutism or when mutism has regressed, the patient presents a nonfluent, arduous verbal output, characterized by difficulties to initiate spontaneous speech, effortful with hesitations and slow output (10–15 words/minute), and interrupted by word-finding pauses. Sometimes, he presents dysprosody (oral expression is monotonously, melodic modulation being absent) [1, 2, 3, 4, 5, 15, 16, 17, 18].
Presence of deviations at various levels
Sound/arthric level (incorrect articulation of a sound)—dysarthria.
Phonemic level (omission, substitution, addition, or inversion of a phoneme)—phonemic paraphasias.
Verbal level (naming): semantic (verbal) paraphasias; word-finding difficulty (anomia), especially in spontaneous speech; deficits in action naming are more severe than deficits in object naming.
Syntactic level: agrammatism, usually more apparent after the acute phase: omission of functional/grammatical words (prepositions, conjunctions, articles, auxiliary verbs/e.g. “the,” “an,” and inflections), while conceptual words (nouns, verbs, and adverbs) are used in a greater proportion—“telegraphic speech.” Sometimes, the oral production can be restricted to a few stereotyped utterances (e.g., “tan tan”) [4, 5, 17, 19].
Assessment of repetition
\n
\n
Assessment of oral comprehension
Usually, good oral comprehension, at least for commands, is needed to permit clinical exam. In some cases, syntactic comprehension can be affected as requested to understand complex sentences and multiple instructions [2]:
The patient is unable to distinguish between different operational words like “on” or “in.”
Comprehension of passive reversible sentences can be affected [18, 22].
Example:
(Q): “The girl was kissed by the boy. Who kissed whom?
(A): Girl kiss boy.”
Assessment of reading and writing
Reading (frontal alexia-literal alexia) and writing (frontal agraphia) are also impaired [20].
In conclusion, three characteristics represent the core of Broca’s aphasia: dysarthria, agrammatism, and preserved comprehension [1, 2, 3, 4, 5].
\n
Contralateral hemiparesis—lesions that cause Broca’s aphasia also interrupt adjacent cortical motor fibers and deep fiber tracts.
Facial weakness.
Buccofacial apraxia/apraxia of speech, which represents a disturbance in motor programming of speech articulation. The patient is aware of his deficit, so he tries unsuccessfully to correct his disturbance by trial and error. Instead, he presents difficulty in initiating utterances, groping articulatory movements, and articulatory inconsistency on repeated attempts of the same utterance.
The patient with Broca’s aphasia is aware of his oral expression disorders; consequently, he can develop depression [1, 2, 3].
Lesions or dysfunctions usually involves on the left side in right-handed individuals (Figure 2):
\nDifferent types of aphasias: anatomo-clinical correlations.
Broca’s area: the posterior part of the third frontal gyrus-Brodmann areas 44 and 45.
\nLesions in this area determine transitory apraxia of speech. Larger lesions, involving Broca’s area and its subjacent white matter, produce transitory mutism, which is replaced by a rapidly improving syndrome with prominent arthric deformations and deficits in action naming that are more severe than deficits in object naming.
\nRolandic operculum: lower part of motor area: Fa.
\nLesions can extend or separately affect insular cortex, and subjacent white matter, centrum semiovale, capsulostriatum (caudate nucleus head and putamen), and periventricular areas. Infarctions involving together these structures and Broca’s area can produce the complete syndrome of Broca’s aphasia.
\nBroca’s aphasia is produced by infarcts/severe hypoperfusion (MRI of the brain) of the superior division of the left MCA [1, 2, 5, 23, 24, 25].
\n\n
Assessment of oral production (spontaneous speech)
Fluency
The verbal output is fluent, with easy initialization of speech, plentiful output (100–200 words/minute), the phrase length is normal (~5–8 words/phrase), with normal prosody. There is no quantitative reduction of spontaneous speech. In some cases, the oral production may be augmented (logorrhea), concerning patients with jargon aphasia and anosognosia (differential diagnosis with acute delirium) [1, 2, 5, 26, 27, 28].
Presence of deviations at various levels:
Sound/arthric level: good articulation of sounds, well-articulated speech
Phonemic level: verbal paraphasias (semantically related word substitutions), phonemic paraphasias (phonologically related word or nonword substitutions), and jargon aphasia (associating frequently multiple paraphasias leading to neologisms)
Verbal level (naming): word-finding difficulty anomia (naming is severely affected), frequently associated circumlocutions, perseveration, and occasional neologisms
Syntactic level: paragrammatism: nouns replaced by pronouns (“that” and “those”) or by unspecific words (“thing” and “something”) [1, 2, 5, 26, 27, 28]
Assessment of repetition
Assessment of oral comprehension
Oral comprehension is severe impaired, due to disturbances in language sounds perception (repetition is impossible); incapacity of accessing the meaning of the word (repetition is normal); decrease in verbal memory (repetition may be disturbed depending on the length of the verbal output of the speaker); perturbation in comprehension of the lexicosemantic relations of the phrase or utterance [1, 2, 5, 26, 27, 28].
Sometimes, comprehension is more difficult for isolated words; on the other hand, verbal reception of some lexicosemantic categories may be partially or totally preserved. Syntactic comprehension is significant affected [1, 2, 5, 26, 27, 28].
Assessment of reading and writing
Reading is frequently impaired (alexia).
Writing (agraphia): spontaneous and dictated writing are fully of paragraphia and paragrammatism; copying a text is easier than writing after hearing one [1, 2, 5, 26, 27, 28].
\n
Homonymous hemianopia—frequently associated.
Complete/dissociated Gerstmann syndrome (agraphia, acalculia, finger agnosia, and inability to distinguish between the right and left sides of one’s body).
Limb apraxia.
Anosognosia—it can be observed at the initial stage and decreases gradually; high excitation: logorrhea and exaggeration of mimico-gestural language. The patient with Wernicke’s aphasia, in contrast to a Broca’s aphasic, is unaware of his disorders and seems unconcerned [1, 2, 5, 26, 27, 28].
\n
Wernicke’s area: posterior part of the first two temporal gyri-T1/T2 (BA 22) (Figure 2).
Inferior parietal lobes: angular gyrus (BA 39) and supramarginal gyrus (BA 40).
Lesions can extend to the insular-external capsule region and anterior part of temporal gyri (BA22). Besides the cortical destructions from these areas, subjacent white matter can be also affected.
Wernicke’s aphasia is the result of an infarct/sever hypoperfusion (MRI of the brain) of the inferior division of the left MCA (supplies the posterior part of the temporal lobe and inferior parietal lobule), usually an embolic occlusion/atherothrombotic [1, 2, 5, 23, 24, 25].
\nWernicke’s aphasia is more current in elderly women, due to a higher frequency of infarct in the inferior-posterior territory of the MCA in these patients [1, 2, 5].
\n\n
Assessment of oral production (spontaneous speech)
Fluency: verbal output (spontaneous speech) is fluent, although some hesitations and self-correction attempts to interrupt the flow are noted [1, 2, 5, 29, 30, 31, 32].
Presence of deviations at various levels
Sound/arthric level: normal articulation (speech well-articulated).
Phonemic level: phonemic paraphasias are typically for conduction aphasia. The production of phonemic paraphasias across verbal tasks represents the cardinal feature of conduction aphasia.
Semantic/verbal paraphasias or neologisms are less frequent in conduction aphasia than in other fluent types of aphasia.
Verbal level (naming): anomia—naming may be mildly impaired.
Syntactic level: the grammar is preserved. Sentences are short and have simple syntax [1, 2, 5, 29, 30, 31, 32].
Assessment of repetition
Repetition is impaired, contrasting with the sparing of the oral comprehension. Repetition of monosyllabic or bisyllabic words can be normal, but repetition of polysyllabic words and of sentences is always incorrect. The patient often paraphrases the sentence rather than repeating it.
Repetitive self-corrections, word-finding difficulties, and paraphrasing are attempts to correct phonemic deformations by successive approximations, named “conduit d’approche” [2, 29, 30, 31, 32].
Assessment of oral comprehension
It involves sparing of oral comprehension. The patient understands simple, active sentences, but guesses at comprehension of passive sentences [1, 2, 5, 29, 30, 31, 32].
Assessment of reading and writing
It involves usually good reading comprehension, but paraphasic oral reading. More precisely, the patient has difficulties in spelling and reading unfamiliar words, but correctly reads and spells words.
In conclusion, conduction aphasia presents three major characteristics: a relatively fluent, though phonologically paraphasic speech; poor repetition; and relatively spared comprehension [1, 2, 5, 29, 30, 31, 32].
\n
\n\nThe lesions affect the inferior parietal lobes, especially the supramarginal gyrus or/and the external capsule; they classically disrupt the arcuate fasciculus (a large bundle of fibers), although its role remains debated for the repetition impairments: probably disconnection between the superior temporal cortex and the inferior frontal gyri, respectively (Figure 2).
\nOther explanations for the repetition impairments have been noted, such as short-term memory syndrome (the repetition impairment due to limited working memory)—so, the associated lesions are situated in areas critical for working memory: inferior parietal lobule (supramarginal and angular gyri), inferior frontal cortex, posterior temporal lobe, and/or their white matter connections (the external capsule).
\nConduction aphasia is the result of an embolic infarct of the inferior division (posterior temporal or parietal) of the left MCA [1, 2, 5, 23, 24, 25].
\nIt is rarely observed at the acute stage of stroke and more frequently affects younger patients.
\nTranscortical aphasias are the less common type of aphasias. They are characterized by preservation of word repetition, even of those words without meaning. Repetition of words is mediated by the perisylvian cerebral region (fronto-temporo-parietal region). Generally, in this type of aphasia, Broca’s area, Wernicke’s area, and the arcuate fasciculus are intact. In transcortical aphasia exists a disconnection between motor and/or sensory areas of language from hemispheric cortex, a process that occurs from lesions of border areas: (a) from ACA and MCA (transcortical motor aphasia) and (b) from MCA and PCA (transcortical sensory aphasia) [1, 2, 23, 24, 25].
\nIt is characterized by poor spontaneous speech (nonfluent, reduced oral output with possible initial mutism, loss of initiation, hypophonia, perseveration, and reduced phrase length). Minor dysarthria is noted in opposition with sever arthric deformation noted in Broca’s aphasia. Sometimes, simplification of grammatical form is noted. Echolalia and perseveration are usually observed. Naming is frequently preserved.
\nRepetition and oral comprehension are typically spared [1, 2, 5, 33, 34, 35, 36].
\n\n
Cortical frontal lesions of border areas (watershed area) between the left anterior cerebral artery (ACA) and middle cerebral artery (MCA); less frequently left premotor and prefrontal regions, situated anterior and superior of Broca’s area (dorsolateral region-sparing Broca area), and supplementary motor area (supero-medial area of the frontal lobe) (Figure 2)
Subcortical frontal lesions: thalamus, centrum semiovale with variable extension into the striatum (hypophonia is noted) [1, 2, 5, 23, 24, 25]
Spontaneous speech (oral output) is fluent, with verbal paraphasias, word-finding difficulty (especially by naming infrequent objects and animals), and circumlocutory speech (use of generic words such as “bird” for a hen and “furniture” for a showcase).
\nComprehension is severely impaired at the word level, especially for unusual nouns. This contrasts with repetition sparing (this is the key feature that distinguishes it from Wernicke’s aphasia). The patient is incapable to describe accurately a name that is correctly repeated. The comprehension deficit is usually associated with semantic impairment [1, 2, 5, 33, 34, 35, 36].
\n\n
Cortical lesions of border areas from MCA and posterior cerebral artery (PCA) territories: temporo-parieto-occipital junction region and inferotemporal region (second and third temporal gyri) (Figure 2)
Subcortical lesions: anterolateral thalamus
Alzheimer’s disease, semantic variant of primary progressive aphasia (PPA) or Creutzfeldt-Jakob disease can produce a similar syndrome [1, 2, 5, 23, 24, 25].
Nonfluent reduced spontaneous speech (verbal output), palilalia, or even transitory mutism, combined with impaired comprehension, impaired reading (alexia), and impaired writing (agraphia), relatively spared repetition. It combines signs of both transcortical motor and sensory aphasia. It looks like a global aphasia with relatively normal repetition [1, 2, 5, 33, 34, 35, 36].
\n\n
Cortical lesions isolating the spared perisylvian language areas (watershed territory between the left ACA and MCA in addition to the watershed territory between the left MCA and PCA) (Figure 2)
Subcortical lesions: large thalamic hemorrhage interrupting the temporal isthmus; infarcts in the left thalamus, putamen, and periventricular white matter [1, 2, 5, 23, 24, 25]
It is the most severe form of aphasia, which associates with the following:
Major disorders of oral production, represented by aphasic mutism (oral output lost), or by a spontaneous speech restricted to some stereotyped utterances (with dysarthria). Repetition is severely affected (it does not improve oral output, differing from mixed transcortical aphasia).
Major disorders of the oral and written comprehension. Global aphasia differs from Broca’s aphasia by the severity of oral comprehension impairment [1, 2, 5, 37].
Right hemiparesis/hemiplegia, right hemi-hypoesthesia, right homonym hemianopia, limbs apraxia, and facio-buccolingual apraxia [1, 2, 5, 37].
\n\n
Extended lesions (including left perisylvian anterior and posterior language areas), which are the result of a left MCA/C1 occlusion (with a total left MCA infarct), produce global aphasia with hemiplegia, hemisensory deficits, and hemianopia (Figure 2) [2].
Broca’s and Wernicke’s areas may be simultaneously hypoperfused in the acute period. Thus, global aphasia can be the initial aphasic syndrome.
Early involution into Broca’s aphasia (with early recovery of comprehension) may result from reperfusion of Wernicke’s area. In this case, the patient presents only left frontal lobe, left basal ganglia, and left insula ischemic lesions (diffusion-weighted image shows infarct in superior division of left MCA territory, which includes Broca’s area), sparing in the same time the left temporoparietal region (global aphasia with hemiplegia and early improvement of comprehension).
Later recovery of comprehension may appear from the reorganization of the language network:
Frontal and temporoparietal lesions (two lesions) produce global aphasia without hemiplegia. When sensory-motor deficit is missing, we should search for mixed transcortical aphasia.
Subcortical infarct extended into basal ganglia [1, 2, 5, 23, 24, 25, 38].
Typical anomic aphasia is a fluent aphasia with word-finding difficulty anomia (noted in spontaneous speech and naming), usually associated with circumlocutions. Comprehension and repetition are spared.
\nAnomic plus aphasia presents additional minimal deficit of language (mild arthric deformation or mild impairment of oral comprehension or repetition). It is the mildest aphasic syndrome [1, 2, 5, 39].
\nThis is a very rare condition (1% of all acute ischemic stroke aphasias) [39], defined by an aphasic syndrome in a right-handed patient (free from developmental disorders and previous brain lesions, fully lateralized, which is demonstrated using a questionnaire like Edinburgh Inventory) [40], caused by a right hemisphere lesion (nondominant hemisphere).
\nThe anatomical determinants are similar to those observed in left hemisphere lesion, although a higher proportion of deviant cases are observed, particularly with mild aphasia contrasting with the large lesion. This fact is usually reported as evidence for bilateral representation of the language [2].
\nIn the past, crossed aphasia was considered to be nonfluent, although today is reported that all aphasic syndromes can be registered (some cases of crossed Wernicke’s aphasia in right-handed patients with lesions in the homologous area of the right cerebral hemisphere are noted [2].
\nPure left striatocapsular infarcts (left deep MCA infarcts) can produce different types of aphasias (mainly nonfluent, especially motor transcortical aphasia and Broca’s aphasia). Frequently, hypophonia (poor speech volume) can be noted.
\nFluent and nonfluent aphasias have been reported in thalamic lesions. Usually, a thalamic aphasia presents a significant impairment of spontaneous speech, with verbal paraphasias, but with oral comprehension and repetition relatively spared [1, 2, 5, 28]. Patients with subcortical aphasias are older, because the main mechanism of ischemic stroke is small vascular disease.
\nThere are two distinct mechanisms concerning subcortical vascular aphasias: (a) a possible sustained cortical hypoperfusion and infarction not visible on structural imaging studies and (b) a possible thalamic disconnection, due to striatocapsular infarcts [28].
\nAny type of lesion (localized/diffuse, acute/chronic, intermittent, progressive, or permanent) restricted to any of all mentioned language network from the dominant hemisphere in right-handed subjects (and rarely, in the nondominant hemisphere in right-handed subjects—“crossed aphasia”) can cause aphasia [1, 2].
\nThe most common causes of aphasia are the vascular pathology (ischemic and hemorrhagic stroke, aneurysm, cerebral veins, and dural sinus thrombosis), which produces vascular aphasias, traumatic brain injury, brain tumors, neuroinfections (especially Herpes simplex encephalitis), stroke mimics (aura migraine, epilepsy - ictal EEG sustaining the diagnosis of an epileptic seizure, and MRI-DWI), multiple sclerosis (rarely), and neurodegenerative diseases such as Alzheimer disease and primary progressive aphasia.
\nAphasia has a prevalence of 25–30% in acute ischemic stroke; it is a marker of stroke severity and of poststroke outcome, being associated with a higher risk of mortality, poor functional prognosis (can have a dramatic impact on person’s ability to communicate), and increased risk of poststroke dementia [1, 2, 7, 8, 9, 10, 11, 41, 42, 43].
\nVascular aphasias have not typically corresponded to linguistic domains network due to the fact that ischemic injuries specifically imply arterial territories, rather than being limited to the language network. Thus, the arterial syndromes include different concomitant neurological signs (hemiparesis, hemianopia, etc.,) that are reported together with aphasia because they all represent functions that depend on arterial supply of a peculiar brain region (vessel which can be occluded, producing an ischemic stroke) [1, 22, 44].
\nThe main determinant of the type of vascular aphasia is the infarct location [1, 2]. Recent studies concerning the hyperacute stage of ischemic stroke have demonstrated that aphasic symptoms have a similar evolution to that of cortical hypoperfusion; thus, improvement in cortical perfusion (following spontaneous or therapeutic recanalization) generates recovery of aphasia [1, 2, 5, 28]. Recanalization of an occluded M1 branch of MCA through development of collateral blood flow or through treatment in a patient with aphasia and a striatocapsular infarct can reverse the aphasia (the patient may present the late vascular syndrome due to the infarct rather than the initial vascular syndrome due to the hypoperfused area [1, 2, 5, 28].
\nUsing different functional imaging techniques (perfusion computer tomography, diffusion- and perfusion-weighted magnetic resonance imaging, and positron emission tomography), recent studies have indicated characteristics of aphasia (in hyperacute stage), suggested prognosis (in the era of thrombolysis), and observed even the potential new treatments [such as transcranial magnetic stimulation (TMS)] [2].
\nMeasuring cerebral blood flow and volume enables the definition of maps of penumbra (diminution of cerebral blood flow and normal/increase of cerebral blood volume) and infarct (diminution of cerebral blood flow and volume) in the hyperacute stage of ischemic stroke. It has been demonstrated that penumbra dynamics is the major determinant for aphasia evolution. Saving a cerebral area implicated in a specific language function (naming, etc.) clinically improved this modality [2].
\nFunctional MRI studies demonstrated that cerebral tissue at risk of infarction (as indicated by the mismatch of PWI and DWI) can survive if recanalization occurs quickly. This represents the major site explaining postischemic recovery, as proved by language task-specific activation adjacent to the infarct lesion within the region certified by the imaging mismatch.
\nDifferent studies using positron emission tomography reported that spontaneous recovery of vascular aphasias still occurs with the persistence of the lesion and it takes place by a few distinct mechanisms. The activation appears in some spared left hemisphere language areas, new left hemisphere areas not commonly involved in language processing (pars orbitalis of the inferior frontal gyrus, anterior insula, and middle frontal gyrus), and right hemisphere areas homotopic to control subjects language network. Interestingly, compensation by the right hemisphere respected the aphasia subtype network, the right F3 being recruited when the left F3 was affected [1, 2].
\nUsually, vascular aphasias become less severe in the first 3 months after stroke. The spontaneous recovery depends on the severity of the initial aphasia (which has been related to the lesion location and size), but also on general stroke severity, etiology (ischemic and hemorrhagic), time from onset, age, gender, handedness, treatment, motivation and personality, associated disorders, etc. [1, 2, 5].
\nNonfluent aphasia can rarely evolve into fluent aphasia, whereas a fluent aphasia never evolves into a nonfluent aphasia [45].
Global aphasia may regress to Broca’s aphasia (or less frequently to Wernicke’s aphasia). Prognosis for global aphasia persisting at 1 month is poor, because only one-third of aphasics communicate satisfactorily at 2 years [2, 13, 46].
Broca’s aphasia may transform to anomic-plus aphasia. The prognostic for Broca’s aphasia is relatively poor, because only 40% of patients regain ability to communicate satisfactorily [2].
Transcortical-motor aphasia may transform to anomic-plus aphasia. The prognosis of transcortical-motor aphasia is relatively good, depending on the severity of spontaneous speech diminution and associated executive and memory impairment.
Wernicke’s aphasia may transform to conduction aphasia. The prognosis is relatively good, as nearly 60% of patients regain ability to communicate satisfactorily (those involving in conduction aphasics) [2].
Conduction aphasia has a relatively good prognosis, because 70% of patients regain ability to communicate [2].
Transcortical sensory aphasia has a relatively good prognosis, because 60% of patients regain ability to communicate satisfactorily in everyday activities [2].
Anomic aphasia has a good prognosis (they have a good ability to communicate) [2, 13, 46].
The outcome of aphasia at 1 year after stroke can be predicted in the first week [45] by stroke subtype, the phonology score (the strongest predictor), age, educational level, and the Barthel Index score. Severe comprehension impairment is reported as a negative factor for stroke recovery, as the aphasic could not understand the rehabilitation tasks. In 2009, Parkinson et al. [47] observed improvement in object and action naming in chronic vascular aphasics. They noted that better recovery was associated with larger lesion in the anterior regions of the brain and absence of lesion in the subcortical regions.
\nVascular aphasics may present some spontaneous language amelioration (spontaneous recovery), but speech therapy can significantly contribute to a better aphasia rehabilitation.
\nA very good language assessment is the key point for any program of speech therapy (the role of a dedicated and competent neurologist is very important) [48].
\nSpeech therapy should not be used in the hyperacute stage of stroke. In this stage, we should focus on reperfusion (i.v. thrombolysis/thrombectomy) of the affected arterial territory. Speech and language therapy should be typically started as soon as the clinical condition becomes favorable, which is nowadays generally possible in acute stroke units (in the acute/subacute stage of stroke) [2].
\nThe speech therapy has five objectives:
\n
\n
\n
\n
\n
Bhogal et al. [50] reviewed 10 studies and noted that intense speech therapy over a short period (approximately 9 hours of therapy per week during 12 weeks) ameliorate outcome. Conversely, lower intensity (2 hours a week) over a longer period (more than 20 weeks) did not improve evolution compared with informal support. In conclusion, speech therapy intensity should be of at least of 1 hour per day in the first 3 months after stroke onset [2].
\nDue to the specific level of the language which is affected, the speech therapy strategy to be used will be different (auditory analysis, word identification, etc.). For example, in global aphasia, the main goals of therapy are represented by helping the patient to use remaining abilities, to restore language abilities, to learn other methods (nonverbal) of communicating, etc. [48].
\nNowadays, treatment of reperfusion (designed to restore cortical perfusion (i.v. thrombolysis/thrombectomy)) during the first 4–5 h (thrombolysis), and 6–12 h (thrombectomy) from the clinical onset, represents the main prevention approach.
\nPreliminary positive results were found using piracetam in nonfluent aphasias [51], but it has not been proven to be effective in long-term use [52]. Despite positive preliminary reports, bromocriptine did not improve nonfluent aphasias in a randomized, double-blind, placebo-controlled clinical trial [53]. Preliminary positive results were also noted using cholinergic agents (donepezil) in fluent aphasias [2, 54]. Efficacy of pharmacological treatments in the chronic phase needs to be demonstrated.
\nFunctional imaging studies of language in nonfluent aphasics usually report a possible overactivation in right hemisphere language homologues [55].
\nEvidence exists that left hemisphere functional recovery is clinically more relevant than right hemisphere activation as a compensatory mechanism after stroke. Thus, right hemisphere activation might be a negative factor for aphasia recovery after stroke [55]. Use of TMS could provide right hemisphere inhibition and, therefore, ameliorate regression of language deficits. Preliminary reports suggested that TMS can improve naming in nonfluent vascular aphasics [55]. This assertion needs to be confirmed by randomized controlled trials.
\nAs a general rule, pharmacological treatment or TMS would be better delivered just before speech and language therapy [2].
\nVascular aphasia is a term that covers complex syndromes, and it is considered not only a stroke severity marker outcome (it is associated with a higher risk of mortality) but also a poststroke poor functional outcome (can have a dramatic impact on person’s ability to communicate and increased risk of developing poststroke dementia). Taking into consideration the unpredictable evolution of all mentioned aphasic syndromes and the lack of treatment strategies, next researches should focus on combined methods of improving patients’ language after acute and even chronic stage of stroke (such as transcranial magnetic stimulation and speech therapy applied in consecutive, consequent, and sustained sessions).
\nOver the past millennium, countless individuals have offered some version of the concept that actions are particularly important to human relationships. In the 1200s, Francisican friar Anthony of Padua is attributed with saying, “… let your words teach and your actions speak.” In 1628, John Pym said, “… actions are more precious than words.” In 1693, Thomas Manton wrote, “… Work and Scope … speak much louder than Words.” In 1856, Abraham Lincoln said, “‘Actions speak louder than words’ is the maxim.” Or, in modern vernacular, “Don’t just talk the talk; walk the walk [1].” Yet, what we do depends on what we think and feel. Therefore, it is important to understand how thinking, feeling, and behaving relate to each other.
Psychology involves cognitions, motivations/emotions, and behaviors. Cognitions are what we perceive, think, and believe. Motivations/emotions are how we feel and underlie why we think and act as we do. Behaviors are actions that we take, for and against ourselves and others. What we think matters; what we feel matters; what we say matters; but what we actually do probably matters most, especially with regard to treatment and relationships with others.
During the twentieth century and continuing to this day, empathy has received interest and attention from counselors, educators, life coaches, spiritual leaders, political leaders, scholars, and researchers in the social sciences and neurosciences because of its relevance to all aspects of life and interactions with others. The fact that empathy is the subject of this volume exemplifies the breadth and depth of interest is this psychosocial concept.
Recently, the question has been raised whether empathy
This chapter begins with a discussion of the scholarly origins of empathy because of the substantial attention already given to this particular concept and because empathy is the focus of this volume. That discussion introduces the importance of actions beyond thoughts and feelings. Next, we present nine different psychological constructs along an aggression-compassion continuum that includes two dimensions. Each construct is defined and briefly explained. Then, we present four biopsychosocial aspects of people—character, competence, context, communication—and four psychosocial levels—personal, interpersonal, team, organizational. We relate these eight elements to the constructs of the Aggression-Compassion Continuum. Finally, we discuss how the constructs that appear on the Aggression-Compassion Continuum are distinguished from good and bad cognitions, emotions, and behaviors.
Interestingly, in 1871 Charles Darwin described how humans and animals come to help others. Darwin’s discussion of what he called “sympathy” included concern and actions that are more similar to what we now refer to as “empathy” and “compassion [9].” This focus on concern and actions for the welfare of others complemented Darwin’s notions of competition and survival of the fittest [10].
Consistent with Darwin’s Theory of Continuity of Species, primatologist Frans de Waal has noted that apes and other infrahuman species also demonstrate behaviors that involve caring for others and, perhaps, feeling the emotions of others [11]. Shortly after Darwin’s [9] discussion about humans and animals helping others, the German concept of “Einfühlung”—or “feeling into”—was introduced by Robert Vischer in 1873 to explain relations of people to others and to artwork [12]. This particular application of “feeling into” to understand other people as well as reactions to artwork was further discussed by Theodor Lipps [13, 14] (cf. Curtis and Elliott [15] for a historical overview). Edward Titchener [16] and James Ward (cf. Lanzoni [17]) translated this concept with the English word “empathy [12].”
In the twentieth century, empathy has been addressed in more detail by authors, scholars, and scientists with a wide range of interests and expertise. The study and analysis of empathy and how it relates to other psychological constructs, such as sympathy and compassion, is ongoing among psychologists and neuroscientists.
For example, author and motivational speaker Brené Brown has offered that empathy involves four qualities that distinguish it from sympathy [18, 19, 20, 21]:
To be able to see the world as others see it
To be nonjudgmental
To understand another’s feelings
To communicate your understanding of that person’s feelings
Other researchers have differentiated between “emotional or affective empathy” and “cognitive empathy,” where “affective empathy” involves sensations and feelings in response to others’ emotions and “cognitive empathy” involves identification and understanding of others’ emotions [22, 23].
Emotional empathy consists of three separate components, according to Hodges and Myers:
Feeling the same emotion as another person
Personal distress in response to perceiving another’s plight
Feeling compassion for another person
Cognitive empathy (or empathic accuracy) refers to how well we can perceive and understand the emotions of another [23, 24].
Psychologists Daniel Goleman and Paul Ekman have identified three components of empathy, that include cognitive and emotional (or affective) and adding “compassionate empathy”— a prelude to Hougaard and Carter’s distinction between empathy and compassion [22]. With regard to these three components of empathy [11, 22, 25]:
Emotional empathy involves sharing another\'s feelings and matching that person\'s behavioral states by “simulation”
Cognitive empathy or perspective taking or theory of mind involves thinking about and understanding another\'s feelings
Empathetic concern, or compassion, adds motivation and intent to act in order to do something about another’s suffering
Denworth [26] has suggested that empathetic concern is “compassion” and includes motivation to help; i.e., to take action. Neuroscientists also are studying empathy and compassion and are seeking to identify neural circuits and specific regions of the brain that are involved in and that distinguish between these constructs [27, 28]. Empathy requires the involvement of neural networks that underlie perception of others’ emotions, ability to connect with them emotionally and cognitively, and ability to distinguish between our own and others’ emotions [29].
Social neuroscientists have offered two theories of empathy: (a) Simulation Theory and (b) Theory of the Mind. Simulation Theory proposes that empathy occurs because when we see another person experiencing an emotion, we simulate that to know what it feels like. It has been suggested that this phenomenon involves “mirror neurons” that are activated when we observe and experience emotion and that the medial prefrontal cortex is primarily involved. Theory of Mind proposes that we use thought processes to explain the mental state of others. In addition, context and situation affect which of these empathetic responses occur [23, 30, 28].
With regard to compassion, Gilbert [31] has suggested that compassion arose from the evolutionary advantage of caring for others, especially offspring, kin, and in-group allies. Rasmus Hougaard [32] has proposed that compassion is better for humanity than empathy for four reasons:
Empathy is impulsive. Compassion is deliberate.
Empathy is divisive. Compassion is unifying.
Empathy is inert. Compassion is active.
Empathy is draining. Compassion is regenerative.
He also argues that: compassion can be developed; we should have more self-compassion; and that we should practice compassion daily [32].
Neff has emphasized the importance of self-compassion as well as compassion for other people [33, 34, 35]. Hougaard and colleagues [2, 3] went even further and proposed that empathy alone is not sufficient to optimize relationships. Instead, these authors emphasized that compassion is necessary to influence relationships because compassion includes actions. These authors offered a pictorial representation of a continuum of feeling and acting with regard to others, ranging from pity to sympathy to empathy to compassion. We believe that this representation is important and relevant to consider in building relationships, but that it is only part of a broader continuum and additional, related concepts.
Figure 1 depicts nine constructs that we believe are relevant to human relations and well-being (including self, dyads, teams, and organizations): Aggression, Hostility, Animosity, Antipathy, Apathy, Pity, Sympathy, Empathy, Compassion. The four constructs that appear in the upper right quadrant and in the manner presented in Figure 1 are based on Hougaard and Carter [2]. The addition of the other five constructs with the particular two-dimension labels is new. We have labelled the axes differently from Hougaard and Carter [2] to capture the three key aspects of psychology: cognitions, emotions, and behaviors. The x-axis is labelled “Cognitive and Emotional” ranging from “Opposition” on the far left to “Support” on the far right; the y-axis is labelled as “Behaviors” from “Opposition” on the bottom to “Support” on the top. In addition, each construct appears in Figure 1 in a location meant to correspond to the relative amount of each type of support or opposition. Each of the nine constructs is defined and differentiated in this section of the chapter following a comment about word meanings.
Aggression-compassion continuum.
The study of the origin of words and the way in which their meanings change (Etymology) is relevant to understand the distinctions among the concepts along the Aggression-Compassion continuum. Words with the “–ion” suffix (including Aggression and Compassion) are nouns of state, condition, or
The upper right quadrant of Figure 1 lists four psychological constructs and can be broadly categorized as the “support” quadrant because all of the constructs that appear in this quadrant provide some sort of support. The support can be cognitive and emotional; it also can be behavioral support. The four constructs that appear in this quadrant increase in amount of all types of support provided from pity to sympathy to empathy to compassion.
The lower left quadrant of Figure 1 lists four psychological constructs and can be broadly categorized as the “oppose” quadrant because all of the constructs that appear in this quadrant provide some sort of opposition. The opposition can be cognitive and emotional; it also can be behavioral opposition. The four constructs that appear in this quadrant increase in amount of all types of opposition provided from antipathy to animosity to hostility to aggression.
With regard to the nine psychological constructs on the Aggression-Compassion continuum, there may be a tendency to think about these nine psychological constructs as involving relationships only between oneself and another individual. In fact, they are relevant to four psychosocial levels: Personal, Interpersonal, Team, Organizational. These four categories have been described as part of the Leader-Follower Framework (LF2) because they refer to and help guide understanding of the individual (personal or self), relationships between two people (interpersonal), interactions within small teams, and consideration of large groups, cultures, systems (organizational). The LF2 also distinguishes among four biopsychosocial aspects of people: character (who we are), competence (what we think, feel, and do), context (when and where we are), and communication (how we express ourselves and seek understanding). Each of these topics is described below [4, 5, 6, 7]:
We submit that all eight of the LF2 elements should be applied to better understand each of the nine constructs along the Aggression-Compassion Continuum. This type of analysis will likely reveal contributing factors to each of the constructs. Such understanding may suggest how to better work with others.
For example, consider Aggression and each of the LF2 elements. Is the reason an individual acts aggressively because of character (e.g., personality, differing values, mental health), competence (e.g., KSAs to act aggressively or the lack of KSAs to control oneself and to not act aggressively), context (e.g., hunger, tiredness, stress, situation, existential threat), or communication (e.g., the only option to convey intended meaning or lack of options to reach understanding)? Is the individual acting aggressively towards oneself (personal), one other (interpersonal), a team, or an organization/culture system? Also, is the individual acting aggressively because of personal (e.g., self-hate, frustration), interpersonal (e.g., disagreement with a single other person), team (e.g., going along with others or opposing particular others), or organizational (e.g., the culture of the larger group) reasons? A similar analysis can be applied to the other three constructs in the Opposition Quadrant of the Aggression-Compassion Continuum: Hostility, Animosity, Antipathy.
As another example, consider Apathy and each of the LF2 elements. Is the reason an individual does not care, does not express any emotions, and does not take any actions because of character (e.g., personality, perception of hopelessness, physical illness, mental illness, picking their battle), competence (e.g., lacks the KSAs to take any action relevant to the situation at hand, overwhelmed with other things on their plate), context (e.g., lack of necessary resources to act, exhaustion, overwhelming odds or opposition), or communication (e.g., lacking any way to communicate, not receiving any communication that the issue or situation is worth addressing)? Is the lack of caring directed at oneself, one other, a team, an organization? Also, is the reason that an individual does not care because of personal (e.g., lack of self-esteem, lack of self-confidence), interpersonal (e.g., perception that no concern or action will affect the other person, that the other person will do what they want anyway, or that the other person does not matter), team (e.g., lack of respect from or connection with the team, belief that nothing can be done to affect the team), or organizational (e.g., experience or belief that there is no way to alter the organization, culture, or system) reasons? A similar analysis can be applied to the other three constructs in the Support Quadrant of the Aggression-Compassion Continuum: Pity, Sympathy, Empathy.
In addition, consider Compassion and each of the LF2 elements. Is an individual acting compassionately because of character (e.g., personality, understanding their own and others values and beliefs), competence (e.g., having the KSAs to act and perform compassionate acts), context (e.g., the needs of the recipient(s) of the compassionate acts are overwhelmingly heart-breaking, understanding of the stress with the individual, team, or organization), or communication (e.g., the recipient(s) of the compassionate acts effectively expressed need for help, the provider(s) of the compassionate acts can effectively understand and communicate with others to understand what they are saying and discuss what is needed)? Is the individual acting compassionately towards oneself (personal), one other (interpersonal), a team, or an organization/culture system? Also, is the individual acting compassionately because of personal (e.g., acting in accordance with one’s own values), interpersonal (e.g., concern for that particular person), team (e.g., commitment to the team), or organizational (e.g., commitment to the particular organization) reasons?
To understand and enhance relationships, we suggest that it is useful to consider which of the LF2 elements contribute to the particular psychological state and which of these elements may be key to modulate (either to increase or to decrease) the given psychological construct. With regard to the nine constructs along the Aggression-Compassion continuum, it is important to consider that there likely is a tendency to think of each construct as relevant especially to relationships and interactions with one other person (interpersonal) or a group of people. But each construct also can be applied to oneself and to organizations. We need to act with compassion and not with aggression towards ourselves as well as consider to whom and in what context we should allow ourselves to experience and exercise each of the nine constructs. In other words, we need to maximize our emotional and social intelligence so that we are aware of motivations and emotions that accompany and underlie our own thoughts and actions as well as the motivations and emotions that accompany and underlie the thoughts and actions of others [50, 51, 52, 53].
Another important point to consider is that although “Support” and “Oppose” can be considered as corresponding to “good” and “bad” poles of the Aggression-Compassion continuum, that type of identity simply is not true. Most if not all publications about pity, sympathy, empathy, compassion imply or state explicitly that these concepts and corresponding actions (in the case of compassion) are, indeed, “good.” Conversely, it is implied or explicitly stated that antipathy, animosity, hostility, and aggression are “bad.” Neither of these generalizations is correct.
Providing cognitive, emotional, and behavioral support— as is done when exercising the four constructs depicted in the upper right—for kindness, generosity, altruism, open-mindedness, liberty, freedom, democracy, and so on certainly would be considered as “good.” But consider, for example, what it means when one is “supporting” in thoughts, emotions, and actions bigotry, robbery, hatred, dishonesty, cruelty, slavery, authoritarianism; then, exercising and expressing pity, sympathy, empathy, and compassion for these particular thoughts and actions would be considered as “bad.”
The same dichotomy of good and bad applies to the “opposing” poles of the Aggression-Compassion Continuum dimensions. Aggression, hostility, and the other constructs on the “oppose” cognitive, emotional, and behavioral poles certainly would be considered “bad” when the opposition is to kindness, generosity, altruism, open-mindedness, liberty, freedom, democracy. Conversely, opposing in thoughts, emotions, and actions bigotry, robbery, hatred, dishonesty, cruelty, slavery, authoritarianism, and so on, would be considered as “good.”
So, it is important to recognize that supporting others can be good or bad. And opposing others can be for good or bad. Aggression and Compassion involve actions of opposition or support, respectfully, and, thereby, set the poles of a psychological continuum with regard to self and others, but who and what we are opposing or supporting determines what is good and bad from each of our perspectives and based on each of our values. Generalizations such as “both sides are to blame” and “there are good people on both sides,” are not always true.
Additionally, it is important to recognize that the value and accompanying good or bad of each construct along the Aggression-Compassion Continuum also depends on the situation and people involved. For example, empathy can be so powerful that feeling the pain or suffering of another can be damaging to the well-intentioned empath. Also, empathy can be so absorbing that it freezes or prevents the empath from taking action to help others. Compassion, despite providing well-intentioned support, can be counter-productive if provided to someone(s) who does not want the actions of support or who needs to learn to act for themselves. A common dilemma confronts parents who act to help their children with every challenge, even when their children are not in danger and need to learn to handle their own challenges and to accept and to be resilient after experiencing their own disappointments or failures. Conversely, aggression, even when opposing dangers, can be bad if the individuals being helped want to handle the situation themselves or need to learn to handle the situation themselves.
The Aggression-Compassion Continuum includes nine psychological constructs that involve different amounts of cognitive and emotional support or opposition and different amounts of action. It is important to understand where you are along this continuum to optimize relationships with others as well as your own well-being. We believe that applying the eight elements of the Leader-Follower Framework when considering relevant points on the Aggression-Compassion Continuum also will help to enhance emotional and social intelligence.
The authors greatly appreciate discussions with colleagues about the psychosocial constructs and topics addressed in this chapter.
The authors declare no conflict of interest.
The opinions and assertions contained herein are the sole ones of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences or the Department of Defense.
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\n\nIntechOpen partners do not provide shipping service from Europe to the countries listed below. Please refrain from mailing items addressed to the countries listed below, until further notice.
\n\nWhen ordering our books from the countries listed below, please provide an alternative mailing address. For any further assistance, please contact us at orders@intechopen.com.
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Risks of collapse and large deformations at the surface are high; thus negative impact on old buildings are likely to occur if appropriate measures are not taken in advance, when designing and constructing the tunnel. For deep tunnels with high overburden and low rock mass properties, squeezing conditions and excessive loads around the excavation can jeopardize the stability of the tunnel, leading to extensive collapse. The aim of the chapter is to give details on advance computational modelling and analytical methodologies, which can be used in order to design shallow and deep tunnels and to present real case studies from around the world, from very shallow tunnels in India with only 4.5 m overburden to a deep tunnel in Venezuela with extreme squeezing conditions under 1300 m overburden.",book:{id:"7690",slug:"tunnel-engineering-selected-topics",title:"Tunnel Engineering",fullTitle:"Tunnel Engineering - Selected Topics"},signatures:"Spiros Massinas",authors:[{id:"295762",title:"Dr.",name:"Spiros",middleName:null,surname:"Massinas",slug:"spiros-massinas",fullName:"Spiros Massinas"}]},{id:"68157",title:"Introductory Chapter: Textile Manufacturing Processes",slug:"introductory-chapter-textile-manufacturing-processes",totalDownloads:4502,totalCrossrefCites:17,totalDimensionsCites:27,abstract:null,book:{id:"8892",slug:"textile-manufacturing-processes",title:"Textile Manufacturing Processes",fullTitle:"Textile Manufacturing Processes"},signatures:"Faheem Uddin",authors:[{id:"228107",title:"Prof.",name:"Faheem",middleName:null,surname:"Uddin",slug:"faheem-uddin",fullName:"Faheem Uddin"}]},{id:"66828",title:"Breathing Monitoring and Pattern Recognition with Wearable Sensors",slug:"breathing-monitoring-and-pattern-recognition-with-wearable-sensors",totalDownloads:3130,totalCrossrefCites:12,totalDimensionsCites:16,abstract:"This chapter introduces the anatomy and physiology of the respiratory system, and the reasons for measuring breathing events, particularly, using wearable sensors. Respiratory monitoring is vital including detection of sleep apnea and measurement of respiratory rate. The automatic detection of breathing patterns is equally important in other respiratory rehabilitation therapies, for example, magnetic resonance exams for respiratory triggered imaging, and synchronized functional electrical stimulation. In this context, the goal of many research groups is to create wearable devices able to monitor breathing activity continuously, under natural physiological conditions in different environments. Therefore, wearable sensors that have been used recently as well as the main signal processing methods for breathing analysis are discussed. The following sensor technologies are presented: acoustic, resistive, inductive, humidity, acceleration, pressure, electromyography, impedance, and infrared. New technologies open the door to future methods of noninvasive breathing analysis using wearable sensors associated with machine learning techniques for pattern detection.",book:{id:"7654",slug:"wearable-devices-the-big-wave-of-innovation",title:"Wearable Devices",fullTitle:"Wearable Devices - the Big Wave of Innovation"},signatures:"Taisa Daiana da Costa, Maria de Fatima Fernandes Vara, Camila Santos Cristino, Tyene Zoraski Zanella, Guilherme Nunes Nogueira Neto and Percy Nohama",authors:[{id:"192464",title:"Ph.D.",name:"Percy",middleName:null,surname:"Nohama",slug:"percy-nohama",fullName:"Percy Nohama"},{id:"285706",title:"MSc.",name:"Taísa Daiana",middleName:null,surname:"Da Costa",slug:"taisa-daiana-da-costa",fullName:"Taísa Daiana Da Costa"},{id:"285707",title:"MSc.",name:"Maria de Fatima Fernandes",middleName:null,surname:"Vara",slug:"maria-de-fatima-fernandes-vara",fullName:"Maria de Fatima Fernandes Vara"},{id:"285708",title:"BSc.",name:"Camila Santos",middleName:null,surname:"Cristino",slug:"camila-santos-cristino",fullName:"Camila Santos Cristino"},{id:"285709",title:"Prof.",name:"Guilherme Nunes",middleName:null,surname:"Nogueira Neto",slug:"guilherme-nunes-nogueira-neto",fullName:"Guilherme Nunes Nogueira Neto"},{id:"293109",title:"BSc.",name:"Tyene",middleName:null,surname:"Zoraski Zanella",slug:"tyene-zoraski-zanella",fullName:"Tyene Zoraski Zanella"}]},{id:"41411",title:"Textile Dyes: Dyeing Process and Environmental Impact",slug:"textile-dyes-dyeing-process-and-environmental-impact",totalDownloads:20696,totalCrossrefCites:101,totalDimensionsCites:320,abstract:null,book:{id:"3137",slug:"eco-friendly-textile-dyeing-and-finishing",title:"Eco-Friendly Textile Dyeing and Finishing",fullTitle:"Eco-Friendly Textile Dyeing and Finishing"},signatures:"Farah Maria Drumond Chequer, Gisele Augusto Rodrigues de Oliveira, Elisa Raquel Anastácio Ferraz, Juliano Carvalho Cardoso, Maria Valnice Boldrin Zanoni and Danielle Palma de Oliveira",authors:[{id:"49040",title:"Prof.",name:"Danielle",middleName:null,surname:"Palma De Oliveira",slug:"danielle-palma-de-oliveira",fullName:"Danielle Palma De Oliveira"},{id:"149074",title:"Prof.",name:"Maria Valnice",middleName:null,surname:"Zanoni",slug:"maria-valnice-zanoni",fullName:"Maria Valnice Zanoni"},{id:"153502",title:"Ph.D.",name:"Farah",middleName:null,surname:"Chequer",slug:"farah-chequer",fullName:"Farah Chequer"},{id:"153504",title:"MSc.",name:"Gisele",middleName:null,surname:"Oliveira",slug:"gisele-oliveira",fullName:"Gisele Oliveira"},{id:"163377",title:"Dr.",name:"Juliano",middleName:null,surname:"Cardoso",slug:"juliano-cardoso",fullName:"Juliano Cardoso"},{id:"163393",title:"Dr.",name:"Elisa",middleName:null,surname:"Ferraz",slug:"elisa-ferraz",fullName:"Elisa Ferraz"}]},{id:"70242",title:"Advancements in the Fenton Process for Wastewater Treatment",slug:"advancements-in-the-fenton-process-for-wastewater-treatment",totalDownloads:1992,totalCrossrefCites:14,totalDimensionsCites:27,abstract:"Fenton is considered to be one of the most effective advanced treatment processes in the removal of many hazardous organic pollutants from refractory/toxic wastewater. It has many advantages, but drawbacks are significant such as a strong acid environment, the cost of reagents consumption, and the large production of ferric sludge, which limits Fenton’s further application. The development of Fenton applications is mainly achieved by improving oxidation efficiency and reducing sludge production. This chapter presents a review on fundamentals and applications of conventional Fenton, leading advanced technologies in the Fenton process, and reuse methods of iron containing sludge to synthetic and real wastewaters are discussed. Finally, future trends and some guidelines for Fenton processes are given.",book:{id:"9415",slug:"advanced-oxidation-processes-applications-trends-and-prospects",title:"Advanced Oxidation Processes",fullTitle:"Advanced Oxidation Processes - Applications, Trends, and Prospects"},signatures:"Min Xu, Changyong Wu and Yuexi Zhou",authors:[{id:"307479",title:"Dr.",name:"Changyong",middleName:null,surname:"Wu",slug:"changyong-wu",fullName:"Changyong Wu"},{id:"307546",title:"Prof.",name:"Yuexi",middleName:null,surname:"Zhou",slug:"yuexi-zhou",fullName:"Yuexi Zhou"},{id:"311139",title:"Dr.",name:"Min",middleName:null,surname:"Xu",slug:"min-xu",fullName:"Min Xu"}]}],onlineFirstChaptersFilter:{topicId:"24",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82676",title:"Electrospinning of Fiber Matrices from Polyhydroxybutyrate for the Controlled Release Drug Delivery Systems",slug:"electrospinning-of-fiber-matrices-from-polyhydroxybutyrate-for-the-controlled-release-drug-delivery-",totalDownloads:19,totalDimensionsCites:0,doi:"10.5772/intechopen.105786",abstract:"The submission provides an overview of current state of the problem and authors’ experimental data on manufacturing nonwoven fibrous matrices for the controlled release drug delivery systems (CRDDS). The choice of ultrathin fibers as effective carriers is determined by their characteristics and functional behavior, for example, such as a high specific surface area, anisotropy of some physicochemical characteristics, spatial limitations of segmental mobility that are inherent in nanosized objects, controlled biodegradation, and controlled diffusion transport. The structural-dynamic approach to the study of the morphology and diffusion properties of biopolymer fibers based on polyhydroxybutyrate (PHB) is considered from several angles. In the submission, the electrospinning (ES) application to reach specific characteristics of materials for controlled release drug delivery is discussed.",book:{id:"11127",title:"Electrospinning - Material Technology of the Future",coverURL:"https://cdn.intechopen.com/books/images_new/11127.jpg"},signatures:"Anatoly A. Olkhov, Svetlana G. Karpova, Anna V. Bychkova, Alexandre A. Vetcher and Alexey L. Iordanskii"},{id:"82600",title:"Impact of the Spreading of Sludge from Wastewater Treatment Plants on the Transfer and Bio-Availability of Trace Metal Elements in the Soil-Plant System",slug:"impact-of-the-spreading-of-sludge-from-wastewater-treatment-plants-on-the-transfer-and-bio-availabil",totalDownloads:14,totalDimensionsCites:0,doi:"10.5772/intechopen.103745",abstract:"The spreading of sludge from sewage treatment plants increased the production of durum wheat and rapeseed. Their richness in nitrogen, phosphorus, and potassium gives them a beneficial effect on crops. However, the application of the sludge can induce increases in the concentration of metals in plant tissues. This increase can generate disturbances at the level of the cell and organelles, such as mitochondria and chloroplasts, which can be altered. Repeated applications of the sludge on the same site tend to increase the accumulation of heavy metals in the soil, so that an cause toxicities for soil microorganisms, animals, and humans, via the food chain. However, it is important to specify that these nuisances mainly concerned industrial sludge, but the use of this sludge is strictly prohibited. In addition, the high doses used in our field experiments are significantly higher than those authorized in agricultural practice. Finally, the risk assessment by calculating both the level of consumer exposure and the number of years for soil saturation shows that the use of urban sludge is safe, especially in the short and medium-term. Nevertheless, the quality of the sludge to be spread must be constantly monitored.",book:{id:"11173",title:"Wastewater Treatment",coverURL:"https://cdn.intechopen.com/books/images_new/11173.jpg"},signatures:"Najla Lassoued and Bilal Essaid"},{id:"81249",title:"Electrospun Polymeric Substrates for Tissue Engineering: Viewpoints on Fabrication, Application, and Challenges",slug:"electrospun-polymeric-substrates-for-tissue-engineering-viewpoints-on-fabrication-application-and-ch",totalDownloads:8,totalDimensionsCites:0,doi:"10.5772/intechopen.102596",abstract:"Electrospinning is the technique for producing nonwoven fibrous structures, to mimic the fabrication and function of the native extracellular matrix (ECM) in tissue. Prepared fibrous with this method can act as potential polymeric substrates for proliferation and differentiation of stem cells (with the cellular growth pattern similar to damaged tissue cells) and facilitation of artificial tissue remodeling. Moreover, such substrates can improve biological functions, and lead to a decrease in organ transplantation. In this chapter, we focus on the fundamental parameters and principles of the electrospinning technique to generate natural ECM-like substrates, in terms of structural and functional complexity. In the following, the application of these substrates in regenerating various tissues and the role of polymers (synthetic/natural) in the formation of such substrates is evaluated. Finally, challenges of this technique (such as cellular infiltration and inadequate mechanical strength) and solutions to overcome these limitations are studied.",book:{id:"11127",title:"Electrospinning - Material Technology of the Future",coverURL:"https://cdn.intechopen.com/books/images_new/11127.jpg"},signatures:"Azadeh Izadyari Aghmiuni, Arezoo Ghadi, Elmira Azmoun, Niloufar Kalantari, Iman Mohammadi and Hossein Hemati Kordmahaleh"},{id:"82145",title:"Slope Casting Process: A Review",slug:"slope-casting-process-a-review",totalDownloads:9,totalDimensionsCites:0,doi:"10.5772/intechopen.102742",abstract:"Semi solid processing is a near net shape casting process and one of the promising techniques to obtain dendritic free structure of metals. Semi solid casting gives numerous advantages than solid processing and liquid processing. Semi solid casting process gives, Laminar flow filling of die without turbulence, Lower metal temperature, Less shrinkage, Less porosity, Higher mechanical properties. Semi solid casting process is industrially successful, producing a variety of products with good quality. Slope Casting process is a simple technique to produce semi solid feed-stoke with globular microstructure and dendrite free structure castings. Slope casting process depends on different process parameters like slope length, slope angle, pouring temperature etc. The present study mainly focuses on review of various explorations made by researchers with different process parameters of the Slope casting process and explain the mechanisms that lead to microstructural changes which leads to good mechanical properties.",book:{id:"11119",title:"Casting Processes",coverURL:"https://cdn.intechopen.com/books/images_new/11119.jpg"},signatures:"Mukkollu Sambasiva Rao and Amitesh Kumar"},{id:"81861",title:"Emerging Human Coronaviruses (SARS-CoV-2) in the Environment Associated with Outbreaks Viral Pandemics",slug:"emerging-human-coronaviruses-sars-cov-2-in-the-environment-associated-with-outbreaks-viral-pandemics",totalDownloads:25,totalDimensionsCites:0,doi:"10.5772/intechopen.103886",abstract:"In December 2019, there was a cluster of pneumonia cases in Wuhan, a city of about 11 million people in Hubei Province. The World Health Organization (WHO), qualified CoVid-19 as an emerging infectious disease on March 11, 2020, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which spreads around the world. Coronaviruses are also included in the list of viruses likely to be found in raw sewage, as are other viruses belonging to the Picornaviridae family. SRAS-CoV-2 has been detected in wastewater worldwide such as the USA, France, Netherlands, Australia, and Italy according to the National Research Institute for Public Health and the Environment. In addition, the SARS-CoV-2 could infect many animals since it has been noticed in pigs, domestic and wild birds, bats, rodents, dogs, cats, tigers, cattle. Therefore, the SARS-CoV-2 molecular characterization in the environment, particularly in wastewater and animals, appeared to be a novel approach to monitor the outbreaks of viral pandemics. This review will be focused on the description of some virological characteristics of these emerging viruses, the different human and zoonotic coronaviruses, the sources of contamination of wastewater by coronaviruses and their potential procedures of disinfection from wastewater.",book:{id:"11173",title:"Wastewater Treatment",coverURL:"https://cdn.intechopen.com/books/images_new/11173.jpg"},signatures:"Chourouk Ibrahim, Salah Hammami, Eya Ghanmi and Abdennaceur Hassen"},{id:"81797",title:"Study of Change Surface Aerator to Submerged Nonporous Aerator in Biological Pond in an Industrial Wastewater Treatment in Daura Refinery",slug:"study-of-change-surface-aerator-to-submerged-nonporous-aerator-in-biological-pond-in-an-industrial-w",totalDownloads:11,totalDimensionsCites:0,doi:"10.5772/intechopen.104860",abstract:"Daura refinery, with a capacity of 140,000 barrel per stream day as a refining capacity, wastewater discharged from refining and treatment processing units, polluted water as foul water, drainages, oil spills, blowdown of boilers and cooling towers, and many other polluted water sources, aims to remove pollutants and reject clean water to the river; wastewater treatment system takes place in this treatment process. Wastewater treatment system suffers from many problems and specifically biological stage; at this stage, activated sludge with bacteria, should be supplied with oxygen, aeration system done by surface aerators with four surface fans; these fans suffer from high vibration, loss support, and in consequence, lack in oxygen supply to aerobic bacteria less than 4 ppm. The nonporous aerator is suggested as an oxygen source for the biological pool. The pilot plant builds the aim to study the ability to apply the new aeration system at the biological pool, pilot plant build with 1 cubic meter capacity tank and continuous overflow of wastewater of 10 liters.min−1, air injected with the pressure of (0.5–0.75) bar(g), and airflow of (7.6–9.7) liter.min−1 respectively. 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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. 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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:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{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:"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:'"Politechnica" University Timişoara',institution:null},{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:{name:"Tecnalia",country:{name:"Spain"}}},{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:"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:null,institution:null},{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. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"417317",title:"Mrs.",name:"Chiedza",middleName:null,surname:"Elvina Mashiri",slug:"chiedza-elvina-mashiri",fullName:"Chiedza Elvina Mashiri",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"352140",title:"Dr.",name:"Edina",middleName:null,surname:"Chandiwana",slug:"edina-chandiwana",fullName:"Edina Chandiwana",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"342259",title:"B.Sc.",name:"Leonard",middleName:null,surname:"Mushunje",slug:"leonard-mushunje",fullName:"Leonard Mushunje",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"347042",title:"Mr.",name:"Maxwell",middleName:null,surname:"Mashasha",slug:"maxwell-mashasha",fullName:"Maxwell Mashasha",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"2941",title:"Dr.",name:"Alberto J.",middleName:"Jorge",surname:"Rosales-Silva",slug:"alberto-j.-rosales-silva",fullName:"Alberto J. Rosales-Silva",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"437913",title:"Dr.",name:"Guillermo",middleName:null,surname:"Urriolagoitia-Sosa",slug:"guillermo-urriolagoitia-sosa",fullName:"Guillermo Urriolagoitia-Sosa",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"435126",title:"Prof.",name:"Joaquim",middleName:null,surname:"José de Castro Ferreira",slug:"joaquim-jose-de-castro-ferreira",fullName:"Joaquim José de Castro Ferreira",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"437899",title:"MSc.",name:"Miguel Angel",middleName:null,surname:"Ángel Castillo-Martínez",slug:"miguel-angel-angel-castillo-martinez",fullName:"Miguel Angel Ángel Castillo-Martínez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"289955",title:"Dr.",name:"Raja",middleName:null,surname:"Kishor Duggirala",slug:"raja-kishor-duggirala",fullName:"Raja Kishor Duggirala",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Jawaharlal Nehru Technological University, Hyderabad",country:{name:"India"}}}]}},subseries:{item:{id:"5",type:"subseries",title:"Parasitic Infectious Diseases",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. 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